La Farmacia en Europa

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La Farmacia en Europa

• Filip BABYLON
• President
• Pharmaceutical Group of the European Union
• Representing European Community Pharmacists
• XVII National Pharmaceutical Congress Blbao
  20th October 2010

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Pharmaceutical Group of European Union
Members Professional Bodies Pharmacists
Associations
Netherlands Poland Portugal Romania Slovakia Slove
nia Spain Sweden United Kingdom Croatia FYR
Macedonia Norway Serbia Switzerland Turkey
Austria Belgium Bulgaria Cyprus Czech
Rep Denmark Finland France Germany Greece Hungary
Ireland Italy Latvia Luxembourg
2010 30 Countries
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1300
2010

• 400.000 Community Pharmacists in Europe
• 160.000 Community Pharmacies in Europe
• 46 million citizens visit a pharmacy every day

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11 december 2008 IFB
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We have a winner

• Pharmacists help people get well, stay healthy,
  feel better, and save money.
• We help people safely use vaccines that prevent
  infections, medicines that cure diseases or
  prevent them from getting worse, and vitamins,
  supplements, or special foods to improve health
  and wellness.
• But most importantly, we are near your home,
  easy to talk to, good at answering questions, and
  care about you and your family.

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Regulatory Change
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Regulatory Change in Europe

• Strong tendencies toward liberalisation over the
  last 10 years e.g. Ireland, Norway, Hungary,
  Portugal, Italy, Sweden
• Now only Spain, France, Austria, Greece and
  Finland have all three traditional pillars of
  regulation ownership rules, establishment rules
  and OTC monopoly.
• European Court Judgement on Ownership prevented
  big bang liberalisation, but left room for
  change at national level e.g. did not affect
  liberalisation in Sweden. Most recent country to
  liberalise ownership is Latvia (July 2010)

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Regulatory Change in Europe

• Outcome of the Asturias case involving
  establishment rules in Spain strongly vindicates
  regulatory approach European Commission
  arguments totally dismissed by the Court.
• Still strong advocacy from the EU Commission e.g.
  OTC monopoly
• However, still more than 80 per cent of EU
  pharmacies are pharmacist owned.
• Future arguments about ownership will be based on
  economics e.g. free ownership allows lower prices.

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• Spanish Pharmacy remains a model of how the needs
  of patients and health systems can be addressed
  within a regulated system.

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Reductions in Payments Margins since 2008
Reduction
Planned Reduction
N.A.
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Reductions in Medicine Prices Since 2008
Reduction
Planned Reduction
N.A.
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Pharmacist remuneration systems in EU
Pure Margin
Predominantly Margin
Pure fee
Predominantly fee
Balance of fee/Margin
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Economic Change

• The Problem of Falling Prices
• There is a tendency both towards increased
  generics use, and falling generic prices. Margin
  based and rebate systems stand to lose.
• At the same time in some countries more expensive
  medicines are being distributed through other
  channels.

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Economic Change

• The coming squeeze?
• Many EU countries are suffering either direct
  reductions in statutory remuneration schemes (e.g
  Ireland, Spain) or declines in remuneration due
  to falling prices (e.g. Netherlands, Finland).
• Pressure is short term (economic crisis) and long
  term (sustainability)
• Distribution increasingly seen as a source of
  unnecessary cost.

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The pharmacists evolving roleredefining the
role

• Filip BABYLON
• President
• Pharmaceutical Group of the European Union
• Representing European Community Pharmacists

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the role of the pharmacist

• The pharmacist must be an active counsellor
• The responsibility is extending beyond quality
  and conformity of products to a more rational
  and optimal use
• The pharmacy is becoming a healthcare centre
• Relationship based on confidence and personal
  contact

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Survey Readers Digest

• Trust in professions
• Firefighters 92
• Airline pilots 88
• Pharmacists 85
• Nurses 84
• Doctors 82

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Pharmaceutical Care

• Shifting the pharmacists focus towards
• The quality of the dispensing activity(
  counseling technique, scientific databases,
  patient records)
• The outcome of the treatment( registration of
  activities and results)
• The rational and optimal use of medication(
  choice of therapy and compliance)

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Shift the focus from product to patient
professional service
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Services provided by pharmacies
Source PGEU Database 2006
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New Possibilities

• Community Pharmacy as a locus of innovative
  health care services
• Self care and community care in an ageing society
• The challenge of improving adherence
• Connectivity and continuity within the health
  system

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The Challenge

• Reduce and prevent avoidable medication errors
• Identify, manage and prevent drug-related
  problems
• Improve adherence
• Promote rational and safe medicines use
• Early identify risk factors
• Promote healthy lifestyles

WHAT SHOULD BE DONE?
AT WHAT PRICE? HOW TO VALUE IT?
WHO PAYS?
HOW TO SHARE THE INVESTMENT RISK?
HOW TO USE THE RETURN ON INVESTMENT?
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Conclusion

• Re-engineer the profession in 3 steps
• Redefine the role of the pharmacist not only in
  dispensing medicines but also as a healthcare
  service provider
• Implement quality through Good Pharmaceutical
  Practice
• Adapt the remuneration system going from margins
  to fees

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•  In evolution it is not the strongest, the
• most aggressive or even the most
• intelligent who are likely to survive.
• Rather, it is those most able to adapt to
• the demands of environmental change. 

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www.pgeu.eu
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