HDA Media And Political Bulletin – 30 September 2016

What does the future hold for community pharmacy?

Chemist and Druggist, Emma Wilkinson, 22 September 2016


With the news that the funding “package” for community pharmacy will be announced in mid-October and implemented in December, C&D asks sector leaders to speculate about the future of the industry and its opportunities. HDA Chief Executive Martin Sawer sees the pressure on the NHS and GPs as an opportunity for community pharmacy to demonstrate value. APPG Chair Kevin Barron adds that the Government ought to stop looking at costs and recognizing values.


Pharmacy services review will inform contract negotiations

Chemist and Druggist, James Waldron and Grace Lewis, 29 September 2016


NHS England’s ongoing review of services, commissioned by England’s chief pharmaceutical officer Keith Ridge, will be used as advice on how to modernise the community pharmacy sector and to negotiate community pharmacy contracts.



Pharmacy Biz, Neil Trainis, 28 September 2016


Community pharmacies delivered more than 150,000 flu vaccinations in the first three weeks of this year’s national flu vaccination service, intensifying hope that pharmacy can surpass last year’s total amid reports of growing dissatisfaction among some GPs at pharmacy’s roll-out of the scheme.


Quality issues account for two-thirds of shortages

Irish Medical Times, 29 September 2016


At the BioPharma Ambition Conference, Michael Kopcha, Director, Pharmaceutical Quality with the US Food and Drug Administration (FDA), explained that quality issues and aging technologies were to blame for nearly two-thirds of drug shortages. According to Kopcha, innovations such continuous manufacturing process and 3D drug printing could hold the key of decreased drug shortages.


Could people tell a real medicine from a fake?

P3 Pharmacy, 29 September 2016


The International Pharmaceutical Federation (FIP) launched a campaign to raise awareness of counterfeit medicines. A series of videos showing consumers and healthcare professionals having to choose between real and fake medicines have been pushed out on social media. The World Health Profession Alliance (WHPA) is calling on policymakers to strengthen laws against counterfeiting.


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What does the future hold for community pharmacy?

Chemist and Druggist, Emma Wilkinson, 22 September 2016


C+D asks sector leaders to look into their crystal balls and predict what’s in store


Even if you manage to source a pair of rose-tinted glasses, the future of community pharmacy doesn’t look particularly promising at the moment. For many, it’s difficult not to feel pessimistic. Since the bombshell of a funding cut to pharmacies in England was first outlined at the end of last year, the sector has been preparing for the worst.


Some took comfort from pharmacy minister David Mowat’s video message to the Royal Pharmaceutical Society (RPS) conference earlier this month, in which he spoke about “taking time” to make the right decision for the sector. But now it appears that was only a brief reprieve. A funding “package” will be announced in mid-October and implemented in December – not quite the pause for thought that many had hoped for.


The threat of a £170 million drop in the global sum has galvanised the profession to fight its corner. The National Pharmacy Association’s (NPA) petition gained more than two million signatures from pharmacists and concerned members of the public, and two key documents – the Community Pharmacy Forward View, and a PricewaterhouseCoopers analysis of the value of community pharmacy to the NHS – have spelled out what the sector has to offer.


With a new ministerial team in place, and fresh negotiations between the Department of Health and the Pharmaceutical Services Negotiating Committee (PSNC) starting shortly, there is potential for opportunities. But where do they lie? We’ve asked key figures for their predictions – and what you can do to prepare.


Sandra Gidley, RPS English pharmacy board chair


Everyone is in a state of limbo and no one is quite sure what is going to happen. We do have an opportunity to lobby our case and there is lots of work being planned for the [party] conference season coming up. What we haven’t done very well so far is get allies – we will have to work more constructively with other healthcare professionals.


But for the first time, the pharmacy bodies are working together and have a very coordinated effort putting forward a single case – the Community Pharmacy Forward View document has been very helpful.


Given all the work that’s been going on to show the value of what pharmacy does every day, I would hope that in the future community pharmacy would provide a lot more clinical services and be adequately remunerated for them.


Personally, I would like to see some sort of ‘Pharmacy First’ type scheme – where pharmacies provide clinical advice and short-term drug treatments for certain minor ailments – that is properly resourced. I hope the profession will embrace a wider range of clinical services – I think that is the right thing for the profession and the right thing for the NHS.


