Memorandum by the Chief Executive of the
National Pharmaceutical Association (PI 116)
INFLUENCE OF THE PHARMACEUTICAL INDUSTRY
I write following my appearance before the Select
Committee on 11 November 2004 to provide additional information
on a number of issues raised during the session.
The NPA represents the owners of community pharmacies
in the UK. We have in membership the owners of around 11,000 pharmaciesjust
about all except Boots. In representing the interests of our members
we inevitably have extensive contact with pharmaceutical manufacturers
and their representatives. We have regular contact with the industry
associations (ABPI in the case of prescription medicine manufacturers
and PAGB in the case of the manufacturers of non-prescription
medicines) to explore areas of mutual interest and to ensure that
we keep abreast of developments within each other's sectors. On
a similar basis we have contact with individual manufacturers
on an ad hoc basis.
There is considerable interest in community
pharmacy at the present time given its changing role. As a means
of helping manufacturers understand the changing face of pharmacy
so that this can be incorporated into their strategic planning,
we have established a corporate members programmeNPA Matrixthrough
which manufacturers can have a structured dialogue with the NPA's
senior management team. We have six Matrix members, each paying
a membership fee of £10,000.
We also look to the industry for sponsorship.
This is principally to support training and education materials
or resources to improve pharmacy practice provided by the NPA
to its members. For example, we have had sponsorship to help cover
the costs associated with our medicines counter assistant course,
a dispensing technician course, CD-ROMs covering the Drug Tariff
and Pharmacy Law and Ethics, and a guide to implementing standard
operating procedures (SOPs) into pharmacies. This sponsorship
is a means of keeping costs down for our members. In 2003 we received
sponsorship of £54,000. The additional costs associated with
the design, printing and distribution of our SOP pack were settled
directly by the sponsor with the agencies carrying out the work.
We are currently seeking sponsorship of a resource we are producing
to help members understand and implement the requirements of the
new pharmacy contract, which has just been agreed with the Department
I should stress that this sponsorship relates
to the design, printing or distribution of our materials. However
the detail contained in these resources is the sole responsibility
of the NPA and materials are normally written and developed in-house.
The NPA therefore retains full editorial control over the content.
Any sponsorship is recognised through the inclusion of the sponsor's
name and logo within the material.
As one would expect, manufacturers produce their
own materials for pharmacists and pharmacy staff. We actively
encourage manufacturers to produce objective material, which is
truly training or education material rather than company propaganda.
To help them achieve this we offer an NPA Training Seal service
where the NPA will vet material to ensure they achieve this objective.
We charge a fee for this to reflect the time and effort we put
into examining their materials. Total revenue from the Training
Seal in 2003 was £32,000. A brochure giving further information
on the Training Seal is enclosed.
One of the issues raised at the evidence session
on 11 November was Patient Information Leaflets (PILs). In dispensing
prescriptions, pharmacists face an obligation to provide fully
labelled packs and patient information leaflets to patients. Their
ability to do this is however frustrated by the fact that they
are obliged in many cases to provide the exact quantity written
on a prescription. Where a prescription calls for the same quantity
as contained in a patient pack, there is no problem; a fully labelled
pack with a PIL will be provided. In cases, where the quantity
is at variance with the patient pack quantity however, the pharmacist
must "break bulk" and issue the required quantity from
a larger pack. As there will only be one PIL in the pack this
means that subsequent supplies will be made without a leaflet.
Clearly this places pharmacists in an invidious position. Attempts
by the DH and MHRA to solve this conundrum have not been successful.
The last proposal was for pharmacists to either photocopy or download
PILs from the internet. For a variety of reasonsprincipally
those of safetythe proposals were rejected by all stakeholders
Pharmacists endeavour to issue leaflets whenever
they can. However even where leaflets are issued, they are difficult
to understand or interpret by many patients. The reason for this
is that leaflets are principally legal defence documents rather
than an attempt to provide comprehensible information to patients.
At the meeting I read out an extract of one such leaflet. The
PIL I selected was for Delta Cortril (a brand of prednisiolone).
A copy of this leaflet is enclosed.
We have not done any work on improving the content
of PILs to make them easier for patients to understand. However,
the Committee on Safety of Medicines is undertaking work in this
area. They have established a working group to look at PILs. A
consultation document toward improving the utility of PILs is,
we understand, to be published soon.