Welcome to this weeks’ edition of i2P (Information to Pharmacists) E-Magazine dated Monday, 29 June 2015.
Well there was certainly a flashpoint over an article written by Mark Coleman and published in our last edition. Titled “Homeopathy – a Political Diversion Rather than a Valid Issue”  it  attracted a range of “diversionists” and some of their comments were moderated under i2P policy because they did not contribute towards a sensible conversation.

When Mark Coleman first discussed his proposed topic for inclusion in i2P I initially wondered why it might impact pharmacy.
It is really such a small indirect component of pharmacy it is almost irrelevant.

Then he showed me the spirited defence by the Australian Homeopathic Association and it was obvious that all was not well with the investigation supposedly independently carried out by the Homeopathic Working Committee of the NHMRC.
The investigation panel contained no expert homeopath, ignored the offer of a body of knowledge held by the Australian Homeopathic Association, and contained a Friends of Science in Medicine (FSM) member with an anti-homeopathic stance (who later resigned from FSM to avoid the appearance of conflict of interest).
The Australian Homeopathic Association response to the NHMRC report was published last week at this link:  Open_response_letter_by_AHA_to_NHMRC

All pharmacists are urged to read this response and make up their own minds.

The following excerpt appears in the open letter, and to my mind invalidates the NHMRC report completely.

“As one of the NHMRC (external) expert reviewers stated in relation to the Homeopathic Working Committee (HWC) review into homoeopathy, “I am concerned that no homeopathic expert was appointed to the NHMRC Review Panel. I cannot imagine this being agreed in oncology, orthopedics, or other disciplines.” [Obtained through a FOI request]”

All these “muddy issues” including the refusal to provide the working body of information used to prepare the final report recommendations, even after FOI requests, suggests that something is not right about this entire issue.
Hence my interest, being concerned that if pharmacy was similarly attacked at some future date, FSM external influence could distort an issue that a majority of pharmacists might be in full agreement with.

My purpose in shining a light on this subject is because the obvious manipulations through a group of well-placed people who seem bent on pursuing a power base to “own” all of health. That this group appears to align with the objectives of Big Pharma is concern enough.
While homeopaths face total annihilation, major drug companies shrug off proven fraud as “marketing” – paying their $’s multi-million fines – and none of their executives are jailed as being responsible for this fraud.
FSM have no comment on this but conflict of interest may exist through payments from the pharma industry for “services” rendered to individuals, directly or indirectly.

One of the persons posting a comment was Dr Lance Emerson CEO of the Pharmaceutical Society of Australia, who wrote:
The NHMRC concluded that “there are no health conditions for which there is reliable evidence that homeopathy is effective”. Defending homeopathy only serves to denigrate the fine profession of pharmacy. PSA believes members must caution consumers against the use of homeopathic products and doesn’t support the sale of homeopathy products in pharmacy – we will be releasing a policy statement on this shortly. If some real evidence (as opposed to commentary, pseudoscience and shonky studies) were to materialise in the future, then our position may change – until then, we believe homeopathy has no place in ethical, evidence based pharmacy practice.

That the NHMRC may have produced a flawed report means that the Homeopaths have been found guilty without being able to defend themselves.
This is simply a denial of natural justice and in no way does i2P feel that it is “denigrating the fine profession of pharmacy” because defending pharmacy is one of the platforms of i2P.
The PSA seems to be dancing to the tune of the FSM – not a good look.

That PSA is going to rely on a potentially flawed NHMRC report (without independently verifying the facts), to generate future policy statements – well, i2P feels it is defending pharmacy by reporting this information, and pharmacists need to have all information pertaining to all of pharmacy policies.

Does PSA have the intestinal fortitude to stand up to the form of coercion exemplified in the NHMRC homeopath report?
And more seriously, is pharmacy policy being developed openly by pharmacists or by under the radar people in other organisations?
I’ll reserve judgement on that one!

Most pharmacists, including myself, do not practice homeopathy or recommend it.
Patients may request homeopathic products and I have no issue with their supply provided it is accompanied with relevant and appropriate information as determined by the supplying pharmacist.

