Survey
* Your assessment is very important for improving the workof artificial intelligence, which forms the content of this project
* Your assessment is very important for improving the workof artificial intelligence, which forms the content of this project
Ireland’s Official Pharmacy Publication DECEMBER 2016/JANUARY 2017 Future Pharmacy Practice report IPU Member Assistance Programme Pharmacy Awards 2016 CPD: Wound care | Irish prescription market trends | Retail customer experience That Enstilar moment ® Discover what the NEW foam spray Enstilar can do for your plaque psoriasis patients Extraordinary Delivery Visit www.enstilar.ie Abbreviated Prescribing Information for Enstilar® 50 micrograms/g + 0.5 mg/g cutaneous foam Please refer to the full Summary of Product Characteristics (SmPC) (www.medicines.ie) before prescribing. Indication: Topical treatment of psoriasis vulgaris in adults. Active ingredients: 50 µg/g calcipotriol (as monohydrate) and 0.5 mg/g betamethasone (as dipropionate). Dosage and administration: Apply by spraying onto affected area once daily. Recommended treatment period is 4 weeks. The daily maximum dose of Enstilar should not exceed 15 g, i.e. one 60 g can should last for at least 4 days. 15 g corresponds to the amount administered from the can if the actuator is fully depressed for approximately one minute. A twosecond application delivers approximately 0.5 g. As a guide, 0.5 g of foam should cover an area of skin roughly corresponding to the surface area of an adult hand. If using other calcipotriol-containing medical products in addition to Enstilar, the total dose of all calcipotriol-containing products should not exceed 15 g per day. Total body surface area treated should not exceed 30%. Safety and efficacy in patients with severe renal insufficiency or severe hepatic disorders have not been evaluated. Safety and efficacy in children below 18 years have not been established. Shake the can for a few seconds before use. Apply by spraying, holding the can at least 3 cm from the skin, in any orientation except horizontally. Spray directly onto each affected skin area and rub in gently. Wash hands after use (unless Enstilar is used to treat the hands) to avoid accidentally spreading to other parts of the body. Avoid application under occlusive dressings since systemic absorption of corticosteroids increases. It is recommended not to take a shower or bath immediately after application. Contraindications: Hypersensitivity to the active substances or any of the excipients. Erythrodermic and pustular psoriasis. Patients with known disorders of calcium metabolism. Viral (e.g. herpes or varicella) skin lesions, fungal or bacterial skin infections, parasitic infections, skin manifestations in relation to tuberculosis, perioral dermatitis, atrophic skin, striae atrophicae, fragility of skin veins, ichthyosis, acne vulgaris, acne rosacea, rosacea, ulcers and wounds. Precautions and warnings: Adverse reactions found in connection with systemic corticosteroid treatment, e.g. adrenocortical suppression or impaired glycaemic control of diabetes mellitus, may occur also during topical corticosteroid treatment due to systemic absorption. Application under occlusive dressings should be avoided since it increases the systemic absorption of corticosteroids. Application on large areas of damaged skin, or on mucous membranes or in skin folds should be avoided since it increases the systemic absorption of corticosteroids. Due to the content of calcipotriol, hypercalcaemia may occur. Serum calcium is normalised when treatment is discontinued. The risk of hypercalcaemia is minimal when the maximum daily dose of Enstilar (15 g) is not exceeded. Enstilar contains a potent group III-steroid and concurrent treatment with other steroids on the same treatment area must be avoided. Skin on the face and genitals are very sensitive to corticosteroids. Enstilar should not be used in these areas. Instruct the patient in the correct use of the product to avoid application and accidental transfer to the face, mouth and eyes. Wash hands after each application to avoid accidental transfer to these areas. When lesions become secondarily infected, they should be treated with antimicrobiological therapy. However, if infection worsens, treatment with corticosteroids should be discontinued. When treating psoriasis with topical corticosteroids, there may be a risk of rebound effects when discontinuing treatment. Medical supervision should therefore continue in the posttreatment period. Long-term use of corticosteroids may increase the risk of local and systemic adverse reactions. Treatment should be discontinued in case of adverse reactions related to long-term use of corticosteroid. There is no experience with the use of Enstilar in guttate psoriasis. During Enstilar treatment, physicians are recommended to advise patients to limit or avoid excessive exposure to either natural or artificial sunlight. Topical calcipotriol should be used with UVR only if the physician and patient consider that the potential benefits outweigh the potential risks. Enstilar contains butylhydroxytoluene (E321), which may cause local skin reactions (e.g. contact dermatitis), or irritation to the eyes and mucous membranes. Pregnancy and lactation: There are no adequate data from the use of Enstilar in pregnant women. Enstilar should only be used during pregnancy when the potential benefit justifies the potential risk. Caution should be exercised when prescribing Enstilar to women who breast-feed. The patient should be instructed not to use Enstilar on the breast when breast-feeding. Side effects: There are no common adverse reactions based on the clinical studies. The most frequently reported adverse reactions are application site reactions. Uncommon (≥1/1,000 to <1/100): Folliculitis, hypersensitivity, hypercalcaemia, skin hypopigmentation, rebound effect, application site pruritus, application site irritation. Not known frequency: Hair colour changes. Calcipotriol: Adverse reactions include application site reactions, pruritus, skin irritation, burning and stinging sensation, dry skin, erythema, rash, dermatitis, psoriasis aggravated, photosensitivity and hypersensitivity reactions, including very rare cases of angioedema and facial oedema. Systemic effects after topical use may appear very rarely causing hypercalcaemia or hypercalciuria. Betamethasone (as dipropionate): Local reactions can occur after topical use, especially during prolonged application, including skin atrophy, telangiectasia, striae, folliculitis, hypertrichosis, perioral dermatitis, allergic contact dermatitis, depigmentation and colloid milia. When treating psoriasis with topical corticosteroids, there may be a risk of generalised pustular psoriasis. Systemic reactions due to topical use of corticosteroids are rare in adults; however, they can be severe. Adrenocortical suppression, cataract, infections, impaired glycaemic control of diabetes mellitus, and increase of intra-ocular pressure can occur, especially after long-term treatment. Systemic reactions occur more frequently when applied under occlusion (plastic, skin folds), when applied on large areas, and during long-term treatment. Precautions for storage: Do not store above 30°C. Extremely flammable aerosol. Pressurised container. May burst if heated. Protect from sunlight. Do not expose to temperatures exceeding 50°C. Do not pierce or burn, even after use. Do not spray on an open flame or other ignition source. Keep away from sparks/open flames. No smoking. Legal category: POM. Marketing authorisation number and holder: PA 1025/5/1. LEO Pharma A/S, Ballerup, Denmark. Last revised: May 2016 Further information can be found in the Summary of Product Characteristics or from: LEO Pharma, Cashel Road, Dublin 12, Ireland. e-mail: [email protected] ® Registered trademark MAT-04855 Date of preparation: September 2016 Reporting of Suspected Adverse Reactions Reporting suspected adverse reactions after authorisation of the medicinal product is important. It allows continued monitoring of the benefit/risk balance of the medicinal product. Healthcare professionals are asked to report any suspected adverse reactions via HPRA Pharmacovigilance, Earlsfort Terrace, Dublin 2, Tel: +353 1 6764971, Fax: +353 1 6762517, Website: www.hpra.ie, e-mail: [email protected]. Adverse events should also be reported to Drug Safety at LEO Pharma by calling +353 1 4908924 or e-mail [email protected] ALL LEO TRADEMARKS MENTIONED BELONG TO THE LEO GROUP ® Contents IPU REVIEW DECEMBER 2016/JANUARY 2017 40 08 Cover photo: Pictured receiving the Overall Pharmacist of the Year Award at the recent Clanwilliam Pharmacist Awards is Kathy Maher (centre), with Ultan Molloy, Chairperson of the Pharmacist Awards Committee (left), and Paul Reilly of United Drug, sponsors of the award. The IPU Review is published monthly and circulated to Irish pharmacists. The views expressed by contributors are not those of the IPU nor is responsibility accepted for claims in articles or advertisements. Subscription: €95 (Ireland North & South) and €140 (including postage overseas). Publisher: Irish Pharmacy Union (IPU Services Ltd), Butterfield House, Butterfield Avenue, Rathfarnham, Dublin 14, D14 E126 Tel: (01) 493 6401 Fax: (01) 493 6626 Email: [email protected] Website: www.ipu.ie Editor: Jack Shanahan MPSI Editorial Associates: Aoibheann Ní Shúilleabháin, Jim Curran and Ciara Browne Advertising: Aoibheann Ní Shúilleabháin Email: [email protected] Tel: (01) 493 6401 ©2016 Copyright: All Rights Reserved, Irish Pharmacy Union. Printed by Ryson Colour Printers Ltd. IPU Review is a Registered Trademark of the Irish Pharmacy Union. IPUREVIEW DECEMBER 2016/JANUARY 2017 16 05 A Note from the Editor IPU News The latest news and events from Butterfield House 06 06 06 07 IPU Conference is coming to Croke Park IPU Academy 2016 – another successful year Return to Community Pharmacy Practice in Ireland Pharmacy in the Media Features 18 08 16 18 24 28 34 38 40 44 48 Pharmacists honoured at Clanwilliam Pharmacist Awards IPU Member Assistance Programme PSI publishes Future Pharmacy Practice report IPU Advertising Campaigns – promoting the role of the pharmacist CPD: Wound care Clinical Tips: Interaction between proton pump inhibitors and food Retail customer experience in pharmacy Employment round-up Irish prescription market trends Political Report – All the latest pharmacy news from the Houses of the Oireachtas 54Studies 28 News 58 International News 60 IPU Supervisory Development Course 62 Local pharmacy owners attend inaugural CarePlus Conference at Croke Park 63 totalhealth Pharmacy Gala Ball & Pharmacy Awards 2016 65 Minister Corcoran Kennedy launches second Healthy Ireland survey 65 HIQA to commence medication safety inspections in public acute hospitals 66 European pharmacists host EP event on health systems 68 Minister for Health confirms Meningitis B and Rotavirus vaccinations for 1 December 70 Classified Ads 38 24 3 As an adjunct to diet and exercise for appropriate patients with type 2 diabetes SUPPORT YOUR PATIENTS WITH CONFIDENCE sitagliptin/metformin sitagliptin INCLUDING EVIDENCE FROM TEC S TRIAL EVALUATING CARDIOVASCULAR O U T C O M E S W I T H S I TA G L I P T I N NOW EVEN MORE REASONS TO CHOOSE JANUVIA® FIRST AS A PARTNER TO METFORMIN1 Januvia or Janumet. For Januvia only– Renal Impairment: Lower dosages are recommended in patients with moderate and severe renal impairment, as well as in ESRD patients requiring haemodialysis or peritoneal dialysis- see Dosage. For Janumet only - Lactic acidosis and renal function: a very rare, but serious, metabolic complication can occur due to metformin accumulation. Cases in patients on metformin have occurred primarily in diabetic patients with significant renal failure. Reduce incidence by assessing other associated risk factors. If suspected, discontinue treatment and hospitalise patient immediately. Determine serum creatinine concentrations regularly, i.e. at least once a year in patients with normal renal function and at least two to four times a year in patients with serum creatinine levels at or above the upper limit of normal and in elderly patients. Decreased renal function in elderly patients is frequent and asymptomatic. Exercise special caution where renal function may become impaired, e.g. when initiating antihypertensive or diuretic therapy or when starting treatment with a non-steroidal anti-inflammatory drug (NSAID). Surgery: due to metformin hydrochloride content of Janumet, discontinue treatment 48 hours before elective surgery with general, spinal or epidural anaesthesia. Do not resume earlier than 48 hours afterwards and only after renal function is normal. INTERACTIONS For Janumet only - Alcohol: avoid alcohol and medicinal products containing alcohol due to risk of lactic acidosis. Cationic agents that are eliminated by renal tubular secretion (e.g., cimetidine): these may interact with metformin by competing for common renal tubular transport systems. Consider close monitoring of glycaemic control, dose adjustment within the recommended posology and changes in diabetic treatment when these agents are co-administered. Iodinated contrast agents in radiological studies: intravascular administration of these agents may lead to renal failure, resulting in metformin accumulation and a risk of lactic acidosis. Discontinue Janumet prior to, or at the time of the test and do not reinstitute until 48 hours afterwards, and only after renal function is found to be normal. Combination requiring precautions for use: glucocorticoids (given by systemic and local routes) beta-2-agonists, and diuretics have intrinsic hyperglycaemic activity. Inform the patient and perform more frequent blood glucose monitoring, especially at the beginning of treatment. If necessary, adjust dose of the anti-hyperglycaemic medicine during therapy with, or on discontinuation of the other medicine. ACE-inhibitors: as these may decrease the blood glucose levels, if necessary, adjust dose of the antihyperglycaemic during therapy with, or on discontinuation of the other medicine. PREGNANCY AND LACTATION: Do not use during pregnancy or breast-feeding. Animal data do not suggest an effect of treatment with sitagliptin on male and female fertility. Human data are lacking. SIDE EFFECTS Refer to SmPC for complete information on side effects There have been no therapeutic clinical trials conducted with Janumet tablets however Janumet is bioequivalent to co-administered sitagliptin and metformin. Sitagliptin: Serious adverse reactions including pancreatitis and hypersensitivity reactions have been reported. Hypoglycaemia has been reported in combination with sulphonylurea and insulin. The following adverse reactions were reported from both clinical trials and post-marketing experience: Sitagliptin only: Common: hypoglycaemia, headache, Uncommon: dizziness, constipation and pruritus. Sitagliptin with metformin: Common: hypoglycaemia, nausea, flatulence and vomiting; Uncommon: somnolence; upper abdominal pain, diarrhoea, constipation and pruritus. For Januvia and Janumet: Post-marketing experience additional side effects have been reported (frequency not known): hypersensitivity reactions, including anaphylaxis, angioedema, rash, urticaria, cutaneous vasculitis, exfoliative skin conditions including Stevens-Johnson syndrome (see precautions), and bullous pemphigoid; acute pancreatitis, including fatal and non-fatal haemorrhagic and necrotising pancreatitis (see precautions); impaired renal function, including acute renal failure (sometimes requiring dialysis); vomiting; pain in extremity, arthralgia, myalgia, back pain and arthropathy; interstitial lung disease. Januvia: Description of selected adverse reactions Adverse experiences reported regardless of causal relationship to medication and occurring more commonly in patients treated with sitagliptin included upper respiratory tract infection, nasopharyngitis, osteoarthritis and pain in extremity. In the Trial Evaluating Cardiovascular Outcomes with sitagliptin (TECOS), after a median follow up of 3 years, sitagliptin, when added to usual care, did not increase the risk of major adverse cardiovascular events, or the risk of hospitalisation for heart failure compared to usual care without sitagliptin in patients with type 2 diabetes and established cardiovascular disease. PACKAGE QUANTITIES Januvia 25 mg, 50 mg and 100 mg film-coated tablets 28 tablets Janumet 50mg/850mg and 50mg/1000mg film-coated tablets 56 tablets Legal Category: POM. Marketing Authorisation Numbers Januvia 25 mg: EU/1/07/383/002 Janumet 50 mg/850 mg: EU/1/08/455/003 Januvia 50 mg: EU/1/07/383/008 Janumet 50 mg/1000 mg: EU/1/08/455/010 Januvia 100mg: EU/1/07/383/014 Marketing Authorisation Holder Merck Sharp & Dohme Limited, Hertford Road, Hoddesdon, Hertfordshire EN11 9BU, UK Date of revision: January 2016 © Merck Sharp & Dohme Ireland (Human Health) Limited, 2016. All rights reserved. Further information is available on request from: MSD, Red Oak North, South County Business Park, Leopardstown, Dublin 18 or from www.medicines.ie. Date of preparation: October 2016. Adverse events should be reported. Reporting forms and information can be found at www.hpra.ie Adverse events should also be reported to MSD (Tel: 01-299 8700) Reference: 1. Green JB, Bethel MA, Armstrong PW, et al. Effect of sitagliptin on cardiovascular outcomes in type 2 diabetes. N Engl J Med. 2015;373(3):232–242. Red Oak North, South County Business Park, Leopardstown, Dublin D18 X5K7 Ireland DIAB-1198859-0000 JANUVIA® (Sitagliptin) JANUMET® (Sitagliptin/metformin hydrochloride) ABRIDGED PRESCRIBING INFORMATION Refer to Summary of Product Characteristics (SmPC) before prescribing. PRESENTATION Januvia® 25 mg, 50 mg and 100 mg film-coated tablet each containing 25 mg, 50 mg or 100 mg of sitagliptin respectively. Janumet® 50 mg/850 mg and 50 mg/1000 mg tablets each containing 50 mg sitagliptin and 850 mg or 1000 mg metformin hydrochloride. INDICATIONS For adult patients with type 2 diabetes mellitus Januvia is indicated to improve glycaemic control: as monotherapy • in patients inadequately controlled by diet and exercise alone and for whom metformin is inappropriate due to contraindications or intolerance as dual oral therapy in combination with • metformin when diet and exercise plus metformin alone do not provide adequate glycaemic control • a sulphonylurea when diet and exercise plus maximal tolerated dose of a sulphonylurea alone do not provide adequate glycaemic control and when metformin is inappropriate due to contra-indications or intolerance • a PPARγ agonist (i.e. a thiazolidinedione) when use of a PPARγ agonist is appropriate and when diet and exercise plus the PPARγ agonist alone do not provide adequate glycaemic control as triple oral therapy in combination with • a sulphonylurea and metformin when diet and exercise plus dual therapy with these medicinal products do not provide adequate glycaemic control. • a PPARγ agonist and metformin when use of a PPARγ agonist is appropriate and when diet and exercise plus dual therapy with these medicinal products do not provide adequate glycaemic control. Januvia is also indicated as add on to insulin (with or without metformin) when diet and exercise plus stable dosage of insulin do not provide adequate glycaemic control. Janumet: as an adjunct to diet and exercise to improve glycaemic control in patients inadequately controlled on their maximal tolerated dose of metformin alone or those already being treated with the combination of sitagliptin and metformin. • in combination with a sulphonylurea (i.e., triple combination therapy) as an adjunct to diet and exercise in patients inadequately controlled on their maximal tolerated dose of metformin and a sulphonylurea. • as triple combination therapy with a PPARγ agonist (i.e., a thiazolidinedione) as an adjunct to diet and exercise in patients inadequately controlled on their maximal tolerated dose of metformin and a PPARγ agonist. • as add on to insulin (i.e., triple combination therapy) as an adjunct to diet and exercise to improve glycaemic control in patients when stable dosage of insulin and metformin alone do not provide adequate glycaemic control. DOSAGE AND ADMINISTRATION Januvia - One 100 mg sitagliptin tablet once daily, with or without food. Janumet - The dose of antihyperglycaemic therapy with Janumet should be individualised on the basis of the patient’s current regimen, effectiveness, and tolerability while not exceeding the maximum recommended daily dose of 100 mg sitagliptin. For patients not adequately controlled on metformin alone, the usual starting dose should provide sitagliptin dosed as 50 mg twice daily (100 mg total daily dose) plus the dose of metformin already being taken. For patients switching from co-administration of sitagliptin and metformin, Janumet should be initiated at the dose of sitagliptin and metformin already being taken. For patients inadequately controlled on dual combination therapy with the maximal tolerated dose of metformin and a sulphonylurea or with maximal tolerated dose of metformin and a PPARγ agonist or with maximal tolerated dose of metformin and insulin, the dose should provide sitagliptin dosed as 50 mg twice daily (100 mg total daily dose) and a dose of metformin similar to the dose already being taken. All patients should continue their recommended diet with an adequate distribution of carbohydrate intake during the day. Januvia and Janumet - In combination with a sulphonylurea or with insulin, consider a lower dose of sulphonylurea or insulin, to reduce risk of hypoglycaemia. Renal impairment: For Januvia only: When considering sitagliptin with another anti-diabetic product, its use in patients with renal impairment should be checked. Moderate impairment (CrCl ≥30 to <50 mL/min), the dose is 50 mg once daily. Severe impairment (CrCl <30 mL/min) or with end-stage renal disease (ESRD), the dose is 25 mg once daily. Mild impairment, no dose adjustment. Assessment of renal function is recommended prior to initiation of Januvia and periodically thereafter. For Janumet only: Should not be used in patients with moderate or severe renal impairment (creatinine clearance < 60 ml/min). Hepatic impairment: For Januvia only - no dosage adjustment necessary for patients with mild to moderate hepatic impairment. Januvia has not been studied in patients with severe hepatic impairment and care should be exercised. However, because sitagliptin is primarily renally eliminated, severe hepatic impairment is not expected to affect the dose of sitagliptin. For Janumet only – do not use. Elderly < 75 years: For Januvia only - no dosage adjustment necessary. For Janumet only - use with caution as age increases. Monitoring of renal function is necessary to aid prevention of metformin-associated lactic acidosis. Children: no data available. CONTRAINDICATIONS For Januvia - Hypersensitivity to active substance or excipients. For Janumet - Hypersensitivity. Diabetic ketoacidosis and diabetic pre-coma. Moderate and severe renal impairment (creatinine clearance < 60 ml/min). Acute conditions with the potential to alter renal function such as dehydration, severe infection, shock. Intravascular administration of iodinated contrast agents. Acute or chronic disease which may cause tissue hypoxia such as cardiac or respiratory failure, recent myocardial infarction, shock. Hepatic impairment. Acute alcohol intoxication, alcoholism. Lactation. PRECAUTIONS AND WARNINGS For Januvia and Janumet - General: do not use in patients with type 1 diabetes or for diabetic ketoacidosis. Acute pancreatitis: Use of DPP 4 inhibitors has been associated with a risk of developing acute pancreatitis Inform patients of the symptom of acute pancreatitis: persistent, severe abdominal pain. Resolution of pancreatitis has been observed after discontinuation of sitagliptin, but very rare cases of necrotising or haemorrhagic pancreatitis and/or death have been reported. If pancreatitis is suspected, Januvia or Janumet and other potentially suspect medicinal products should be discontinued; if acute pancreatitis is confirmed, Januvia or Janumet should not be restarted. Caution should be exercised in patients with a history of pancreatitis. Hypoglycaemia when used with other anti-hyperglycaemic medicinal products: Rates of hypoglycaemia reported with sitagliptin were generally similar to rates in patients taking placebo. Hypoglcaemia has been observed when sitagliptin was used in combination with insulin or a sulphonylurea (see side effects). Therefore consider a lower dose of sulphonylurea or insulin to reduce the risk of hypoglycaemia when administering Janumet or Januvia. Hypersensitivity reactions: Serious hypersensitivity reactions have been reported, including anaphylaxis, angioedema, and exfoliative skin conditions including Stevens-Johnson syndrome. Onset occurred within the first 3 months after initiation of treatment with some reports occurring after the first dose. If suspected, discontinue A NOTE FROM THE EDITOR Jack Shanahan, MPSI The ground is set for ePrescriptions GDPR. You would be forgiven for yawning at yet another acronym, in a world splattered by four letter epithets. Yet this innocuous sounding phrase has the potential to cause major grief and misery for any pharmacy that falls foul of its reach. T he General Data Protection Regulation is of vital significance to us all, as data controllers. While we all pay homage at this altar of data protection, it typically takes the form of signing a form and sending off a cheque. A regulatory box ticked for another year. Nicht mehr, as the real Taoiseach Angela might say. This GDPR legislation is a little different, in that it puts a large amount of responsibility on the data controller, ensuring that they do not have a data breach. We are evolving into the controllers of an essential part of the Electronic Health Record. While you might have thought that, up to now, internet leaks fell into the realm of the net merchants, this will no longer be the reality. As we move into the ePharmacy space, there are clear and immediate risks presenting themselves. Electronic prescriptions are on the way. By the time you read this, HIQA should have signed off on new standards for dispensing records. Now that we have national standards for both prescription and dispensing, the ground is set for standardised eprescriptions to take