s Countdown to Supermarket pharmacies - Advantages and disadvantages? | I2P: Information to Pharmacists - Archive
Publication Date 01/07/2014         Volume. 6 No. 6   
Information to Pharmacists


From the desk of the editor

Welcome to the July 2014 homepage edition of i2P (Information to Pharmacists) E-Magazine.
At the commencement of 2014 i2P focused on the need for the entire profession of pharmacy and its associated industry supports to undergo a renewal and regeneration.
We are now half-way through this year and it is quite apparent that pharmacy leaders do not yet have a cohesive and clear sense of direction.
Maybe the new initiative by Woolworths to deliver clinical service through young pharmacists and nurses may sharpen their focus.
If not, community pharmacy can look forward to losing a substantial and profitable market share of the clinical services market.
Who would you blame when that happens?
But I have to admit there is some effort, even though the results are but meagre.
In this edition of i2P we focus on the need for research about community pharmacy, the lack of activity from practicing pharmacists and when some research is delivered, a disconnect appears in its interpretation and implementation.

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News Flash

Newsflash Updates for July 2014

Newsflash Updates

Regular weekly updates that supplement the regular monthly homepage edition of i2P. 
Access and click on the title links that are illustrated

Comments: 1

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Feature Contribution

Woolworths Pharmacy - Getting One Stage Closer

Neil Johnston

It started with “tablet” computers deployed on shelves inside the retailer Coles, specifically to provide information to consumers relating to pain management and the sale of strong analgesics.
This development was reported in i2P under the title Coles Pharmacy Expansion and the Arid PGA Landscape”
In that article we reported that qualified information was a missing link that had come out of Coles market research as the reason to why it had not succeeded in dominating the pain market.
Of course, Woolworths was working on the same problem at the same time and had come up with a better solution - real people with good information.

Comments: 5

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Intensive Exposition without crossing over with a supermarket

Fiona Sartoretto Verna AIAPP

Editor's Note: The understanding of a pharmacy's presentation through the research that goes into the design of fixtures and fittings that highlight displays, is a never-ending component of pharmacy marketing.
Over the past decade, Australian pharmacy shop presentations have fallen behind in standards of excellence.
It does not take rocket science - you just have to open your eyes.
Recently, our two major supermarkets, Woolworths and Coles, have entered into the field of drug and condition information provision - right into the heartland of Australian Pharmacy.

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The sure way to drive business away

Gerald Quigley

I attended the Pregnancy, Baby and Children’s Expo in Brisbane recently.
What an eye and ear opening event that was!
Young Mums, mature Mums, partners of all ages, grandparents and friends……...many asking about health issues and seeking reassurances that they were doing the right thing.

Comments: 1

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‘Marketing Based Medicine’ – how bad is it?

Baz Bardoe

It should be the scandal of the century.
It potentially affects the health of almost everyone.
Healthcare providers and consumers alike should be up in arms. But apart from coverage in a few credible news sources the problem of ‘Marketing Based Medicine,’ as psychiatrist Dr Peter Parry terms it, hasn’t as yet generated the kind of universal outrage one might expect.

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Community Pharmacy Research - Are You Involved?

Mark Coleman

Government funding is always scarce and restricted.
If you are ever going to be a recipient of government funds you will need to fortify any application with evidence.
From a government perspective, this minimises risk.
I must admit that while I see evidence of research projects being managed by the PGA, I rarely see community pharmacists individually and actively engaged in the type of research that would further their own aims and objectives (and survival).

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Organisational Amnesia and the Lack of a Curator Inhibits Cultural Progress

Neil Johnston

Most of us leave a tremendous impact on pharmacies we work for (as proprietors, managers, contractors or employees)—in ways we’re not even aware of.
But organisational memories are often all too short, and without a central way to record that impact and capture the knowledge and individual contributions, they become lost to time.
It is ironic that technology has provided us with phenomenal tools for communication and connection, but much of it has also sped up our work lives and made knowledge and memory at work much more ephemeral.