There will be a role for pharmacy in the future – the NHS will still need a medical supply function and it’s not quite as straightforward as automation. But we do need to be looking at what pharmacy can do more of for patients – we should be the first point of call when anyone is ill.


Martin Sawer, Healthcare Distribution Association chief executive


The message coming out is that pharmacy needs to take its share of the NHS cuts. The challenge is then for community pharmacy to demonstrate its value. I think everyone is going to take a hit and it is going to be about trying to minimise the impact of that.


If community pharmacy is able to take the cuts on the chin – and if they are not too deep – it needs to make a concerted effort to win more services. The problem is the reliance on prescription income, which is skewing what the government thinks of us.


Community pharmacy as a sector has a huge opportunity. We have new government ministers and it is great that the PSNC and Pharmacy Voice are working together and produced the Community Pharmacy Forward View.


There will be some great, innovative stuff going on locally, but it’s about trying to link that to the national agenda. What we need to do now is bring it all to life, because if the government is going to invest, they need to see it happening.


A year from now, I would like to think we would have more nationally commissioned services in place and that we have rebalanced the way that income is supplied to pharmacy.


You would have thought that the [government drive for a] seven-day NHS and the pressures on doctors would be a great chance for community pharmacy to step up.


Rob Darracott, Pharmacy Voice chief executive


At the moment, we just don’t know what is going to happen with the cuts and nobody really knows how the politics of this is going to play out. I like to think that we have created an opportunity, by working together as a sector, to present a considered view about what pharmacy might look like.


The aspect that is really interesting is the idea of community pharmacy as a health and wellbeing hub. GPs now recognise that they can’t do everything and the wider primary care team can share some of that load, so we want to see proper partnerships between community pharmacy and the NHS.


Pharmacists now need to get engaged with what is happening on their patch – [by finding out] what the local pharmaceutical committee (LPC) is doing and what local GPs think, and contributing to data sets. All of these things build the case for pharmacies doing things differently. Don’t wait for permission, there are things that happen in discrete localities now that are not necessarily recognised from a national perspective, but that can be fed back through the LPC.


I am also constantly persuaded by the need to take a fresh look at over-the-counter medicines. We have been so focused on long-term conditions that we have forgotten that 1.3 million people come into a pharmacy every day for a health-related reason. Other businesses would kill for that kind of footfall.


I wouldn’t like to think that in 12 months’ time there will be another surprise around the corner. The past few months have been a great energiser and now we need to work collectively to get people to buy into community pharmacy, and have more constructive conversations – rather than a bunch of random ideas foisted on us.


John D’Arcy, Numark managing director


The significant thing is that we have a new minister who is saying we are going to have a conversation about pharmacy’s future. The Community Pharmacy Forward View document, and the added support from the RPS, means that for the first time we have a joined-up vision.


More and more people are going to use pharmacies, yet we are the ‘Cinderella service’. The PricewaterhouseCoopers report estimated savings of £3 billion achieved by utilising just 12 existing pharmacy services. Let’s make pharmacy the hero.


There is plenty to be positive about, [such as] a changing attitude to the idea of pharmacy being an integral part of primary care, and we have shown quickly and convincingly we can handle national services like flu. Right now, there needs to be absolute engagement with consumers as part of the preparation for taking on more services.


To make this happen, pharmacists will have to get better at delegating to their staff, and there needs to be a division of labour in a different way. The sector also needs to be getting itself properly IT-enabled, with systems that are fit for purpose.


There has been a transition for a number of years to a more patient-focussed role, but lets see 2017 as the time to set up national services – minor ailments being the obvious one, but why not all 12 services in the PricewaterhouseCoopers report?


However, I would want to see better integration between GPs and pharmacists, and that the Department of Health has bought into the vision that community pharmacy has set out.


At the very least, we need a sensible conversation about what pharmacy should be doing.


Kevin Barron MP, all party pharmacy group chair


I am deeply disappointed that it appears the government has just delayed introducing cuts rather than looking at the impact it is going to have on pharmacy and the communities it serves. PSNC did some brilliant work with PricewaterhouseCoopers to calculate the value of pharmacy. But it does look like [the government] are just going to go ahead – they need to stop just looking at cost and consider values instead.