off. The onus will be on every pharmacy, and pharmacist, to ensure that they are operating in an electronically-secure area. A security breach could cost, at IPUREVIEW DECEMBER 2016/JANUARY 2017 a minimum, 4% of your last year’s turnover. Never mind the reputational damage. A great place to start is by looking at the IPU guidelines on data protection. This is too important to allocate a boxticking moment. Take some time to digest and act. The good news is that, in broad terms, the eHealth landscape looks positive on the pharmacy front. There is a consensus that a ‘pull’ rather than a ‘push’ system meets the public needs more effectively. While there is quite an amount of fluidity, the general plan is simple. Prescribers will send a prescription to a central depot. This is proposed to be managed by Healthlink, a HSE-funded body that has a successful track record in the electronic message area for lab results and other confidential data. Once a patient gives the pharmacist authority, they can retrieve the electronic prescription. If everything is working well, you then treat this like any other prescription until you hit the complete button. Then a message will go back to the central repository with dispensing information. What happens at this stage is still open to debate. What is clear is that there needs to be clear governance of this data. This is a core part of a person’s private health record. It cannot be left to the technocrats; it is much too important for that. The PCRS/HSE decided to give us an early Christmas present by reducing further the prices of already depressed reference prices. The bottomless pit just got a little deeper. Yet, the average pharmacist cannot help thinking that we are at the business end of a rather senseless stick. The hmR figures are stark. As we see many common drug prices heading rapidly towards zero, we see more medicines that defy all business logic. For example, even using the PCRS figures, looking at atorvastatin over the last five years, we can see that the amount of prescriptions remained static at just over 1.8 million. The State cost has plummeted from €71 to €19 million. This is a spectacular result for the taxpayer. On the other hand, we must ask what on earth is going on with the TNF alpha inhibitor costs? Over five years, the cost to the State of these for drugs has doubled to almost €200 million, a huge chunk of the drugs budget. While there is no doubt that these are brilliant efficacious medicines, there seems to be no rationality in relation to cost control. Similarly, we have seen a profound change in the costs of psychiatric depot injections. Some newer three-monthly depots are staggeringly expensive, coming in at €1,800 a shot. While there is much comment about the costs of newer High Tech drugs, there is a feeling that the State is completely missing the boat in relation to currently-allowed extremely costly medicines. Meanwhile, we see a news story that a reference price will be set for a therapeutic group, the erectile dysfunction treatments. If this comes to pass, it will signify a profound change in policy. Without significant legislative change, it will also be an extremely dysfunctional process. With this cheerful thought, it is time to wish you all a very happy Christmas. And may the New Year bring some economic cheer to all. 5 IPU NEWS Happy Christmas to all our readers We would like to wish all our readers a happy and peaceful Christmas. This year, instead of sending cards, the IPU has made a donation to LauraLynn Children’s Hospice to help them with their work to provide support for children with limiting conditions and their families. IPU Conference is coming to Croke Park The IPU National Pharmacy Conference will be held in Croke Park, Dublin on 5-7 May 2017. Registration for the Conference will launch next month. The Conference will be open to pharmacy staff on the Friday evening, where they will have the opportunity to place orders with companies in attendance and also attend a session on retailing. We look forward to seeing you there! IPU Training Course 2017 IPU Academy 2016 – another successful year 2016 has been another great year for IPU Academy with close to 5,200 attendances in total over 10 courses countrywide. We are looking forward to a successful 2017 with our IPU Academy Spring Programme due to commence in mid-February. We will be rolling out another five exciting topics which are accredited by Trinity College Dublin. Keep an eye on the IPU e-newsletter for updates on the upcoming programme. We have also created an electronic version of the topics presented in the IPU Academy Autumn Programme, available on www. ipuacademy.ie. This is to facilitate those of you who were unable to attend the live courses during the Autumn Programme 2016. Use your personal membership log-in to complete an eLearning version of the topics. This eLearning format allows you, as a member of IPU Academy, to engage with Continuing Education at a time that is convenient to you and remove the need to travel to attend a course. 6 Return to Community Pharmacy Practice in Ireland Pharmacy practice in Ireland at the “coalface” can change rapidly over time. Returning from a career break, e.g. from Maternity Leave or a Sabbatical, may be a daunting prospect. Equally, entering Irish Pharmacy practice as a new registrant pharmacist from another jurisdiction is also a challenge. The ‘Return to Community Practice in Ireland’ programme is designed to equip such pharmacists with the skillset to be able to approach their re-entry or entry into Irish Community Pharmacy Practice. It will be delivered over dual platforms by the experienced team at the IPU Training Unit – one of which will be a day-long live training event. Dates and details will be published in January 2017. Places are limited and Expressions of Interest can be made by contacting Susan McManus, Training and HR Manager, at the IPU Training Unit on 01 406 1555 or [email protected]. IPUREVIEW DECEMBER 2016/JANUARY 2017 PharmaConex.com Pharmacy in the media Earlier this month, we issued a press release following the results of our latest Quarterly Business Trends Survey, highlighting that business confidence among Ireland’s pharmacy sector has continued to decline with many pharmacists of the opinion that the business environment is in fact worsening. Pharmacy Contractors’ Committee Chairman Eoghan Hanly said, “With footfall, sales and employment down in Q3, it is not surprising that pharmacy owners/managers are less confident about the business environment and their own business prospects”. The topic received national media coverage in the Irish Examiner and the Irish Sun, and there was a substantial amount of coverage on regional radio stations. To help promote European Antibiotic Awareness Day, we issued a press release warning that antibiotic resistance is one of the most significant threats to patient safety in Ireland. IPU President Daragh Connolly commented on the dangers of the overuse of antibiotics saying, “If we allow antibiotic resistance to grow, the antibiotics used to treat infections today will become ineffective or will stop working altogether in the future”. The press release was covered in national newspapers such as the Irish Daily Mirror and the Irish Star, and there was online media coverage on TheJournal.ie. Daragh was also interviewed on several regional radio stations and the campaign was also highly promoted via social media. The campaign is supported by the HSE website undertheweather.ie and there was a fullpage ad in the Irish Independent for the website, which also reflected the support from the IPU, alongside a full-page ad for our own “Ask your Pharmacist First” message, which further promoted the importance of asking your pharmacist first about your health concerns and medicines. Health Market Research (hmR) Ireland featured in The Irish Times after they published an analysis of prescription drugs sold in pharmacies which shows that the cost of a basket of prescription drugs in the Republic of Ireland has fallen by almost 60% in the last three years, from €13.52 to €5.64. In response to an internal Road Safety Authority report, which found that 30% of people who died in road crashes in Ireland in 2013 had taken some form of prescription medicine, we issued a press release to highlight this important issue and warn drivers of the possible dangers when taking prescribed medications. IPU Executive Committee member Caitriona O’Riordan advised that patients should discuss the potential side-effects associated with their medication with their pharmacist and to also always read the accompanying Patient Information Leaflet. The topic received a substantial amount of media coverage in national newspapers including The Irish Times, Irish Independent, Irish Examiner and Irish Daily Mail. There was online media coverage on Newstalk FM’s website, as well as coverage in the Evening Echo. Let us Help You Fill the Gap RECRUITMENT Need a permanent Pharmacist, Technician or need to fill Locum positions? Let the largest Pharmacy recruitment company help you out. We understand the needs of your business and are confident in matching you with the right candidates for the job. LOCUM WITH PHARMACONEX Working as a Locum in Ireland could not be easier, with the support of the PharmaConex team. FREE CPD, TRAINING & MORE As part of our commitment to provide highly skilled & quality candidates, and to support our Locum Pharmacists we offer a host of extras: • CPD webinars • Clinical CPD sessions • Dispensing Systems Training • Full Payroll • Manage your account & bookings online • Team on call 24/7 • Locum Heroes - Rewarding Locum Triumphs For further information just call, email, or go to the ‘Training’ section on the PharmaConex website www.pharmaconex.com DUBLIN: IPUREVIEW DECEMBER 2016/JANUARY 2017 FREE TRAINING & CPD Suite 503, The Capel Building, Mary’s Abbey, Dublin 7. T:+353 1 4853522 SHANNON: 4230 Atlantic Avenue, Westpark Business Campus, Shannon, Co. Clare. T: +353 61530202 Emergency Number: +353 87 201 5947- E: [email protected] PHARMACIST AWARDS 2015 Ten pharmacists honoured at Clanwilliam Pharmacist Awards The Clanwilliam Pharmacist Awards were held on 26 November in the Mansion House, Dublin. 10 pharmacists were honoured at the Awards, which aim to celebrate pharmacy and raise awareness of the outstanding work being undertaken by pharmacists across the country. The event was attended by almost 400 people and MC’d by well-known broadcaster, Matt Cooper. C lanwilliam Pharmacist Awards Committee Chairperson Ultan Molloy said this year’s event helped in some way to recognise the outstanding work being undertaken by pharmacists across the country, often behind the scenes. “The Awards allow us to recognise those pharmacists who are going the extra mile for their patients, their peers and the pharmacy sector as a whole every day,” he said. Winner of the Patient Nominated Award (L-R): Matt Cooper, Ultan Molloy, Clare Long (Foynes Pharmacy, Co. Limerick), Daragh Connolly (IPU President) and Jennifer Hughes. 8 IPUREVIEW DECEMBER 2016/JANUARY 2017 NEW aspirin • atorvastatin • ramipril The 1st polypill licensed for secondary prevention of cardiovascular events in Ireland Trinomia 100 mg/20 mg/10 mg, 100 mg/20 mg/5 mg, 100 mg/20 mg/2.5 mg hard capsules (acetylsalicylic acid, atorvastatin (as atorvastatin calcium trihydrate) and ramipril) Abbreviated Prescribing Information Please consult the Summary of Product Characteristics (SmPC) for full prescribing information. Presentation: Hard capsules containing: two 50 mg acetylsalicylic film-coated tablets, two 10 mg atorvastatin film-coated tablets and one 10 mg ramipril film-coated tablet; or two 50 mg acetylsalicylic filmcoated tablet, two 10 mg atorvastatin film-coated tablets and one 5 mg ramipril film-coated tablet; or two 50 mg acetylsalicylic film-coated tablet, two 10 mg atorvastatin film-coated tablets and one 2.5 mg ramipril film-coated tablet. Uses: Secondary prevention of cardiovascular accidents as substitution therapy in adult patients adequately controlled with the monocomponents given concomitantly at equivalent therapeutic doses. Dosage: Oral administration. 1 capsule per day, preferably after a meal. Swallow with liquid. Do not chew or crush. Avoid grapefruit juice. Patients currently controlled with equivalent therapeutic doses of acetylsalicylic acid, atorvastatin and ramipril can be directly switched. Treatment initiation should take place under medical supervision. Cardiovascular prevention, target maintenance dose of Ramipril is 10 mg once daily. Daily dose in renal impairment based on creatinine clearance - ≥ 60 ml/min, maximum daily dose is 10 mg ramipril; 30-60 ml/min, maximum daily dose is 5 mg ramipril. Contraindicated in hemodialysis and/or with severe renal impairment (creatinine clearance <30 ml/min). Administer with caution with hepatic impairment. Perform liver function tests before initiation of treatment and periodically thereafter. Maximum daily dose of is 2.5 mg ramipril and initiate treatment under close medical supervision. Contraindicated in severe or active hepatic impairment. Start treatment in very old and frail patients with caution. Contraindications: Hypersensitivity to any component, to other salicylates, to NSAIDs, to any other ACE inhibitors, tartrazine, soya or peanut. History of previous asthma attacks or other allergic reactions to salicylic acid or other NSAIDs. Active, or history of recurrent peptic ulcer and/or gastric/intestinal haemorrhage, other kinds of bleeding. Haemophilia and other bleeding disorders. Severe kidney and liver impairment. Hemodialysis. Severe heart failure. Concomitant treatment with methotrexate at a dosage of 15 mg or more per week. Concomitant use with aliskiren-containing products with diabetes mellitus or renal impairment. Nasal polyps associated with ashma induced or exacerbated by acetylsalicylic acid. Active liver disease or unexplained persistent elevations of serum transaminases. Pregnancy, lactation and in women of childbearing potential not using appropriate contraceptive measures. Concomitant treatment with tipranavir, ritonavir, ciclosporin. History of angioedema. Extracorporeal treatments leading to contact of blood with negatively charged surfaces. Significant bilateral renal artery stenosis or renal artery stenosis in a single functioning kidney. Hypotensive or haemodynamically unstable states. Children and adolescents below 18 years of age. Warnings and Precautions: Only for use as a substitution therapy in patients adequately controlled with the monocomponents given concomitantly at equivalent therapeutic doses. Special populations requiring particularly careful medical supervision: Hypersensitivity to other analgesics/ antiinflammatory/antipyretic/antirheumatics or other allergens. Other known allergies, bronchial asthma, hay fever, swollen nasal mucous membranes and other chronic respiratory diseases. History of gastric or enteric ulcers, or of gastrointestinal bleeding. Reduced liver and/or renal function. Particular risk of hypotension: strongly activated renin-angiotensin-aldosterone system, transient or persistent heart failure post MI, risk of cardiac or cerebral ischemia, in case of acute hypotension medical supervision including blood pressure monitoring is necessary. Deterioration of cardiovascular circulation. Glucose 6 phosphate dehydrogenase deficiency. Risk of elevated levels of uric acid. Consumption of substantial quantities of alcohol and/or have a history of liver disease. Diagnosed pregnancy, stop treatment immediately, and, if appropriate, start alternative therapy. ACE inhibitors cause higher rate of angioedema in black patients than in non-black patients. The blood pressure lowering effect of ACE inhibitors is somewhat less in black patients than nonblack patients. Monitoring during treatment is required for: Concomitant treatment with NSAIDs, corticosteroids, SSRIs, antiplatelet drugs, anticoagulants. Signs or symptoms suggestive of liver injury. Stop treatment temporarily prior to elective major surgery and when any major medical or surgical condition occurs. Particularly careful monitoring is required in patients with renal impairment, risk of impairment of renal function, particularly with congestive heart failure or after a renal transplant. Risk of development of hyperkalaemia – regular monitoring of serum potassium recommended. Specific side-effects: Perform liver function tests periodically if hepatic effects occur. May affect the skeletal muscle and cause myalgia, myositis, and myopathy that may progress to rhabdomyolysis, ask patients to promptly report skeletal muscle effects (muscle pains, cramps or weakness) especially if accompanied by malasie or fever and measure CK levels, stop treatment if significantly elevated or if severe muscular symptoms occur. Do not co-administer with systemic fusidic acid or within 7 days of stopping fusidic acid. Where use of systemic fusidic acid considered essential, discontinue statin treatment during fusidic acid treatment. Reports of rhabdomyolysis in patients receiving fusidic acid and statins in combination. Where prolonged systemic fusidic acid needed, consider need for co-administration of Trinomia and fusidic acid on case by case basis with close medical supervision. Discontinue statin treatment if interstitial lung disease occurs. Monitor patients at risk of diabetes mellitus. Discontinue treatment if angioedema occurs and initiate emergency treatment promptly. Concomitant use of ACE-inhibitors and angiotensin II receptor blockers or aliskiren is not recommended and should not be used in patients with diabetic nephropathy. Anaphylactic reactions during desensitization, consider temporary discontinuation of Trinomia during desensitization. Monitor white blood cells for neutropenia/agranulocytosis and more regularly in the initial phase of treatment, impaired renal function, concomitant collagen disease and other mediciens that can change the blood picture. Cough. Contains lactose. Patients with rare hereditary problems of galactose intolerance, the Lapp lactase deficiency or glucose-galactose malabsorption should not take this medicine. Interactions: Acetylsalicylic acid: other platelet aggregation inhibitors, other NSAIDs,and antirheumatics, systemic glucocorticoids, diuretics, alcohol, SSRIs, uricosuric agents, anticoagulant and thrombolytic therapy, digoxin, antidiabetic agents including insulin, methotrexate, valproic acid, , antacids, ACE inhibitors, ciclosporin, vancomycin, interferon ∝, lithium, barbiturates, zidovudine, phenytoin, laboratory tests. Atorvastatin: CYP3A4 inhibitors, CYP3A4 inducers, transport protein inhibitors, gemfibrozil/fibric acid derivatives, ezetimibe, colestipol, fusidic acid, colchicine, digoxin, oral contraceptives, warfarin. Ramipril: potassium salts, heparin, potassiumretaining diuretics and other plasma potassium increasing active substances, antihypertensive agents and other substances that may decrease blood pressure, vasopressor sympathomimetics and other substances, allopurinol, immunosuppressants, corticosteroids, procainamide, cytostatics and other substances that may change the blood cell count, lithium salts, antidiabetic agents including insulin. Monitor as appropriate. Pregnancy and Lactation: Contraindicated in pregnancy. Not recommended during lactation. Women of child-bearing potential should use effective contraception during treatment. Side Effects: Ramipril: Common (≥ 1/100, <1/10): dyspepsia, nausea, diarrhoea, vomiting, digestive disturbances, abdominal discomfort, gastrointestinal inflammation, non-productive tickling cough, bronchitis, sinusitis, dyspnoea, headache, dizziness, rash in particular maculo-papular, blood potassium increased, myalgia, muscle spasms, chest pain, fatigue, hypotension, orthostatic blood pressure decreased, syncope. Atorvastatin: Common: dyspepsia, nausea, diarrhoea, constipation, flatulence, pharyngolaryngeal pain, epistaxis, nasopharyngitis, headache, allergic reactions, hyperglycaemia, myalgia, muscle spasms, pain in extremity, joint swelling, back pain, arthralgia, liver function test abnormal, blood creatine kinase increased. ASA: Very Common (≥ 1/10): Gastrointestinal complaints such as heartburn, nausea, vomiting, stomach ache and diarrhea, minor blood loss from the gastrointestinal tract (micro-bleeding). Common: Paroxysmal bronchospasm, serious dyspnoea, rhinitis, nasal congestion. For less frequent side effects see SmPC. Pack Sizes: Blister containing 28 film-coated tablets. Legal Category: POM. Product Authorisation Numbers: PA 1744/002/001-003. Product Authorisation Holder: Ferrer Internacional, S.A., Gran Vía Carlos III, 94, 08028 Barcelona, Spain. Marketed by: A. Menarini Pharmaceuticals Ireland Ltd. Further information is available on request from A. Menarini Pharmaceuticals Ireland Ltd, 2nd Floor, Castlecourt, Monkstown Farm, Monkstown, Glenageary, Co. Dublin A96 T924 or may be found in the SmPC. Date of Preparation: September 2016 Date of item: September 2016. IR-Tri-012-2016 Clanwilliam Pharmacist Awards Winners 2016 Excellence in Community Pharmacy Award Matt Cooper, Ultan Molloy, Kathy Maher (Haven Pharmacy Duleek, Co. Meath), Collin Botha (Teva) and Jennifer Hughes. “Of course, the Awards are also the key annual fundraising event for the Pharmacy Benevolent Fund charity, which supports those associated with pharmacy who are in need of assistance.” Clare Long, Foynes Pharmacy, Co. Limerick, was presented the Patient Nominated Award, which was sponsored by the IPU. Clare was nominated for the award for her astounding dedication to her patients, her kindness, sensitivity and manner. One patient described how the Limerick-based pharmacist, who is originally from Kerry, helped to support her family and her husband after he was diagnosed with terminal cancer. “We felt very safe in her hands and she went above and beyond to help us,” the patient explained. Another described how “nothing is ever a problem for her, even if the shop is full of people, she never rushes you and always makes you feel as if she has all the time in the world to explain things to you.” The Liz Herbert Memorial Lifetime Achievement Award was bestowed on Anne Mooney. Anne spent much of her career working within and as Chief Pharmacist Young Pharmacist of the Year Award (L-R): Matt Cooper, Ultan Molloy, Cormac Spooner (Barry’s CarePlus Pharmacy, Templeogue, Dublin), Richard Collins (Pharmawealth) and Jennifer Hughes. 10 Excellence in Hospital Pharmacy Award (L-R): Matt Cooper, Ultan Molloy, Jennifer Brown (Mater Hospital, Dublin), Shane O’Connor (Sanofi) and Jennifer Hughes. at Connolly Hospital Blanchardstown, Dublin. During her time there, Mrs Mooney worked closely with consultants on patient care, campaigned to ensure pharmacists were able to continue to procure medicines and worked to raise the profile of hospital pharmacists. She also spent some time in her early career working abroad in Tanzania, and later in Kenya, where she set up and trained people in how to develop an IV production system. Mrs Mooney also played an active role in the Hospital Pharmacists Association of Ireland. Speaking at the Awards, Mrs Mooney said, “I’m humbled and honoured to receive the award. I never met Liz Herbert but what I have heard about her is that she was a dynamic sort of person who didn’t just do her day job, but much more, and I am proud to be associated.” Overall Pharmacist of the Year went to IPU Past President Kathy Maher. Kathy, of Haven Pharmacy Duleek, Co. Meath, also won the Excellence in Community Practice Award. Jennifer Hughes, Director of Marketing, Clanwilliam Group, said, “Clanwilliam Pharmacist Contribution to the Community Award (L-R): Matt Cooper, Ultan Molloy, Adrienne Stack (Stack’s Pharmacy), Danny Lynskey (Pinewood Healthcare) and Jennifer Hughes. IPUREVIEW DECEMBER 2016/JANUARY 2017 Easofen Easofen––for forthe therelief reliefofofpain pain Easofen Easofen 200mg 200mg film-coated film-coated tablets. tablets. Easofen Easofen MaxMax Strength Strength 400mg 400mg film-coated film-coated tablets. tablets. Ibuprofen. Ibuprofen. Clonmel Clonmel Healthcare Healthcare Ltd.,Ltd., Waterford Waterford Road, Road, Clonmel, Clonmel, Co. Tipperary. Co. Tipperary. A copy A copy of the of summary the summary of product of product characteristics characteristics is available is available on request. on request. Medicinal Medicinal product product available available for retail for retail salesale through through pharmacy pharmacy only.only. 2016/ADV/IBU/026. 2016/ADV/IBU/026. DateDate prepared: prepared: February February 20162016 Clanwilliam Pharmacist Awards Winners 2016 Practice Based Research Award (L-R): Matt Cooper, Ultan Molloy, Susan O’Dwyer (Boots Ireland), Filipe Infante (hmR) and Jennifer Hughes. Professional Excellence Award (L-R): Matt Cooper, Ultan Molloy, Mary Rose Burke (Dublin Chamber of Commerce), Gillian Grealy (Pfizer) and Jennifer Hughes. Pharmacist Led Team Award (L-R): Matt Cooper, Ultan Molloy, Leonora O’Brien (Pharmapod), Karen Walsh (Abbvie) and Jennifer Hughes. Excellence in Locum Pharmacy (L-R): Matt Cooper, Ultan Molloy, Lorraine Ward, Anthony O’Brien (Clarity Locums) and Jennifer Hughes. Health, part of Clanwilliam Group, is delighted to be on board sponsoring the Pharmacist Awards, which recognise the immense talent of the pharmacy community in Ireland. We are fortunate to have incredibly dedicated pharmacists in Ireland who go above and beyond for their patients every single day. We especially congratulate Anne Mooney, recipient of the Liz Herbert Memorial Lifetime Achievement Award, an inspiring figure with an admirable career.” 