s Power in Numbers rises up the charts in Pharmacy. | I2P: Information to Pharmacists - Archive
Publication Date 01/11/2009         Volume. 1 No. 6   
Information to Pharmacists


From the desk of the editor

Welcome to the November edition of i2P – Information to Pharmacists.
The month just finished has been an exceptionally busy one for pharmacy with an interesting PAC being concluded.
The “Great Debate” from PAC stirred considerable interest, also the talk given by John Menadue.
The latter has been reported and commented on in the article “Pharmacy’s Professional Future” and it is recommended that this article be bookmarked.
Better still, add your comment at the foot of the article.
All our columnists are back on deck and we are delighted to report that our New Zealand columnist, John Dunlop, has been accorded high honours by the New Zealand Pharmaceutical Society.
See the article in the Recent News section or look for the editor’s logo in the column section.
Our congratulations go out to John for this honour that resulted from his work in the pharmacy professional services area..

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Recent Comments

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Pharmacy’s Future Professional Services

Neil Johnston

The recent “Great Debate” at the 2009 Pharmacy Australia Congress had an excellent topic choice (“The answer to our future is increasing front of shop sales, not professional services”).
The answer is, of course, that pharmacies need both activities as “core business” to survive – it just depends on what balance is required for each unique pharmacy practice sufficient to allow for differentiation and emphasis on specialties (whether professional services or retail activities).
However, it could be argued that policies in recent years have tipped the balance in favour of supply services that favour retail activity.
Little research or effort has gone into the development of professional services (there is actually major amounts of unspent grant money from the Fourth Agreement), so many pharmacies see little relevance in promoting services they may not have the training for, or the infrastructure to deliver the necessary training (which comes at a cost).

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Servants to the world.

Ken Stafford

Recently I received a number of calls from a concerned relative of one of our veteran clients currently in an aged care facility.
The problems I am hearing about relate to the difficulty in getting the patient’s doctor to write prescriptions for necessary medications, echoing many of the stories I heard during my pharmacy visits about the problem of “owing scripts” and just how hard it is for pharmacists to get them written. If we break down the problem we get this sequence of events:

Comments: 2

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Communicate anywhere and everywhere – is getting nowhere

Pat Gallagher

Is talking about talk the best way to start solving the sharing of data in a health informatics scenario?

I have often written on the subject off interoperability; referring to broken and failed systems and in the attempts to get everyone in healthcare, primarily inside a hospital, to exchange information without re-working it all the time.

This can be a complex subject matter because it has little to do with technology and all to do with people. If various departments and fiefdoms want to share their data it can happen; if they behave in a recalcitrant manner, it won’t happen.

Which takes us down a path, for perhaps another time, regarding the subject of IT systems and collaboration? We Australians are not good at this – there is something in our makeup that resists sharing certain things, notably information management systems. Not sure whether it is a streak of independence or immaturity, or both. Anyway, moving on to the matters at hand, let’s continue.

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Power in Numbers rises up the charts in Pharmacy.

Chris Wright

There is power in numbers.

It is said that Chemist Warehouse is growing at 25/30% per annum, the traditional franchises are growing at about half that rate and the poor old unbranded Pharmacy is trailing behind at about 10%. This really means that Chemist Warehouse is flying along with a wet sail doing nicely and all others are wondering where to find growth or are spending far too much time with their accountants’ trying to work out how to survive the future.
This is no surprise of course; the Chemist Warehouse business model is brilliant, they are compelling marketeers and proof that the power in numbers prevails.

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It's all in the Genes

Staff Writer

When you think about it, genetics are likely to determine your skin type.
It is little wonder that if one or more of your relatives, including your ancestors, had a predisposition to skin cancer, then you may have inherited that trait.
Researchers believe that there is up to a 50 percent risk involved that you will develop skin cancer through genetic inheritance.

Skin cancer can be inherited: studies

Source: Reuters

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Why New Zealand must rapidly halve its greenhouse gas emissions

Staff Writer

Editor: It is good to see the New Zealand medical professionals getting behind climate change strategies in their country.
Pharmacy, particularly here in Australia is conspicuous by its absence in this activity.
Yet there are many things we can influence - particularly in the areas of the supply chain, shop design and the type of fixtures and fittings we select.
Unless we all begin to be proactive in this area, events will pass us by to our detriment.
Add your comments at the foot of this article to start off a discussion.

Source: New Zealand Medical Journal
Article written by: Scott Metcalfe, Alistair Woodward, Alexandra Macmillan, et al; for the New Zealand Climate and Health group


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The Pharmaceutical Society of New Zealand 2009 Honours

From the desk of the editor

In Issue number six of Pharmacy e-Edge, the newsletter of the Pharmaceutical Society of New Zealand, four New Zealand pharmacists were awarded a range of honours. The report was prepared by Richard Townley, the CEO of the Society. Among them was John Dunlop, our i2P writer representing New Zealand, and we are pleased to share in John's achievement. John was awarded a Fellow of the Pharmaceutical Society of New Zealand in recognition of his outstanding contribution to the advancement of the practice of pharmacy in New Zealand. Congratulations John!

