The pharmacist as an administrator

Administration and management are facets of the pharmacy profession that often disregarded, or at least relegated to a footnote at the end of minor credits, within the context of pharmacy undergraduate courses. They are, however, vital skills within our multiple-disciplinary mindset, especially in the context of the Maltese Islands.

One must consider that amongst most pharmacists that enter the field of community practice, most are required to carry out the duties of professional pharmacist and shop manager. These duties require as a bare minimum a working knowledge of administrative functions and procedures.

This point of argument is also relevant outside the area of community practice, as in the running a state owned pharmacy, or the management of the budget and expenditure of a pharmaceutical distributor. Such duties still impose the supposition of the knowledge of money and people management. Even though one might argue that management and administrative duties do not fall within the remit of a pharmacist's core responsibilities, one would be short-sighted and very blinkered not to recognize the possibilities, both from a career-ameliorating aspect, and also from that of personal satisfaction, that could be realized with the addition of management and administrative skills to the pharmacist's already broad knowledge base.

One might even argue for a greater focus at undergraduate level on such matters, and the possibility of a post-graduate specialization in healthcare administration, possibly in co-operation with the faculty of management and accountancy. Integrating a high level of functionality and versatility into the pharmacist's repertoire of skills will set up future graduates on a better footing for professional and personal success in the long haul.

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Generic medicines in Malta

The low market penetration and the consumer's lack of information about generic medicine products was highlighted by a survey carried out last year by the Malta Medicines Authority, from which it transpired that over 80% of the general population had no idea what generic medicines really meant.

This is of great import to the general discussion on the very hot topic of medicine prices, as price variations in generic and branded products can be substantial, especially when one considers that a considerable amount of new products have been introduced to the Maltese market in the past year.

Below is an unpublished opinion piece written last year on the subject. The link to pdf file is here:http://www.stsimonpharmacy.com/Docs/In%20defence%20of%20the%20Pharmacist%20II.pdf


Generic Medicines and lower prices!

Most members of the public do not have a clear idea of what the term generic constitutes when applied to the context of medicinal products. This short article aims to correct this lack of information, and also provide points on how a Maltese consumer can obtain the therapeutic benefits provided by modern medicines whilst saving on expenditure.

A generic medicinal product is a version of a previously patented (that is protected by a monopoly licence) medicine, that is identical to it in composition and action. In most cases the generic product is cheaper than the originator product. Locally, one can draw comparisons between the prices of generic paracetamol(€ 2 per 100) and the branded version(€ 1.61 per 24).

A generic version is just as safe and effective as the originator and passes all the minimum quality requirements that are demanded by the European Medicines Agency (EMEA), and also the Malta Medicines Authority. Maltese legislation allows brand substitution of prescribed products unless the physician expressly prohibits this on the script. In certain cases a pharmacist is morally obliged to point out the availability of cheaper alternatives to the patient, as the savings can be substantial. For example, in the case of a particular proton pump inhibitor (for stomach acidity), the variance between the originator and generic for a six-month prescribed course from Mater Dei General Hospital is a whopping € 277!

Not all generic drugs provide savings of the magnitude described above, and in certain cases the difference may not be significant enough to warrant changing brand, especially in the case of chronic medication and elderly patients. However it is imperative that the patient is aware of the existence of equivalent and cheaper alternatives, as this will increase the access of the general public to pharmaceutical treatment and lead to a better quality of life. No patient should object to paying a high price for a newly discovered and cutting edge drug treatment; on the other hand, it is every patient’s and Maltese citizen’s right to have access to the same treatment at much reduced prices once the monopoly period of manufacture has expired.

All patients have the right to demand the existence of an alternative medicine, and if this is available, take the decision on whether or not to migrate to a more cost-effective healthcare solution. The role of the pharmacist is to point out the existence of such alternatives, and provide professional and unbiased advice on the best treatment option to be chosen, as cheaper is not always necessarily better!

Hoping for the best?!

The recent public announcement by the Minister of Health, The Honourable Dr. Joe Cassar, regarding an expansion of the number of diseases included under Schedule V is to be applauded. To those uninitiated in the myriad complexities of the Maltese state-run healthcare system, any disease listed under Schedule V of the Medicines Act is considered to be chronic and therefore any citizen of the Maltese Islands suffering from a disease classified as such, is entitled to free, unlimited treatment, at least with respect to pharmaceutical care. Also announced were an increase in the number of patients entitled to free glucose testing kits and replacement strips.Read the full article here: http://www.timesofmalta.com/articles/view/20111012/local/reform-of-free-medicines-system-announced.388858.

This is a step in the right direction, as Malta has often been criticised by other members of the European Union on the grounds that a number of chronic, debilitating diseases were being excluded from state-provided care systems, and thus discriminating against those afflicted by them.

What is, on the other hand, a worrying fact, is that no statistics whatsoever have been presented to back up the manner in which this increase in the disbursement of funds is to supported. Whether there is to be an increase in the budget allocated to pharmaceutical care, or there are to cuts in the same said budget, or in other areas of the global healthcare budget, remains to be seen. From an observer's point of view, these are the questions that need to be answered, and soon, as any improvements to the public healthcare system need to be sustainable and approached with  long-term benefits to the patient in  mind.