So i2P is not defending the practice of homeopathy in pharmacy, but does defend the right of homeopaths to exist and practice in their own environments, and not be eradicated by methods that are questionable, even illegal.
i2P also defends the right of patients to choose to use whatever medications they wish to legally access, after an informed consent – even homeopathic medicines.
The balance of power is shifting to consumers and pharmacists need to continually remind themselves that this is happening.
Rather, PSA should look to extending pharmacists into advising patients about quality health issues for medicines e.g. “inert” substances in medications that may not be inert such as gluten in some tablets, and being able to have quality control systems to verify dispensed medicines as just one example.
There are a number of near infrared devices that can quickly identify all components of a medication, including the doses and composition of active and inert substances.
And in addition, PSA be part of an evidence-verifying system that can detect Pharma fraud, rather than worrying about harmless homeopathic issues.
But the major effort should be to develop the opportunity presented by government to promote “self care” and primary health care.
A Medicare rebate on the advice component of self care would be a great assist for all pharmacists, and would help prevent the leakage of OTC medicines to supermarkets.
Supermarkets are well aware of the power of pharmacists’ advice and continue to research alternative methods to get around it.
Be proactive rather than be influenced by other organisations and their questionable agendas.

If pharmacists were not aware that they legally had patients and medical records, then they will be pleased to note that a legal opinion has been established in a US court.
Read this story in the article: Are Your Consumers Customers or Patients?

John Cook is back with us this month and he has some firm ideas on rolling out clinical services.
Read his article at: Provider Numbers are the key to clinical services rollout.

With the news that Sussan Ley, Minister for Health, will be supporting a Self Care initiative involving pharmacists, John Cook’s article dovetails with the possibility that provider numbers may make this a seamless possibility.

A Report commissioned by government to outline the Self Care initiative is called the Gap Report, which gives the rationale for pharmacists to drive this initiative.
The funny thing is that it follows the pharmacy model that existed pre-1952, around the time the PBS was created.
The original PBS offered free doctor consultations and free prescriptions written by GP’s.
The system thus altered the patient pathway at that time, which was pharmacist first – then referral to a doctor if required, which freed up a GP to service the more complex patient.

Now PBS is commoditised for pharmacy and GP’s have become traffic directors not having the time to treat complex patients – and Australia is facing an avalanche of ageing, more complex patients, without the financial or human resources organised to deliver a solution.
What pharmacists have practiced at an earlier time can be resurrected, and hopefully it will not be a case of “too little-too late”.
That pharmacists can retrain to do the job is not the question, it is whether pharmacies can restructure to accept clinical service pharmacists in an alliance structure, because it will require an investment of capital and goodwill from these people if pharmacies are to deliver.
Read about the basic problems in the article: The Gap Report & Its Opportunities‘

 Every now and then someone takes an existing product and innovates it to provide an extended or different function.
Some creative thinking has been applied to condom manufacture, and basically a new product has emerged.
These new condoms are set to become a major component of any pharmacists sexual health program. Read all about it in: Re-inventing the Condom with a range of useful benefits.

Loretta Marron is a long-standing writer for i2P, and the association pre-dates her appointment as CEO for the Friends of Science in Medicine (FSM).
Our association has been both professional and cordial, even though some policies of FSM are opposed by some other writers for i2P.
In particular, FSM opposes the existence of chiropractors and homeopaths in their current format.
Loretta’s current article explains some of her perspectives on chiropractors, titled:
Weasel words, fuzzy phrases and other chiro “cons”.

Our new space for pharmacy “News Roundup” continues this week. It contains news important for pharmacists without any analysis or opinion.
Open it at this link: News Roundup for Monday 29 June 2015

 Also, please find PSA media releases as this link:
PSA Media Releases – 1. UNE Students Welcomed 2. Self Care Support Welcomed

 ASMI Media releases at this link:
ASMI Media Releases 1. Expert Panel Falls Short 2. Self Care and the GAP Report

 NPS media releases at this link: NPS Media Releases – Tropfest Short Film Winners

 Enjoy your read for this week.

Neil Johnston, Editor, 29 June 2015