A consultation with the pharmacist
Free newspapers and pharmacies have something in common. Both companies offer a service but charge nothing for it. How is that possible? The free newspaper is free to the reader only because the advertising sold in it pays for the editorial and printing. In pharmacies, advice from academically trained specialists is traditionally also free. This is astonishing, because comparably qualified academics, such as lawyers, charge several hundred francs per hour for their services. Advice in pharmacies can only be offered free of charge because it is cross-subsidized by the sale of over-the-counter and prescription drugs and numerous other products. The products are paid for on the one hand by the customers and on the other hand by the collective of the health insured. For some years now, this model has come under increasing pressure. For example, drug prices are being reduced every year in many countries. It is often forgotten that pharmaceutical services are also linked to the prices – as shown above – and that the price is therefore not paid for the product alone. Another critical point is the price erosion caused by the introduction of new generics. At the end of May 2012, generic versions of the best-selling cholesterol-lowering drug Sortis went on sale for the first time in many countries. Within a few weeks, the price of a pack of one hundred atorvastatin (20 mg) fell from over 200 Swiss francs to the current level of around 70 Swiss francs. Pharmacists are trying to respond to this development with various measures. Among other things, the sale of services and the provision of advice, some of which is subject to a charge, is seen as a promising means. This step is logical – because if the paper can no longer be dispensed free of charge, it will have to be sold. Two new such services have already been introduced in many countries. The first is the so-called polymedication check, in which the patient’s drug treatment is discussed on the basis of a form in a discreet environment. In a dialog between the specialist and the patient, it is discussed for 15-20 minutes whether the patient is taking and using the medication correctly, knows why and for what purpose it is being administered to him, and whether he forgets to take it now and then. The customers are very grateful for this. They got the name a bit wrong, because this tongue twister is hardly suitable for the layman. The second service, netCare, is also basically an individual discussion between the customer and the pharmacist in the consultation room. For clinical pictures such as cystitis or conjunctivitis, there are defined algorithms (instructions for action) with which the patient is clarified in a structured manner. Here, there is also the option of bringing a doctor from the Medgate telemedicine center directly into the pharmacy via a screen, which expands the possibilities for consultation. These new offerings are interesting and have been launched at great expense. We summarize them under the general term “pharmacist consultation”, i.e. a kind of consultation with the pharmacist in a discreet setting. In our view, one disadvantage is the fact that both services are limited and standardized. For example, netCare is only available for a very limited selection of clinical pictures. However, the issues in pharmacies are very diverse and at the same time the knowledge of pharmacists is extremely broad. Therefore, it would be desirable to establish a general pharmacist consultation hour that is less formalized and that allows the discussion of topics that are of importance in the pharmacy. Such a consultation hour would also be much more cost-effective and streamlined to implement than the currently implemented services.
Diverse issues in pharmacies
- What is a wrinkled tongue?
- What medicines are suitable for the treatment of knee osteoarthritis?
- Can you treat gallstones with olive oil, grapefruit juice and Epsom salts?
- How to administer an eye ointment?