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Brits love the NZ version - "Fush 'n Chups"

Staff Writer

In a press release by Dr Allan Bell of Auckland University of Technology (sure to raise eyebrows with some Australian i2P readers), it is stated that:

"The New Zealand accent has been rated the most attractive and prestigious non-British form of English, according to a BBC survey.
New Zealand English came in first ahead of Australian, American and most regional British accents in the study published in the international Journal of Sociolinguistics, edited by Professor Allan Bell, Director of AUT’s Institute of Culture, Discourse and Communication."

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Food as medicine - brown rice benefits diabetic patients

Staff Writer

Choosing your rice variety may provide an inexpensive support for a program to treat diabetes.
Menus involving varieties of brown rice may reduce glycation and the rate at which sugar is absorbed by the body.
Cinnamon is another food known to sensitise insulin and reduce sugar levels.
With a some thought it appears that a variety of foods that combat diabetes could be combined to create dishes that are not only functional, but delicious to eat as well.

Brown rice could aid diabetes control

By Anuradha Alahakoon

Source: SciDev.net

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The Starting Point

Neil Johnston

It was refreshing to read some positive recent announcements, comments and opinions in the media over the past three weeks.

First was the announcement by Nicola Roxon regarding the National Preventive Health Agency and the positioning by the Pharmaceutical Society of Australia firmly in support of this development of her initiative.
It is not quite 12 months ago that i2P ran a story on Nicola Roxon, her family and political background, at a time when she was relatively unknown in health circles.
Some observational and predictive points from that i2P article dated December 2008  -"Have you met Nicola Louise Roxon?" -are shown below.
Go to http://archive.i2p.com.au/?page=site/article&id=1168  for the full article.

"* Nicola appears to be a very normal and stable personality with strong family values, and is direct, straightforward and honest in her professional life.

* Nicola will endeavour to broaden the concept of health from illness treatment to illness prevention. She is well documented in many statements that “prevention is better than cure”.

* Pharmacy will be included within primary health care (something that other professions have tried to restrict), and the role pharmacy already plays in self-care will be recognised. I am sure that funds will be made available for the extension of self-care, work that has always been unpaid work performed by pharmacists.

* Nicola, however, needs to understand exactly what depth pharmacists have provided primary care, almost in a secretive fashion, because of constant harassment by doctors. While there is a surface cooperation between doctors and pharmacists, it is really only lip service.

The removal of this harassment would allow pharmacists to thrive as well as the general public.

* Nicola also needs to understand that while pharmacy owners provide infrastructure to provide medicine distribution, the pressure of this infrastructure works against the development of clinical services.

For this role she needs to recognise pharmacists individually as health practitioners and separate their income from the PBS model.

By providing incentives to individual pharmacist practitioners, development ideas and capital would flow in from these people and pharmacy owners would form beneficial relationships to harness benefit for the supply side of their businesses.

* From the recent address given at the Pharmacy Guild of Australia annual dinner, Nicola said, in part:

“The examples of existing Professional Programs and Services confirm the pharmacist’s role within the primary healthcare team.There may still be some debate about the borders of that role – but the direction is already well and truly established.

I want to be clear here – and I suspect my earlier comments have already given this away – any expanded role for pharmacists will take an incremental approach, and will be dictated by the need for safety and quality in health care.”

In other words, she will do what she has always done – carefully plan and test any program before it becomes policy.

It would seem that we were substantially correct and that the National Health Preventive Agency will offer a great opportunity for pharmacists to take advantage of their current training and skills set.

The second item was contained in a press release by the PSA dated 16/10/09 regarding a Memorandum of Understanding that was signed in Sydney by the President of the PSA, Warwick Plunkett, and the President of the RACGP, Dr Chris Mitchell, at a ceremony during the Pharmacy Australia Congress.

While details of the memorandum still have to be released, it may eventually mean that pharmacists will be able to practice independently and in alliance with GP's without the constant sniping that has been a feature of a relationship, which if worked cooperatively, has always been proven to provide maximum patient benefit. Good work PSA!

The third item of interest was an opinion article written by Geoff Marsh, president of APESMA.
Few comments have originated from APESMA, so it was good to see a comment from this organisation, as is really the voice of non-pharmacy owners, or to put it more succinctly, the logical representative of the pharmacists who provide professional services (whether or not they are paid up members).
The following appeared in Pharmacy e-News on 23/10/09 (located at

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Power in Numbers rises up the charts in Pharmacy.

Chris Wright

articles by this author...

Chris has spent many years in the pharmaceutical industry and is semi-retired.
He has an interest in supply chain procedures, and work flows within community pharmacies, and he provides consultancies around those activities.

There is power in numbers.

It is said that Chemist Warehouse is growing at 25/30% per annum, the traditional franchises are growing at about half that rate and the poor old unbranded Pharmacy is trailing behind at about 10%. This really means that Chemist Warehouse is flying along with a wet sail doing nicely and all others are wondering where to find growth or are spending far too much time with their accountants’ trying to work out how to survive the future.
This is no surprise of course; the Chemist Warehouse business model is brilliant, they are compelling marketeers and proof that the power in numbers prevails.