12 Rachel Gubbins, President of the Pharmacy Benevolent Fund, added, “I would like to thank the Awards Committee and Clanwilliam Group for the immense support they continue to give to the Pharmacy Benevolent Fund. This support allows us to extend a helping hand to our colleagues and their families who are experiencing financial difficulty at this time.” The Award Winners were: n Patient Nominated Award, sponsored by IPU: Clare Long, Foynes Pharmacy, Co. Limerick. n Excellence in Community Pharmacy Award, sponsored by TEVA: Kathy Maher, Haven Pharmacy Duleek, Co. Meath. n Excellence in Hospital Pharmacy Award, sponsored by Sanofi: Jennifer Brown, Mater Hospital, Dublin. nPharmacist-Led Team Award, sponsored by Abbvie: Leonora O’Brien, Pharmapod. n Excellence in Locum Pharmacy Award, sponsored by Clarity Locums: Lorraine Ward. n Practice Based Research Award, sponsored by hmR: Susan O’Dwyer, Boots Ireland. IPUREVIEW DECEMBER 2016/JANUARY 2017 INTENSIVE W E N FAST, TARGETED RELIEF FOR UP TO 6h Help your customers forget about sore throat with Strepsils Intensive Throat Spray Provides fast targeted relief for up to 6 hours Compact handy bottle to directly target the throat INTENSIVE Spray Important: Strepsils Intensive 8.75 mg/dose Oromucosal Spray contains Flurbiprofen indicated for the short term symptomatic relief of acute sore throat in adults. Not suitable for use in those under 18 years of age. Item Number: IRL/SP/0916/0006 Date of Prep: September 2016 Max duration of use 3 days. ALWAYS READ THE LABEL Clanwilliam Pharmacist Awards Winners 2016 Overall Pharmacist of the Year (L-R): Matt Cooper, Ultan Molloy, Kathy Maher (Haven Pharmacy Duleek, Co. Meath), Paul Reilly (United Drug) and Jennifer Hughes. nProfessional Excellence Award, sponsored by Pfizer: Mary Rose Burke, Dublin Chamber of Commerce . n Pharmacist Contribution to the Community Award, sponsored by Pinewood Healthcare: Adrienne Stack, Stack’s Pharmacy. n Young Pharmacist of the Year Award, sponsored by Pharmawealth: Cormac Spooner, Barry’s CarePlus Pharmacy, Templeogue, Dublin. Liz Herbert Memorial Lifetime Achievement Award (L-R): Matt Cooper, Ultan Molloy, Anne Mooney, Padraic Ferguson (JPA Brenson Lawlor) and Jennifer Hughes. n Overall Pharmacist of the Year Award, sponsored by United Drug: Kathy Maher, Haven Pharmacy Duleek, Co. Meath. n The Liz Herbert Memorial Lifetime Achievement Award, sponsored by JPA Brenson Lawlor: Anne Mooney. “The Awards allow us to recognise those pharmacists who are going the extra mile for their patients, their peers and the pharmacy sector as a whole every day.” Ultan Molloy, Clanwilliam Pharmacist Awards Committee Chairperson GET THE RETAIL FACTOR IN YOUR PHARMACY. For further information on the IPU Retail Review service, please contact Darren Kelly on (01) 493 6401 / 086 028 9825 or email: [email protected] IPU Retail Banners 190X45 MAR16 ART.indd 4 14 25/03/2016 17:55 IPUREVIEW DECEMBER 2016/JANUARY 2017 5-7 May 2017 | Croke Park, Dublin BOOKING OPENS JANUARY 2017 The IPU National Pharmacy Conference will take place from 5-7 May in Croke Park, Dublin. Registration for the Conference will open next month through the Conference website, where you will be able to get full details of the educational sessions and book your place and accommodation. We look forward to seeing you there! SUPPORTED BY www.pharmacyconference.ie BUSINESS IPU Member Assistance Programme The Member Assistance Programme (MAP) is a free and confidential counselling and information support service. The service is available for IPU members and their family to provide assistance in coping with a variety of issues, including those related to working in the health profession and concerns at home. T he MAP is provided by Vhi Corporate Solutions, who follow strict ethical guidelines and codes of practice, meaning that any contact with IPU members and their 16 families remains completely confidential. The service is widely used by IPU members and during 2016, issues such as work stress, emotional health, finances and anxiety were of primary concern. IPUREVIEW DECEMBER 2016/JANUARY 2017 Key Features of MAP n Free to members n Available 24/7 n Confidential n Independent n Solution-focused n Available to you and your family Telephone counselling Through the Member Assistance Programme, IPU members have access to telephone counselling 24 hours a day, seven days a week. Telephone Counsellors make a constructive effort from the very first phone call to determine a client’s anticipated outcome and ascertain the best and most appropriate intervention going forward. There is no limit to how many times IPU members can avail of MAP telephone support. members have access to up to eight sessions of face-toface counselling per issue, per year and appointments can be made at a location convenient to members. Information service The MAP also provides access to a Specialist Information Service from 8:00am to 10:00pm, Monday to Friday, and 9am to 5pm weekends and Bank Holidays. All callers have direct access to qualified and experienced Information Specialists. The Specialist Information Service can be accessed by telephone and email. The MAP information specialists also have access to in-house databases that are updated regularly to ensure that individuals receive upto-the-minute information, options and support. There is no limit to the number of times individuals can call and a wide range of issues are covered, including but not limited to: n Consumer n Education Career coaching This support is suitable for an employee who has questions or concerns about career and performance and wants to explore these work-related issues in a confidential manner. Typically, over a number of sessions, members are supported in identifying and evaluating their own strengths, weaknesses, opportunities and threats to progression. Coaching will support members in utilising their skills and competence more effectively. Parent coaching Parenting today is not an easy job. There are times when we can all use a little extra support and information to get us through normal parenting challenges. By listening in a confidential and supportive way, our trained staff can help identify what the problem is and to identify goals and develop strategies to work towards solutions. The types of issues that can be dealt with are: n Eldercare n Coping with Change Face-to-face counselling n Property n Moving House MAP also offers access to our network of face-toface counsellors. The type of counselling available is called ‘Solution-Focused Short-Term Counselling’ and works with current issues in a goal-orientated manner. IPU n Financial n New School n Legal n Bereavement n Debt n Self-esteem, Anxiety and Bullying n Taxation and State Benefits n Sibling Issues n Dealing with Challenging Behaviour n Identifying strengths as a Parent LiveWell website The LiveWell website has also been rolled out to IPU members as part of their Member Assistance Programme. The website is an extensive resource of fact sheets and articles across a wide range of areas including finances, property, legal, mental health, parenting and working concerns. The website can be accessed through www.wellbeing4life.com (the exclusive IPU password is available by contacting the service at the details below). The site also includes useful support tools such as the new Personal Empowerment Programme (PEP). The self-help PEP helps individuals to understand the strong link between thinking and actions through a variety of interactive tools including videos, mindfulness tools, learning modules and exercises. How do I contact the service? It couldn’t be simpler. The MAP is available 24 hours a day, 365 days a year through: Freephone 1800 995 955 or [email protected]. ”IPU members have access to up to eight sessions of face-to-face counselling per issue, per year and appointments can be made at a location convenient to members.” IPUREVIEW DECEMBER 2016/JANUARY 2017 17 NEWS PSI publishes Future Pharmacy Practice report On 23 November, the PSI published a significant research report that presents a vision for the future of pharmacy practice in Ireland. The report, Future Pharmacy Practice in Ireland – Meeting Patients’ Needs, is the culmination of an extensive consultation and informationgathering process involving patients, healthcare professionals, including pharmacists, other regulatory bodies, and engagement with the Department of Health, HSE and others. T he project was commissioned by the PSI Council in the summer of 2015 to seek to address challenges facing the health service and to see where pharmacists might play a fuller role to address the needs of patients, both independently and as part of multidisciplinary teams. The significant level of engagement involved in this project has helped to identify how patients consider pharmacists could best use their skills, and where policymakers believe pharmacists could contribute more valuably to the healthcare system to ensure the needs of patients are being met in the most cost-effective way. Launching the report were Dr Norman Morrow, former Chief Pharmaceutical Officer at the Department of Health, Social Services and Public Safety in Northern Ireland, and Niall Byrne, Registrar, PSI. 18 IPUREVIEW DECEMBER 2016/JANUARY 2017 Product Information Lysopadol Mint 20 mg Lozenges ambroxol hydrochloride 20 mg. Lysopadol Lemon 20 mg Lozenges ambroxol hydrochloride 20 mg. Indication: Pain relief in acute sore throat. Dose and administration: Adults and children over 12 years: up to 6 lozenges to be sucked per day. Not to be used for more than 3 days. Contraindications: Hypersensitivity to ambroxol hydrochloride or any of the excipients, patients with fructose intolerance as the lozenges contain sorbitol. Warnings and precautions: If symptoms or signs of a progressive skin rash (sometimes associated with blisters or mucosal lesions) are present, ambroxol hydrochloride treatment should be discontinued immediately and medical advice should be sought. Exercise caution in patients with rare hereditary problems of galactose intolerance, the Lapp lactase deficiency or glucose-galactose malabsorption, impaired renal function or severe hepatopathy. Not suitable for the treatment of oral ulcers. Pregnancy and lactation: Not to be taken in pregnancy, especially the first trimester, and during breast feeding, unless the expected benefit is thought to outweigh any possible risk. Side effects: Uncommon: diarrhoea, upper abdominal pain, dyspepsia, dry mouth. Common: dysgeusia, oral and pharyngeal hypoaesthesia, nausea. Rare: Hypersensitivity reactions, dry throat, rash, urticaria. Not known: Severe cutaneous adverse reactions (including erythema multiforme, Stevens-Johnson syndrome/toxic epidermal necrolysis and acute generalized exanthematous pustulosis), anaphylactic reactions including anaphylactic shock, angioedema, pruritus, vomiting. Pack size: 18 lozenges. Legal category: Retail sale through pharmacies. Product authorisation numbers: PA 7/63/1 & PA 7/64/1. Product authorisation holder: Boehringer Ingelheim Limited, Consumer Healthcare, Ellesfield Avenue, Bracknell, Berkshire, RG12 8YS, UK. For further information please see Summary of Product Characteristics. Date of revision: May 2016. Lysopadol 17.86 mg/ml Oromucosal Spray ambroxol hydrochloride 2.5 mg per actuation. Indication: Pain relief in acute sore throat. Dose and administration: Adults and children over 12 years: 10 mg (4 actuations) to be sprayed into the back of the throat up to 6 times per day. Not to be used for more than 3 days. Contraindications: Hypersensitivity to ambroxol hydrochloride or any of the excipients. Warning and precautions: If symptoms worsen or persist after 3 days or if the patient has a high fever, a doctor should be consulted. If symptoms or signs of a progressive skin rash (sometimes associated with blisters or mucosal lesions) are present, ambroxol hydrochloride treatment should be discontinued immediately and medical advice should be sought. Exercise caution in patients with impaired renal function or severe hepatopathy. Contains propylene glycol which may cause mucosal irritation. Not suitable for the treatment of oral ulcers. Pregnancy and lactation: Not to be taken in pregnancy, especially the first trimester, and during breast feeding, unless the expected benefit is thought to outweigh any possible risk. Side effects: Uncommon: upper abdominal pain, dyspepsia, dry mouth. Common: dysgeusia, oral and pharyngeal hypoaesthesia, nausea. Rare: Hypersensitivity reactions, dry throat, rash, urticarial, diarrhoea. Not known: Severe cutaneous adverse reactions (including erythema multiforme, Stevens-Johnson syndrome/toxic epidermal necrolysis and acute generalized exanthematous pustulosis), anaphylactic reactions including anaphylactic shock, angioedema, pruritus, vomiting. Pack size: 20 ml. Legal category: Retail sale through pharmacies. Product authorisation number: PA 7/63/2. Product authorisation holder: Boehringer Ingelheim Limited, Consumer Healthcare, Ellesfield Avenue, Bracknell, Berkshire, RG12 8YS, UK. For further information please see Summary of Product Characteristics. Date of revision: May 2016. References 1. Lysopadol Mint 20mg Lozenge SPC, Lysopadol Lemon 20mg Lozenge SPC, Lysopadol Oromucosal Spray SPC 2. De Mey C, et al. ArzneimForschDrugRes 2008; 58(11);557-568 3. Gillessen A & Hinkel U. Med Monaasschr Pharm 2005; 28(11); 399-403 Speaking on behalf of the Council at the launch of the report, PSI President Ann Frankish spoke of how the Council is conscious that the PSI must play a part in furthering effective public healthcare provision and facilitating an evolving pharmacist role in accordance with changing societal and policy demands, where there is clear patient value. Consultation In addition to the stakeholder engagement process with focus groups, interviews and meetings, the report’s development also included national and international research on healthcare trends and best practice, which provides the evidence base for change. The output of the research and consultations have informed the main report and its recommendations, but in addition, the extensive data gathered can be read as standalone supporting papers that are also made available on the PSI website. One of those supporting papers outlines details extracted from the 141 submissions made by pharmacists to the innovations portal, which gathered information on pharmacy practice in community and hospital settings that have sought to meet patients’ needs in different ways, improve medicines adherence and patients’ safety, and provide health promotion services. Recommendations The report sets out in significant detail areas in which pharmacists should provide health system support and within which they should be positioned to develop and provide a means of enhancing patient care and treatment into the future. Particularly, the project Steering Group made recommendations for future pharmacy practice in three key areas: n Pharmacist involvement in health and wellbeing initiatives through structured population health information and awareness campaigns and providing reliable, informed information to the public on preventative medicine to support the maintenance and improvement of the health of the public. n Pharmacists supporting medicines management throughout the patient care pathway with the greater application of pharmacists’ expertise through structured medication reviews for at-risk and vulnerable patients in the community and other local settings, and the greater use and sharing of pharmacists’ medicines expertise through education of both patients and other healthcare professionals in acute settings, to increase safety, ease transfer of care, reduce medication errors and optimise the use and impact of medicines for patients. The report comments on the availability of increasingly complex medicines and rising rates of polypharmacy, and how the knowledge and expertise of pharmacists should be better used to ensure the safety and efficacy of medications in all patient care settings, with the integration of the pharmacist role within the primary care team. As public and patient feedback continues to demonstrate, there is a very accessible interface between the public and a community pharmacy. With approximately two million people visiting a pharmacy every month, pharmacists are the most accessed health practitioner by those who are both healthy and ill, and n Pharmacists providing expertise in assisting patients to manage their chronic diseases and improve adherence to prescribed medicines with structured medicines initiatives, availing of ongoing disease monitoring and, where appropriate, patient access to pharmacist supplementary prescribing, which allows therapy or medicines continuation in collaboration with a patient’s GP. Evidence suggests that 2 million people visit a community pharmacy each month and that 20 million prescriptions are filled in pharmacies annually. Research indicates that 40% of Ireland’s population will have at least one chronic disease by 2020. Irish health statistics show 26% of people over 50 are using 5 or more medicines each day. 20 IPUREVIEW DECEMBER 2016/JANUARY 2017 Available in pharmacy But emergency contraception has. ellaOne® is the most effective emergency contraceptive pill1 www.ellaonepharmacists.ie exécution Further information available from: HRA Pharma, Haines House, 21 John Street, Bloomsbury, WC1N 2BF, London. Freephone: 1800 812 984. Email: [email protected] 30, rue Saint-Augustin 75002 PARIS (France) tél. : +33 (0)1 42 66 46 fax : +33 (0)1 42 66 4 www.byagencydesign. ÉTAPE / STEP : 01 DATE : 13 / 03 / 14 DOCUMENT D’EXÉCUTION / ARTWORK FILE : HRA Pharma Women Health Circle Quadri Com CLIENT : HRA Pharma FICHIER / FILE : HRA Pharma Women Health Circle Quadri Com.eps LOGICIEL / SOFTWARE : Illustrator CS6 DIMENSIONS / SUPPLIER : ÉCHELLE / SCALE : 100 % Adverse events should be reported. Reporting forms and information can be found at www.hpra.ie. Adverse events should also be reported to HRA UK & Ireland Ltd on Freephone: 1800 812 984 or email: [email protected] *unprotected sexual intercourse 1. Glasier AF et al. Lancet 2010; 375: 555-62. Date of preparation: March 2016 PLAN / CUTTING LINES : IMPRESSION / PRINTING PROCESS : OFFSET SUPPORT / PRINTING MEDIUM : WHITE CARDBOARD POLICES / FONTS : GILL SANS IE/ELLA/0216/0003 DOCUMENT TECHNIQUE RÉALISÉ EN ARTWORK REALISED IN 4 COULEURS PROCESS CL Quadri C 86, M 100, J 30 C40, M30, J30, N0 C 68, M 72, J 0, N 0 GillSans Bold artwork BRAILLE : DOCUMENT D’EXÉCUTION Ce document nécessite l’aperçu de la surimpression pour sa visualisation complèt WARNING l’impression de la surimpression pour effect une sortie correcte. La réalisation technique que la surimpression des encres, les grossi-maigri, le recouvrements, restent à l’entière charge de l’imprime La taille et les positionnements des Gencods sont à vali par le fabricant. Un BàT imprimeur doit être soumis a client avant l’impression définitive. ARTWORK FILE Please make sure to check the artwork with the Overpr Preview is on. Trapping, overprint colours, colour adjustments, must be processed in photoengrav Barcods must be checked by the Printer. A Printer Approval is required before the final printin wellness strategy and oversee the safety and efficacy of medicines use.” Also speaking at the report launch was Dr Norman Morrow, the former Chief Pharmaceutical Officer at the Department of Health, Social Services and Public Safety in Northern Ireland. He chaired the project’s Steering Group, appointed by the PSI Council to oversee the project. “This report puts patients at its centre, seeing how their needs can be best met. It is not designed to be selfserving or to present a ‘wish list’ of services, rather the identification of what patients’ needs will be in the future, particularly mindful of their safety, and the recognition of the role that pharmacy can play as part of the solution to the formidable healthcare challenges facing the country,” Dr Morrow said. the report points to the ideal position pharmacists are in to support patients to protect and improve their health and further contribute to the national health and wellbeing strategy. In particular, patients with chronic diseases are already frequent pharmacy visitors, and in recognition of the growing burden of chronic disease and inherent risk of multiple drug therapies, there is opportunity for better integration of pharmacy with the rest of the healthcare team to support patient self-management of their conditions. The report emphasises the well-informed, professional resource that pharmacists can provide and suggests their greater inclusion in early intervention initiatives aimed at keeping the nation well. Available network and resource Speaking about the report, Dr Ann Frankish said, “We hope that the findings and recommendations will be used by policy-makers to guide them in the future direction of pharmacy in Ireland, which can valuably contribute to the health and wellbeing of patients. The report acknowledges the available network and resource of pharmacists with the opportunity to make the most appropriate use of their knowledge and professional insight to support and promote the national health promotion ABC Advert and JULY2014.pdf Collaboration and inspiring leadership There is an underlying focus on collaborative and integrated care throughout the report. In this regard, the PSI has said that engagement with health service providers and other healthcare professionals in the course of broad consultations was very encouraging. In addition, insight has been gained into government policy and priorities and how pharmacy and pharmacists could potentially contribute in the future in the most costeffective way. 1 28/07/2014 14:41 Dr Morrow spoke about the report as a roadmap offering a direction of travel for the profession within the context of Government strategy and reform that will provide for multidisciplinary teams and a more integrated approach to managing care of the public, and said, “My hope is that it will inspire leadership and innovation and will empower pharmacy to play its full part within the healthcare system in Ireland so that it supports the public in healthy lifestyle choices and in managing patient conditions to offer better quality of life.” Insight was supported by the varied membership of the previously mentioned project Steering Group, which included representatives of the Department of Health, the HSE, a health service user and patient advocate, pharmacists from different practice areas and a medical doctor nominated by the Medical Council. In addition, they were supported by a community pharmacy and a hospital pharmacy subgroup, all of whom met several times in the course of the report’s development. The report recognises the necessary enablers to implementing the recommendations and to support the development of future pharmacy practice. This includes ongoing research, regulation and governance, education, continuing professional development and continued investment in IT. The report also identified that leadership by the profession and collaboration between healthcare professionals was a critical element in securing progress in the best interests of patients, the public and the wider health service. Progressing an integrated solution to patient care In this regard, as has been the intention of the PSI Council since its commencement, the report will be widely distributed and the PSI will continue to engage with all relevant people and organisations in the implementation of the recommendations. This report is fundamentally about patients and how the pharmacy sector, and the role of the pharmacist, can continue to contribute to public and patient care, public health improvements and efficiencies, where there is public benefit. As the health system in Ireland continues to be reformed, there is a clear need to consider how the particular medicines expertise of pharmacists could be an integrated solution to patient and healthcare demands. The PSI presents the report in the knowledge that it too has a role to play in ensuring pharmacists’ education, training and practice standards can meet these changes in the future care of patients. The report and its supporting research papers are available on the PSI website, www.psi.ie. A BC STOCKTAKING SERVICES C M PHARMACY SPECIALISTS | SAME DAY AUDITABLE REPORTS LIVE STOCK INTEGRATION WITH: Y CM MY CY CMY K 44 Church Street, Tullamore, Co. Offaly Phone/Fax 057 93 20045 Alan Daly – Director 087 2666431 Darren Donoghue – Manager 086 3809082 22 IPUREVIEW DECEMBER 2016/JANUARY 2017 Voltarol® Emulgel® 2% w/w Gel EXTRA STRENGTH Voltarol® Emulgel® Extra Strength 2% w/w Gel for the relief of pain and inflammation. Contains diclofenac diethylammonium. Always read the label / leaflet. Diclofenac Diethylammonium Product Information: Please consult the Summary of Product Characteristics for full product information. Voltarol Emulgel Extra Strength 2% w/w Gel (diclofenac). Indications: For the local symptomatic relief of pain and inflammation in trauma of tendons, ligaments, muscles and joints, localised forms of soft tissue rheumatism. Dosage: Adults and adolescents 14 years and over: 2g to 4g of gel, applied topically 2 times daily – morning and evening. It is recommended that treatment to be limited to 7 days. Patients should consult their doctor if the condition does not improve. Contraindications: Patients with or without chronic asthma in whom attacks of asthma, urticaria or acute rhinitis are precipitated by aspirin or other non-steroidal anti-inflammatory agents. Hypersensitivity to diclofenac, acetylsalicylic acid or other non-steroidal anti-inflammatory drugs. Hypersensitivity to any other ingredient of the gel. Use in third trimester of pregnancy, in children and adolescents aged less than 14 years is contraindicated. Warnings and Precautions: Caution with oral NSAIDs as may result in unwanted side effects. Avoid use with other products containing diclofenac. Apply only to intact, non-diseased skin and not to skin wounds or open injuries. It should not be used with occlusion. It should not be allowed to come into contact with the eyes or mucous membranes, and should never be taken by mouth. Application over extensive areas for prolonged periods or application in excess of recommended dosage may give rise to systemic effects. These include gastrointestinal disturbances and bleeding, irritability, fluid retention, rash, hepatitis, renal dysfunction, anaphylaxis and rarely blood dyscrasias, bronchospasm and erythema multiforme. Discontinue if rash develops. Use with caution in patients with a history of peptic ulcers, gastrointestinal bleeding, hepatic or renal insufficiency, or bleeding diathesis, or intestinal inflammation. Pregnancy and Lactation: The systemic concentration of diclofenac is lower after topical administration, compared to oral formulations. During the first and second trimester of pregnancy, diclofenac should not be given unless clearly necessary. Only use during lactation on the advice of a health professional. Diclofenac is contraindicated during the third trimester of pregnancy. Should not be applied on the breasts of nursing mothers, nor elsewhere on large areas of skin or for a prolonged period of time. Side effects: Very rare: rash pustular, hypersensitivity (including urticaria), angioedema, asthma, photosensitivity reaction. Rare: Dermatitis bullous. Common: Dermatitis (including contact dermatitis), rash, erythema, eczema, pruritus. Overdose: The low systemic absorption of topical diclofenac renders overdosage extremely unlikely. MA Holder: GlaxoSmithKline Consumer Healthcare (Ireland) Limited, 12 Riverwalk, CityWest Business Campus, Dublin 24, Ireland. MA Number: PA 678/140/3. Legal Category: Pharmacy only. Text revised: October 2016. Further information available on request. Trade marks are owned by or licensed to the GSK group of companies. CHGBI/CHVOLT/0245/16 PROFESSIONAL Aoibheann Ní Shúilleabháin, Communications Manager, IPU IPU advertising campaigns – promoting the role of the pharmacist The IPU runs annual advertising campaigns promoting ‘Ask Your Pharmacist First’ to the public, highlighting the role of the pharmacist and encouraging the public to make their local pharmacy their first port of call for their healthcare needs. In this article, Aoibheann Ní Shúilleabháin, Communications Manager, IPU, provides an overview of the effectiveness of the campaign. 