E-DRUG: To Dispense or not to dispense

[Kirsten Myhr <myhr@online.no>]

E-DRUG: To Dispense or not to dispense (2)
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Dear Margareth,

What Wilbert says is correct. It is very important to separate prescribing 
and dispensing to avoid high cost and irrational prescribing. An example of
a country which some years ago realised that dispensing doctors were very
expensive to health care was Japan (I still have at home an article from
the Economist about that), and a couple of months ago I read in Scrip that
also South Korea would restrict/stop this practice.

The Pharmaceutical Journal of the Royal British Pharmaceutical Society 
carried 13 February 1999 page 211 a notice saying: ''Dispensing doctors 
spent more than half as much again on medicines for their patients as did 
prescribing general medical practitioners in 1997-98.'' Moving on to give 
the exact amounts...
and on the same page is a notice on the dispute which obviously exists 
between dispensing doctors and community pharmacists in UK. May be some UK 
E-drugger can enlighten you more on this?

In the USA, doctors have had a right to dispense, but have never used it 
because they did not need the money. Now, being sqeezes by HMOs, they have 
seen this as an opportunity to earn more money. E.g. they have opened 
Internet clinics where they consult, prescribe and dispense - most common 
are probably sex clinics, clinics for men with hair growth problems and 
clinics for weight problems or to stop smoking. FDA and state authorities 
are not happy with this.

However, also pharmacists must 'get their act together' and abide by the 
law. Of course they should not sell prescription drugs without 
prescription! This is a major problem and one which in the Balkans also is 
common. Never understood why doctors let it happen! The pharmacist's role 
should be clear and is also defined in documents issued by WHO and FIP (the
International Society of Pharmacists, http://www.fip.nl) and are available 
electronically.

In Norway, like in the Netherlands, license to dispense has in rare cases 
been given to doctors in remote areas.

Wishing you all the best in your struggle to make a good Pharmacy Act and 
Medicines Act!

Kirsten

Kirsten Myhr, MScPharm, MPH
Pharmaceuticals Officer
WHO HA Office
Rruga 'Sotir Kolea', Vila nr. 34/1
Tirana, Albania
Tel/fax: +355 42 71 831 or +355 42 72 522
myhr@online.no
 
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