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Academics on the payroll: the advertising you don't see

Staff Writer

This article was first published in The Conversation and was written by Wendy Lipworth, University of Sydney and Ian Kerridge, University of Sydney
In the endless drive to get people’s attention, advertising is going ‘native’, creeping in to places formerly reserved for editorial content. In this Native Advertising series we find out what it looks like, if readers can tell the difference, and more importantly, whether they care.
i2P has republished the article as it supports our own independent and ongoing investigations on how drug companies are involved in marketing-based medicine rather than evidence-based medicine.

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I’ve been thinking about admitting wrong.

Mark Neuenschwander

Editor's Note: This is an early article by Mark Neuenschwander we have republished after the soul-searching surrounding a recent Australian dispensing error involving methotrexate.
Hmm. There’s more than one way you could take that, huh? Like Someday when I get around to it (I’m not sure) I may admit that I was wrong about something. Actually, I’ve been thinking about the concept of admitting wrong. So don’t get your hopes up. No juicy confessions this month except that I wish it were easier for me to admit when I have been wrong or made a mistake.
Brian Goldman, an ER physician from Toronto, is host of the award-winning White Coat, Black Art on CBC Radio and slated to deliver the keynote at The unSUMMIT for Bedside Barcoding in Anaheim this May. His TED lecture, entitled, “Doctors make mistakes. Can we talk about it?” had already been viewed by 386,072 others before I watched it last week.

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Dispensing errors – a ripple effect of damage

Kay Dunkley - BPharm, Grad Dip Hosp Pharm, Grad Dip Health Admin, MPS, MSHPA

Most readers will be aware of recent publicity relating to dispensing errors and in particular to deaths caused by methotrexate being incorrectly packed in dose administration aids.
The Pharmacy Board of Australia (PBA), in its Communique of 13 June 2014, described a methotrexate packing error leading to the death of a patient and noted “extra vigilance is required to be exercised by pharmacists with these drugs”.
This same case was reported by A Current Affair (ACA) in its program on Friday 20 June

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Take a vacation from your vocation

Harvey Mackay

Have you ever had one of those days when all you could think was, “Gosh, do I need a vacation.”
Of course you have – because all work and no play aren’t good for anyone.
A vacation doesn’t have to be two weeks on a tropical island, or even a long weekend at the beach. 
A vacation just means taking a break from your everyday activities. 
A change of pace. 
It doesn’t matter where.
Everyone needs a vacation to rejuvenate mentally and physically. 
But did you also know that you can help boost our economy by taking some days off? 
Call it your personal stimulus package.

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Explainer: what is peer review?

Staff Writer

This article was first published in the Conversation. It caught our eye because "peer review" it is one of the standards for evidence-based medicines that has also been corrupted by global pharma.
The article is republished by i2P as part of its ongoing investigation into scientific fraud and was writtenby Andre Spicer, City University London and Thomas Roulet, University of Oxford
We’ve all heard the phrase “peer review” as giving credence to research and scholarly papers, but what does it actually mean?
How does it work?
Peer review is one of the gold standards of science. It’s a process where scientists (“peers”) evaluate the quality of other scientists' work. By doing this, they aim to ensure the work is rigorous, coherent, uses past research and adds to what we already knew.
Most scientific journals, conferences and grant applications have some sort of peer review system. In most cases it is “double blind” peer review. This means evaluators do not know the author(s), and the author(s) do not know the identity of the evaluators.
The intention behind this system is to ensure evaluation is not biased.
The more prestigious the journal, conference, or grant, the more demanding will be the review process, and the more likely the rejection. This prestige is why these papers tend to be more read and more cited.

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Dentists from the dark side?

Loretta Marron OAM BSc

While dining out with an elderly friend, I noticed that he kept his false tooth plate in his shirt pocket. He had recently had seven amalgam-filled teeth removed, because he believed that their toxins were making him sick; but his new plate was uncomfortable. He had been treated by an 'holistic dentist'. Claiming to offer a "safe and healthier alternative" to conventional dentistry, are they committed to our overall health and wellbeing or are they promoting unjustified fear, unnecessarily extracting teeth and wasting our money?