24 T he 2016 campaign built on the success of the national radio and TV advertising campaigns in 2014 and 2015, with social media becoming a key component of this year’s campaign. The 2016 advertising campaign consisted of six segments: four bursts of radio ads and two television ads. The ads were broadcast at different stages throughout the year, according to the issue being highlighted, and received extensive national airplay. The first ad campaign of the year was the Flu Vaccination radio ad, which ran in early January. The timing of the ad served as a reminder IPUREVIEW DECEMBER 2016/JANUARY 2017 “The IPU advertising campaigns aim to highlight the professional services provided to the public. The IPU will continue to promote the role of the pharmacist to members of the public, the media, politicians and other stakeholders.” to the public to ask their pharmacist about the flu vaccination. The ad ran for one week on RTÉ Radio 1 and Newstalk, and regional radio stations including Highland Radio, Radio Kerry, Midlands 103, Q102, Limerick Live, Galway Bay and WLR. The ad would have been heard by 75% of adults 55+, with the opportunity to hear the ad 4.3 times. The next burst of radio ads aired on 9 May and encouraged people to ‘Ask Your Pharmacist First’ about their hay fever symptoms and the best treatment options available. The target audience for the media plan changed from the flu vaccination ad, as it is a different cohort of patients that may be coming to pharmacies for hay fever advice. The ad ran for one week on Today FM and 2FM, as well as regional radio stations such as IRadio, 4FM, Cork 96/103 and 98FM. The first of our television ads returned to our screens at the beginning of June. TV is an effective medium to allow us to engage with patients and communicate the valuable role of community pharmacists to a large audience. The ‘Toe to Go’ TV ad, which ran for three weeks, highlights the importance of seeking healthcare advice from a trusted healthcare professional. The media plan, developed by Language and ZenithOptimedia, performed extremely well, with good placement of the ad at peak IPUREVIEW DECEMBER 2016/JANUARY 2017 times and in the position in the ad break. The ad was broadcast on RTÉ One, RTÉ 2, TV3, 3E, UTV Ireland, TG4 and SKY Media package and appeared during key programmes such as Coronation Street, RTÉ One’s Nine News, Tonight with Vincent Browne, UEFA Euro 2016, Nationwide, Emmerdale and The Chase. 55% of all adults would have seen the TV ad at least once. The ad also appeared on Video on Demand and YouTube from 6 June for six weeks. Total impressions delivered were 505,426, with an above-average of 85% video completion rate. The ad also appeared on Farm TV, which is broadcast at 21 livestock marts around the country, providing an audience reach of 24,200 farmers per week. The next burst of radio ads ran in September to coincide with the beginning of the 2016-2017 flu season. The ad ran for one week again, with posters and leaflets available to download from the IPU website to complement the ads. A video was also created, highlighting the pharmacy flu vaccination service, and was broadcast on Farm TV, as well as at the National Ploughing Championships, which had an attendance of 283,000 people. The second of our TV ads was broadcast during October and ran for three weeks. The ad exaggerates the notion of people getting the wrong advice online and uses humour to engage the audience. The message delivered at the end of the ad is clear and unambiguous: ask your pharmacist first for advice you can really trust. The target audience for this TV ad was young men. The ad was broadcast during top programming such as RTÉ One’s Six-One News, RTÉ One’s Nine News, Tonight with Vincent Browne and Emmerdale. The ad would have been seen by over two million adults at least once. On Video on Demand, total impressions delivered was 408,122. Due to the content of the ad (using the internet for health advice), we expanded the media plan to include Facebook in the mix. The ad performed exceptionally well, with 302,796 views. The social sentiment was positive on Facebook and there was a total of 199,424 people taking action on the post, i.e. reacting, commenting and sharing the video post. 75% of people who watched the video were male, with the largest audience to engage with the ad being men aged 25-34 years old; thus, reaching our target audience. Another radio ad ran from 5 December for one week, highlighting the Christmas gift ideas that are available in pharmacies. The target audience for the ad was 18-34 year olds, with the ad expected to reach 63% of this cohort and 49% of all adults. Community pharmacies are the most accessible part of the healthcare system and pharmacists and pharmacy staff play a vital role in the primary healthcare system. The IPU advertising campaigns aim to highlight the professional services provided to the public. The IPU will continue to promote the role of the pharmacist to members of the public, the media, politicians and other stakeholders. 25 COMMERCIAL FEATURE Sarah Sambrooks, OTC & Front of Counter Trading Manager, Uniphar What to do about wellness in pharmacy? Allcare has some answers Allcare has been looking into the wellness category. We have done research with customers on wellness and piloted a new dedicated Wellness section in three stores across the country. We share some of the findings of the research and Ian McLaren, pharmacist in Clearwater Allcare Pharmacy tells us about his experience of the pilot in his store. I n the last five years, the interest in healthy lifestyle/ wellness and all the products and services that go with it has grown exponentially, as a visit to your local supermarket will tell you. Now estimated to be worth more than $3 trillion worldwide, in 2002, pharmacy owned just over 16% of that market. Today, it is estimated that less than 5% of wellness spend resides with pharmacies (Euromonitor, December 2015). The Uniphar team was interested in seeing whether a new focus on Wellness would reap rewards for the Allcare stores. We planned a pilot in a number of Allcare stores and alongside that, we asked an independent research company to talk to Allcare customers and ask them about their attitudes to Wellness. We focused on Vitamin and Mineral Supplements (VMS) products and the following were some of the highlights of the research: ■ 69% of customers claimed to have taken VMS products in the last 12 months. This rose to 78% in the 18-34 age group ■ 65% said they bought their VMS products in a pharmacy, with 16% using health shops and 18% supermarkets to source their product ■ When asked what factor was of most help in buying VMS products, by far the most important to customers was well trained staff at 52%, followed by sections in store clearly laid out by brand at 19% and sections in store clearly laid out by condition (e.g. heart health, arthritis etc.) at 13% ■ 74% claim that they trust the VMS products recommended by pharmacy staff and 3 in 5 claim they prefer purchasing in pharmacy because they will get the right advice. ■ Interestingly, Wellness purchases do not appear to be overly price sensitive with 47% of respondents claiming they were willing to spend more on VMS purchased from a pharmacy and 33% were neutral on the matter. The research was carried out in September and October 2016 with a base of 487 Allcare customers responding. Allcare franchisees and managing pharmacists had access to deeper and broader range of information on Wellness and other relevant topics from the customer research. On the basis of the research, we’re hoping to extend the pilot to 12 more stores in the coming months. Uniphar will be offering a wider range of Wellness products to all its customers from January – see LinkUp for details. Wellness addresses the needs of a changing consumer Ian McClaren, Managing Pharmacist at Clearwater Allcare Pharmacy store in Dublin gives us his experience piloting a focused “Wellness” offering. T he “Wellness” project was installed in Clearwater Allcare Pharmacy in late August so we have had a few months now to assess its early impact to the pharmacy. Along with the new wellness section, we had an additional refit to increase the overall retail space. This has been a success and the feedback with customers has been excellent. I feel we have doubled the space we use now in terms of retail trade. It has modernised our look and allows for an overall improved customer experience. I feel “Wellness” addresses a need that the changing consumer now wants. We have a fully dedicated section. This marks us out as being a destination for healthy living and gives us an edge against competitors for this evergrowing market. People are living ever busier lifestyles and are choosing to spend more on self-improvement. As a Crossfit enthusiast, we are told that healthy lifestyle consists of 20% exercise and 80% what we consume. This is true for all levels from beginners to elite athletes. To support active lifestyles people now invariably turn to VMS for help. Wellness has enabled myself and our team to refocus on this growing area within the pharmacy. The new branding takes the customer on a health journey from pregnancy to young children to older customers. This helps to further this idea of a wellbeing destination. Along with the launch of this pilot scheme we received a comprehensive “Wellness” training folder for all staff members. I have found this very useful resource in my everyday job and to also to initiate staff training. The resource folder compliments the “Wellness” section and will empower staff members to sell with the correct knowledge behind each product. Since its installation we have seen a considerable increase in the VMS section on our weekly sales. Maybe it is too soon to say exactly what is driving this figure, as there are a number of factors that will ultimately feed into the increase. Overall, since it’s been launched our VMS category is up 41% on last year’s figures from a relatively good base. We have over the years constantly promoted healthy lifestyle in our store through focus days, weight loss programmes, smoking cessation, health checks and many more. Wellness compliments this ethos perfectly and serves to mark us out as a progressive, modern community pharmacy. Ian McLaren with a customer in the ‘Wellness’ section in Clearwater Allcare Pharmacy We’ve also been able to leverage “Wellness” products through the dispensary trade. We have a dedicated section that allows us to link and upsell from prescriptions. For example, we now carry a wide range of probiotics. We have wide ranging and pricing which allows us to advise the customer as to the best one for them. Overall, wellness a great addition for the community pharmacy. We look forward to developing this project both in terms of staff knowledge and new lines to become a one stop destination for health and wellbeing in our community. There is huge scope going forward with this project.” If you’re interested in becoming an Allcare franchise partner, please contact Marie McCarthy on 085 877 3771 or [email protected]. ” Since it’s been launched our VMS category is up 41% on last year’s figures, from a relatively good base.” CPD Mary Martin, Independent Consultant to Wound Care industry Self-appraisal Evaluate Document your learning Personal plan Action Wound care The physiology of wound healing is complex and intricate. It involves the related processes of tissue repair and tissue regeneration, processes which evolution has optimised and which are usually very effective. The process of uncomplicated wound healing is often described as being ‘dynamic’ because progression through the healing process is stimulated by the wound itself, which repairs quickly with minimal complications. However, if this process ceases to be dynamic and controlled, outcomes can become unpredictable and the wound is considered to have become chronic. A defining feature of chronic wounds is an alternating pattern of healing and skin breakdown, leading to delayed wound healing and frequent recurrence. Traditionally, wounds have been categorised as either acute or chronic. However, all wounds can potentially become chronic, for example, a pre-tibial laceration (acute wound) can become chronic due to underlying venous disease. It may be more useful to categorise wounds as healing or non-healing. 28 Wound healing stages The body’s response to healing commences immediately after injury and is traditionally divided into distinct, overlapping phases resulting in the full restoration of skin integrity. The progression of healing through each phase of the process is dependent on the preceding stage, e.g. the intensity and duration of the inflammatory response will affect proliferation, which, in turn, will affect remodelling of new tissue. The inflammatory response Immediately following injury, the wound may be filled with spilled blood, dead cells, foreign material and bacteria. While further blood loss is prevented by vasoconstriction and clotting, the immediate need is to prevent infection, cleanse the injured area and provide optimum conditions for progression to healing. During the inflammatory response, the initial brief constriction of blood vessels is reversed by vasodilation and blood supply to the area increases. The classic signs of inflammation may now be evident with the area surrounding the wound appearing red, hot and swollen. IPUREVIEW DECEMBER 2016/JANUARY 2017 THE PERFECT SOLUTION FOR ADVANCED WOUND MANAGEMENT SILICONE FOAM DRESSINGS TRANSPARENT FILM DRESSINGS For moderate to highly exuding wounds, ulcers, second degree burns and traumatic wounds. For superficial burns, IV sites, abrasions, lacerations, donor sites, superficial pressure ulcers and closed surgical wounds. NON ADHERENT WOUND PADS FOAM DRESSINGS For wounds with low to moderate exudate levels, sutured wounds and abrasions. For use on highly exuding wounds such as ulcers, second degree burns and traumatic wounds. SKIN CLOSURE STRIPS PARAFFIN GAUZE DRESSINGS For wound support post-operatively and for highly contoured areas of musculoskeletal movement. Soothes and promotes healing in burns, ulcers, skin grafts and traumatic wounds. SURGICAL DRESSINGS SUPER ABSORBENT DRESSINGS For low to moderately exuding wounds such as surgical incisions, minor burns, cuts and abrasions. A super absorbent dressing for moderate to highly exuding wounds, ulcers, second degree burns and traumatic wounds. FOR MORE INFORMATION AND DETAILS ON TRAINING ON WOUNDCARE FREEPHONE: 1800 307 777 Fleming Medical LTD, Corcanree Business Park, Limerick, Ireland Email: info@flemingmedical.ie www.flemingmedical.ie Neutrophils are attracted to the damaged tissue where they defend against infection and are responsible for cleaning the wound by ingesting bacteria and devitalised tissue. As neutrophils complete their job, they degenerate and die on the wound surface where they are visible as slough, which is moist, sticky, stringy, devitalised tissue and is typically a creamy yellow. Macrophages now recognise that these cells are dying and they enter the wound to continue the job of cleaning the wound and to remove dying neutrophils to prevent them prolonging the inflammatory process. Macrophages now recruit fibroblasts and stimulate their proliferation. The destructive, inflammatory phase of healing is nearing completion and the wound environment can now support new tissue formation. However, if all is not well at a cellular level then the point of transition between the inflammatory and proliferative phase of healing may be delayed and the wound may be at risk of becoming chronic. Proliferation: new tissue growth During the proliferative stage of healing, the wound needs to develop a new blood supply, a process known as angiogenesis, and to create a new matrix to support it. Fibroblasts, the ‘fibre makers’, migrate to the wound area where they proliferate and produce collagen fibres. New blood vessels are embedded in the new matrix and granulation tissue fills the wound from the base up. Granulation tissue may initially appear as pale pink, changing to bright red as it proliferates with new blood vessels. Wound closure As granulation tissue is being laid down in the wound, keratinocytes (epidermal cells) begin to migrate from the wound margin and intact hair follicles, and the 30 wound area will begin to diminish. As long as the local environment is conducive to healing, keratinocytes will creep over the slippery, moist surface of healthy granulation tissue to form a protective layer of epithelium across the wound’s surface to repair the epidermal defect. Since a moist environment is required for cellular migration, dressings should not allow wound exudate to dry out or allow the formation of a scab. The ideal dressing, at this stage, should allow for appropriate exudate management while maintaining moist wound healing. Wound contraction As the formation of new tissue continues, progress to complete wound closure is helped by wound contraction, which decreases the area requiring coverage by the migrating epithelial cells. Factors delaying healing and promoting healing There is significant evidence that factors such as inadequate wound perfusion, presence of nonviable tissue, high bacterial bioburden, smoking, malnutrition and systemic conditions (such as diabetes mellitus) cause significant delays on wound healing. Other delaying factors are the ageing process, the negative effect of drug therapies, mechanical factors (such as pressure) and the inappropriate use of dressings. It is also widely recognised that stress and anxiety have a detrimental effect on wound healing. Adequate levels of protein are needed for tissue repair, wound tensile strength and resistance to infection. Tissue repair is optimised by effective management of barriers to healing. A healthy wound, with minimal biofilm infection, controlled exudate levels, absence of necrotic tissue and appropriate dressing choices is conducive to preparation of a local wound environment, which will progress to healing. Dressing choices The wound, the patient and their multiple needs must be considered when choosing a wound dressing. Wound dressings are designed to function in specific circumstances and the choice of product for optimal wound management may not be straightforward. There is not one ideal dressing that can manage all the different local conditions found in wounds. However, dressings which encourage moist wound healing are known to enhance healing, reduce pain and allow the healing process to progress naturally. Categories of dressings which create a moist wound-dressing interface include: n Transparent polyurethane film dressings are suitable for superficial, clean, low exuding wounds. They do not absorb moisture and may be used either as primary or secondary dressings. n Alginate dressings are highly-absorbent and form a non-adherent gel when placed in exuding wounds. They are not suitable for dry wounds and usually require a secondary dressing. n Hydrocolloid dressings are suitable for clean wounds. They absorb low to moderate levels of exudate and may be used to promote autolytic debridement. Shaped sacral and heel dressings are available, which are conformable and flexible. n Hydrofibre dressings absorb high levels of exudate and form a non-adherent gel in exuding wounds. They are available as both flat sheets and packing rope for cavities and sinus. n Hydrogels have a high water content between 30% and 90%. They are most frequently used to promote autolytic debridement of sloughy wounds or those with dry necrotic eschar. Hydrogels are also indicated for small burns and may have a soothing/cooling effect. They are available as flat sheets and, more usually, amorphous gels. n Polyurethane foam dressings are indicated for a wide range of wound types and clinical environments and are available in a wide range of shapes and sizes. Their capacity to manage exudate varies from low to high and may have either acrylic or silicone adhesive borders. n Simple absorbent dressings are indicated for a wide range of clean wounds particularly post-operative wounds, minor lacerations and abrasions. However, they may dry out on the wound surface. n Topical antimicrobial dressings are indicated for wounds that have a local infection. They may also be used in conjunction with systemic antibiotics where there is spreading or clinical infection. Topical antibiotics are not advisable. A variety of antimicrobial dressings are available, including povidone iodine, cadexomer iodine, silver and honey. Before making a dressing choice, a careful and comprehensive assessment of the wound and of the patient should be carried out to prioritise the aims of treatment. Wounds should be re-assessed as appropriate. Pharmacists’ role A variety of wounds may present to a pharmacist. If the wound has recently occurred and is in the early stage of the inflammatory phase, it may be appropriately dressed with dressings available in the pharmacy and re-assessed to confirm healing is progressing. If the wound does not progress IPUREVIEW DECEMBER 2016/JANUARY 2017 COMMERCIAL FEATURE New store launches at Haven Pharmacy Ireland’s only independent co-operative pharmacy group Haven Pharmacy is delighted to welcome four additional pharmacies to the Haven brand: Paul Kenny, Haven Pharmacy Kennys, Tramore, Co. Waterford; Dan Ryan, Haven Pharmacy Frawleys, Roscrea, Co. Tipperary; Mary Scannell, Haven Pharmacy Scannells, South Main St, Bandon, Co. Cork; and Mary Scannell, Haven Pharmacy Scannells, Riverview Shopping Centre, Bandon, Co. Cork. T here was great excitement at the launch days, with some great local celebrities like Henry De Bromhead (racehorse trainer), Tipperary Hurling captain Brendan Maher, the Cork Ladies Footballers and Paralympian Corkman John Twomey to cut the ribbons at the newlybranded stores. There were spot prizes, goodie bags and face painting, and a great day was had by staff and customers alike. Being part of the Haven Pharmacy brand means that these independent pharmacies can benefit from: n Strong cost efficiencies from being part of a pro-active and growing buying group n The sharing of the latest thinking amongst their co-operative community n Work practices and support provided to the pharmacies such as category management, retail space planning, local marketing & PR toolkits, staff training, to name but a few. All of this is delivered while still retaining their autonomy and independence to deliver on the needs of the changing pharmacy consumer – and their own local community. These latest four stores brings the total number of Haven Pharmacies to Haven Pharmacy Tramore 52. Haven Pharmacy is committed to growing its network on a consistent basis and continuing to deliver excellent, expert care to each of its customers. If you are interested in joining the Haven Pharmacy group, please see: havenpharmacy.ie/contactus/pharmacist-interestedbecoming-member/ or email niamh.mcdermott@ indepharm.ie Haven Pharmacy Scannells, South Main St, Bandon Haven Pharmacy Frawleys, Roscrea Haven Pharmacy Scannells, Riverview, Bandon CPD overview Self-appraisal Can I describe the stages of wound healing? Evaluate professional resource materials available in the pharmacy and source additional material if necessary. Am I aware of the factors that delay or promote wound healing? Evaluate patient support material and source additional material if necessary. Am I able to counsel patients and their carers effectively on different types of wound dressings? Evaluate Consider outcomes of learning and impact of learning. Personal Plan Including a list of desired learning outcomes in a personal learning plan is a helpful self-analytical tool. Create a list of desired learning outcomes. Have I met my desired learning outcomes? Do I now feel confident in my understanding of wound care? How will I accomplish these learning outcomes? Do I now feel confident to engage with and counsel patients about wound care? Identify resources available to achieve learning objectives. Have I changed my management of patients with wound care needs? Review professional resource materials available in pharmacy. Have further learning needs been identified? Review patient support material available in pharmacy. Document your learning Create a record in my ePortfolio. Action Activities chosen should be outcomes based to meet learning objectives. As part of this record, complete an evaluation, noting whether learning outcomes were achieved and identifying any future learning needs. Implement plan. Read this article. 32 2014, there were eight lower limb amputations per week in Ireland, with over 1,600 people with diabetes requiring hospital in-patient treatment for foot ulceration. 80% of diabetes-related amputations are preventable with regular screening and early intervention. Patients with diabetes should be educated in the importance of foot care and of daily foot examinations. Your 5-minute assessment Answer the following five questions true or false: 1. The Inflammatory Response is the first stage in the wound healing process. 2. Adequate levels of carbohydrate are needed for tissue repair, wound tensile strength and resistance to infection. 