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It really
isn't that different for a high-stakes industry such as ours.
We begin from a strong position with high potential for not only
growth but also contributing to Australia's health.
To realize
that sort of potential in the future will necessarily require
some inspired stewardship and even more cooperation between pharmacy
and the consumer healthcare products industry.
We can ensure the fertility of our future, the viability of this
industry-as the National Medicines Policy puts it-in no small
part by the way we choose to address ourselves to key issues.
I'd like to
talk to you about some of the key areas in which I see this potential
for our joint contribution, our cooperative safeguarding of a
fertile future.
Scheduling
Top of my mind is the opportunity presented to pharmacy by way
of those products that are rescheduled 'pharmacist only'.
The way we choose to address "switch" is important.
A focus on S3 rather than on those few products that have gone
open is a better way to a fertile future.
The opportunity
in S3 is -overtly-- to:
* demonstrate the most distinctive contribution pharmacy makes
to the local community; and
* demonstrate the vital role pharmacy can play as part of the
National Health Agenda.
It is perhaps
less obvious that S4 to S3 switch is an opportunity for pharmacy
to work with industry to identify those products which should
be switched.
Switch does not have to be something industry does "to"
pharmacy-we can do it very appropriately together.
This may seem
an unprecedented idea, but it is certainly viable and less revolutionary
than some of the government-driven switch in other markets.
Did you know that the Mexican government switched 350 prescription
medicines in three years-to combat self-prescription?
By switching these products with a high safety profile, appropriate
labels were introduced to aid their responsible use, and scarce
government resources were concentrated on limiting self-prescription
of the remaining higher-risk prescription substances.
Granted, we
do not compare our market with that of Mexico, but the point remains
highlighted that there is a relationship between appropriate sale
of medicines and their quality use.
We must not, therefore, inexorably link high control with quality
use-it just isn't that simple.
We are all
familiar with the "cradle to grave" metaphor.
I'd like to suggest a slightly different personification, along
the lines of god-parenting.
The birth parents of a lot of the products in our sector are on
the Rx side of the business or in the hands of traditional medicine
practitioners.
You pharmacists are the chosen god-parents.
Over the years you come to know these products well and how they
behave and how they interact with others.
You have a pretty good idea of which ones-due to their safety
record-- are ready for a little more freedom.
A product in S3 is like an adolescent.
There is a need for advice-and it must we well given to be heeded.
Their desire to attract a little attention is natural and helps
them to thrive and find their way in the world. Too much thwarting
of this desire has led to growing up too fast, and other forms
of rebellion.
S2 products
are like university students.
They can stand on their own with occasional help.
What I'd like
to suggest to you now is that unscheduled products have not run
away from home.
Instead, they've graduated and gone out to live on their own-in
small doses.
This is not a betrayal.
And in the best tradition of the Australian family, the large
pack sizes will be living at your house indefinitely.
I'd like to
make clear that our industry does not think every product should
"graduate" eventually. Supermarket sale of some medicine
is inappropriate.
Some products are better sold in an environment where the advice
of a pharmacist can be accessed. This is, of course, predicated
on the idea that there is a difference.
The difference
is the supportive advisory role a pharmacist can play.
Despite warnings by John Chapman and others, this role was missed
in the smoking cessation category.
The Galbally
report underlined the importance of fulfilling the potential of
scheduling categories-or potentially losing them.
You may call
cynical those in industry who shook their heads when some in pharmacy
complained about not being prepared for the morning-after pill.
But as George Bernard Shaw once said, "The power of accurate
observation is commonly called cynicism by those who have not
got it."
International trends forecast many of the switches we are seeing
here-sometimes years ahead.
And one wonders at the preparedness of these folks to dispense
an Rx medicine for years only to throw up their hands at the time
of a switch that was gazetted six months previously.
The next big chance to get it right
But I'm not cynical.
I see a chance to get it supremely right in the very near future.
The rescheduling of Xenical as of May 1 is the biggest chance
yet to address this issue.