We need some 21st century thinking about how pharmacies are contracted to the NHS. Pharmacy should be an integral part of the primary care team – of that, there is no question in my mind. We need recognition of its professionalism but also what the cost should be, and make changes in the national contract to recognise that.


It is quite clear there is a role for pharmacy to play in looking after people with long-term conditions – there are some really good things the government should be looking at now which is not about cost, but value to the public.


Something which is really key is that the public need to have healthcare professionals who are engaging with them and advising on lifestyle and health issues, and I see pharmacy as the main gateway for that.


I would hope the government would do some more work with the relevant bodies – a petition of over two million people is not something that can be ignored easily.


Pharmacy services review will inform contract negotiations

Chemist and Druggist, James Waldron and Grace Lewis, 29 September 2016


NHS England’s ongoing review of services will inform future negotiations over the community pharmacy contract, the commissioner has said.


The wide-ranging review – commissioned by England’s chief pharmaceutical officer Keith Ridge to advise him on how pharmacy services can be “modernised” – will ensure NHS England has the “information and recommendations when we’re planning for the future, especially contract negotiations”, said the organisation’s assistant head of primary care Dr Jill Loader.


The review – being led by Richard Murray, director of policy for think tank the King’s Fund – should “inform and develop our thinking around clinical roles going forward”, Dr Loader added.


She also acknowledged “how unsettling” the delays to the announcement of the sector’s funding has been for pharmacists.


“We completely recognise how long the unsettling period has gone on [for],” she told delegates at the Pharmacy Show in Birmingham on Monday (September 26).


An national minor ailments scheme?


Speaking at the same event, Boots UK chief pharmacist Marc Donovan said he hopes the services review will lead to a national minor ailments scheme.


“I believe minor ailments as a national service would be a great benefit to community pharmacy, and certainly pharmacy can embrace that,” Mr Donovan said.


Well chief executive John Nuttall also stressed that he is “an advocate of nationally commissioned services”. “It is a good way for multiples to engage with the 150-plus clinical commissioning groups across the country.”


“I hope Keith Ridge considers this – in particular minor ailments, which should happen across the country,” Mr Nuttal added.


At the time of going to press, NHS England was unable to confirm when its services review would be completed.



Pharmacy Biz, Neil Trainis, 28 September 2016


Community pharmacies delivered more than 150,000 flu vaccinations in the first three weeks of this year’s national flu vaccination service, intensifying hope that pharmacy can surpass last year’s total amid reports of growing dissatisfaction among some GPs at pharmacy’s roll-out of the scheme.


Figures from PharmOutcomes and Sonar Informatics revealed that pharmacy teams provided 150,160 vaccinations in just over three weeks, a figure the PSNC said was higher because of some pharmacies’ failure to use electronic systems to record their provision of vaccines.


Reaching the 150,000-mark will heighten optimism and expectation that community pharmacy can beat the 595,467 vaccines it administered last year.


“As these figures show, the national flu vaccination service has had a spectacular first few weeks and this really is a testament to all the hard work put in by contractors, pharmacy teams, LPCs and others,” said Alastair Buxton, director of NHS services at the PSNC.


“A huge amount of effort went into getting the necessary materials and resources ready and then preparing for the service; so a very big well done is deserved for all involved.


“Once again we are showing that that community pharmacy can deliver. The number of patients accessing the service through pharmacy shows how much they value the convenience of pharmacies, and every vaccination is another contribution towards NHS targets.


“This is a brilliant result, and I look forward to seeing some even more impressive statistics over the next few months.”


The PSNC revealed that as of September 16, 7,998 contractors had signed up to provide flu vaccinations on the NHS Business Services Authority website.


Pharmacy’s impressive roll-out of flu vaccines comes as reports emerge of GP surgeries in some areas attempting to put patients off having their jab in pharmacy, allegations NHS England has promised to look into.


General practice’s apparent irritation with pharmacy providing vaccines even spilled on to Twitter. When pharmacist Darshan Negandhi commented that pharmacy’s flu service can reduce the pressure on general practice, GP Survival, a body claiming to be “the voice of UK general practice” responded: “Taking away income from practices is adding to the pressures in GP.”


When asked if pharmacy providing flu vaccinations was a threat to GPs, GP Survival tweeted: “anything that worsens #gp crisis is a threa(t).”