3. Stress and anxiety have a detrimental effect on wound healing. Adapted from Wound Healing and Skin Integrity: Principles and Practice. Ed. Madeleine Flanagan. 2013 Wiley & Sons. Chapter 3 Physiology of Wound Healing, Mary Martin; Chapter 5 Principles of Wound Management, Madeleine Flanagan. 4. Alginate dressings are suitable for dry wounds. 5. Hydrocolloid dressings are suitable for clean wounds. Answers: 1. True. 2. False. 3. True. 4. False. 5. True. out of the inflammatory phase, it should be referred. Refer pre-tibial lacerations in older patients as they have a high risk of developing into a leg ulcer. Dog or cat bites may look small but the puncture can be deep and should also be referred. Pharmacists can also play an important education role in preventing wounds. Patients with a healed venous leg ulcer who are progressing from compression bandaging to compression stockings should understand the importance of compliance in wearing support stockings in order to reduce the risk of wound recurrence. Pharmacists may be aware of patients with diabetes who are at risk of developing a diabetic foot ulcer. In IPUREVIEW DECEMBER 2016/JANUARY 2017 NEW! NOW AVAILABLE Benecol® Soft Chews The proven cholesterol-lowering effect of plant stanol ester now in a convenient chewable supplement • • • • Fresh-tasting, Lemon & Lime flavour Daily intake of 3 to 6 Benecol® sugar-free Soft Chews with meals Convenient, customers can bring them with them wherever they go Ongoing consumer marketing support programme Available to order via: – United Drug (code 78016) – Uniphar (code 763358) Plant stanol ester has been shown to lower blood cholesterol. High cholesterol is a risk factor in the development of Coronary Heart Disease. CLINICAL TIPS Tara Kelly, IPU Product File Pharmacist Interaction between proton pump inhibitors and food Proton Pump Inhibitors, as a group, are one of the most frequently dispensed medicines. Esomeprazole, Lansoprazole, Omeprazole and Pantoprazole all ranked in the Top 20 Most Commonly Prescribed Products in 2014 (PCRS GMS and DPS Combined Figures)1. The information regarding the interaction between Proton Pump Inhibitors and Food is somewhat confusing and conflicting. This can make it difficult to know how best to counsel patients on the timing of these medications in relation to meal times. The table below attempts to summarise the information available from both the Product Information (SmPCs and Patient Information Leaflets (PILs)) and Stockley’s Drug Interactions (online resource). Proton Pump Inhibitor Product Information (SmPC and PIL) Stockley’s Drug Interactions Esomeprazole Food intake both delays and decreases the absorption of esomeprazole, although this has no significant influence on the effect of esomeprazole on intra-gastric acidity. The AUC of esomeprazole can be reduced by 4353% by food. The US manufacturer recommends that esomeprazole should be taken at least one hour before meals. However, the UK manufacturer notes that, although food intake delays and decreases the absorption of esomeprazole, this does not appreciably alter the effect of esomeprazole on gastric acidity. You can take your tablets with food or on an empty stomach. Lansoprazole Should be taken at least 30 minutes before food. Intake of food slows the absorption rate of lansoprazole and reduces the bioavailability by about 50%. For the best results from your medicines, you should take lansoprazole at least 30 minutes before food. A study in 12 healthy subjects found that food reduced bioavailability by 27%.2 In another study, the efficacy of both lansoprazole and omeprazole measured by intra-gastric pH, seemed to be greater when it was given 15 minutes before breakfast compared with when they were taken without any food until lunchtime.3 Some manufacturers recommend that to achieve optimal efficacy, lansoprazole should be taken at least 30 minutes before food. Omeprazole It is recommended to take the gastro-resistant tablets in the morning, preferably without food. Two studies concluded that omeprazole may be taken without regard to meals.4, 5 You can take your tablets with food or on an empty stomach. One study (see under lansoprazole above) suggests it should be taken 15 minutes before breakfast. Concomitant intake of food has no influence on the bioavailability. Pantoprazole Concomitant intake of food has no influence on bioavailability. The tablets should be swallowed whole with liquid before a meal. Rabeprazole 34 The manufacturers state that food delays the absorption of pantoprazole from the tablets but has no effect on the total amount absorbed (AUC). Should be taken in the morning before eating, and although neither time of day nor food affects availability, this aids compliance. A study in healthy subjects found that, although a standard breakfast delayed the absorption, the AUC and maximum plasma level were not significantly affected.6 There was no clinically relevant interaction with food. Other studies showed similar results. IPUREVIEW DECEMBER 2016/JANUARY 2017 The table above includes only some of the studies cited in Stockley’s Drug Interactions; the full text is available through the online resource by searching ‘Proton Pump Inhibitors and Food’. What is clear from the above is that esomeprazole (e.g. Nexium®) can be taken either with food or on an empty stomach and the PIL is consistent with that message. Patients can be advised accordingly. It is also clear that lansoprazole (e.g. Zoton®) should be taken without food. Patients can be advised to take lansoprazole at least 30 minutes before food to maximise bioavailability. What is not very clear from the studies to date is whether food is actually necessary after those 30 minutes to maximise efficacy as suggested in the Hatlebakk et al. study.3 The BNF 72 includes the Cautionary and Advisory Label 22, “Take 30 to 60 minutes before food”, for lansoprazole. In relation to pantoprazole (e.g. Protium®) and rabeprazole (e.g. Pariet®), the PILs instruct patients to take these with water before a meal. This is not absolutely necessary as food does not influence bioavailability. As mentioned in the rabeprazole SmPCs, this is a compliance aid more than anything else. In relation to omeprazole (e.g. Losec®), the information is slightly contradictory. The SmPCs state that the tablets need to be taken in the morning, preferably without food, yet the PILs state that they can be taken with food or on an empty stomach. The IPU Product File queried this with the manufacturers of Losec Control® and received the following response: “The recommendation to take Losec preferably on an empty stomach is based on the pharmacological properties; acid-suppressing effects only occur after the drug reaches the small intestine and gets absorbed, which happens faster on an empty stomach. For the MUPS tablets, however, it was demonstrated that (due to the fact that the tiny micro pellets can pass the pylorus even when they are taken after meals), they have a faster onset compared to just an enteric coated capsule. As the Cmax value is still higher and faster when omeprazole is taken ca. 30 minutes before meals, this type of intake is preferable.” Therefore, patients can be advised to take omeprazole without food, but again this is not absolutely necessary. This can be reassuring for parents who sometimes struggle with the timing and the administration of omeprazole to young babies. References 1. HSE PCRS Statistical Analysis of Claims and Payments 2014. 2. Delhotal-Landes, B., Cournot, A., Vermerie, N., Dellatolas, F., Benoit, M., Flouvat, B. (1991) The effect of food and antacids on lansoprazole absorption and disposition. Eur J Drug Metab Pharmacokinet. Spec no 3, 315-20. 3. Hatlebakk, J.G., Katz, P.O., Camacho-Lobato, L., Castell, D.O. (2000) Proton pump inhibitors: better acid suppression when taken before a meal than without a meal. Aliment Pharmacol Ther. 14, 1267-72. 4. Rohss, K., Andren, K., Heggelund, A., Lagerstrom, P.0., Lundborg, P. (1986) Bioavailability of omeprazole given in conjunction with food. III World Conf Clin Pharmacol Ther, Stockholm July-Aug 1986. Acta Pharmacol Toxicol (Copenh). 85 (5), Abstract 207. 5. Thomson, A.B.R., Sinclair, P., Matisko, A., Rosen, E., Andersson, T., Olofsson, B. (1997) Influence of food on the bioavailability of an enteric-coated tablet formulation of omeprazole under repeated dose conditions. Can J Gastroenterol. 11, 663-7. 6. Yasuda, S., Ohnishi, A., Ogawa, T., Tomono, Y., Hasegawa, J., Nakai, H., Shimamura, Y., Norishita, N. (1994) Pharmacokinetic properties of E3810, a new proton pump inhibitor, in healthy male volunteers. Int J Clin Pharmacol Ther. 32, 466-73. IPU PRODUCT FILE The IPU Product File has been in existence for more than 30 years and is an indispensable resource for community pharmacists. It was designed for pharmacists by pharmacists and is also used by doctors and hospital personnel. It is a vital support tool for prescribing, dispensing, claiming with PCRS, stock ordering, stock taking, price checking and product sourcing. What is in the File? ISO Certified The File contains information on over 63,000 products, including: In 2016, the IPU Product File achieved ISO Certification for 9001 (Quality) and 27001 (Information Security). The audit and certification process for ISO Certification emphasises the robustness of the IPU Product File and underpins its position as the definitive medicinal product catalogue in Ireland. Licensed medicinal products Unlicensed medicinal products Medical devices and sundries (bandages, dressings, ostomy equipment etc.) Nutritional products, including foods for special diets Veterinary products Photographic products Cosmetic products Front of Shop products (shampoos, toothpastes, vitamins etc.) In addition to pricing information, barcodes etc., the IPU Product File provides valuable professional information on health products. The professional information provided includes the Medicinal Product Name, PA/EU number, Generic Name, Pharmaceutical Form, Strength and Legal Status. IPUREVIEW DECEMBER 2016/JANUARY 2017 ISO 9001 ISO 27001 Registered Registered Quality Management Information Security Management Easy to Use The IPU Product File is an open system, so no matter what vendor you choose, the file can be adapted for your needs. The IPU Product File is available by electronic download, where you can log-in and download your monthly update. Contact Us The IPU Product File team are available to answer your queries, whether it’s on sourcing a product, pricing queries etc., the team will be able to assist you. For any queries relating to the IPU Product File, please contact a staff member on 01 406 1550 or [email protected] 35 Using point-of-sale materials to unlock revenue potential Special offers and promotions are a fantastic way to generate sales, but they are of little value if they are not signposted effectively instore. Marketing your front of shop can often be a daunting task for pharmacists, and is unchartered or unknown territory for many. There are considerable benefits to be had in doing so, however, not least boosting customer footfall and increasing sales. There is a growing appreciation for the value of retail sales and the potential revenue stream it presents to the pharmacy community. The challenge is in unlocking this opportunity, and this is where clever marketing solutions can help to reap dividends. Regardless of whether you have a large or small front of shop, it’s important that you utilise every tool at your disposal and make it count. “We know from working with pharmacists that they offer fantastic value to consumers in CHRISTMAS KARDASHIAN CRACKERS! NIVEA Smooth Skin Gift Set Beauty Luxury Hai Rejuvenation Kit r EAL L'ÓR An Extraordinary Experience ONLY ONLY ONLY € CHRISTMAS CRACKE RS! 18.50 € 23 DLES G CELTIC CAN BULLDO Double Candles Moisturiser ONLY ONLY 7 25 with Plate Cracker € .95 € € 21.99 MANY MORE CHRISTMAS OFFERS IN STORE! “Your retail space should be attractive, starting from the outside in” their retail offerings,” said Aimée Roche, Category Management Associate at United Drug. “Very often, however, ineffective communication is preventing the pharmacist from capitalising on the opportunity.” How you communicate with consumers is increasingly as important as the offer or promotion itself. One of the most simple and effective communication methods is through point-of-sale (POS) materials. “Your retail space should be attractive, starting from the outside in,” explains Aimée. “A cluttered window and shop floor creates a poor first impression; rather, you want to create an attractive aesthetic that encourages customers instore and, more importantly, makes them want to stay and shop.” Aimee Roche, United Drug This is where strong POS materials come into their own. “Not only does clever and compelling POS material draw customers into the shop’ says Aimée ‘but it can also be used to highlight in store services, to educate customers regarding specific product benefits and to inform customers of your pharmacy’s areas of expertise, as well as helping to drive impulse sales.” “Using clever POS Materials is also an effective way of communicating core and relevant pharmacy services to your customers” POS doesn’t need to be a complicated or costly exercise either. There are a growing number of services available to pharmacists that allow them to manage their POS centrally using templates or working with an experienced team who can develop the materials on your behalf. communication pieces. There are quick links to create POS for Profitlines and Pharma Le Chéile promotions too. We also know that one size doesn’t fit all so we have created templates to suit all categories, promotions and seasons. You can personalise the templates to give your POS a professional yet local feel, selecting colour to match your branding, adding your logo and uploading your own images to promote any unique ranges that you may carry. You can also seamlessly link to Facebook, which is a growing channel from which to frequently communicate with customers. Materials are printed by a professional printing company and generally delivered to the Finally, we can provide staff training if required. We also offer a bespoke service whereby we will create your suite of POS and dress your pharmacy for you. This service proves popular for new pharmacy openings or post re-fits. Cleverly communicating pharmacy services, highlighting in store promotions and connecting with your customers frequently by means of social media should be important aspects of your over all marketing plan. These steps should allow you to reap considerable benefits in the end in terms of increased footfall and revenue.” To find out more contact Aimee Roche on 087 4003500 or email [email protected] Remember, POS materials can: “‘Using clever POS Materials is also an effective way of communicating core and relevant pharmacy services to your customers’ says Aimée ‘and it doesn’t need to be an arduous task.” “‘We have developed a simple, effective Point of Sale toolkit for pharmacists that cuts out the hassle. Using the toolkit, pharmacists can access over 4000 product images and create posters, shelf talkers, shelf edge strips, fliers and general in store pharmacy the next day. • Improve sales performance by highlighting promotional offers in a simple and clear manner • Communicate seasonal services and products • Enhance the overall pharmacy look and feel and improve shopper experience BUSINESS Darren Kelly, Business Development Manager, IPU Retail customer experience in pharmacy Many pharmacy owners focus solely on the prescription side of their business and fail to put enough effort toward boosting retail sales. Some put it down to inexperience or just don’t feel that it is profitable enough. If you fall into that category, you are missing a big opportunity for extra revenue. Whether it’s suntan lotion, vitamins, toiletries or skin care, your retail section is often the most memorable area of your pharmacy. In this article, Darren Kelly, Business Development Manager, IPU, will outline how you can increase the customer experience within your pharmacy, which will in turn lead to increased retail sales. 38 IPUREVIEW DECEMBER 2016/JANUARY 2017 “Depending on the layout of the pharmacy, most customers don’t actually move around the pharmacy because the shopping experience is not there.” L et’s start outside your pharmacy. I have written before about window displays and how to create better visuals to passing customers but your window is the starting point of what the customer’s retail experience of your pharmacy is going to be. If the window is cluttered with point of sale or blocked with posters, the customer may not really associate a retail experience with the pharmacy. Perception of retail value for money in pharmacy is changing yearon-year so we must capitalise on this and start to let our customers know that we are open for business. Many pharmacies do not maximise the potential for retail sales that their prescription footfall can deliver. Many pharmacy customers who are collecting a prescription will often make a beeline for the counter, often ignoring the “front-of-shop” sales space. Depending on the layout of the pharmacy, most customers don’t actually move around the pharmacy because the shopping experience is not there. Take some time to watch how your customers move through your pharmacy and you will see what I mean. Pharmacy customers often walk straight to the pharmacy counter from the entrance to hand in their prescription, ignoring everything they pass. By placing something different in the middle of an aisle or IPUREVIEW DECEMBER 2016/JANUARY 2017 angling a gondola to direct a customer to the areas where you want them to shop, you can distract your customer into stopping. Retail layout If you look at your retail layout in the pharmacy, try to think as a customer would and how easy or hard it is to find items in your pharmacy. Think about a logical separation of categories to create different experiences within the pharmacy for the different customers that you have. Split your retail space into zones (e.g. skin care, hair care, cosmetics). Create a “going out” zone, which will be everything that your female shopper needs, especially at this time of year with party season in full swing. Have a Health & Wellbeing section to include vitamins, minerals, supplements, foot care and first aid. These are predominantly advice-driven sales so should be located in an area that the customer can easily access staff for advice. Within each zone, groups of products should be arranged logically so that when a customer buys one product, it is surrounded by other products that may also be of use (e.g. cotton pads with nail varnish remover, mitts with self-tan). You may think this is common sense but you would be surprised at how many retailers are not providing this in their business. Directional products Tell the customer Many people ask me should they have overhead signage to show customers where the men’s section or the dental section are and my own opinion is that you don’t. Most pharmacies are not big 10,000 sq. ft. operations that customers could get lost in. Customers will use brand names to help them find the product they are looking for. This may not be the brand they intend to buy but is often used as a guide by consumers to locate their desired product, e.g. Colgate – Dental, Gillette – Men’s, Cocoa Brown – Self Tan. These “signpost brands” should be placed where possible at eye level so that customers can easily find what they want to buy. Pharmacies are buying retail products at a better rate than before; therefore, they are offering their customers great value for money. But who knows about the value? You do, the staff does but does the customer? Customers shop with peripheral vision and are often hungry for value for their money. Using signage with information on new products or special offer signage will grab the customer’s attention. Promotion planning and promotional reviews help to keep the offerings fresh and make the customer want to see what value you have for them this week. The level of value that is available in pharmacies around the country is phenomenal but most don’t tell their customer. Customer experiences can be created in any pharmacy, big or small. You just need to stand back, look in and see what your customer sees when they enter your pharmacy. De-clutter shelves On my pharmacy visits around the country, I am astounded by the ranges of products in each category that we carry. If you carry too many items in a range and try to squeeze them onto a shelf, you just create a lot of noise on the shelf and the message is lost to the customer who will just walk away. It has been proven that the consumer perceives that you have a bigger range when the display is less cluttered and better structured. If you would like any further information or help with your retail offering, please contact me in Butterfield House on 01 493 6401 to discuss our one-day retail review. 39 HR Laura Murphy MCIPD, Bright Contracts Employment round-up 2016 has been another busy year for employment law in Ireland with both new legislation and case law developments. Our newsfeeds are currently populated with public sector talks and disputes, and it certainly looks like an autumn of discontent from a public sector point of view. From the private sector’s perspective, keeping abreast of legal changes will ensure your competitiveness in an aggressive market. In this article, Laura Murphy, HR Manager, Bright Contracts, sums up some of the key changes employers need to be aware of. What has happened in 2016? 40 IPUREVIEW DECEMBER 2016/JANUARY 2017 Retirement Ages Many employment contracts will have historically had a default retirement age of 65; however, such a retirement age may not be legally enforceable. January 2016 saw the introduction of The Equality (Miscellaneous Provisions) Act 2015 which stipulates that employers must objectively justify a mandatory company retirement age. The advice to employers in this regard is to review employment contracts and staff policies. Where a mandatory retirement age exists, employers should include a robust policy objectively justifying the retirement age. Natural Relief from Mild Eye Irritation 6 Dublin Office Freephone: 1800 816 005 Email: [email protected] Visit: www.scopeophthalmics.ie OTC Exclusive! Available from your local distributor DELIVERING INNOVATION Freephone: 1800 816 005 Email: [email protected] Visit: www.scopeophthalmics.ie Paternity Leave 1 September 2016 saw the introduction of paid paternity leave in Ireland. Fathers / partners are now entitled to two weeks paid paternity leave within the first 26 weeks following the birth of a child / placement of a child for adoption. Paternity pay is processed through the Department of Social Protection, with the current rate set at €230 per week. At their own discretion, employers may top-up this pay. The leave must be taken in a continuous block and employees must give four weeks’ notice of their intention to take paternity leave. Minimum Wage Following the establishment of the Low Pay Commission, which was set up to advise the Government on minimum wage levels, January 2016 saw the minimum wage increase from €8.65 per hour to €9.15 per hour. It is believed that this affected just under 125,000 employees in Ireland. Further to this, as announced in Budget 2017, the minimum wage will increase again in January 2017, with the new rate being €9.25 per hour. CCTV in the Workplace The use of CCTV has always been heavily regulated by Data Protection legislation. As its use and capability continues to develop, the Data Protection Commission this year released updated guidelines on CCTV use. The guidelines include a requirement for: n a written CCTV policy to be in place; n a risk assessment to be conducted to justify the use of CCTV; n a privacy impact assessment; n evidence of previous incidents that have led to concerns that may justify the use of CCTV; and n clear signage indicating that there is CCTV recording in operation. Generally, the use of CCTV for security purposes is an acceptable reason; however, using CCTV to constantly monitor employees may be slightly more difficult to justify. Should you have CCTV in operation in your pharmacy, you are advised to review employment policies to ensure that its use is in line with the Data Protection Commissioner’s guidance. Discretionary Bonuses The development in this area is a result of a High Court ruling. The employer, in this case B&Q, sought to terminate a discretionary bonus scheme. The bonus policy stated that: “All bonus schemes are discretionary and are subject to the scheme rules. They may be reviewed or withdrawn at any time.” Whilst the Court found in favour of B&Q in that they could indeed withdraw the bonus scheme going forward, they held that the clause was not applicable to a bonus that had already accrued and had been earned by employees, i.e. the employees had worked with the expectation that they would receive the bonus for that period. Employers thinking of changing their bonus scheme are advised to seek legal advice. Other considerations might be to: n include in your bonus policy that bonuses may be removed retrospectively; or n communicate with employees at an early stage if it is likely that the bonus will not be paid. Spent Convictions The Criminal Justice (Spent Convictions and Certain Disclosures) Act 2016 allows convictions for a range of minor offences to be considered spent after seven years. This means that an employee is generally not required to disclose a spent conviction in any criminal background check. For employers, this may have a knock-on effect to your pre-employment screening process, which may need to be revised. Laura has headed up the Bright Contracts team since 2013, in which time she has created and launched a UK programme and also developed Bright Contracts Ireland into the reputable product it is today. An experienced Human Resource professional with unique global experience, she has worked in-house and in external consultancy roles for SMEs, international organisations and public sector bodies across the UK and Ireland. Laura understands SMEs and how employment law and HR practices can be applied to suit their commercial needs. Laura is a Chartered member of the Chartered Institute of Personnel and Development (CIPD) and graduate of International Business and Languages at Dublin City University. “Employers thinking of changing their bonus scheme are advised to seek legal advice.” FANCY A MERCHANDISING PLAN TAILOR-MADE FOR YOUR PHARMACY? For further information on the IPU Retail Review service, please contact Darren Kelly on (01) 493 6401 / 086 028 9825 or email: [email protected] IPU Retail Banners 190X45 MAR16 ART.indd 1 42 25/03/2016 17:54 IPUREVIEW DECEMBER 2016/JANUARY 2017 IS YOUR PHARMACY COMPLIANT WITH THE LATEST PSI GUIDANCE? Are you aware that significant implications have been placed on community pharmacies & pharmacists • Ireland’sonlycompoundingfacilityfor as a result of the published ‘Guidance extemporaneouslypreparedmedicinal for Pharmacists on Extemporaneous products,manufacturingabespoke Dispensing’ rangeofproductsunderGMP. • Comprehensiverangeofexempt medicinalproductsavailable includingcoldchain& controlleddrugs. • HPRAauthorizedManufacturer &WholesaleDistributor. • NoMinimumorderquantity& FREE NEXT DAY DELIVERY includingSaturdays. • Experiencedteamavailableto answerallyourqueries. QM Specials, Mayfield Business Park, Lismore, Co. Waterford. t: 058 72111 f: 058 72333 e: [email protected] www.qmspecials.ie Opening Hours: 9.00am - 5.30pm Monday to Friday WE LOOK FORWARD TO DOING BUSINESS WITH YOUR PHARMACY BUSINESS Filipe Infante, Country Manager, hmR Ireland Irish prescription market trends In this article, Filipe Infante, Country Manager, hmR Ireland, gives an overview of the total prescription market in Ireland for October 2016 and identifies some key market trends. A t a national level, the total prescription market in October 2016 increased by 2.2% in value but decreased by 1.1% in volume when compared to October 2015. Branded medicines have increased by 2.9% in value in this period but have decreased by 3.2% in volume. Generic medicines have experienced an increase in both value and volume, with an increase of 1.0% and 1.1% respectively. Dispensary OTC medicines have experienced the largest decrease with a fall in value and volume of 2.7% and 4.3%, respectively. In the same period, three counties experienced a total market growth in value of 6% or greater. Counties included are Clare (8.5%), Donegal (6.3%) and Offaly (6%). Sligo was the only county to experience a fall in value greater than 10% (-12.2%). In similar analysis, this time looking at a 12-month basis (MAT), we see that five counties experienced a growth higher than 6%: Clare (6.6%), Galway (6.0%), Laois (6.3%), Meath (6.6%) and Monaghan (6.3%). However, there were five counties in total that experienced a decrease in value. These counties are 44 Figure 1 / Prescription Market Segment Trends: October 2016 v October 2015 C M Y CM MY CY CMY K Leitrim (-2.7%), Longford (-2.4%), Roscommon (-0.3%), Sligo (-3.9%) and Waterford (-0.6%). Out of the five, Leitrim and Waterford experienced a fall in Pharmaceutical, Branded and Generic markets. IPUREVIEW DECEMBER 2016/JANUARY 2017 Figure 2 / Prescription Market Trend by County: October 2016 v October 2015 Insimilaranalysis,thistimelookingata12monthbasis(MAT),weseethatjustthreecounties experiencedagrowthhigherthan5%,Galway(5.1%),Limerick(5.2%),andWestmeath(5.4%), howevertherewere6countiesintotalthatexperiencedadecreaseinvalue.Thesecounties include, Carlow (-2.1%), Leitrim (-4.4%), Longford (-3.4%), Louth (-1.4%), Sligo (-0.8%) and Waterford(-2.9%).Outofthe6,Carlow,Leitrim,LouthandWaterfordexperiencedafallin Pharmaceutical,BrandedandGenericmarkets. 