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Planning for Profit in 2015 – Your key to Business Success

Chris Foster

We are now entering a new financial year and it’s a great time to reflect on last year and highlight those things that went well and those that may have impacted negatively in the pursuit of your goals.
It's also a great to spend some time re-evaluating your personal and business short, medium and long term goals in the light of events over the last year.
The achievement of your goals will in many cases be dependent on setting and aspiring to specific financial targets. It's important that recognise that many of your personal goals will require you to generate sufficient business profits to fund those aspirations

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ReWalk™ Personal Exoskeleton System Cleared by FDA for Home Use

Staff Writer

Exoskeleton leader ReWalk Robotics announced today that the U.S. Food and Drug Administration has cleared the company’s ReWalk Personal System for use at home and in the community.
ReWalk is a wearable robotic exoskeleton that provides powered hip and knee motion to enable individuals with Spinal Cord Injury (SCI) to stand upright and walk.
ReWalk, the only exoskeleton with FDA clearance via clinical studies and extensive performance testing for personal use, is now available throughout the United States.

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Attracting and Retaining Great People

Barry Urquhart

Welcome to the new financial year in Australia.
For many in business the past year has been described as a challenging period.
Adjectives are a key feature of the English language.  In the business lexicon their use can be, and often is evocative and stimulate creative images.  But they can also contribute to inexact, emotional perceptions.
Throughout the financial pages of newspapers and business magazines adjectives abound.
References to “hot” money draw attention and comment.  The recent wave of funds from Chinese investors, keen to remove their wealth from the jurisdiction and control of government regulations is creating a potential property bubble in Australia.

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Updating Your Values - Extending Your Culture

Neil Johnston

Pharmacy culture is dormant.
Being comprised of values, unless each value is continually addressed, updated or deleted, entire organisations can stagnate (or entire professions such as the pharmacy profession).
Good values offer a strong sense of security, knowing that if you operate within the boundaries of your values, you will succeed in your endeavours.

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Evidence-based medicine is broken. Why we need data and technology to fix it

Staff Writer

The following article is reprinted from The Conversation and forms up part of our library collection on evidence-based medicines.
At i2P we also believe that the current model of evidence is so fractured it will never be able to be repaired.
All that can happen is that health professionals should independently test and verify through their own investigations what evidence exists to prescribe a medicine of any potency.
Health professionals that have patients (such as pharmacists) are ideally placed to observe and record the efficacy for medicines.
All else should confine their criticisms to their evidence of the actual evidence published.
If there are holes in it then share that evidence with the rest of the world.
Otherwise, do not be in such a hurry to criticise professions that have good experience and judgement to make a good choice on behalf of their patients, simply because good evidence has not caught up with reality.

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Laropiprant is the Bad One; Niacin is/was/will always be the Good One

Staff Writer

Orthomolecular Medicine News Service, July 25, 2014
Laropiprant is the Bad One; Niacin is/was/will always be the Good One
by W. Todd Penberthy, PhD

(OMNS July 25, 2014) Niacin has been used for over 60 years in tens of thousands of patients with tremendously favorable therapeutic benefit (Carlson 2005).
In the first-person NY Times best seller, "8 Weeks to a Cure for Cholesterol," the author describes his journey from being a walking heart attack time bomb to a becoming a healthy individual.
He hails high-dose niacin as the one treatment that did more to correct his poor lipid profile than any other (Kowalski 2001).

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Culture Drive & Pharmacy Renewal

Neil Johnston

Deep within all of us we have a core set of values and beliefs that create the standards of behaviour that we align with when we set a particular direction in life.
Directions may change many times over a lifetime, but with life experiences and maturity values may increase in number or gain greater depth.
All of this is embraced under one word – “culture”.
When a business is born it will only develop if it has a sound culture, and the values that comprise that culture are initially inherent in the business founder.
A sound business culture equates to a successful business and that success is often expressed in the term “goodwill” which can be eventually translated to a dollar value.