I'm temped to say "with your biggest customers", but
I won't go there…
What I will suggest is that Roche has a lot of global experience
in switching this product.
If you work closely together, a good outcome is certainly possible.
Perhaps, as
pointed out by Kos Sclavos in February issue of Pharmacy News,
pharmacies are a first port of call when it comes to dealing with
weight issues-- and indeed other health issues.
That's a vibrant
place to be.
And a big responsibility.
I'm encouraged that you have some substantial programs in place
to help you maximize your potential. I'm thinking particularly
about the Quality Care Pharmacy Program and PSA's practice support
programs.
I'm told that
more than 2000 pharmacies across Australia subscribe to QCPP-
the PSA program helps these pharmacies meet and maintain 18 QCPP
standards.
But as you well know, that's not full coverage.
Word needs to spread to the remaining 3000 pharmacies-- pharmacies
must embrace the implementation of professional services.
And if they do it will be very persuasive for product marketers.
It will help dispel the notion that S3 is the "black hole"
that statistics suggest.
Why
Why will these programs have this effect (if they are well subscribed
and implemented)?
Because they will highlight and practice the very factors that
differentiate pharmacy from alternate distribution models; namely
their advisory role and the contribution it can make to the National
Health Agenda.
This makes sense to people in consumer healthcare companies with
marketing and sales backgrounds. They understand unique selling
propositions and positioning and value-adding.
What of the role Manufacturers can play?
The good news that it is in the interest of manufacturers to ensure
pharmacy understanding of the medical solutions they offer.
How can we ensure that such training occurs?
It is as simple as return on investment and with that I lead to
issues currently in review by the bodies of industry.
Both pharmacies and manufacturers expect a return on investment,
effort time and allocated resources.
Consistency and compliance
From a manufacturer's point of view, investment is intended to
bring consistency and compliance-both in manufacturing and in
marketing. It is no different for a retail pharmacist who wants
staff training to be some guarantee of consistent quality, wants
customer education to be some assurance of compliance, etc.
And yet when
it comes to the relationship between the producer and the retailer,
this investment sometimes results in neither consistency nor compliance.
I'm referring to the issue of switching at Point of Sale where
at the end of a marketing sequence that has traversed advertising,
Point of Sale support and merchandising and training-not to mention
conference sponsorship and other more generalized support-- the
consumer is motivated to select my brand but at the point of sale
is encouraged by pharmacy staff to switch to a private label that
has made no greater investment than the effort to be on hand.
Why compromise a flow of opportunities highlighted above if the
long term consequence of a compromised ROI leads manufacturers
to seek alternate partnerships in the face of your choice of alternatives
to us?
When you have
one voice across an industry as complex as ours, it is foolish
to expect agreement on all fronts on our various agendas.
But while we might not be singing the same note, wouldn't it be
grand if we were on the same page of the score and perhaps even
within an octave of one another, in synch with the momentum of
debate, applying our intelligence, energies and expertise across
the issues… seeking an outcome together and creating a positive
outward perception of this industry
That is my
view of this industry.
To use the
words of one well known Executive Director, "Most often it
is not so much having a carrot as knowing where to stick it!"
I'd like to stick it so the view is one going forward and not
one that leaves us chasing our tails, mimicking the holding pattern
of the past with little to show for our talk but the changes that
are cast upon us by default.
In closing,
I am a keen observer of the industry/pharmacy relationship in
my hat as ASMI President, as well as in my company cap and even
as an AIPM board member.
I am not, however, cynical about our chances so long as we can
all agree to embrace the god-child.
It is a joint responsibility.
We'll need to invite you into our processes, consult you sooner
and support our products with pharmacist-friendly training.
That will be a challenge for some of us-and we can all look for
ways to do it better.
Meanwhile, I'll call upon you to support the efforts being made
by your industry bodies to maximize your effectiveness in a challenging
and changing profession that has yet to reach its fullest potential.
And beyond that I'll call upon you to take a long-range view with
regard to my industry.
As you know, god-parents don't raise a child.
They do take some responsibility for its long-term best interests,
though.
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