1309 - We can help Pharmacists HALF-PAGE Ad SMALLER.pdf 1 30/04/2015 12:02 Are there medicines currently unavailable to your patient in Ireland? We can help... www.medisource.ie | Call 1-890 2866366 | Fax 01 2866288 | Email [email protected] 227548-DPS-MEDISOURCE-AMA-IHCA.indd Medisource Ad Sept 2013.indd 1 2 IPUREVIEW DECEMBER 2016/JANUARY 2017 06/09/2013 10:06:11 05/09/2013 12:17:14 45 Elements Accessing unlicensed medicines can be a challenge for pharmacists. United Drug Elements is designed to remove the hassle, freeing up pharmacy hours and ensuring a consistent care path for patients. Exempt Medicinal Products (EMP’s) in Ireland are typically drugs that have been discontinued for commercial reasons, where the drug is no longer seen as commercially viable, particularly in a market deemed to be as small as ours. The provision of EMPs, therefore, is an important service provided by Irish pharmacies to ensure consistency of care for patients. However, accessing these drugs can create difficulties for pharmacists, especially when the medicine is needed urgently for a patient. of Surprise! Elements Exempt Medicinal Products Challenges in sourcing EMPs can lead to considerable inconvenience and cause unnecessary stress to a patient. Worst case scenario, it can affect patient outcomes. As such, when it comes to providing quality patient care in the community, it is vital that pharmacists have access to a reliable and speedy supply source for unlicensed medicines. Leonard Manley is Exempt Medicinal Products Business Unit Manager at United Drug. He said: “While we don’t have Irish-specific data, we know that pharmacists in the UK can spend on average three hours per week sourcing medicines, or 156 hours per year. Pharmacists in Ireland would be in a similar situation, which is why we set up our Elements service to provide important support in terms of accessing and ordering EMPs, thereby freeing up pharmacy hours.” United Drug Elements is a swift and efficient service for sourcing and supplying EMPs and pharmaceutical supplies not normally available through regular pharmaceutical distribution channels. The service operates in line with Health Products Regulatory Authority (HPRA) and Primary Care Reimbursement Service (PCRS) guidelines. The online ordering service (www.ud-elements.ie) has been live since July 2012 and 85% of all orders are now ordered from this platform. “Our ambition for Elements was to provide a user-friendly, online service that reduced pressure on the pharmacy community in terms of sourcing and ordering EMPs,” Leonard Manley, United Drug “Our ambition for Elements was to provide a user-friendly, online service that reduced pressure on the pharmacy...” said Leonard. “We offer nextday delivery on the majority of our lines and our online service ensures that products may be ordered outside of normal business hours, at weekends or on Bank Holidays. And of course, we also have a dedicated and highly experienced team available to answer any queries from customers also. procurement and view invoices, statements and their online order history at the click of a button. In offering an ‘always-on’ service, we can support the primary care community in ensuring that there is no break in care for vulnerable or at-risk patients.” Indeed, many case studies have shown that when EMPs have not been available or prescribed to a patient, their conditions have deteriorated with a relapse, resulting There is also a hard-working, back-office engine behind Elements. Along with being able to place orders, browse the extensive catalogue, check stock availability, and search by ingredient, pharmacists can also use the online service to request a new product While there can be no denying that EMPs on average cost more than licenced products, this does not take into consideration the overall costs associated with them being unavailable. in a return to hospital care. This implies that the secondary and tertiary costs associated with the patient’s care far exceeds the initial cost of the EMP. For further information contact the Elements Team - Leonard Manley, Tara Byrne, Joan Gibson, Sharon Cheever & Yvonne Byrne - via email on [email protected] or call 01-4632300, or visit us online at www.ud-elements.ie. PROFESSIONAL POLITICS Stephen O’Byrnes New community pharmacy unit in Department of Health The Minister for Health said the establishment of a new Community Pharmacy, Dental, Optical and Aural Policy Unit in the Department of Health was bringing a renewed focus to the development of policy in relation to community pharmacy and the issues associated with achieving maximum benefit to patients. Simon Harris, Fine Gael Gino Kenny, PBP Alliance Billy Kelleher, Fianna Fáil 48 “The HSE has also recently established a Drugs Management Portfolio, which includes a range of projects to optimise value in the primary care and hospital settings. The Portfolio also includes the work of the HSE’s Medicines Management Programme, which introduced the preferred drugs initiative to facilitate more cost-effective prescribing, particularly in relation to high-cost medicines. “It continues to engage with general practitioners to reinforce the message around safe, effective and costeffective prescribing including generic prescribing,” he added. He was replying to a question from Deputy Gino Kenny (People Before Profit Alliance, Dublin Mid-West) about securing more cost-effective prescribing, pricing and payment systems for drugs. The Minister added that another important initiative was the ongoing implementation of generic substitution and reference pricing. “To date, 47 substances have been included in this process and I have recently requested that the Health Products Regulatory Authority review an additional 15 substances. The implementation of generic substitution and reference pricing delivered €47m in savings in 2014 and €94m in savings in 2015.” Department of Health developing biosimilar medicines policy The Department of Health is currently assessing biosimilar medicines and is developing a biosimilar policy. This was stated in the Dáil recently by the Minister for Health in reply to a question from the Fianna Fáil Health Spokesperson, Deputy Billy Kelleher (Cork North-Central), who asked whether a greater use of biosimilars could assist in controlling the cost of medications. The Minister, Deputy Simon Harris (Wicklow), said the use of biotechnology in the pharmaceutical field had led to the development of many new biological medicines, offering new treatments for a range of serious illnesses. “The manufacturing of a biological medicine is a complex process. Biosimilar medicines are similar but not identical to their reference biological medicines, and therefore are not considered in the same way as generic medicines. Under the Heath (Pricing and Supply of Medical Goods) Act 2013, biosimilars are not considered to be interchangeable and, therefore, cannot be substituted for biological medicines. “It is likely that the use of biosimilar medicines will grow in Ireland in the coming years as the patents on biological medicines expire, offering opportunities for the State to make further savings on the cost of medicines. The recently signed Framework Agreement on the Supply and Pricing of Medicines 2016-2020 with the Irish Pharmaceutical Healthcare Association (IPHA) includes a provision to take advantage of these new developments in the pharmaceutical industry. Under the new Agreement, the price of a biologic medicine will be reduced by 20% and an additional rebate of 12.5% provided upon entry into the market of a biosimilar. “They will be working with the Health Products Regulatory Authority and the IPUREVIEW DECEMBER 2016/JANUARY 2017 HSE to progress this agenda and will be examining the need for legislative changes in this area. It is useful to note that the HSE’s Medicines Management Programme issued a position paper earlier this year supporting the appropriate introduction of biosimliars into clinical use in Ireland,” the Minister added. HSE has ended reimbursing eye medication The Labour Party Leader, Deputy Brendan Howlin (Wexford); the Fianna Fáil Health Spokesperson, Deputy Billy Kelleher, and Deputy Mick Wallace (Independent, Wexford) asked the Minister for Health why the eye medication MacuShield has been withdrawn from medical card patients and if a substitute medication would be made available to medical card patients. The Minister said the HSE had advised that MacuShield products had never been made available to all persons with medical card eligibility. “However, MacuShield and similar products were historically available to medical card holders in many areas under Discretionary Hardship Arrangements,” he added. “In developing a national framework for the administration of Discretionary Hardship Arrangements, the HSE’s Medicines Management Programme (MMP) was asked to review the available therapeutic evidence for supporting reimbursement of MacuShield and similar products. The MMP report supported the view of the National Centre for Pharmacoeconomics that the evidence for dietary carotenoids for the prevention of age-related macular degeneration (AMD) is inconclusive and the MMP therefore does not recommend that products containing these preparations be reimbursed under any community drug scheme.” In light of this, the HSE had decided to cease reimbursement support for these dietary supplement IPUREVIEW DECEMBER 2016/JANUARY 2017 products, and the MMP report was available on the HSE website. Calls for various drugs to be added to GMS A number of Deputies questioned the Minister recently to have certain drugs available in Ireland and/ or available to medical card holders. Deputy Niamh Smyth (Fianna Fáil, Cavan-Monaghan) asked the Minister for Health of his plans to introduce Vimizim. The Minister said that, at the request of the HSE, the NCPE was currently conducting an assessment of Vimizim for the treatment of mucopolysaccharidosis, type IVa (also known as Morquio A syndrome) in patients of all ages. “As the NCPE’s assessment of Vimizim is ongoing, it is not possible to provide further details at this time,” he added. Deputy Carol Nolan (Sinn Féin, Offaly) asked the Minister when a decision might be made to include Ataluren in the drugs reimbursement list and if he will make a statement on the matter. The Minister said that the NCPE completed a health technology assessment of Ataluren (brand name Translarna) in April and did not recommend reimbursement. Cannibis-based products Permitting the use of cannabis-based products for medical purposes in Ireland would be considered in the context of the new National Drugs Strategy, the Minister for Health said in reply to a Dáil Question from Deputy Pat Buckley (Sinn Féin, Cork East) who asked about families affected with Dravet Syndrome who were seeking access to Cannabidiol. The Minister said that Cannabidiol (CBD) was derived from cannabis. However, since it did not have psychoactive properties, it was not controlled under the Misuse of Drugs Acts. To date, the HPRA had not received any applications for authorisation for any cannabis-based product other than one authorised in 2014. “Where a medicinal product is not authorised in Ireland, a licensed wholesaler may import it if it has been prescribed by a doctor for a patient under his/her care, on his/her direct responsibility and in order to meet the special needs of a patient. Therefore, if a CBD oil preparation does not contain an ingredient which is a controlled substance, such as THC, it may be feasible to have that product imported and used in Ireland, in accordance with specific conditions, should a patient’s doctor be of the opinion that this is an appropriate treatment,” he said. European Court ruling on pharmacy prices in Germany In another Parliamentary Question to the Minister recently, Deputy Kelleher asked the Minister’s views on a European Court of Justice ruling “that a fixed price system for the sale by pharmacies of prescriptiononly medicinal products for human use is incompatible with the free movement of goods and if there are any implications for pharmacies here”? Minister Harris said the case concerned “a challenge to the German system of fixed pricing for prescription medicines, which I am advised involves a standard minimum price. The German court requested a preliminary ruling from the European Court of Justice, which determined that the Government-regulated minimum pricing system interfered with free trade, as it provided more of an obstacle to pharmacies outside Germany than to those within Germany. “Ireland does not use a fixed minimum pricing structure for prescription medicines and, in line with a previous European Court of Justice ruling, does not permit mail order pharmacy sales. Accordingly, the Court’s ruling does not appear to hold direct relevance for our community Brendan Howlin, Labour Mick Wallace, Independent Niamh Smyth, Fianna Fáil Carol Nolan, Sinn Féin Pat Buckley, Sinn Féin 49 drug schemes. However, my officials will continue to monitor the issue,” he added. Joe Carey, Fine Gael Gerry Adams, Sinn Féin Alan Kelly, Labour Richard Boyd Barrett, People Before Profit Alliance Róisín Shortall, Social Democrats Tony McLoughlin, Fine Gael Michael Fitzmaurice, Independent 50 Talks on price of CF drug Orkambi continuing The HSE is engaged in ongoing dialogue with the manufacturer of the cystic fibrosis drug Orkambi “in an effort to secure significant price reductions”, the Minister for Health said in the Dáil recently. The issue has been raised by many deputies in recent weeks by way of Parliamentary Questions. The Minister said, “the HSE will consider the outcome of these engagements and any other, together with the National Centre for Pharmacoeconomics’ (NCPE) recommendation, in making a final decision on reimbursement”. He was replying to Deputy Joe Carey (Fine Gael, Clare). He also pointed out that the NCPE had completed a detailed study, submitted to the HSE last June, which concluded that “the manufacturer failed to demonstrate costeffectiveness or value for money from using the drug”. A summary of the HTA has been published on the NCPE website and is available at: http://www.ncpe.ie/wpcontent/uploads/2015/12/ Website-summary-orkambi. pdf. The Sinn Féin Leader, Deputy Gerry Adams (Louth), asked the Minister if he had raised “the issue of unjustified pricing of life-changing drugs such as Orkambi at EU Council level” and if the pricing of the drug was an issue in other EU countries. A related question was also posed by Deputy Alan Kelly (Labour, Tipperary). Minister Harris said, “the issue of pricing and reimbursement of medicines, and patient access to affordable medicines, has been addressed at European level. In June of this year, the EU Council adopted conclusions on strengthening the balance in the pharmaceutical systems in the EU and its Member States. “Those conclusions invited Member States to explore opportunities for cooperation on pricing and reimbursement of medicines and to identify areas for cooperation which could contribute to higher affordability and better access to medicines. I have indicated my support for these measures and I welcome the opportunity for Member States to cooperate by sharing information so that we can achieve affordable and sustainable access to medicines.” Deputy Richard Boyd Barrett (AAA-People Before Profit, Dun Laoghaire) asked the Minister what was the Government’s strategy for dealing “with the issue of overcharging for medication here in general, and for newly released drugs for specific conditions in particular”. In his reply, the Minister said that, “under the new Framework Agreement on the Pricing and Supply of Medicines agreed between the State and IPHA, medicines are now subject to an annual downward-only price realignment. The price realignment is now based on a basket of 14 countries; this has been extended from nine and also includes more lower-cost countries. This will ensure that the State achieves better value for money on the cost of medicines as prices in the other reference countries are adjusted downwards over time. It also ensures that the prices paid by Ireland are not out of line with the other 13 EU Member States.” He added that the issue of affordability and access to new and innovative medicines represented a major challenge to the health service in Ireland and indeed to health systems internationally. “I have said previously that I am willing to examine, with the Oireachtas, new ways in which this challenge might be addressed.” Gardasil vaccine use should continue Gardasil, and alleged adverse reactions by some girls. Deputy Róisín Shortall (Social Democrats, Dublin North West) asked the Minister what steps he was taking to address “serious concerns of parents of girls who are reporting adverse reactions to the HPV vaccine”, and similar questions were posed by Deputies Tony McLoughlin (Fine Gael, Sligo-Leitrim) and Michael Fitzmaurice (Independent, Roscommon-Galway). Minister Harris said that each year in Ireland, around 300 women are diagnosed with cervical cancer. By January 2016, over 200 million doses of Gardasil had been distributed worldwide. In Ireland, over 580,000 doses had been administered and over 220,000 girls had been fully vaccinated against HPV since it was introduced in 2010. Last January, the European Commission endorsed the conclusion of the European Medicines Agency stating that there was no need to change the way HPV vaccines were used or to amend the product information. “This final outcome by the Commission is now binding in all member states. I encourage the parents of all eligible girls to ensure that their daughters receive this important cancer preventing vaccine,” the Minister added. Glucose monitoring for diabetes Deputy Ruth Coppinger (AntiAusterity Alliance, Dublin West) asked the Minister for Health when the Freestyle Libre flash glucose monitoring system will become available for public patients with diabetes. The Minister replied that the manufacturer must apply to the HSE for reimbursement of the device under the Community Drugs Schemes. A health technology assessment might then be required to assess its clinical benefits and cost-effectiveness. Many Dáil Deputies continue to raise concerns via Parliamentary Questions about the HPV vaccine, IPUREVIEW DECEMBER 2016/JANUARY 2017 Capecitabine for same le y da Availa b Accord Capecitabine Accord, available in presentations of 150 mg, 300 mg and 500 mg Available for same day delivery via United Drug! Please refer to the Summary of Product Characteristics (SmPC) for further information or scan above QR code Associated member Accord Healthcare Ltd., United Drug House, Magna Park, Magna Drive & Citywest Road, Dublin 24, Ireland Tel: +353 (0)1 463 2368 IE/CORP/002/11/16 healt hcare Ltd. www.accord-healthcare.ie Compassionate access scheme for emphysema drug Michael Fitzmaurice, Independent Margaret Murphy O’Mahony, Fianna Fáil Deputy Margaret Murphy O’Mahony (Fianna Fáil, Cork South-West) asked the Minister for Health if the clinical trial of the drug Respreeza, which treats emphysema caused by severe alpha-1, would continue to be made available to the 21 patients who are currently receiving the drug and if he would make it available to approximately 40 more patients if current assessments were favourable. The Minister said the NCPE was currently conducting an assessment of Respreeza as maintenance treatment of emphysema in adults with documented severe alpha1proteinase inhibitor deficiency. Once this assessment was completed, the HSE would consider it as part of its decision-making process when considering the drug for reimbursement. “The Minister said that for patients currently accessing Respreeza on a compassionate use basis, the company CSL Behring will continue to provide and administer the drug until the end of the year. However, the operation of compassionate access schemes are at the discretion of manufacturers. I have previously asked manufacturers to show compassion to reopen or maintain compassionate access schemes to patients during the assessment process by the HSE.” A related question about the same drug was raised by Deputy Sean Sherlock (Labour, Cork East). No supplies of BCG vaccine until next year The BCG vaccine to protect babies against tuberculosis (TB) has not been available in Ireland since May 2015, and the manufacturer has informed the HSE there will be no further supplies until next year. Consequently, BCG vaccination clinics in HSE clinics and maternity hospitals have been postponed until new stock arrives. This was stated in the Dáil recently by the Minister for Health in reply to Deputy Niamh Smyth. He said there was now a worldwide shortage of the vaccine and that last year, the United Nations Children’s Funds (UNICEF) had estimated a worldwide shortage of 65 million doses of BCG. The Minister also stated that efforts had been made to find another company to provide the vaccine to the requirements of the Health Products Regulatory Authority (HPRA) on safety and efficacy but no suitable alternative BCG product had been found. In Ireland, the number of cases of tuberculosis (TB) had been falling. In 2015, 318 cases of TB were notified to the Health Protection Surveillance Centre, giving a national TB notification rate of 6.9 per 100,000, the lowest rate reported since surveillance commenced. “According to the World Health Organisation, the definition of a low incidence TB country is one with a national TB notification rate of less than 10 cases per 100,000; Ireland is in this category. The risk to babies remains unchanged, even allowing for delay in getting BCG vaccine in Ireland,” he added. RECRUITMENT Assistant Professor (Practice Educator) School of Pharmacy and Pharmaceutical Sciences 5 year contract part-time (0.5 FTE) Applications are invited for this 5 year part-time appointment within the School of Pharmacy and Pharmaceutical Sciences tenable from 1st March 2017 (or as soon as possible thereafter). The School of Pharmacy and Pharmaceutical Sciences currently offers the Pharmacy degree, postgraduate degrees by research and a number of taught postgraduate courses. This new position has been introduced to support the introduction of the 5-year Integrated Pharmacy programme which commenced in the academic year 2015/16. It is designed to strengthen the School’s existing teaching and research in the pharmacy practice area and the appointee will participate in the proposed activities of APPEL (Affiliation for Pharmacy Practice Experiential Learning). APPEL is a joint initiative of the three Schools of Pharmacy (Trinity College Dublin, Royal College of Surgeons in Ireland (RCSI) and University College Cork (UCC)) to coordinate workplace-based learning and assessment. Applications will only be accepted through e-recruitment and further information and application details can be found at: https://jobs.tcd.ie Closing date for receipt of completed applications is: no later than 12 Noon (GMT) on