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ReWalk™ Personal Exoskeleton System Cleared by FDA for Home Use

Staff Writer

Exoskeleton leader ReWalk Robotics announced today that the U.S. Food and Drug Administration has cleared the company’s ReWalk Personal System for use at home and in the community.
ReWalk is a wearable robotic exoskeleton that provides powered hip and knee motion to enable individuals with Spinal Cord Injury (SCI) to stand upright and walk.
ReWalk, the only exoskeleton with FDA clearance via clinical studies and extensive performance testing for personal use, is now available throughout the United States.

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Pharmacy 2014 - Pharmacy Management Conference

Neil Johnston

The brave new world of health and wellness is not the enemy of Pharmacy, it is its champion.
Australian futurist, Morris Miselowski, one of the world's leading business visionaries, will present the Opening Keynote address on Pharmacy's Future in the new Health and Wellness Landscape at 2.00pm on Wednesday July 30.
Morris believes the key to better health care could already be in your pocket, with doctors soon set to prescribe iPhone apps, instead of pills.
Technology will revolutionise the health industry - a paradigm shift from healthcare to personal wellness.
Health and wellness applications on smartphones are already big news, and are dramatically changing the way we manage our personal health and everyday wellness.

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Generation and Application of Community Pharmacy Research

Neil Johnston

Editor’s Note: We have had a number of articles in this issue relating to pharmacy research.
The PGA has conducted a number of research initiatives over the years, including one recently reported in Pharmacy News that resulted from an analysis of the QCPP Patient Questionnaire.
Pharmacy Guild president, George Tambassis, appears to have authored the article following, and there also appears to be a disconnect between the survey report and its target audience illustrated by one of the respondent comments published.
I have asked Mark Coleman to follow through, elaborate and comment:

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Countdown to Supermarket pharmacies - Advantages and disadvantages?

Joseph Conway

articles by this author...

Joe Conway is an Irish born pharmacist who qualified in the UK in 1998.
After completing a residency in a hospital in London, he embarked on a 3 year locum stint that involved working all over the UK, Ireland, and Australia in over 350 pharmacies of all varieties (hospitals large and small, community, even a prison pharmacy).In 2002, Joe emigrated to Australia and worked in the Private Hospital sector gradually moving in to management positions with Slade Pharmacy where he developed a keen interest in Oncology services. In 2006, Joe took up a position setting up a Pharmacy service to a newly built Day Hospital in Frankston, Victoria. The Pharmacy now conducts over 40 clinical trials.
Joe is currently studying for a Master of Biostatistics to help him progress in the area of clinical trials, and think outside the square (or at least be left-field).

Editor's Note:
With a researcher's perspective and a pair of fresh eyes, Joseph Conway has mapped out his version of the trends and future directions for pharmacy, community pharmacy in particular.
In presenting his logic he argues from two opposite points of view - a model comprising supermarket majority ownership compared to a more traditional model of pharmacist ownership.
His article is presented in four parts, with supermarket ownership looked at first.
2013 will be an extraordinarily difficult year as the 45 year pharmacy business and professional cycle bottoms out with no soft landing.
The hiatus in pharmacy leadership that is apparent in the lack of a cohesive forward plan leaves all pharmacists (pharmacy owners and non-owners) with no sense of direction, a mix of disjointed "bits and pieces" that is the substitute for a clear and definitive plan
While Joseph has outlined some options, it will be up to individuals to complete the puzzle and fill in all the gaps.

