Editorial: Am I Missing Something Here!

In the first paragraph of a weekly newsletter, a major professional pharmaceutical organization reported this week that the future of pharmacy will involve using technicians to perform more managerial and clinical activities that have traditionally been performed by pharmacists.

Am I missing something here? If technicians already perform much or most of the technical distributive and compounding roles in pharmacy and there is a drive to involve them also to the performance of "managerial and clinical activities" in the pharmacy, I fail to understand what pharmacists will be doing. The article states that this will provide pharmacists more time to provide "pharmaceutical care" (for limited, inadequate, or no reimbursement). However, I thought that pharmaceutical care was involved to some extent in ALL the functions of a pharmacist, i.e., dispensing, clinical activities, counseling activities, compounding activities, etc. If "pharmaceutical care" is not involved in performing "clinical activities," then we need to have a better understanding of the predictions of what pharmacists will be doing and how they will be receiving adequate reimbursement to support a $100K annual salary (which requires about $125K total commitment by the employer).

During the 1970s and 1980s, when clinical pharmacy was being promoted as the future of pharmacy, I clearly remember it being promoted that pharmacy should "do away with the drug products and only be clinicians in an office-based practice!" This battle was fought for several years. Where would we be now if we turned our backs on the drug product (no dispensing functions; our primary source of income) and set ourselves up as an office-based profession to provide pharmaceutical care (for limited or no reimbursement)? We certainly would not be having a pharmacist shortage, as the number of positions that only provide that function (apart from the relationship with the product) is extremely limited!

Time for a "reality check!" "Compounding pharmacists" are more involved in clinical activities and pharmaceutical care than most pharmacists; it is a part of the process of individualizing medications by working hand in hand with physicians and patients. Physicians rely upon compounding pharmacists for clinical recommendations in all facets of drug therapy.

I still wonder why some promote a practice where the functions of a 6-year college graduate are being assigned to technicians with far less training�please don't get me wrong; there are many fantastic technicians in pharmacy, and I applaud and support their work because we could not do without them. Nonetheless, either we are trained professionals to practice "pharmacy" or we are not. The decisions of what pharmacy is and will be are being made�please weigh in by voicing your opinion and by being active in the pharmacy organizations.


Loyd V. Allen, Jr., PhD, RPh
Editor-in-Chief

Rockville, Md., November 27, 2007 - The U.S. Pharmacopeia is pleased to announce that changes to General Chapter Pharmaceutical Compounding - Sterile Preparations <797> are final and available online prior to becoming official. This revision tightens standards and conditions for sterile compounding over the current version of <797>, and will help improve patient safety.

The full chapter will be posted as a Revision Bulletin on USP's Web site at http://www.usp.org/USPNF/pf/generalChapter797.html as of December 3, 2007. These revisions will become official on June 1, 2008, and will be included in USP 32-NF 27 and the second edition of the Pharmacists' Pharmacopeia, which will be published in March 2008. The revised standards are being published online to give the compounding community time to implement changes before the official date. After June 1, the current version in USP 31-NF 26 will no longer be the official chapter.

According to a November 29, 2007 New York Times article, Senator Kohl, Democrat of Wisconsin, is investigating Genentech�s plan to restrict the availability of Avastin. Such actions by Genentech would force physicians to use a more expensive medicine for the treatment of eye diseases. According to Senator Kohl, the cost to US taxpayers will be between $1 billion to $3 billion a year if ophthalmologists are not allowed access to Avastin.

Two flu drugs (Tamiflu and Relenza) may receive additional precautionary labeling about neurological problems seen in children. Tamiflu's safety review in 2005 was initiated after receiving reports of children experiencing neurological problems, including hallucinations and convulsions. Twenty-five patients under age 21 have died while taking the drug, most of them in Japan. Five deaths of children resulted from "falling from windows or balconies or running into traffic." No child deaths have been connected with Relenza, but some children taking it have shown similar neurological problems. The actual cause of these deaths is still unclear.

A Spoonful of Sugar
Rose RC, Chamberlain J
Binghamton, NY: Haworth Press, Inc.; 2007 (www.haworthpress.com).

This fun-to-read book is a collection of quotations from sources as diverse as Shakespeare, Pope John Paul II, and Gilbert and Sullivan. Included are comments on the work and profession of pharmacists and pharmaceutical scientists. It is divided into 30 chapters by individual topics and grouped by subject matter. Example quotations within the book are:

"The worst about medicine is that one kind makes another necessary" (Elbert Green Hubbard; 1856-1915)

"A miracle drug is any drug that will do what the label says it will do." (Eric Hodgins (1899-1971).

Enjoy reading!

Projection of Image onto Floor
An image, or slideshow, can be projected onto the floor in front of the prescription area for a unique and eye-catching method of communication. If used with a computer and video-projector, an easy-to-prepare PowerPoint presentation can be assembled and set to run automatically from a ceiling-mounted video projected onto the floor. It's different and will stimulate some comments. You can also prepare slides of holiday decorations and community events.