Monday January 9th 2017. Trinity College Dublin, The University of Dublin www.tcd.ie TCD217 14x2 (83) 52 IPUREVIEW DECEMBER 2016/JANUARY 2017 We’re making it even easier to find unlicensed medicines. They’re now just a click away. shop.medisource.ie Medisource is delighted to introduce our new online ordering system for exempt medicinal products. Pharmacists can register for online access at shop.medisource.ie ■ Real-time stock information ■ Easy search filter ■ Tracking of online order history ■ Fast re-order option ■ Relevant product details e.g. HSE code, Fridge item, Foreign pack ■ No fax requirement The first dedicated and No. 1 supplier of unlicensed or difficult to get medicines in Ireland. Medisource is Irish-owned and has a team of pharmacist-led experts to deal with your enquiries. www.medisource.ie | Call 1890 2866366 | Fax 01 2866288 | Email [email protected] STUDIES MSD in Ireland launches Zerbaxa to treat complicated intra-abdominal and urinary tract infections, and acute pyelonephritis MSD has announced the availability of Zerbaxa (ceftolozane/tazobactam) in Ireland, a new intravenous antibiotic for the treatment of complicated intra-abdominal infections (cIAI), acute pyelonephritis and complicated urinary tract infections (cUTI) in hospital settings. The licensing of Zerbaxa was supported by positive data from two pivotal Phase 3 clinical trials demonstrating non-inferiority to their comparator; one in patients with cIAI and the other in patients with cUTI. Both trials met the pre-specified primary endpoints agreed with the European Medicines Agency (EMA). Zerbaxa represents a new option in the fight against antimicrobial resistance (AMR) in the gram-negative cIAI, cUTI and acute pyelonephritis space. The European Centre for Disease Control (ECDC) estimates 25,000 deaths per year associated with AMR and €1.5 billion in healthcare costs and lost production for the European Union (EU) as a whole. Zerbaxa (1g/0.5g) is a combination product consisting of the cephalosporin antibacterial drug ceftolozane sulfate and the betalactamase inhibitor tazobactam sodium. It is administered every eight hours by an intravenous infusion lasting one hour, with the treatment length normally lasting 4-14 days. Consideration should always be given to official guidance on the appropriate use of antibacterial agents. Two major studies demonstrate potential of MSD’s KEYTRUDA® (pembrolizumab) for the first-line treatment of metastatic non-small cell lung cancer in a broad range of patients At the ESMO 2016 Congress, the annual meeting of the European Society for Medical Oncology, MSD announced results from two major studies of KEYTRUDA® (pembrolizumab), the company’s anti-PD-1 therapy, in the first-line treatment of patients with metastatic non-small cell lung cancer (NSCLC). In the KEYNOTE-024 study, which evaluated squamous and non-squamous NSCLC patients whose tumours expressed high levels of PD-L1 (tumour proportion score, or TPS, of 50% or more), KEYTRUDA® provided a 50% reduction in the risk of disease progression or death and a 40% reduction in the risk of death compared to platinum doublet, the current standard of care. These data were also published in The New England Journal of Medicine. Based upon the results observed from this study, to date, KEYTRUDA® is the only anti-PD-1 to demonstrate superior progression-free survival (PFS) and overall survival (OS) compared to chemotherapy for the firstline treatment of both squamous and non-squamous NSCLC in patients whose tumours express high levels of PD-L1 and do not express EGFR or ALK genetic aberrations. A second study presented at ESMO was KEYNOTE-021; Cohort G included patients with metastatic non-squamous NSCLC regardless of PD-L1 expression level, KEYTRUDA (pembrolizumab) plus chemotherapy (carboplatin plus pemetrexed). The trial achieved a 55% objective response rate (ORR) compared to 29% for chemotherapy alone (the standard of care) and reduced the risk of disease progression or death by 47%. To date, KEYTRUDA® is the only anti-PD-1 therapy to demonstrate superior efficacy in combination with chemotherapy compared to chemotherapy alone in patients receiving first-line treatment. These data were published in The Lancet Oncology. MSD is currently advancing multiple registration-enabling studies in NSCLC with KEYTRUDA as monotherapy and in combination, including the combination of KEYTRUDA plus a platinum/pemetrexed-based chemotherapy regimen in patients with previously untreated, non-squamous NSCLC in the ongoing phase 3 KEYNOTE-189 trial. The KEYTRUDA clinical development programme includes more than 350 clinical trials across more than 30 tumour types, including more than 100 trials that combine KEYTRUDA with other cancer treatments. Over 100 Irish patients have participated in MSD’s KEYTRUDA clinical trials or were treated with pembrolizumab through MSD’s Expanded Access Programme (EAP). This research programme is part of a €300 million investment by MSD in R&D in Ireland, with a further €20 million investment in clinical trials activity in Ireland anticipated over the next five years. European Commission approves Stelara® (Ustekinumab) for treatment of adults with moderately to severely active Crohn’s disease Janssen-Cilag International NV has announced that the European Commission (EC) has approved the use of STELARA® (ustekinumab) for the treatment of adult patients with moderately to severely active Crohn’s disease who have had an inadequate response with, lost response to, or were intolerant to either conventional therapy or a tumour necrosis factor alpha (TNFα) antagonist or have medical contraindications to such therapies. STELARA is the first biologic therapy for Crohn’s disease that targets interleukin (IL)-12 and IL-23 cytokines, known to play a key role in inflammatory and immune responses. The recommended dosing regimen for STELARA is an initial induction dose (~6mg/kg) given via a single intravenous (IV) infusion. The first subcutaneous (SC) administration of 90mg STELARA should take place at week 8 after the intravenous dose. After this, dosing every 12 weeks is recommended. Patients who have not shown adequate response at week 8 after the first SC dose may receive a second SC dose at this time. Patients who lose response on dosing every 12 weeks may benefit from an increase in dosing frequency to every eight weeks. Patients may subsequently be dosed every eight weeks or every 12 weeks according to clinical judgement. The EC approval is based on data from three pivotal Phase 3 trials which included approximately 1,400 patients with moderately to severely active Crohn’s disease. The Phase 3 studies showed that treatment with STELARA-induced clinical response and maintained clinical remission in a significantly greater proportion of adult patients with moderately to severely active Crohn’s disease after one year of therapy compared to placebo. 54 IPUREVIEW DECEMBER 2016/JANUARY 2017 ar 01 h ip 75 n 1 468 U o ll 0 t r Ca e v si r.ie o clut Uniph x E a a EFFICAC EN 10 MULA NEW N AT R A L F U www.wellbelabs.com 0 % Y PRO V THE GENIUS HAIRBAND THAT PREVENTS LICE OR r de Or The Lice-Preventing Hairband Easily protect your kids with Leeloop, the Revolutionary Lice-Preventing Hairband. STUDIES STELARA was generally well tolerated as an induction and maintenance therapy in all three studies, and the safety profile of STELARA in the Crohn’s disease clinical development programme remained consistent with five years of cumulative data acquired in patients with psoriasis (with STELARA subcutaneous injections up to 90mg) and two years of safety data in patients with psoriatic arthritis who were treated with STELARA. In the placebo-controlled IM-UNITI maintenance study, adverse events were reported in similar proportions across STELARA and placebo treatment groups, the majority of which were related to gastrointestinal disorders, such as abdominal pain and diarrhoea, and infections/infestations, of which, nasopharyngitis and upper respiratory infection were the most common. Reported serious adverse events were similar in the STELARA groups compared to placebo and no deaths or major adverse cardiovascular events were reported. The marketing authorisation approval follows a positive opinion from the European Committee for Medicinal Products for Human Use (CHMP) of the European Medicines Agency (EMA) issued on 15 September 2016. This approval allows for the marketing of STELARA in all 28 member states of the European Union as well as the European Economic Area countries (Norway, Iceland and Liechtenstein). STELARA also received approval by the US Food and Drug Administration in September 2016 for the treatment of adult patients with moderately to severely active Crohn’s disease. European Commission grants marketing authorisation for MSD’s ZEPATIER™ (elbasvir and grazoprevir) for the treatment of chronic hepatitis C infection MSD has announced that the European Commission has approved ZEPATIER™ (elbasvir and grazoprevir) with or without ribavirin (RBV) for the treatment of chronic hepatitis C virus (HCV) genotype (GT) 1 or GT4 infection in adults. ZEPATIER is MSD’s once-daily, fixed-dose combination tablet containing the NS5A inhibitor elbasvir (50mg) and the NS3/4A protease inhibitor grazoprevir (100mg). The recent approval allows marketing of ZEPATIER tablets in the 28 countries that are members of the European Union, as well as European Economic Area members, Iceland, Liechtenstein and Norway. Thousands of chronic HCV patients worldwide participated in the ZEPATIER clinical development programme, which was designed to include patients with known treatment challenges, such as those with compensated cirrhosis and those who have previously failed treatment with peginterferon plus RBV, with or without a HCV protease inhibitor. In the trials, sustained virologic response (SVR) 12 weeks after the completion of therapy (SVR12, considered virologic cure based on undetectable HCV RNA levels) was achieved in 96% (301/312) of chronic HCV GT1b-infected patients treated with ZEPATIER for 12 weeks. In chronic HCV GT1ainfected patients, 93% (483/519) and 95% (55/58) achieved cure following treatment with ZEPATIER for 12 weeks or ZEPATIER plus RBV for 16 weeks, respectively. Elbasvir/grazoprevir is an investigational, once-daily, fixed-dose combination therapy containing elbasvir and grazoprevir. The combination was granted breakthrough therapy designation by the FDA, for the treatment of patients with chronic HCV GT1 infection with end stage renal disease on haemodialysis, and breakthrough therapy designation for elbasvir/grazoprevir for the treatment of patients with chronic HCV GT4 infection. IBRANCE® (palbociclib) receives approval in EU for the treatment of women with HR+/HER2- metastatic breast cancer Pfizer has announced that the European Commission (EC) has approved IBRANCE® (palbociclib) for the treatment of women with hormone receptor-positive, human epidermal growth factor receptor 2-negative (HR+/HER2-) locally advanced or metastatic breast cancer. The approval is for IBRANCE to be used in combination with an aromatase inhibitor. The approval also covers the use of IBRANCE in combination with fulvestrant in women who have received prior endocrine therapy. IBRANCE is the first medicine to be approved in Europe that works by inhibiting cyclin-dependent kinases 4 and 6 (CDK 4/6). It also is the first new medicine approved for the treatment of women with this type of metastatic breast cancer in the first-line setting in nearly 10 years. Women with HR+/HER2- metastatic breast cancer represent about 60% of all metastatic breast cancer cases. The EC approval is based on a robust submission package including results from the Phase 2 PALOMA-1 trial in postmenopausal women with estrogen receptor-positive (ER+)/HER2- metastatic breast cancer who had not received prior systemic therapy for their advanced disease, the Phase 3 PALOMA-2 trial in the same population and the Phase 3 PALOMA-3 trial in women with HR+/HER2metastatic breast cancer who had progressed on prior endocrine therapy. All three randomised trials demonstrated that IBRANCE in combination with an endocrine therapy significantly prolonged progression-free survival (PFS) compared to endocrine therapy alone or endocrine therapy with placebo. Breast cancer is the most common cancer among women. According to the National Cancer Registry of Ireland there are almost 30,000 women living with breast cancer in Ireland. Up to 30% of women diagnosed with and treated for early breast cancer will go on to develop metastatic breast cancer. Metastatic breast cancer is the most advanced stage of breast cancer which occurs when the cancer spreads beyond the breast to other parts of the body. There is no cure for metastatic breast cancer and patients are in need of new treatment options that help keep their cancer from worsening, manage symptoms and help them maintain quality of life for as long as possible. 56 IPUREVIEW DECEMBER 2016/JANUARY 2017 ar 01 h ip 75 n 1 468 U o ll 0 t r Ca e v si r.ie o r DON'T GET LICE. GET LEELOOP. EFFICAC EN 10 NEW N AT R A L F U www.wellbelabs.com 0 % Y PRO V de Or MULA a OR clut Uniph x E a The Lice-Preventing Hairband INTERNATIONAL NEWS Roisin Molloy, Membership & Secretary General’s Office Manager, IPU International pharmacy news Austria Successful lung checks in pharmacies will run for a second round The initiative “10 minutes for my lungs”, ran originally in the spring of 2016, was a great success. For two weeks, pharmacists in Vienna, Lower Austria, Salzburg and Carinthia screened patients for the risk of lung diseases. More than 20,000 people had their lung function measured with a digital COPD Screener and, together with the pharmacists, a risk assessment was performed using a validated questionnaire. The second round of “10 minutes for my lungs” took place in late November. For a week, the risk of lung disease could be detected in pharmacies and the lung function measured with a digital COPD Screener. Source: PGEU Monthly Newsletter October 2016 UK Pharmacy access to GP summary records slashes admin by 80% Granting local pharmacists access to summary information from GP patient records alleviates strain on GP practices and cuts admin time dealing with pharmacists by up to 80%, NHS Digital has said. One pharmacist 58 cut down on calls to their local GP practice from 200 to just 30 a month after being given access to the practice’s summary care records (SCRs), according to Harpreet Shergill, NHS Digital’s lead for rolling the scheme out across community pharmacy. With some practices having up to five pharmacies working with them, this has the potential to drastically cut down on GP workloads once the technology beds down, he said. Mr Shergill, who is himself a pharmacist, said the move marked the “biggest single change in pharmacy in the last 10 years”, with early data showing some pharmacies access the system up to 70 times a week. “Having access to this information empowers me as a pharmacist to provide care back to patients,” he told a King’s Fund event on emerging models in primary care recently. He said it allowed his pharmacy to sort “92% of cases” with patients on-site, without having to direct them back to their GP. The initiative also means that pharmacies are not reliant on practices being open to deal with certain enquiries, allowing issues to be sorted in the evening and on Sundays. To access the system, a pharmacist must use an NHS smartcard to see the patient’s information. This action is logged to show when the SCR is accessed and by whom and requires the patient’s verbal consent. Around 41% of pharmacies are enabled to use SCRs so far, with plans for them all to be live by the end of March 2017. Having access to the SCR means pharmacists can see information about any medicines prescribed, the strength and quantity of treatment and the date they were issued. They can also see information about allergies and adverse drug reactions. This enables them to deal with patient queries about their treatment or prescriptions. “Having access to this technology and this subset of the GP patient record allows me to contribute directly to patient care and support primary care in the provision of that care,” said Mr Shergill. “Historically, by not having access to the SCR, that would have necessitated a phone call to the practice, a conversation with the receptionist – or even with the GP.” Access to the information can quickly cut through all that and give clarity to patient. “We used to ring our local GP practice probably 200 times a month with all these queries around patients, prescriptions and medication. After the SCR was introduced and we got used to the technology, that call volume fell to 30 calls per month. That’s an 80% reduction in calls going in to that GP practice. So, if I’m a GP practice – and I had five pharmacies surrounding me locally – then how many calls are coming into my practice? How much time is being taken up by reception having to filter those calls, then deciding what needs to happen? The second benefit is because we’re solving this inpharmacy, there’s a reduction in unplanned patient visits and footfall into GP practices.” Source: PGEU Monthly Newsletter October 2016 UK RPS launches campaign to improve the care of people with long-term conditions The Royal Pharmaceutical Society has launched a new campaign to improve the care of people with longterm conditions through the better use of pharmacists. An average of one in three people across Great Britain have at least one long-term condition. Caring for them accounts for around 50% of GP appointments and approximately 70% of the health and social care budget across the country. As the third largest health profession in the UK, the skills and expertise of pharmacists must be maximised within the multidisciplinary team to provide the best care for patients. Without changing the model of care, the NHS risks being unable to meet the unprecedented increase in demand for its services. These new opportunities in clinical practice will enable pharmacists in all sectors to develop new roles. The RPS has published policy documents that focus on how the role of the pharmacist can be enhanced to prevent, identify, treat and support people with longterm conditions, as part of a multidisciplinary approach. The RPS is making four key calls to action: 1. Pharmacists providing direct patient care should have the IPUREVIEW DECEMBER 2016/JANUARY 2017 opportunity to train to become a prescriber, fully utilising those skills as part of the multidisciplinary approach to managing and supporting people with long-term conditions. To enable this change, we are asking for the law to change to allow practising prescribing pharmacists to mentor pharmacists who want to become prescribers. 2. The patient journey will be made easier by enabling pharmacists to directly refer to appropriate health and social care professionals, improving patient access to care and reducing the number of unnecessary appointments. 3. Patients will benefit from further integration of pharmacists into their multidisciplinary team, ensuring support at every stage of their journey, from prevention IPU Yearbook & Diary through to treatment and management of their long-term condition(s). 4. All pharmacists directly involved in patient care should have full read and write access to the patient health record, with patient consent, in the interest of high-quality, safe and effective patient care. Conference, where around 200 health professionals and NHS managers heard the calls to action and recommendations on how these can be achieved. A separate Parliamentary event on 30 November at the House of Commons will mark the launch in England with further activity in Scotland on 1 December at the RPS Board strategy day. Source: http://www.rpharms.com The RPS launched its campaign in Wales at the 6th Annual Medicines Safety 2017 The IPU Yearbook and Diary is the key information and reference publication for pharmacists, pharmaceutical companies, health professionals, and health officials, as well as providing financial, insurance and other service supplier details. The cost of the Yearbook is €60 including post and packing, with a 10% discount for 5 or more copies. Company Name: Address: Number of copies required: Purchase Order No: If your company uses a Purchase Order system, please ensure that the PO number is provided when ordering copies of the Yearbook. Please return order to: Irish Pharmacy Union, Butterfield House, Butterfield Avenue, Rathfarnham, Dublin 14, D14 E126. Telephone: 01 493 6401. Fax: 01 406 1556. Email: [email protected] BOOST YOUR PHARMACY SALES (WITHOUT OVERSTRETCHING YOUR BUDGET!) For further information on the IPU Retail Review service, please contact Darren Kelly on (01) 493 6401 / 086 028 9825 or email: [email protected] IPU Retail Banners 190X45 MAR16 ART.indd 3 IPUREVIEW DECEMBER 2016/JANUARY 2017 25/03/2016 17:55 59 IPU SUPERVISORY DEVELOPMENT COURSE – INFORMATION The role of a Supervisor is both challenging and complex! O ne of the objectives of a Supervisor is to manage the performance of their team by ensuring that they are performing to the best of their ability and engaged in the business’ objectives. This process includes setting performance goals, enabling the team to perform and managing individuals when performance is off target. This interactive workshop is delivered over two days, one month apart. Day one will specifically focus on the development of the Supervisor in skills such as communication and delegation. Day two will focus on the skills needed by the Supervisor to maximise the performance of the individual team member. DAY 1 – STEP UP TO SUPERVISOR Day 1 Workshop aims to equip participants to become effective in their role by providing them with a fuller understanding of their role as well as practical skills in communication, planning, delegation and feedback skills. Topics Covered nThe Role of the Supervisor – Role performance, behaviour and accountability nCommunication Skills – Verbal, non-verbal and behavioural nPlanning & Prioritising – Time, tasks, teams and self nDelegation Skills – Benefits, delegation continuum and how to nPerformance Feedback Skills – Re-enforcing feedback and corrective feedback COURSE METHODOLOGY This highly interactive workshop delivered over two days (one day per month) uses group discussion, case studies and role plays specifically aimed at guiding participants through realistic pharmacy based scenarios to practise these vital skills. COURSE ASSESSMENT, QUALIFICATION AND PROGRESSION Participant assessment includes an Assignment and Action Plans specifically related to evaluating themselves against Management Competencies. Participants who successfully complete the Assignment and Action Plans can progress to the Award in Leadership & Management with the Institute of Leadership & Management (ILM) through the IPU. COURSE SCHEDULE, FEES & VENUE There are no formal entry requirements but participants will either be practising or aspiring supervisors or managers with the opportunity to meet the assessment demands and have a background that will enable them to benefit from the course. Participants must have access to a PC and be computer literate. The cost for this course is €495 for participants working for IPU Members; €795 for participants working for Non-Members. The courses will be held in Butterfield House, Dublin, starting at 9.30am. The Spring course will be held on 21 February and 28 March 2017; the Autumn course will be held on 24 October and 22 November 2017. DAY 2 – COACHING FOR PERFORMANCE Day 2 Workshop aims to equip participants with the necessary skills and attitude to develop and manage the performance of employees and to conduct a performance and development review in a professional and enthusiastic manner. Topics Covered nPerformance Management – Defined, the Role of the Manager in Performance Management nWorkplace Coaching – Defined, Coaching Skill, Setting Performance Objectives nModelling, Managing and Monitoring Performance – Types of Performers, Feedback Skills nPerformance and Development Review – Personal Development Planning, Rewarding and Recognising Performance 60 IPUREVIEW DECEMBER 2016/JANUARY 2017 Application Form IPU Supervisory Development Course The IPU Supervisory Development Course is an introduction to Leadership and Management and is aimed at candidates who are in a supervisory or management role or aspire to be in the future. This interactive workshop is delivered over two days, one month apart. Pharmacy Details Name of Supervising Pharmacist: IPU Membership Number: GMS Number: Pharmacy Name: Business Name: Telephone Number: Email: Student Details Mr/Mrs/Miss/Ms: Forename(s): Surname: Date of Birth: Mobile Number: Email: Pharmacy Address: Cost of Course Cost for Part 1 and 2 is €495 to IPU Members - €795 to Non-Members. Course Dates Spring 2017 Day 1 Tue 21 Feb – Day 2 Tue 28 Mar – 9.30 – 17.00 Butterfield House q Autumn 2017 Day 1 Tue 24 Oct – Day 2 Wed 22 Nov – 9.30 – 17.00 Butterfield House q Please Return Completed Form to: IPU Training Unit, Irish Pharmacy Union, Butterfield House, Butterfield Avenue, Rathfarnham, Dublin 14, D14 E126, with a cheque made payable to IPU Services Ltd. Payment is also accepted by credit or debit card on 01 493 6401, Direct Dial: 01 406 1555, Fax: 01 406 1556, Email: [email protected]. NEWS Local pharmacy owners attend inaugural CarePlus Conference at Croke Park On 16 October, pharmacists from across Ireland attended the inaugural CarePlus Annual Conference, which was held in Croke Park, Dublin. The two-day conference brought together representatives from all 30 pharmacies from the CarePlus Group. Also in attendance were staff from Axium buying group, parent company of CarePlus. The conference’s theme was “The Changing Landscape of Irish Retail Pharmacy – Shaping the Future”. Many of the discussions during the conference centred around issues and opportunities currently facing the sector. 01 02 03 04 05 01 (L-R) Yvette Moynihan, Store Manager, Halley’s CarePlus Pharmacy; John Carroll, Managing Director, CarePlus Pharmacy; Fiona O’Malley, Supervising Pharmacist, Halley’s CarePlus Pharmacy. 02 Pictured (L-R) are Anton Savage, TodayFM host; John Carroll, Managing Director, CarePlus Pharmacy; Bobby Kerr, Entrepreneur and Chairman of Insomnia Coffee. 03 Pictured (L-R) are John Keane, CarePlus Green Road, Market Point and Enfield, with Donagh McTiernan, CarePlus, Kinnegad and Rochfortbridge. 