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In New Zealand, the launch of Countdown pharmacy seems to have gone down with little fuss. However, from an Australian pharmacy perspective, the issue of concern is that Countdown Pharmacies are at least in part owned by Woolworths. This raises the possibility that Woolworths is using this Kiwi venture to hone its skills in the area of pharmacy before a possible bid to be allowed to provide such services here. People aren’t marching the streets in Australia wanting pharmacies in Supermarkets and the Discount model of pharmacy is already providing Australians with access to cheaper medicines that is the catch-cry of the Supermarkets when extolling their virtues as potential custodians of prescription medicines. An example of this was Chemist Warehouse supplying the Lipitor® generic Atorvastatin Sandoz® for $0 for a limited time on a valid prescription.
You can’t get any cheaper than that?
Over a four article series, I would like to explore what I think are the advantages and disadvantages potentially of a Supermarket pharmacy service being allowed to operate in Australia.

Part 1: Advantages of a supermarket pharmacy

Lowest Price AND the best service at the same time:

The evolution of pharmacies in Australian has gone from many sole operators in small pharmacies to one where pharmacies are made bigger by deliberate Government design. There has been an incentive for smaller pharmacies to join together with the thinking that bigger pharmacies can afford to deliver PBS services cheaper due to economies of scale. This process is still happening with big warehouse pharmacies appearing in the last 10 years whose catchcry is that people shouldn’t pay too much for their medicines. What is the next step in this process? Is it to allow Supermarket pharmacies which would be able (if they choose?) to be cheaper than any Discount pharmacy out there currently? If there were a Coles or Woolworths pharmacy tomorrow, they would almost certainly advertise that they provide the cheapest prices on prescriptions and that they would guarantee to be 10% less than Chemist Warehouse (my opinion the current market leader). They could leverage on Chemist Warehouse’s claim to be Australia’s cheapest Chemist and confirm that they will always be lower or at least similar to them in price.

However, Supermarket pharmacies could also offer the best service in addition to the lowest prices. Coles Owners Westfarmers Bunning’s Warehouse model of service or the Woolworths Masters model is ideal (I think) could easily be adjusted to suit pharmacy. If a patient comes in with a query on nutrition, then there could be an expert employed on that. If another patient was diabetic, there could be a Diabetes consultant available to address their issues. The scope for this is limitless and rarer, more specialized queries could be dealt with over the telephone/teleconference (by appointment) with an expert employed/contracted by the Supermarket. (For more on this see section on Consulting rooms)

Do people want this?

Well, with or without a Carbon tax, energy costs are rising in Australia. When faced between the choice of heating their home or taking preventative health medicines, it’s easy to see why someone could refuse to fill a script for (e.g. Atorvastatin 40mg) which Currently costs $35.40 per month on valid PBS script = $424.80 per year (will probably be $15/month in 3 years with Price disclosure) and instead use this money to pay energy bills. It’s conceivable that a high usage drug such as Atorvastatin 40mg could be less than $5 per month or even a token $2 per month (to card members) in a Supermarket pharmacy which has got to increase a patient’s compliance with their statin medication regimen and possibly help reduce the number of individuals developing stroke and other heart problems each year potentially leading to greater long term wider health savings. It’s widely stated that the cost of medications to the patient is a prime reason for non-compliance with medication. Supermarkets should increase patient compliance through cheaper costs of medications particularly to patients not covered by a Pension/concession card. If members of the Pharmacy Guild (i.e. Chemist Warehouse owners) agree that medications should be given out for free sometimes, then what’s the argument against allowing corporates to operate pharmacies who can afford to give out medications for free more often than any franchisee owner is able to sustain?

Convenience for many patients:

Most people in Australia shop at a Coles or a Woolworths for their groceries each week. There are pharmacies near many Coles and Woolworths, but these are open limited hours (not profitable to open late in many cases). People who are working fulltime may have to travel a few kilometres out of their way to get a monthly script filled at one of the pharmacies that do provide an evening pharmacy service. In a Supermarket pharmacy, these people (and probably other groups) would save time and might be more inclined to get their script filled possible increasing patient compliance with further intended health benefits of prescription medication.

Savings for the Federal budget?

