Pharmacists to be paid for advising

DOCTORS and pharmacists have met to agree on their respective roles as changes to pharmacists work approach.

From next year they are set to have a reinforced role, including being paid “dispensing fees” for advising on how to take medicines or store them, length of treatment and possible side effects.

They will also be paid for “pharmaceutical interviews” following up treatment of patients taking anti-coagulants (“blood thinners” used to prevent various serious illnesses) or asthma treatments, for which they will receive an annual fee per patient.

“We’re looking at a real change to the profession of pharmacist,” the head of pharmacists’ union USPO, Gilles Bonnefond said.

Unlike doctors, pharmacists are well spread out across France, so it is suspected that the measures might partly be aimed at coping with the “medical desert” problem - with doctors being plentiful in places like Paris and the Riviera, but scarce in some other, rural parts of France.

However doctors expressed concerns that the chemists might encroach on their role.

Changes must be done in “cooperation” with doctors, said the MG France doctors’ union - it must not be a matter of one profession replacing the other. At a joint meeting, representatives agreed that pharmacists’ advice would be limited to “running through how to take the medicines, helping make sure the patient sticks to the treatment and avoiding accidents.

“At no point was it envisaged that pharmacists should take the initiative to modify the treatment,” they said in a joint statement

At present pharmacists are paid a set fee per box of medicines they hand out, plus a percentage of the sale price. They wished to change from this due to reductions in the price of medicines.

This is to be swapped for a combination of new income kinds, including the advice payments and bonuses for hitting objectives on the delivery of generics.

This comes as doctors have been criticised for making out too many prescriptions which refuse the supply of a generic instead of the branded drug.

A survey by Gemme, an association of 12 drug manufacturers, found one in five GPs’ prescriptions is concerned. It said only a quarter of drugs given out are generics in France, compared to two-thirds in Germany.

Pharmacists can take the initiative to offer them, but doctors can write “NS” (not substitutable) on prescriptions to stop them doing so.

While there are no pharmacy “deserts” and the number of them is firmly in the European average, concerns have recently been raised over recruitment into the work.

Professional body the Ordre des Pharmaciens says that a quarter of pharmacy graduates choose to do unrelated work, a tendancy that is increasing, as the figure has risen to 26% in 2012 from 20% in 2011.

There are also concerns over pharmacy closures - 141 last year out of the total 23,000. In a minority of cases this was due to pharmacies joining up but it was mostly because of people retiring and not finding someone to take on the business.

Unlike other medical professions pharmacy does not attract significant numbers of foreign professionals and the profession is aging - 70% of pharmacists are aged over 48.