04 Winner of Community Pharmacist of the Year, Cliona Barry, was unable to attend the award ceremony. Her award was accepted on her behalf by Paula Keating, Co-Owner of Keating’s CarePlus Pharmacies, Dooradoyle and Kilmallock. 05 Alison Cahill, Store Manager, CarePlus Pharmacy, Headford, and John Carroll, Managing Director, CarePlus Pharmacy. 62 IPUREVIEW DECEMBER 2016/JANUARY 2017 01 02 03 04 05 totalhealth Pharmacy Gala Ball & Pharmacy Awards 2016 The totalhealth Pharmacy Group recently held their annual Gala Ball & Pharmacy Awards Ceremony in the Radisson Blu Hotel, Galway. The celebratory event was attended by over 300 pharmacists, staff and employees of the totalhealth Pharmacy group nationwide along with industry partners. Dáithí Ó Sé, Rose of Tralee host and RTÉ personality, proved to be a very popular host and MC for the evening. During the night, Dáithí Ó Sé and Oliver Mc Guinness, Chairman, totalhealth Pharmacy Group, launched the totalhealth Christmas Gift Guide for 2016. The event was an opportunity for the totalhealth Pharmacy group to honour and thank the staff from all pharmacies across the country for the role they play in making the totalhealth Pharmacy brand the success it is. A key part of the evening was the presentation of the Pharmacy Awards and the Certificates of completion for the Medicine IPUREVIEW DECEMBER 2016/JANUARY 2017 01 (L-R): Dáithí Ó Sé; Andrew Buckley, Andrew Buckley’s totalhealth Pharmacy, Dublin; Barry Fitzpatrick, Clonmel Healthcare; Oliver McGuinness, Chairman, totalhealth Pharmacy Group. 03 (L-R): Dáithí Ó Sé; Bryan Dunne, GSK; Emer Kelly, Rose Finlay & AnneMarie Treacy, Rose Finlay totalhealth Pharmacy, Tullamore; Oliver McGuinness, Chairman, totalhealth Pharmacy Group. 02 (L-R): Dáithí Ó Sé; John Ruttledge, United Drug; Gráinne & Cormac Murphy, Murphy’s totalhealth Pharmacy, Ballaghaderreen; Oliver McGuinness, Chairman, totalhealth Pharmacy Group. 04 (L-R): Dáithí Ó Sé; Olive Reynolds, Mylan; Ann Gray and the team at Ann Gray’s totalhealth Pharmacy, Limerick; Oliver McGuinness, Chairman, totalhealth Pharmacy Group. 05 (L-R): Dáithí Ó Sé; Greg Farrell, Actavis; Niamh Murphy and team at Murphy’s totalhealth Medical Hall, Ballinasloe; Oliver McGuinness, Chairman, totalhealth Pharmacy Group. Counter Assistant Training programme. The Pharmacy of the Year 2016 winners in their categories were: Community Award Andrew Buckley’s totalhealth Pharmacy, Rathfarnham. Sponsored by Clonmel Healthcare Brand Award Murphy’s totalhealth Pharmacy, Ballaghaderreen. Sponsored by United Drug Customer Service Award Murphy’s totalhealth Medical Hall, Ballinasloe. Sponsored by Actavis VIP Loyalty Programme Ann Gray’s totalhealth Pharmacy, Limerick. Sponsored by Mylan Over 100 staff members have recently completed the totalhealth Medicine Counter Assistant Training programme. These staff members were presented with their certificates and badges on the night (pictured above). Social Media Rose Finlay totalhealth Pharmacy, Tullamore. Sponsored by GSK 63 HAVING DIFFICULTIES WITH YOUR HSE PCRS CLAIMS? IPU STAFF MEMBERS DEREK REILLY AND AOIFE GARRIGAN CAN ASSIST YOU WITH ANY DIFFICULTIES YOU MAY HAVE WITH THE HSE PCRS. IN 2015, 88% OF PCRS QUERIES RECEIVED BY THE IPU WERE RESOLVED. A wealth of information is available on the HSE Contract section of the IPU website including: Information on the HSE Contract, claim submission dates and fees. Circulars and correspondence relating to each of the community drug schemes. Information on NOACs, ULMs and other medicine categories. Legislation and information relevant to the operation of the community drug schemes. Details in relation to Generic Substitution and Reference Pricing. A record of submissions made by the IPU in relation to FEMPI and copies of recent correspondence to the HSE and DoH. If you need assistance with your PCRS claims, or have any other queries relating to the HSE contract, please contact Derek or Aoife on 01 406 1557/01 493 6401. NEWS Minister Corcoran Kennedy launches second Healthy Ireland survey Marcella Corcoran Kennedy TD, Minister of State at the Department of Health with responsibility for Health Promotion, launched the Summary Report of the second Healthy Ireland Survey in October. The second annual Healthy Ireland Survey of 7,500 people aged 15 and over living in Ireland gives an up-to-date picture of the health of the nation and reports on many lifestyle behaviours such as smoking, alcohol consumption, physical activity, diet and mental health. A number of new topics have been included in this year’s survey, such as multiple risk factors and knowledge and attitudes about health behaviours. The Survey showed that of the four types of unhealthy behaviours under consideration, the most common was that 73% of the population eat fewer than five portions of fruit and vegetables daily. Between a fifth and a third of the population have each of the other three behaviours – binge drinking (28%), sedentary behaviour (26%) and smoking (23%). Some of the important findings include: n 84% of people living in Ireland say their health is very good or good, although 28% indicate that they have a long-standing illness or health condition. n Three in five eat snacks every day, with 42% of the population eating six or more portions daily. n 14% consume sugar-sweetened drinks daily, rising to 22% of those aged 15 to 24. n While 90% of respondents know that alcohol is a risk factor for liver disease, only 27% of women are aware of the increased risk of developing breast cancer as a result of heavy drinking. n The average annual number of GP visits rises from 3.4 visits among 15 to 24 year olds to 8.4 among those aged 75 and older and 27% have consulted a medical or surgical consultant in the past 12 months. n While only 54% of people living in Ireland said they would be willing to live with somebody with a mental health problem, 83% of people said they would be willing to carry on a relationship with a friend who developed a mental health problem. IPUREVIEW DECEMBER 2016/JANUARY 2017 HIQA to commence medication safety inspections in public acute hospitals The Health Information and Quality Authority (HIQA) has announced that it is commencing inspections in public acute hospitals to improve patient safety related to medication usage. Aoife Lenihan, lead inspector on the medication safety monitoring programme, said, “Medications are the most commonly used intervention in healthcare, and advances in medication usage continue to play a key role in improving patient treatment success. However, where medicines are used, the potential for error, such as in prescribing, administering or monitoring, also exists. While most medication errors do not result in patient harm, medication errors have, in some instances, the potential to result in catastrophic harm or death to patients. “Medication safety has been identified by a number of bodies in Ireland as a key focus for improvement and it is estimated that, on average, at least one medication error per hospital patient occurs each day. This means that there could be up to three million medication errors in Irish public hospitals per year.” A phased approach for monitoring medication safety in public acute hospitals will commence, which will allow and encourage incremental improvement in the medication safety systems in place. The first phase will initially focus on the fundamental governance and structure requirements to support a medication safety programme. Further monitoring in subsequent phases will focus on specific structures and systems that have been proven to enhance the safety of medication use in healthcare. The Guide to the Health Information and Quality Authority’s Medication Safety Monitoring Programme in Public Acute Hospitals outlines the requirements for service providers under phase one of the programme. 65 NEWS European pharmacists host EP event on health systems On 15 November, the Pharmaceutical Group of the European Union (PGEU) hosted an event entitled ‘State of Health in EU: Community Pharmacy Contribution’ in the European Parliament, sponsored by Françoise Grossetête MEP (EPP). This event brought together several renowned international experts and senior EU Officials, as well as representatives of patients, the healthcare industry and healthcare professionals to discuss the challenges and common problems that European health systems currently face, including antimicrobial resistance, the burden of chronic diseases, ageing population, adherence problems, access to and fragmentation of care, and spiralling costs. The meeting highlighted community pharmacy’s contribution to sustainable health systems in the form of patient-focused pharmacy services such as medicines use review, health checks, chronic disease management programmes and vaccination, which aim to address some of those challenges. PGEU Immediate Past President, Darragh O’Loughlin, who chaired the meeting, in his closing remarks, said, “More than 90% of medicines are dispensed in community pharmacies. We, as a profession, are ideally placed to improve medication adherence, to address issues relating to polypharmacy and to empower patients to self-manage their long-term conditions. Our network of 160,000 community pharmacies provides a unique opportunity to improve access to disease prevention, health screening and early intervention. Our citizens live most of their lives in the community. We need to keep that in mind when thinking about our health systems. Effective, accessible and resilient health systems rely on strong primary care. All healthcare professionals and in particular community pharmacists must be enabled to play their part fully.” European pharmacists renew eHealth statement On 17 November, PGEU approved a Statement on eHealth recommending (1) to engage with pharmacists as experienced users to develop eHealth policies and services at local, regional or national levels; (2) to integrate eHealth into health systems so it complements and supports existing practice; (3) to link electronic health records with ePrescribing systems; (4) and to improve communication and collaboration between patients, healthcare professionals and information communication technology (ICT) developers to obtain the full potential of eHealth technologies and build confidence and trust. The statement highlights that no other healthcare profession has invested more than community pharmacy in terms of its own funds into innovative ICT infrastructure in order to deliver benefits to the public. Evidence suggests that eHealth improves accessibility to care, promotes further integration of the primary healthcare system, improves health outcomes, reduces costs to health systems payers, improves health literacy, supports self-care and enhances patient safety and quality of care. The statement calls for the community pharmacy profession to be recognised, supported and adequately reimbursed for their continuous investment in eHealth. Pfizer scoops four accolades at Pharma Industry Awards Pfizer swept the boards at this year’s Irish Pharma Industry Awards, winning in four categories across its Irish operations. Pictured is Pfizer MD Paul Reid along with representatives from across Pfizer in Ireland accepting the award for Pharma Company of the Year (Large). Pfizer Ringaskiddy picked up the Operational Excellence Award and the Grangecastle site was awarded Biotech Company of the Year. Pfizer Healthcare Ireland was also honoured with the Communications Award for the Pfizer Health Index 2016. The awards took place in the Ballsbridge Hotel, Dublin. 66 IPUREVIEW DECEMBER 2016/JANUARY 2017 NEWS Defibrillator donated to worthy housing project PGEU welcomes Health at a Glance: Europe 2016 PGEU has welcomed the OECD and European Commission report “Health at a Glance: Europe 2016”, which was released in November. PGEU strongly supports the call to strengthen EU primary care systems and expand the role of community pharmacists. According to the report, earlier diagnosis and better treatments have substantially increased the share of people surviving chronic diseases. Europeans live longer, but not necessarily healthier. According to the most recent figures, the burden of ill-health on social benefit expenditures exceeds that which is spent on unemployment benefits. Even so, EU member states spend on average only 3% of their health budgets on public health and prevention. The global financial crisis has hit the most vulnerable citizens hardest. In several EU countries, the less advantaged members of society have lower life expectancies and difficulties in accessing healthcare, predominantly resulting from lack of financial resources. PGEU Secretary General Jurate Švarcaite said, “Pharmacies have a crucial role to reduce inequalities in access and quality of healthcare, as well as the number of avoidable emergency department visits and hospitalisations across EU countries. The network of 160,000 community pharmacies in Europe provides a unique opportunity to improve access to disease prevention programmes, health screening and early interventions for all citizens, including those with the least means. “We are particularly pleased that the OECD/EC Report recognises that expanding the role of community pharmacists is an important policy lever that European countries could pursue to provide both wider preventive healthcare and better management of long-term conditions. A strong body of evidence shows that enhancing the role of community pharmacists in primary care systems brings significant improvements in disease prevention and quality of services. For example, in an increasing number of European countries, community pharmacists already provide patient-focused pharmacy services such as medication use reviews, health checks, chronic disease management programmes, vaccination etc.” IPUREVIEW DECEMBER 2016/JANUARY 2017 Fleming Medical has recently donated a defibrillator to Clúid Housing, an award winning not-for-profit charity that provides over 5,500 affordable high quality homes to people with different needs in Ireland. Residents from one of Clúid’s sheltered housing schemes, had been calling for the installation of a defibrillator to provide peace of mind within their community. The development is located in Marewood Court, Ballymun, Dublin 9, where residents are aged from 88 years old and downwards. Some of the residents will receive training in the use of the defibrillator. Daniel O’Halloran, Scheme Manager, Marewood Court, said, “We are blown away with such a generous donation. It means that should a cardiac arrest occur on site, we will be fully prepared to carry out resuscitation; this is really reassuring for all our residents, young and old.” “We are delighted to donate the defibrillator to such a great project. Defibrillators should be located more and more throughout our communities to reduce cardiac arrest fatalities,” said Mark Fleming, Fleming Medical. Pictured below are (L-R): James Reihill, Fleming Medical; Sam Webster, Resident; Nuala King, Resident; Pat Blaney, Resident; Kevin Holden, Resident; Daniel O’Halloran, Scheme Manager. 67 NEWS Minister for Health confirms Meningitis B and Rotavirus vaccinations for 1 December Pictured are Oonagh O’Hagan, Meagher’s Pharmacy Group, Stuart Fitzgerald, Director, Fitzgerald Power Ltd, Kate McBride, Ulster Bank, Olaf Fitzsimmons, Ulster Bank Head of SME Bank Area East. Ulster Bank ‘Expansion in Pharmacy’ business breakfast Approximately 60 people attended a Breakfast Briefing event in Ulster Bank headquarters in Dublin on ‘Expansion in Pharmacy’ on 14 November. It was an engaging event where attendees discussed the economic and banking environments for pharmacy expansion. Stuart Fitzgerald of Fitzgerald Power discussed pharmacy ownership and the acquisitions market, while Conor Walsh, Manager of the Dublin Business Centre at Ulster Bank, discussed Ulster Bank’s positive and supportive view of the sector and support of good pharmacists to meet their business goals. A panel discussion was also held featuring Oonagh O’Hagan, Meagher’s Pharmacy; Nicol Baird, Baird’s Pharmacy Group; and Peter Maher, Allcare Pharmacy. Only 1 in 3 women routinely take folic acid supplements Minister for Health Simon Harris TD has confirmed that parents can avail of Meningococcal B and Rotavirus vaccinations from their family doctor from 1 December. This follows consultation under the Framework Agreement between the Irish Medical Organisation, the Department of Health and the HSE. All babies born on, or after, 1 October 2016 will receive vaccines for Meningococcal B (Men B) and Rotavirus disease in addition to the other childhood vaccines currently given. The first doses of these vaccines are given at two months of age, which means that the first babies are due to begin receiving these vaccines from the beginning of December. Results from the latest survey for safefood’s folic acid campaign have revealed that, while more than 95% of women are now aware of the benefits of taking folic acid, only one in three actually routinely take it. The survey coincides with the latest phase of the campaign, ‘Babies Know the Facts About Folic’, which aims to encourage women to take folic acid supplements and help address Ireland’s high incidence rate of Neural Tube Defects (NTDs) like Spina Bifida among new-born babies. Recently-published Irish research has also shown that three out of four women who attend for antenatal care have not taken folic acid supplements at the critical time which is before they become pregnant. Among women surveyed for the campaign, 60% felt that women should take folic acid all the time, whether planning a pregnancy or not. A further 37% of women felt they should take it before getting pregnant and for the first three months. For more information, visit www.safefood.eu/folicacid. 68 IPUREVIEW DECEMBER 2016/JANUARY 2017 NEWS World leaders advocate ending all penalties for drug consumption and possession for personal use Marie Keating Foundation launches ‘Heroes of Hope: Stories of prostate cancer survival’ to showcase real Irish men MarieKeatingFoundation: GAA legend Sean Boylan, former RTÉ broadcaster Michael Murphy and former rugby international Tony Ward, all prostate cancer survivors, are helping the Marie Keating Foundation bring hope and support to people affected by prostate cancer through a new exhibition called ‘Heroes of Hope: Stories of prostate cancer survival.’ 15 men share the story of their diagnoses, treatment and survival for the exhibition, proudly supported by Astellas Oncology. It is currently on display in Connolly and Heuston stations in Dublin until the end of January 2017 and will then tour sporting and hospital venues throughout 2017. The exhibition is also available to view online at www.mariekeating.ie/ heroes-of-hope. IPUREVIEW DECEMBER 2016/JANUARY 2017 Last month, the Global Commission released its new yearly report, Advancing Drug Policy Reform: a new approach to drug decriminalization, which details the destructive and harmful consequences of punitive drug policies and the need to reconsider reviewing current decriminalisation models. The report shows how their implementation has helped to achieve more effective drug policies, with a greater emphasis on justice, dignity and human rights. Building on these successes, the report advocates ending all penalties (civil and criminal) on persons who use drugs, and issues a call for market regulation as the next logical step. “After years of denouncing the dramatic effects of prohibition and the criminalisation of people that do no harm but use drugs on the society as a whole, it is time to highlight the benefits of well-designed and well-implemented peoplecentred drug polices,” said former Swiss President Ruth Dreifuss, Chair of the Global Commission on Drug Policy. “These innovative policies cannot exist as long as we do not discuss, honestly, the major policy error made in the past, which is the criminalisation of personal consumption or possession of illicit psychoactive substances in national laws.” The new report from the Global Commission on Drug Policy issues the following recommendations: 1. States must abolish the death penalty for all drugrelated offenses. 2. States must end all penalties—both criminal and civil—for drug possession for personal use, and the cultivation of drugs for personal consumption. 3. States must implement alternatives to punishment for all low-level, nonviolent actors in the drug trade. 4. UN member states must remove the penalisation of drug possession as a treaty obligation under the international drug control system. 5. States must eventually explore regulatory models for all illicit drugs and acknowledge this to be the next logical step in drug policy reform following decriminalisation. 69 NEWS Statement from Minister for Health, Simon Harris TD regarding medicinal cannabis Minister Harris announced in November that he wants to review Ireland’s policy on medicinal cannabis with the best clinical advice and expertise. As part of this review, the Minister has asked the Health Products Regulatory Authority (HPRA) to provide him with their expert scientific advice. “This is not a discussion about decriminalising cannabis in any way shape or form, it is about reviewing our current policy and seeking to inform ourselves of the latest medical and scientific evidence on the potential medical benefits of cannabis for some people with certain medical conditions,” the Minister said. Cannabis for medical purposes is available in a number of countries, e.g. Netherlands, Czech Republic, Canada, Australia, Malta, Croatia and certain states in the US. However, it remains strictly controlled in Ireland. In the countries where it is available, it is strictly regulated but available on prescription from doctors and supplied in a standardised form through pharmacists. The Minister has asked the HPRA to provide advice on: FULL-TIME PHARMACIST REQUIRED Adrian Dunne Pharmacy requires a Full-Time Pharmacist in Portarlington (10mins from the Kildare Village SC). Please reply with CV to [email protected] or telephone 086 857 6565 WHELANS PHARMACY, GOREY, CO WEXFORD Support Pharmacist 2-5 days per week. May suit new graduate. No Late nights/ Sundays/Bank Holidays. Contact 053 943 0545 or [email protected] n recent developments in the use of cannabis for medical purposes; in particular, this should include an overview of products that have been authorised in other jurisdictions, an overview of the wider ongoing and emerging clinical research in new indications and evidence of efficacy; n the different regulatory regimes in place in countries which allow cannabis to be used for medicinal purposes; and n legislative changes that would be required to allow use of cannabis for medicinal purposes in Ireland. The Oireachtas Health Committee will also examine the issue of cannabis for medical purposes. The Minister hopes to receive the report from the HPRA and the output from the Oireachtas Health Committee in January. He will then be in a position to move forward with any legislative changes that may be recommended. GUERINS PHARMACY, NENAGH Pharmacist required. Full time or part time. Newly-qualified welcome. Contact [email protected] or 086 638 7722. FULL-TIME PHARMACIST REQUIRED FOR MULLINGAR May suit newly qualified or experienced pharmacist. Apply with CV to [email protected]. To advertise here, contact Aoibheann at [email protected] FULL-TIME PHARMACIST AND COUNTER ASSISTANT. New opening in east Galway. Monday to Friday; No Saturdays. Reply to: PO Box 816 ALL BOX NUMBER REPLIES SHOULD BE POSTED TO: Irish Pharmacy Union, Butterfield House, Butterfield Avenue, Rathfarnham, Dublin 14. PHARMACY FOR SALE. With Residence. North Tipperary. Excellent business opportunity. Reply in strictest confidence. Reply to: PO Box 916 This independent service is free to IPU members. Entries will be deleted after three months. Advertisements should be forwarded to: Aoibheann Ní Shúilleabháin, IPU, Butterfield House, Butterfield Avenue, Rathfarnham, Dublin 14. Tel: (01) 493 6401. Fax: (01) 493 6626. Email: [email protected] 70 IPUREVIEW DECEMBER 2016/JANUARY 2017 CLASSIFIEDS NEW Insurance Scheme for PHARMACISTS PROFESSIONAL INDEMNITY, LEGAL EXPENSES including FITNESS TO PRACTICE and RETAIL. O’CALLAGHAN INSURANCES For Best in Class. Contact the professionals Dundalk Office: 042-935 9004 Navan Office: 046-902 1855 Monaghan Office: 047-64998 O’Callaghan Insurances t/a O’Callaghan Insurances is regulated by the Central Bank of Ireland Selling Your Pharmacy RDA Accountants can offer you a complete service including business valuation, negotiations and tax advice in relation to the sale of your pharmacy based on 25 years’ experience in this area. RDA Accountants have contacts with a number of potential buyers who may be interested in the purchase of your pharmacy. To discuss in strictest confidence, please contact Jim Doyle, Senior Partner, on 086 2684184 or email [email protected]. FOR SALE Victorian apothecary / pharmacy and medical antiques, as well as apothecary bottles, for sale. Would make a nice display. Antique apothecary or medical antiques also bought. Please phone 083 181 0011 for details. PHARMACIST REQUIRED Stacks Pharmacy is looking for a Full or Part-Time Pharmacist to join our team in our Callan Pharmacy in Kilkenny. Package: FLEXIBLE HOURS, NO LATE NIGHTS, NO BANK HOLIDAYS, SOME SATURDAYS If interested, send your CV to [email protected] or call 01 880 0120. DROGHEDA START-UP PHARMACY OPPORTUNITY Opportunity for a pharmacist to establish a new business in a prime commercial location on the Dublin Rd, Drogheda. Long-term lease available in established GP-owned medical development. Please call 083 8677777 for further information. To advertise here, contact Aoibheann at [email protected] IPUREVIEW DECEMBER 2016/JANUARY 2017 71 Wishing you all a very Merry Christmas & a Prosperous New Year TRUSTED OTC PRODUCTS MAJORITY OF OUR PRODUCTS MANUFACTURED WITHIN EUROPE BRANDED MEDICINES CLEAR, CONSISTENT, HIGH QUALITY PRODUCTS AND PACKAGING GROWING PORTFOLIO OF OVER 250 LINES HIGH QUALITYGENERIC MEDICINES FLEXIBLE ACCOUNT MANAGEMENT SUPPORT SIMPLE TRANSPARENT PRICING SCHEMES HIGH QUALITY HOSPITAL SPECIALITIES WE CAN SUPPLY OVER 70% OF THE MOLECULES ON THE GENERIC SUBSTITUTABLE LIST € The more we grow, the more we support you Your Preferred Partner Date of preparation November 2016. Reg code NA-093-01