The Supermarkets could achieve major savings for the federal budget. The Community Pharmacy Agreement costs the taxpayer reportedly $15 billion over 5 years. It’s conceivable that Supermarkets would agree to do this for virtually $0. This could be a major saving to Government in times when Fiscal austerity is needed and the Mining tax receipts are declining and with uncertainties in the global economy. There could also be savings through more rapid price disclosure as competitive Supermarkets volunteer savings on their generics with the sole aim of pricing competitors out of the market and making medication much for affordable to those who need it.

Continuity of Care?

Countdown pharmacies are reported going to have Consulting rooms in them. This has the potential to change how health services are delivered to the public from a pharmacy. The clientele of these Consulting rooms can be tailored to the needs of the local population. In an inner city supermarket with a younger surrounding population, there could be mostly Consultants with health experts on nutrition, various alternative medicines, Sport’s diet experts, Pregnancy advice, Breastfeeding, some beauty treatment, etc… In a suburban pharmacy with an elderly population, the services provided from the Consulting rooms could include Medication review and management, Podiatry, Asthma, Wound care, Stoma clinic, Walking aids and similar devices, Prostate clinics, Vaccination and whatever else a free market in this area comes up with. The point is that the choices for the services that these Consulting rooms provide could be designed so that that the customers choose what health service they want/need. A health service for the people designed ultimately by the wishes of the people. A health expert (e.g. Nurse, Pharmacist, Physiotherapist, Podiatrist, whomever) could elect to develop and market a clinic for a few sessions a week. These people could include direct employees of the supermarket (pharmacists) and self-employed people who have existing clinics and bring their existing clientele with them. The price to the expert to hire these rooms could be much more competitive than existing arrangements and in some cases be free (if someone brings an existing clientele with them). The customers could develop relationships with such experts and it could be argued that this would give the customers continuity of care as health experts in such circumstances could continue to do this for years ensuring this.

What of Existing Owners who have invested big time?

Supermarkets can’t just operate pharmacies tomorrow without the expertise of the people who have been running pharmacies for years. The location rules have made pharmacies worth a lot as it’s very difficult for competitors to move in. Some Pharmacy owners have used their equity to buy out pharmacies in the surrounding areas and possibly built monopolies for themselves. However, for any Supermarket to succeed and thrive, I think that the needs of such owners need to be addressed as they are a major political force to go against and Supermarkets don’t want to have to fight Pharmacy Owners. The solution to this could be to allow a transitional arrangement (over 2-3 years) whereby existing pharmacies could be bought by anybody and moved into Supermarkets or just operated as they are. This transitional arrangement could ensure that the market price of a pharmacy could be maintained or actually increase for the initial period as there would be incentive to buy. As well as being paid handsomely for their pharmacies, existing owners (and some managers) could be given lucrative contracts to ensure the survival of their pharmacy after they sell it. I think that utilising the existing owners in this way would ensure the integrity of the Supermarket model of pharmacy and might mitigate a major offense from existing owners who want to protect their existing hard earned assets.

What about Wholesalers?

Supermarkets shouldn’t need to reinvent the wheel. They could buyout existing wholesalers and utilise their expertise and resources. This could also mitigate a political backlash from these and may even present a good deal to shareholders of these companies if that opportunity was to arise.

Who is ultimately responsible for giving out medication?

Existing Pharmacy Owners carry a major responsibility for medications given out in their pharmacies. If a Supermarket bought a pharmacy, then who carries this responsibility? This presents a conundrum, but why can’t a Pharmacy Manager be appointed for every store to have this responsibility for this? Such a Manager would have to have the power to override the store manager where he/she feels that refusal of a profitable sale is necessary for the ultimate health of the patients. Also, publically listed companies are under a lot of scrutiny. If a Store manager gave a warning to Pharmacy Manager for refusing a sale for a legitimate medical reason, then, there could be a lot of scrutiny of that Supermarket pharmacy chain for that. This could ensure that Supermarkets comply with exiting legislation and this would be uniform across all Supermarket pharmacies. Supermarkets could even argue that existing owners often have huge bank loans and rental payments hanging over their heads so they might have a major incentive to get sales. They could argue that the Pharmacy Manager in their stores would be under no direct financial pressure (though would have normal KPI’s to adhere to would have performance reviewed) as the continued loss of a profitable sale won’t send them bankrupt like it could to existing pharmacy owners.

