The 10-Year Market Plan: A new Pharmacopiea+ New Clinical Services

A 10-year market plan has been called for pharmacy.
Who will have the lead in this initiative and how will it be made inclusive so that any pharmacist may contribute?
Indeed, does the traditional leadership group for pharmacies, the Pharmacy Guild of Australia, have sufficient moral capital to be even considered for this important job?
While the lack of any marketing plan highlights the negative of deficient leadership it also highlights a positive – the opportunity to design a thought leadership group to steer pharmacy’s future.
This opportunity creates a pathway to avoid the damaging lack of collaboration between existing pharmacy lead-organisations and to create a mechanism where all pharmacists can contribute to their own future on equal terms.
Something like an Institute of Pharmacists.

Stephen Greenwood wrote in the AJP dated August 2014:

“The fact is that pharmacy has been blasted out of the political arena into no-man’s land.

Pharmacy is in political limbo and in real financial strife with more businesses closing than ever before, profits down and more job cuts on the horizon at a time when no one in government or the bureaucracy is listening.
The biggest petition in Australian history has been derisively ignored, there is no government commitment to compensation, no commitment to new professional services or adequate remuneration and a future made financially inglorious by the savage cuts ushered in by accelerated price disclosure in October which will leave each pharmacy $90,000 in the red.
Pharmacy needs much more than has been offered by the official organisations to date.”

I think that the above statement is a very concise summary of pharmacy’s political and financial health at this point in time.
i2P has warned repeatedly over a period of two years in particular (10 years in total), that the life cycle of the PBS was close to expiring, and now it has officially arrived.

Although I hold very strong views regarding the particular pharmacy leaders who have hastened this demise and ignored a future direction, it serves no purpose to deploy criticism and blame.
As pharmacists, we all need to collectively just “get on with it”.

So the PBS is now an unsupportable product, except for those segments properly remunerated
The PGA and the PSA have nothing to replace it with, leaving you like a “shag on a rock” – very isolated and vulnerable (also poor).

All right then, design a new pharmacopeia of drugs for your pharmacy and use it as a marketing tool to replace as much of the PBS as possible. With low-cost generic drugs it is an idea with “legs”.
Design it for ease of use by GP’s and pharmacists within your own practice.
If possible, get other pharmacists to adopt it and share in its cost and development.
Ensure that it contains a broad range of medications that can be applied to primary health care.
Give it a brand name and nurture the brand to provide a wide range of benefits, particularly in the area of clinical services.
Be careful to separate the service component from the pharmacopeia and use separate brands, otherwise GP’s will get unsettled.
And don’t wait for the Guild or the Society (or your marketing group) to provide it for you. This has to be an exercise for your business and a first-hand one at that!

As support builds for your pharmacopoeia, particularly industry support, apply any rebates and payments towards the building of clinical services.
This should have been the government process over the last decade, but they have opted to run with the money and apply it elsewhere.
We can and should do it as a sustainable private system and never let government develop an ownership position for our services ever again – no matter what the inducement.

That the PBS proved to be such a vote winner is one of the reasons for its long-term success at pharmacy’s expense. Some may remember the period where it became fashionable to include many items on the PBS schedule that were popular with consumers, but had nothing to do with life-saving – the initial intent of PBS.
Items such as antihistamines, vitamins and other complementary medicines created a surge in PBS expenditure and a complete disruption of pharmacy’s OTC market.

As always, a correction had to be made by government and as always this came at the expense of pharmacy.
PBS margins and dispensing fees were attacked and reduced as the mechanism to balance the budget.
Pharmacy took a major financial hit, regrouped its OTC market and adjusted its cash flow processes.
That pharmacists were reasonably skilled managers helped prevent a spate of bankruptcies then. But government-induced crises take their toll as is evidenced currently.
Pharmacy negotiators must find a solid mechanism for insuring against these bureaucratic incursions that damage individuals and that display a chronic lack of understanding of pharmacy management by government agencies.
I confess I do not know how you insure against broken promises of politicians, but this current government must be the most inept and dishonest in recent times.
In the past, coalition governments have never been favourably disposed towards pharmacy, yet you would have thought that a conservative profession managing a big chunk of the national health budget would be treated with more respect, given the savings that have been recently generated through pharmacy initiatives.

Well, let’s not forget the lessons from history and never again allow government to dominate or interfere with the primary business of pharmacy.
Market share by government in any pharmacy activity must be maintained at 15-25 percent of our market at maximum. Let’s go and stay substantially private.

It’s not so long ago that I wrote an article about how things “suddenly” happen, pointing out that an end result for a new initiative usually happens after a decade of input (or lack of input) to get a positive or a negative result.
So, on that basis, we could date the decline of the PBS as starting in 2004 and ending in 2014.

We could also say, as I stated in that “suddenly” article, that it would take a decade to create a clinical services market if we started from the publishing date.
Put another way, any market plan prepared today would not be fully realised until 2024. And as a result there will be a huge gap in pharmacy revenue over this period that cannot be quickly filled.
Our pharmacy leaders are calling for a 10 year plan but everyone realises this is a belated positive. Positive only because one is mooted to come into being, and did it only come into being after I provided the idea that any new service would take 10 years to mature?
I have a further suggestion here, and that is that the president of the PGA and the PSA be replaced every 12 months, in line with other major organisations and that updates to a 10-year plan occur annually to coincide with new leadership elections.
This will help prevent “thought sterility”, mismanagement, and any hint of corruption creeping in. Membership must continue to hold its leaders accountable and one way would be to insist on presidential campaigns being open and with published policies and issues.
I wonder if that idea will ever be taken up?
It would certainly keep our profession “fresh” and have the potential leaders polling their membership for ideas and initiatives.

Internal reforms must occur because they are already too long overdue!

The 10-year lead time of thought development certainly seems to have given our pharmacy leaders some sort of an excuse for their failure to have alternatives in place for now.
And it’s not so long ago that I wrote that the PGA should be leading a massive public relations campaign to eliminate all the political and medical “negatives” aimed at pharmacy, also for nearly a decade now.

But it’s good to hear that it is happening, and that it involves all the major marketing groups.

I2P will continue its process of thought leadership by promoting ideas that will fit into a 10-year marketing plan.
We have already done work on clinical services and the suggestion that they are as equally important to the core business of pharmacy as is dispensing.
In this article we are exhorting pharmacists to claim back their ownership of dispensing by designing their own program of dispensing, but with a holistic “feel” having the inclusion of clinical services.

It’s no good lamenting what has been lost.
It’s better to look forward to what “might be” and get excited about the points on the board as territory is won back.

It is a bit like warfare, but until pharmacy is united with a cohesive culture of “helping”, both each other and our patients, we will not be equipped to fight the battles that will lead to a comprehensive win in the healthcare arena.

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