Quality issues account for two-thirds of shortages

Irish Medical Times, 29 September 2016


Quality issues account for two-thirds of all drug shortages with old technology sometimes responsible for them, attendees at a major biopharmaceutical conference in Dublin Castle last week were told.


Addressing the BioPharma Ambition Conference, Dr Michael Kopcha, Director, Pharmaceutical Quality with the US Food and Drug Administration (FDA), said this was a “staggering” number and that resolving quality issues would lead to a reduction in the number of drug shortages.


According to him, other issues and trends that are currently emerging include the “unprecedented” globalisation of the supply chain and major advances in the scientific landscape which he said were pressuring existing regulatory paradigms, particularly in areas such as biosimilars, precision medicine and advanced manufacturing.


Addressing facilitating innovation in the biopharmaceutical industry, Dr Kopcha gave a detailed outline of the work of the FDA and the Office of Pharmaceutical Quality in particular, which he said had a role in helping to drive innovation within the industry.


He explained that a surveillance group within his office in the FDA examined quality trends within the industry and tried to redress them before they became major issues that could lead to drug shortages.


The FDA official said some of the current technology in the manufacturing sector dates back to World War II and this created some of the quality issues that industry was dealing with today. One of the ways to address this was to enhance or modernise manufacturing technologies through advancing manufacturing science, he added.


Dr Kopcha said one such emerging technology was the continuous manufacturing process.

He explained that continuous manufacturing was a modern approach to pharmaceutical manufacturing, providing consistent and higher quality products with lower potential for adventitious agents. It also eliminates holds where product can degrade and involved less intermediate testing and human error.


Continuous manufacturing, he added, offered flexibility to the manufacturing process and it also had a very small footprint.


“There are companies out there that actually have continuous manufacturing footprint that fits on the back of a pick-up truck,” he stated.


Orkambi was the first New Drug Application (NDA) to get FDA approval using a continuous drug product manufacturing process for a new CF drug, while Persista was the first NDA supplement approved for switching from a batch to a continuous manufacturing process, he explained.


According to Dr Kopcha, additional emerging technologies that the FDA are examining in collaboration with industry include: 3D printing of drug products, novel aseptic filling technology as well as new container or closure systems.


On the importance of partnering with industry, he said: “We have got to work collaboratively to understand the technologies, to be able to regulate that technology and to drive that technology forward within the industry. It is needed for the patients.”


“We advocate that industry get involved in these new advanced technologies to help reduce quality issues, to help bring these new technologies and products to the market, so that we don’t have drug shortages and we have therapeutic agents that can really work wonders with certain diseases”, Dr Kopcha added.


Featuring international industry and research leaders from the medical and biopharma industries, the all-island 2016 BioPharma Ambition Conference took place on September 21 and 22 in Dublin.

The two-day event, sponsored by PwC, GE Healthcare, and United Drug (part of the McKesson Group), and Intertrade Ireland and was addressed by the Minister for Health.


Could people tell a real medicine from a fake?

P3 Pharmacy, 29 September 2016


Consumers and healthcare professionals are being asked to make a choice between two medicines shown in a video, and decide which is real and which is fake. Depending on their choice, they are then shown the consequences of their decision – which could be that the person is now seriously ill in hospital.


The project, to raise awareness of counterfeiting, was led by the International Pharmaceutical Federation (FIP). “We’re seeing an increase in fake medicines around the world and they’re becoming harder to identify due to technological advances. We wanted, through this video, to confront people with a situation to which little thought is often given. We wanted to give viewers the responsibility for what happens and, in doing so, to send home the message that there is a need to think twice about the choices they make. The aim was to enable informed decisions,” said Mr Luc Besançon, chief executive officer of FIP.


The video – created to be shared through social media – offers a range of measures to help reduce potential harm from counterfeit medicines. Health professionals are asked to educate local communities on unsafe sources and what they should look for. Consumers are advised to use an authorised pharmacy to buy medicines.


The initiative is part of the “Counter the counterfeits” project, from the World Health Professions Alliance (WHPA), of which FIP is a member. The WHPA is calling on policymakers to strengthen laws against counterfeiting.

HDA Media And Political Bulletin – 30 September 2016

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