What about Employee Pharmacists/Career progression of pharmacists?

A Supermarket/Corporate Pharmacy offers ambitious young graduates more career choices than the current model presents. Currently, in a Community Pharmacy setting, Ownership appears to be the only route to career progression. Even then, many Owners are struggling with massive loans and are stuck in a myriad of paperwork and there is evidence of cracks in the system. Instead of a career progression that involves more interaction with patients, they end up doing BAS statements, doing 5CPA (massive exercise in paper shuffling?), paying staff, keeping the landlord and banks happy, etc… A recent Fairwork audit of wages of pharmacy staff in Queensland found that many owners are struggling to even pay their staff correctly. I think that most pharmacists want to talk to patients and not spend their time filling forms. A Supermarket model could ensure this doesn’t occur and that motivated pharmacists can spend their time addressing medication issues with patients. There could be a dispensary with many early career pharmacists working together in an environment that stimulates learning and questioning of prescribing habits – a lot can be learnt from this. There could also be a Pharmacy Manager and people in the Consulting rooms in close contact who could give advice on the action to take when an early career pharmacist is unsure of what to do. Early career pharmacists could use this time to try and develop their skills and become familiar with patients possibly building up a clientele for the Consulting rooms. It could start with an early career pharmacist taking a patient in for a 20 minute discussion on their medication and in time, the pharmacist could build a business of their own and may want to specialize in a particular area offering a non-management route to career progression as a Community Pharmacist. Other pharmacists may want to progress within the Supermarket system and become the store manager, or enter areas such as Product purchasing, Health Advice, Regulatory affairs, Custom manufacturing, or any other area that a Supermarket could provide. It’s also possible that Supermarkets could pay professional fees and may pay for training needed for career progression of early career pharmacists.

What about innovation?

Supermarkets have the money to develop good ideas that can bring efficiencies to the world of pharmacy. With a fragmented network of small businesses some of whom are struggling financially, current pharmacy owners could find it harder than a Supermarket pharmacy chain would to implement such changes.

Uniformity of service deliverance:

If a patient was to go on holidays, they could know that any Coles or Woolworths pharmacy would be almost the same (in the dispensary and aisles, but not necessarily in the Consulting Room area). A person would be able to describe themselves as a Coles’ pharmacy person or a Woolworth’s pharmacy person. Many Community pharmacies are currently trying to emulate this with the Franchisee Owner model with people feeling that they belong to a particular pharmacy chain. In the Supermarket Pharmacy chain, there could be an express service where scripts could be quickly sent to another pharmacy when a patient is on holidays. Elderly patients could have a delivery service to their homes. It would be important for people to get to know their driver so that they can feel the personal touch that they get now from some Community Pharmacies. The driver could be part of a network in a suburb and could bring Elderly people other items (milk, newspaper, whatever ordered in person, over the phone, or via the internet) also helping to fulfil that increasing need (due to increasing median age of the population) in the community.

There are many advantages potentially with Supermarkets. You could even claim that Supermarkets could cure cancer. Everybody has the potential to do something great, but what really matters is evidence of what people have actually done. I have tried to put forward a case for Supermarket Pharmacy in Part 1 and in further parts, I will put forward a more negative view of the potential problems with Supermarket pharmacy. In life there are always good and bad points and I think that this certainly applies to Supermarket Pharmacies.

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Submitted by Peter Feros on Tue, 16/04/2013 - 13:09.

