E-DRUG: To Dispense or not to dispense
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Dear E-Druggers,
We are currently working on establishing a Pharmacy Act and A Medicines and
Related Substances Control Act.
However we have a BIG problem. All prescribers in Swaziland with private
surgeries (Clinics) prescribe and dispense their own medicines, i. e. no
scripts are ever sent to pharmacies. The new legislation talks about
controlling this practice.
As a result an argument has arisen: Doctors believe that they can prescribe
and dispense medication directly to patient, there is no sense in sending a
patient out with no medicines, pharmacists now dispense all medicines
without prescription, now what is the role of the pharmacist and the
medical doctors in health care provision. Can all doctors be allowed to
dispense all medicines as they prescribe? Should pharmacist now issue
"prescription" drugs without a prescription. Or should pharmacist just pack
and look for some-other things to do.
Anyone with an answer or ideas please share
Margareth Magagula
pharmacist
Central Medical Stores
Swaziland
Email: magmu@realnet.co.sz [manually added by moderator; WB]
[Dear Margareth,
Most people agree that prescribing and dispensing should be separated in 2
different persons. Dispensing doctors can be a serious problem: South
Africa, Japan, Zimbabwe and many developing countries have the same
problem. Other countries (eg Netherlands) do have a limited number of
dispensing doctors (only in rural areas). Here in SA dispensing doctors
earn more from selling medicines than from consultation. This opens the
possibility for drug companies to market the latest antibiotics and drugs,
as doctors get higher discounts than retail pharmacists. A dispensing
doctor rarely practices generic substitution! The 1996 SA National Drug
Policy also identified this as a problem, and aims to take away perverse
incentives and also proposes to licence dispensing doctors. The criteria
for licencing a dispensing doctor have not yet been published but could
include the distance to the nearest pharmacy, competency of the doctor and
her/his pharmacy assistant, and quality of dispensory.
Good luck with your struggle - let us know if you need help from SA.
WB]
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