s Donations to Political Parties - Their Effect on Democracy and Pharmacy | I2P: Information to Pharmacists - Archive
Publication Date 01/07/2014         Volume. 6 No. 6   
Information to Pharmacists

Editorial

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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Newsflash Updates for July 2014

Newsflash Updates

Regular weekly updates that supplement the regular monthly homepage edition of i2P. 
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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
http://aca.ninemsn.com.au/article/8863098/prescription-drug-warning

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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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Donations to Political Parties - Their Effect on Democracy and Pharmacy

Mark Coleman

articles by this author...

Mark is a semi-retired pharmacist.

I’ve been thinking about the parlous state of community pharmacy, how it arrived to that point and what can be done about it.
That led me to think about the current political battle for hearts and minds , that will resolve in the coming September 2013 elections, and the money required to underwrite such a long campaign.
That brought me to political donations.
The following data is taken from the Australian Electoral Commission, which publishes the donations figures annually. It lists every donation over a "disclosure threshold" of $11,900 for 2011-12. It points out: "Many of these receipts are not donations and may represent, for example, subscription fees or proceeds of goods sold. Although not required by law, most political parties and associated entities mark each receipt as a 'donation' or an 'other receipt'."

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So what does a political donation give you?

It gives you direct access to individual politicians and the ability to influence their thinking face-to-face.
It really gets down to those who contribute most get the greatest access and the entire process does not have a “clean feel” about it.

Only Australian citizens are allowed to vote in Australian elections, yet anyone in the world can contribute to Australia’s political campaigns.
Is this foreign intervention in Australian domestic politics good for our democracy?

• The United States of America allows no donations at all from non-citizens. Americans don’t like the thought that foreign nations might exercise influence on their political process by such means.

• Likewise in Canada: you have to be a citizen to donate.

• In the UK, foreigners may not give more than a £500 donation to any one party. (They are, however, allowed to support candidates’ international travel, “as long as the amount is ‘reasonable’").

• Under New Zealand law, foreigners may donate, but no more than NZ$1,500 to any one party.
In Australia it’s open slather.
That means Australia’s regime for regulating donations is weak and haphazard.

* English-speaking democracies such as Britain and New Zealand, both limit expenditure - the US and Canada both limit donations, and Canada does both.

* Australia has neither of those limits - on donations or on expenditure.
Thus Australia has arguably the weakest electoral funding laws among the English-speaking democracies.

You can see this flawed system currently on display through the clash of Rio Tinto and the inhabitants of the small mining town of Bulga.
Rio decided that it would expand its mine already encroaching on this town, riding over the environmental laws and established legal agreements.
At risk was the very real potential for water, and dust pollution, the destruction of endangered species and habitat plus a damaging level of noise that was already impacting on the long-term residents of Bulga.
The town took Rio on in the High Court of NSW….and won!
An enraged CEO of Rio Tinto (based in the UK) demanded a meeting with the premier of NSW (Barry O’Farrell) that was virtually guaranteed to happen because of the culture around political donations.
The meeting occurred and the outcome for Rio was suddenly changed and with the stroke of a pen O’Farrell agreed to alter the NSW laws that had been built up over decades, for a new set (yet to be written) that will be drafted during the course of the  Rio Tinto appeal currently being heard.

And those laws – which in the future would require those tasked with approving new coal mines to elevate the projects’ economic benefits above their social and environmental impacts – are the rub in all of this. For, no matter what the Court of Appeal might decide about whether Justice Preston’s original historic decision stands or falls, Rio will likely get what it wants in Bulga merely by re-submitting its mine-expansion project and having it considered under the new rules.

The effect will be that the townspeople of Bulga will be dispossessed and will have to abandon their town forever.
Australian democracy appears to be failing its constituents.

However, back to pharmacy, and the impact of political donations there.
Surely pharmacists are not so naïve to not realise that the same forces are at work undermining the institutions and laws that hold the industry and profession into a cohesive and productive infrastructure?

1. Pharmacy wholesaler distribution and the disruption caused by manufacturer direct distribution.


I would ask:
(i) Why hasn’t the government forced Pfizer to become part the CSO  by ensuring their products were available for distribution through wholesalers?
Surely their dominance in the PBS market means they could be charged with market manipulation?
And the corollary, why wouldn’t Pfizer exercise its influence on government (it is a large contributor to the donation pool) before making its intent known to go down an expensive direct distribution process?
All the government had to do was to change the CSO rules to state that all drug manufacturers who have listing with the PBS must also be CSO compliant and include pharmacy wholesalers as part of their distribution strategy.
No matter what Pfizer has done, it has never been able to deliver its products within a 24 hour time span, thus putting patient lives and health at risk.
This is wrong.