Joe Conway in his article about pharmacy in supermarkets claimed that there are economies of scale in dispensing.
This claim could be based on incorrect conclusions made in the Pharmaceutical Benefits Remuneration Tribunal dispensing cost surveys in 1988 and 1990.
In my article in the Australian Journal of Pharmacy AJP Vol 93 November 2012. pages 67, 68 & 69
' The dispensing economies of scale myth' is exposed.
A copy is available on my web site. www.efficientdispensarydesigns.com.au
Where there are economies of scale for community pharmacy, is in front of shop retailing.
I have experience of these economies being a director of Cincotta Discount Chemist Merrylands.
This pharmacy has annual sales of $32m.
This level of sales is commensurate with the sales of the average Woolworths or Coles supermarket.
By generating annual sale per square metre of over $30,000, the Cincotta Discount Chemist Merrylands, rent is less that 1% of sales.
This pharmacy provides front of shop products at supermarket prices which prices can be checked on the Cincotta web site.
The pharmacy also provides professional services which in 2013 will be part of the franchise services provided to its 19 franchised outlets.
My experience is that the things Joe Conway says supermarkets can do, are already being provided or can be provided by community pharmacy franchisees.
I am a partner in 11 pharmacies. In none is the bookkeeping, pays et al, done by the pharmacists.
The work is outsourced to bookkeeping specialists.
If any of your readers would like to review the Cincotta operations at Merrylands. Then they simply have to phone me on 0418 444 802.

Submitted by James on Sat, 08/12/2012 - 00:17.

I have a feeling that the location and ownership rules will be reviewed. They definitely need to be. I myself believe that only pharmacists should be able to own pharmacies BUT the location rules should be relaxed so that any budding pharmacist can open one. The national limit of 5000 pharmacies needs to be raised significantly too. This maximum was introduced years ago and the population of Australia (ageing and otherwise) has grown since. This will reduce pharmacy values to more realistic amounts also and improve competition. Eg: there are a couple of medical centres that an entrepreneurial pharmacist may want to open next to in direct competition with an existing pharmacy - why should the existing pharmacy be able to capture that market simply due to outdated location rules?

Submitted by Joseph Conway on Sat, 08/12/2012 - 07:27.

If pharmacy Ownership was deregulated and the location rules remained, then, the big corporates who would buy every pharmacy, would fight to keep them. This could be a disaster for the industry making small, knowledge based start-ups very difficult inhibiting the progression of the profession...

Submitted by James on Tue, 11/12/2012 - 18:31.

No, what I'm saying is that ownership of pharmacies should remain with pharmacists but location rules be relaxed. Why should pharmacy be so protected compared to other industries? I think the government are looking at what you mention & they will have more support from pharmacists these days than ever before.

Submitted by Philip Day on Sun, 02/12/2012 - 19:11.

As Joseph would know from my comments on Auspharm, I favour a more corporatized approach to ownership more along the lines of say Boots in the UK rather than the big 2 Coles & Woolies owning them. The advantage would be particularly for young pharmacists in terms of career progression & staffing of rural pharmacies. As I stated on Auspharm rural towns could be served by a Pharmacist working for "Boots" or similar for a year or 2 who could then transfer to another "Boots" in their hometown. A bit like country service as happens to teachers, which is another field I once worked in for a few years.
The current system is really only good for those with family money or who are part of a dynasty of pharmacy owners.
Phil D.

Submitted by Joe Conway on Wed, 05/12/2012 - 19:13.

I think that a corporate structure would definitely help with staffing pharmacies in rural towns. The consistency between stores does make it easier to move staff around different stores and between city and country. However, I feel that rural pharmacy owners are often used as political pawns?
If pharmacy went open, then it would be the richest who would own pharmacies still? Rich people own the most in our capitalist society. I don't think that it matters who owns the pharmacy as an argument in itself. I think what matters is how the pharmacy is run, the service experienced by customers,the health outcomes of those customers, and the cost of that pharmacy service to the taxpayers. If Clive Palmer or James Packer bought a pharmacy, do you think that that pharmacy would be any different from what we have now? At least those pharmacies would benefit from having an owner with money to invest to improve the business as opposed to having an owner who is up to their eyeballs in debt, trying to be everything to everybody, and can't get the capital as easily to invest in their business...

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