It’s not always the case that when I have attended a conference that I come home feeling enthused with a new energy drawn from ideas and perspectives of intelligent speakers.
But it was the case for the ASMI annual conference that coincided with their 40th anniversary celebrations.
From the seamless organisation on the day, the choice of facilitator (Virginia Trioli of ABC fame) to the quality of presenters, I can truly say that the day’s events held my interest right up to the end.
And what was the stand-out was the number of speakers from around the world that confirmed pharmacy’s space in the health system as pivotal in self-care and primary health care.
Evidence and studies presented confirmed this conclusively.
Nicholas Hall, a global marketing consultant to the pharmaceutical industry and he covered global consumer healthcare trends, their insights and future drivers.
For pharmacists, this could represent a market in medical devices and diagnostics that pharmacists could provide education and support for.
Scott Koslow, who is the Professor of marketing at Macquarie University, delivered on the theme of how to categorise consumers and the behaviours associated with each category and pointed out that sometimes regulators penalised the majority for the behaviour of one segment of consumer. He stated that he needed to do more research to find a solution to this problem of managing the consumer who was a perpetual abuser of drugs.
His take home message was that consumers resent being treated as idiots and to engage with them respectfully. They hate having to go to doctors for repeat prescriptions that they have sufficient knowledge and experience in using, and would prefer a simplified direct supply from a pharmacist.
Deon Schoombie, Executive director of ASMI gave a passionate presentation on drug “switching” of specifically eleven S4 drugs down to S3, and the barriers preventing this process.
These included the regulators and health professionals’ resistance to advertising.
I can understand the pharmacist resistance because their gatekeeper and education service would be undermined if manufacturers are allowed to advertise.
Doctors have previously felt the “sting” in countries where advertising is allowed and messages delivered by this channel have competed with the health professionals’ ability to deliver a holistic service to their patient.
If the message by manufacturers is agreed by leader organisations representing health professionals and that message includes a direction to purchase only through registered health professionals (without reference to price, location or brand outlet) then “switching” could be a possibility (but not unfettered for future products).
Steve Mister, president and CEO of the US Council for Responsible Nutrition has been a strong driver for this organisation since 2005.
I was given the opportunity to interview this speaker and share some points of view.
Steve proved to be a quietly spoken man who has a legal background and has held some high profile legal positions prior to assuming CRN leadership.
His organisation is prepared to assist in any responsible nutrition project globally and is involved in assisting ASMI in their promotion of complementary medicine with an evidence base.
Steve’s address was on a research paper prepared by Frost and Sullivan, that illustrated large cost savings available in public health, through supplementation with a small range of nutrients.
Bill Turner delivered an update on regulatory reform from a TGA perspective.
Bill carefully responded to all questions directed to him, but had to give incomplete answers to some of them given that TGA was undergoing a review of policies and projects.
Bill indicated that there was some progress on becoming part of a global alliance of regulators and described how TGA had been invited to have input into their regulation process so that global impacts, from Australia’s viewpoint, could be minimised.
Bill was previously a veterinarian and has spent some time working for the RSPCA and joined government service in 1995. Over 17 years he was involved in a range of policy programs, regulatory programs,meat inspection teams in export abattoirs, trade access negotiating culminating as Agricultural Councillor in the Australian Mission to the European Union in Brussels.
His current role with the TGA involves managing the office of Scientific Evaluation.
Gopa Mitra, is a director of Health Policy and Public Affairs at PAGB (Proprietary Association of Great Britain). She has been actively involved in forming a self-care alliance in the UK and is advising interested health organisations in Australia as to how to develop their own.
Gopa has been successful in her endeavours in the UK because she sought the help of GP’s and pharmacists in advance and progressed on an inclusive basis.
She views health care in defined segments with the entry point being self-care, progressing to primary health care, then intermediate care, ending in secondary (hospital) care.
Work has been done in documenting self-limiting illnesses and the timeline and signposts for each illness.
This forms an active framework to educate patients to wait before visiting GP’s and understand what they can do to alleviate symptoms.
Also, the flags that would indicate a doctor’s visit ASAP.
Patient education is unified across the health system by adopting this approach and there are many opportunities for pharmacists to assist patients in their symptom management through the self-care phase and designing treatment for primary health care, if applicable
Adopting the timeline approach means that a pharmacist can give a written referral with background information to prevent treatment duplication by a GP.
At this stage the patient in the intermediate care stage and, if required, is guided by the GP into secondary care.
It sounds like a system pharmacy should support.
Alison Roberts, director of Policy and Practice at PSA.
For me, this was the stand-out delivery for the day, because it was practical and documented with appropriate evidence. Alison’s paper was titled “Health Destination Pilot Study” and it clearly demonstrated that when pharmacists position themselves in the front-of-shop area and attempt to greet every patient, those pharmacies had a healthy increase in gross profit percentage, also health sales growth, prescription volume growth and customer growth.
This simple strategy is a precursor step to buy time to build clinical service volume.
It also uses existing resources without having to invest heavily in plant, furniture and fittings and vividly highlights the value of a pharmacist when used appropriately.
Pharmacy has always been a destination point (one of the reasons why supermarkets value owning a pharmacy) but the reason for arriving has always been the access to a pharmacist.
This is a great first step by PSA in building their argument for clinical services to be expanded as a vital segment of core business. This has not always been recognised by pharmacists, government and other health practitioners.
Steve Sowerby, founder of Xpotential marketing consultancy and brand specialist, gave a very interesting delivery on global, best practice in healthcare retailing, titled “Postcards from around the globe”.Some interesting designs for pharmacies were illustrated with, for me, the stand-out being a “health bar”. This was a bench fitted with computers with Internet access and specialised software.
Located in the middle of a pharmacy it was Apple’s equivalent of their “Genius Bar”, a topic that has been written about in an earlier edition of i2P.
This is an excellent work station where clinical assistants can mix with a pharmacist and specialise in some condition.
In the example illustrated, the focus was on skin care and pain management.
This seems to be an excellent addition to Alison Roberts’ work for PSA because it would be the precursor to paid clinical services.
Logically, this health bar could represent the first step in establishing a clear presence for clinical services in pharmacy, and at the same time recognising and embracing the existing qualifications of pharmacy staff, also providing a platform for other health practitioners to promote acceptable modalities.
Again, something that could be cobbled together economically by renovating and customising an old fitting (counter) and initially utilising older computers that would otherwise be discarded.
Having done some research in this area at an earlier date, I am aware that the health bar is only one clinical space to be developed in pharmacy.
More private and semi-private spaces have to also be developed.
A plenary followed on from paper deliveries with Grant Kardachi, PSA national president participating.
Special mention must be made of Virginia Trioli, who facilitated the day using a great sense of humour coupled with some rigorous interviewing of participants.
Virginia is well known as the ABC News Breakfast presenter, also ABC-1 news and ABC News 24.
This conference staged by ASMI consisted of representatives from the entire pharmaceutical industry with a self care interest.
A common theme by all presenters was that the pharmacist was the key to delivering the aspirations of self care and some aspects of primary health care.
If the PSA continues to develop suitable strategies to integrate with all these industry players, many new resources could emerge that would facilitate lifting pharmacy out of the pot-hole it currently finds itself.
There is definitely room for optimism.