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What a strange coincidence that the acclaimed third album of the alternative hip-hop group Jurassic 5 “Power in Numbers” was in part composed by Lucas MacFadden, who is professionally known as; “Cut Chemist”. I will embark on a reconnoitre to see if Chemist Warehouse is pounding out Power in Numbers tracks in delirious celebration of their imperious, unassailable market position.

Unlike the failed attempt by Nelson Bunker Hunt to corner the silver market in the 70’s, Chemist Warehouse have not only taken control of a huge portion of the market, they have managed to redefine the public’s perception of what a Pharmacy is, which is surely not a good thing.

It must be utterly anathematic for old timers to stick up signs on tired front windows pleading for the opportunity to match prescription prices in an effort to keep the till ticking over. But the cold reality is the power and profile of Chemist Warehouse is causing the demise of the traditional habitat of the old fashioned pharmacy. The proprietors of many of these pharmacies have in part themselves to blame for they have for long steadfastly refused to change the way they do business and move with the times. Conversely, I know one group who has made a science of buying tired old wrecks for a handful of beads and turning them into proverbial little gold mines…before selling on for the equivalent of a nice first division lotto win. Good business if you know how to do it.

The PGA must also accept some responsibility for the impending demise of many of these Pharmacies (who have had an unfortunate sobriquet relating to toilet activity bestowed upon them by some) for ignoring the shift away from community pharmacy to a strong “commercial reality focus”.

The refusal by many to change will no doubt make it easier for the big players to enter new lucrative areas. Yes, even the big players are looking for the elusive edge. Mail order pharmacy is becoming a busy but crowded area and will probably stagnate unless a value-added aspect can be attached. Besides, without an attractive edge, it may be questionable that a mail order business such as pharmacy can be sustained in numbers successfully in a country with a population of 22 million and the size of the US, minus a couple of farms.

Automation will play a part in the future but the solutions currently available are not capable of creating new profit opportunities.

Fee for service is likely to hit a brick wall of opposition by those demanding patients who have long been conditioned to believe they have the right to bail up a busy Pharmacist to discuss anything from the little Princesses’ ballet class to Pantene. Besides, the argument for fee for service suffers considerable dilution when professional service areas are often only 10% of a pharmacy footprint.

Really, in high retail focus pharmacies to achieve sustainable fee for service is about as believable as Jenny Craig sponsoring Krispy Kreme.

In part, some new opportunities may be hindered by the location rules, which are regarded by many as neatly fitting into the category of “Dog’s breakfast”.

Could we not learn something from the, “Essential Small Pharmacy Scheme”, used in Scotland to service remote areas?


Yes, Scotland is the size of a couple of Melbourne suburbs, yet it has invested in establishing a way to deliver care to everybody. Could there be an opportunity for a player to establish (say) 100 Pharmacies offering professional services (only) in a small footprint to needy rural/remote and many indigenous areas?

There must be a better solution to indigenous care than the very discriminatory provisions of s100 and the less than ideal depot system, which is also discriminatory.

Will small footprint professional service only Pharmacies become a sustainable business model in an environment that is now defining a pharmacy as a “retail” orientated business rather than the longstanding half pregnant “retail/care” moniker?


The key to new opportunities is likely to be linked to how care in the home is addressed in the future. The changing needs of our ageing population will no doubt create a huge growth area and open the door for new products and services. The big players with strong marketing images are well placed to extend their reach. The question is what direction?

Some industry commentators argue that the PBS somehow subsidises high rent shopping centre retail orientated pharmacies. If this is a valid position, it might also be valid that PBS payments should be structured to reward pharmacies whose concentration is on professional care rather than retail dominance.

Heresy, you say? Sure, but why reward professional mediocrity?

As PBS contract providers’, pharmacy proprietors should be rewarded for displaying and implementing a culture of professional care, not commercial acumen.

Irrespective of the size of a pharmacy, PBS payment rates could be set on a scale proportionate to the size of the professional services area of a pharmacy. For example, a pharmacy with a professional service area that takes up 50% of the total pharmacy footprint would receive a higher rate for PBS contract work than a pharmacy with a 30% professional service area.

What madness…Chris, wash your mouth out with soap and by the way, you’re grounded!

However, the upside is that intervention rates would increase and pharmacy would claim back its identity, which would lead to a pain free introduction of fee for service.

Can you imagine the furore if Colesworth was forced to accept the lowest scale rate because the relative size of the professional service area in a supermarket will be the size of a billiard table?

This poses an interesting conundrum for Kevin from Queensland and his merry band of apparently less than happy employees.

“Kev, are you prepared to introduce measures to protect community pharmacy? Namely, are you prepared to restructure remuneration for pharmacies to introduce a sliding remuneration rate proportionate to the size of the professional service area in relation to the pharmacy footprint and for the professional service area to be no less than 30% of the footprint?

Will it happen? Nope, it’s got Buckley’s chance…but what a way to repel the boarders!

The gloves are off and the gentle spring breeze is cranking up to a full of wind of change in the kitchen…er, pharmacy, that is.

Chris Wright.
November 2009.

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