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Ireland’s Official Pharmacy Publication
DECEMBER 2016/JANUARY 2017
Future
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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.
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IPUREVIEW DECEMBER 2016/JANUARY 2017
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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
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COULEURS
PROCESS CL
Quadri
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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
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PHARMACY SPECIALISTS | SAME DAY AUDITABLE REPORTS
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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
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TRANSPARENT FILM DRESSINGS
For moderate to highly exuding
wounds, ulcers, second degree burns
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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
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•
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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
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“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.
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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]
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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
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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
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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
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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
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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:
Ÿ
Ÿ
Ÿ
Ÿ
Ÿ
Ÿ
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
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Date of preparation November 2016. Reg code NA-093-01