The Fourth Agreement introduced the Community Service Obligation (CSO) Funding Pool in July 2006 in recognition of the additional costs faced by some pharmaceutical wholesalers in providing the full range of PBS medicines to pharmacies.

The aim of the CSO Funding Pool is to ensure there are arrangements in place for all Australians to have access to the full range of PBS medicines, via their community pharmacy, regardless of where they live and usually within 24 hours.

The CSO Funding Pool financially supports pharmaceutical wholesalers to supply the full range of PBS medicines to pharmacies across Australia, regardless of pharmacy location and the relative cost of supply.

Under these arrangements, payments are provided directly to eligible wholesalers who supply the full range of PBS medicines to any pharmacy, usually within 24 hours, and that meet compliance requirements and service standards. These payments are over and above those made directly to pharmacists to cover the costs of supply from the wholesaler.

2. The government reneges on its agreement to build back income support through increased dispensing fees, after pharmacist assistance in drug price transparency.

(i) Reforms and transparencies – these mean only one thing to me and that is a clawback on agreed prices for items listed on the PBS.
It has nothing to do with stability of pharmacy practice.
In recent time it has more to do with plugging budget “holes”.
It used to be that government wanted pharmacists on side for any of their political aims and objectives.
Why would government deliberately antagonise pharmacists?
Well, simply because they can.
We are now in a weakened state with bankruptcies all around the countryside – with more to come.
All those people and organisations (including pharmacists and pharmacy organisations) have had soured relationships with the PGA, and we are seeing the consequences.
Too late is the cry for unity.

(ii) Pharmacy renewal is now lumbering along in its own time and place, and those who do not recognise this fact will find themselves caught in a downwards business spiral unless they raise their sights to become forward looking.

(iii) Some business owners have become panicked as their financial resources have dwindled to a baseline that is so minimal, it is dangerous.
The blow delivered by government for all the wrong reasons and without discussion (because it would have meant having to admit it was more about filling budget holes) has had one positive – it will force pharmacists to stand on their own two feet and renew their practices to a standard that the community at large would like to see.

(iv) Pharmacist members of the PGA have been lax in ensuring their elected members deliver on their expectations and promises. The PGA became complacent about three years ago it began to use its acquired political power to bully people and to utilise members’ funds in directions that were inappropriate.
One such area was IT systems that have been sourced overseas rather than encourage Australian talent.

(v) Australian Pharmacy does not speak with one voice, and this creates weakness.
An umbrella organisation needs to form up that can give structured membership for all pharmacy groups and organisations so that a single voice can emerge for negotiation and policy planning.
The more organisations that form up to represent valid interests of pharmacists means that creativity can flourish.
Existing organisations are too tired secretive and appear to benefit their executive rather than individual members.
Notice that the call to limit new start up organisations generally comes from the established organisations, who have become too lazy to work on their members’ behalf.
Renewal must be constantly polished in the form of constant reviews of the constitution, particularly with time limits for serving executives (max two years).
When executive positions are valued and fought for, and the currency used is in the form of new ideas, then we will enter a renewal phase.

So where will the leadership come from that will help resolve my issues?
Initially, that comes from within you emerging with a strong personal commitment.

Where will your ideas become tractable and through what organisation(s)?
This comes from sharing your ideas with like-minded people and delivering those ideas through organisations that are a personal best fit for you.
The organisations may not be the ones that are traditionally deemed leadership organisations. If they don’t exist, invent one.

Our traditional enemies will remain in the form of supermarkets, medical centres etc. but with an invigoration within the profession, they can be held in check

We are at the bottom of the pharmacy cycle and it will begin to trend upwards again, once confidence  has been restored. That also includes collegiality and a mentoring process to mould direction and progress.
Best guess is that two years from now the curve will go up with new energy.
There is still a “de-cluttering” process that has to be completed during which many pharmacists will be disappointed and disillusioned.

Just keep in the back of your mind that it is the “old” leadership that has taken you down the road of a “one size fits all” model of illness containment rather than one of health promotion”.
Patients want to be more optimistic than that model allows.

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