No breathing space for pharmacies
After two years marked by the ups and downs of the Covid 19 pandemic, pharmacists are now faced with worsening drug shortages. These are currently affecting low-cost standard medications as well. A review and outlook.
2022 was a year of transition to a certain normality after two years marked by the coronavirus. Pharmacists and their teams have done an enormous amount of work to meet the needs of the population in a professional and competent manner. As in other areas of healthcare, the volume of work in pharmacies is increasing, and fatigue is becoming noticeable among the teams, as well as a shortage of professionals.
After the pandemic - the time of scarcity
For several months, pharmacy teams have faced difficulties stemming from drug supply shortages. This week, according to www.drugshortage.ch 781 medicines (a total of almost 1000 different packages!) are not available in Switzerland. This affects more than 361 active ingredients. In hospital and public pharmacies, supply interruptions cause enormous logistical and safety problems and tie up considerable personnel resources. Costs estimated at ½ to 1 day per week for a public pharmacy are not covered. Fortunately, thanks to the expertise of pharmacists, major problems can be avoided when treatment needs to be changed. In some cases, they can even make medications themselves to cover shortages.
This situation, which pharmaSuisse, the umbrella organization of pharmacists, has been pointing out for several years, is visibly worsening. The authorities are reluctant to address the problem, the association writes. Therefore, pharmaSuisse will participate in the launch of the popular initiative "Yes to medical care security" this spring as part of a broad alliance of experts and partners in the healthcare sector.
Pharmacists - health care stakeholders whose full potential is not being realized
Pharmacists and their teams could provide much more valuable services in the healthcare system. However, this requires that the authorities integrate them into the system on a permanent basis and not just call them in when there is a major health crisis.
The Federal Council has recognized the potential of pharmacies in its second package of measures for cost containment in the OKP (compulsory health care insurance), which is why it is proposing the amendment of Article 25 and a new paragraph in Article 26 KVG. This will (finally) create the possibility of providing services that are covered by the basic insurance, for example in the area of prevention (e.g. vaccinations) and pharmaceutical services, such as support in adherence to therapy or the analysis of complicated medications. The aforementioned services must be effective, appropriate and economical (WZW criteria) and have a demonstrable cost-reducing effect. Discussions on this second package have already begun in the National Council's Commission for Social Security and Health.
With the amendment of the Medical Profession Act (MedBG) in 2015 and the Therapeutic Products Act (HMG) in 2016, the legislature has helped to consolidate the role of pharmacies within primary health care. "Nevertheless, the population is still not sufficiently aware that they can also seek medical advice in pharmacies. Pharmacists have the basic knowledge to diagnose and treat common health problems and diseases. In today's situation of overburdened emergency rooms, they are in a position to triage patients, offer them a solution, and thus relieve the burden on emergency rooms and primary care practices for simple cases. There is no question about it! " says Martine Ruggli, President of pharmaSuisse.
The revision of the distribution share enjoys broad consensus
In a tense economic climate with healthcare costs continuing to rise, mainly for social reasons, medicines are regularly the number one target. In this context, the price and distribution of generic drugs as well as the distribution share come into focus. At the end of 2022, under the aegis of the Federal Department of Home Affairs (FDHA) and the Federal Office of Public Health (FOPH), a consensus on the revision of the distribution share (Art. 38 KLV) was reached between the service providers (FMH, APA Association of Doctors with Patient Pharmacies, H+ The Hospitals of Switzerland, GSASA Swiss Association of Official and Hospital Pharmacists, Swiss Pharmacists Association pharmaSuisse) and curafutura, unfortunately without the support of santésuisse. This consensus will correct the negative incentives and increase the use of generics. Its immediate savings potential is estimated at 60 million Swiss francs and subsequently, through a higher proportion of generics, potentially 100 million. The ball is now in the EDI's court.
Outlook 2023
Pharmacists support the Federal Council's efforts to curb the increase in healthcare costs, pharmaSuisse said in its statement to the media. These savings would not be made by attacking the margins of inexpensive medicines, but the way forward is clearly to further expand the services pharmacies provide to patients, it said. In this sense, pharmaSuisse hopes that 2023 will be a key year for pharmacies with the relaxation of the KVG corset (Art. 25 and 26 of the second package of measures) and the revision of the distribution share.
In the area of digitization of the healthcare system, a national solution for a legally compliant, secure electronic prescription that can be used in all pharmacies is to be introduced in 2023 together with the FMH. The targeted solution will be user-friendly for patients, physicians and pharmacists. On the roadmap of the umbrella organization of pharmacists are several projects to improve the knowledge and perception of pharmacy services among the population. This with the aim to better distribute the current burden of the primary care system among the service providers, to continue the interprofessional cooperation as well as to promote the professions in pharmacy and to secure the next generation and to offer high-quality services to the population.
Source: pharmaSuisse
