Pharmacist: Bulk Dispensing No Remedy
Monday, March 20th 2006
The proposal for medical prescriptions to be filled in three-monthly lots could see North Shore immigrants lose valuable translation services, a city pharmacist says.
It could also see millions of dollars worth of drugs discarded and thrown down the toilet. And, it could make things more confusing for the elderly, who tend to rely on monthly chats with their pharmacist for health advice.
Northcote pharmacist Simon Cameron, of Harris and Cameron Pharmacy, says he'll lose money under the new system and may have to let some of his staff go.
Two of his dispensing staff speak Cantonese, Mandarin and Korean and provide an essential translation service for many of the Asian customers his pharmacy deals with.
Mr Cameron says their jobs will be at risk. He says 40 per cent of his customers are "new" New Zealanders who need translation services to cope with the complicated health system we have. If this proposal goes through this and many other services will be lost.
He also envisages about $24 million in unused drugs being wasted and flushed down the toilet each year.
Dispensing in bulk, every three months means patients can end up with leftover medicine they don't need.
Mr Cameron says there's a toll on the environment in allowing that to happen.
Government drug agency Pharmac has announced it is considering a return to
distributing some prescription medicines in three-monthly lots.
It aims to save $35 million a year.
But the proposal has many pharmacists, including Mr Cameron concerned.
The Pharmaceutical Society of New Zealand, which represents the nation's pharmacists, says the $35 million saving is an illusion, because the proposal will end up costing the health system more in the long run.
"This proposal means people will no longer have their pharmacist helping them manage their medication each month," Pharmaceutical Society president Bernie McKone says.
"This will result in more doctors' visits as people try to sort out problems with their medicines, increased hospitalisation from inappropriate use of medicines and greater demand for residential care as elderly patients struggle to maintain their independence with complicated medical regimes," McKone says.
Mr Cameron says pharmacies nationwide will lose $70 million in prescription subsidies, paid by district health boards on behalf of patients.
He says the reduction in subsidy will devastate pharmacy services such as home care, mental health services, translation services, home deliveries and personal extras community pharmacies offer.
Pharmac has done an efficient job reducing the price of medicines, Mr Cameron says, but the proposed criteria for getting medicine three monthly is money based, on how cheap a medicine is.
He fears cheap drugs being dispensed in bulk could lead to more home poisonings, especially in children.
Patients will still have to go back to their pharmacies every month for expensive medicines like Losec or Lipitor.
Mr Cameron thinks Pharmac should instead make its policy decision based on whether the doctor and pharmacist think it is clinically advantageous for the patient to get three months worth of medicine, rather than on how cheap the medicine is.
He is angered by Pharmac's suggestion that pharmacists are self-interested and that pharmacists can make up the money they'll lose, under the new dispensing system, by selling cosmetics and other chemist items.
He laughs at Pharmac's suggestion that reducing the burden of dispensing will free up his staff to interact more with patients.
Mr Cameron points out that as his staff get paid on the basis of prescription numbers, he will lose the money necessary to pay for them and the services they provide.
Ultimately, Mr Cameron says, New Zealand may become like the Untied States where cost cutting has seen patient-pharmacist relationships reduced to "pills through grills" at the back of Wal-Mart stores.
Sourced from the North Shore Times, 12 June 2003
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