Emergency Hormonal Contraception - Medicines Authentication and Pharmacy Workflow

 
Emergency Hormonal Contraception - Medicines Authentication and Pharmacy Workflow
IRELAND’S OFFICIAL PHARMACY PUBLICATION

NOVEMBER 2018

Medicines
Authentication
and Pharmacy
Workflow

Emergency
Hormonal                                     va
                                            A

                                                  ilab          e
                                                         le Her

Contraception
HSE launches EHC
awareness campaign
in partnership with IPU
   PHARMACOKINETICS | PHARMACYCARE | 10 YEARS OF MOVEMBER
Emergency Hormonal Contraception - Medicines Authentication and Pharmacy Workflow
W
NE

HUMIRA 80mg pen                                                                     ®

is now available
HUMIRA® 80mg pre-filled pen is only licensed for use in moderate to severe rheumatoid arthritis, moderate to severe chronic plaque psoriasis,
moderate to severe hidradenitis suppurative (HS) (from 12 years), moderate to severe Crohn’s disease and ulcerative colitis, moderate to severe
paediatric Crohn’s disease (from 6 years), non-infectious IPP Uveitis, paediatric chronic non-infectious anterior uveitis in patients from 2 years.1
Further information is available in the Humira Summary of Product Characteristics (SmPC), available on www.medicines.ie or from AbbVie Limited,
14 Riverwalk, Citywest Business Campus, Dublin 24.
Legal category: POM.

* IPP – intermediate, posterior and panuveitis
Reference: 1. Humira SmPC, available on www.medicines.ie

Date of preparation: October 2018
IREHUM170655p
Emergency Hormonal Contraception - Medicines Authentication and Pharmacy Workflow
NOVEMBER 2018

                                          07 A Note from the Editor

                                          IPU News
                                          The latest news and events
                                          from Butterfield House

                                          08 Dates for your Diary
                                          08 Pharmacy in the media
                                                                                              23
                                          10 Budget 2019
The IPU Review is published
monthly and circulated to Irish           11 Pharmacists key to driving successful
pharmacists. The views expressed             self care strategy
by contributors are not those             11 IPU welcomes migraine relief now available
of the IPU nor is responsibility
accepted for claims in articles              without prescription at pharmacies nationwide.
or advertisements.                        12 IPU Academy Webinar Series
Subscription:                             12 IPU Training Courses – Spring 2019
€100 (Ireland North & South) and          13 IPU Statement of Strategy July – September 2018
€150 (including postage overseas).

Publisher:
Irish Pharmacy Union
(IPU Services Ltd),
Butterfield House,
Butterfield Avenue,
Rathfarnham, Dublin 14,
D14 E126
Tel: (01) 493 6401
Fax: (01) 493 6626
Email: ipureview@ipu.ie

                                                                                               27
Website: www.ipu.ie
Editor: Jack Shanahan MPSI
Editorial Associates:
Sinéad Fennell, Jim Curran
and Ciara Browne
Advertising: Sinéad Fennell
                                        Features
                                        15 HSE launches Emergency
Email: ipureview@ipu.ie
Tel: (01) 493 6401

©2018
                                           Hormonal Contraception
Copyright: All Rights Reserved,
Irish Pharmacy Union.                      (EHC) awareness campaign,
Printed by Ryson Colour Printers Ltd.
IPU Review is a Registered Trademark       in partnership with IPU
of the Irish Pharmacy Union.

                                        18 IPU Contract Unit –
                                           how can we help you?

                                        21 The first paid patient education at
                                           pharmacy service launched

48
                                        23 Economic Backdrop to
                                           pharmacy sector

IPUREVIEW NOVEMBER 2018
                                        27 Movember
                                                                 18                                 3
Emergency Hormonal Contraception - Medicines Authentication and Pharmacy Workflow
Reach out to
your shoppers

Are you communicating effectively with your customers?
The United Drug Point of Sale Toolkit is your comprehensive
branding and marketing solution for impactful and professional
communications in store and on social media.
Get the best out of your pharmacy.

Contact Aimée Roche
aimee.roche@united-drug.com
Mobile: 087 400 3500
Emergency Hormonal Contraception - Medicines Authentication and Pharmacy Workflow
32 Budget highlights and

                                                             32
                  introduction to PAYE
                  modernisation

               37 Medicines authentication and
                  pharmacy workflow

               40 Pharmacokinetics Part Four –
                  Metabolism: Clinical Implications

               45 Care of adults and children with asthma
                  – e-Learning education programme
                                                             News
               48 Venous Thromboembolism (VTE)               69   Brexit Update – HPRA Brexit Guidance –
                  during pregnancy                                Human and Veterinary Medicines
                                                             70   Health Products Regulatory Authority
                                                                  publishes 2017 Annual Report
               52 Tax breaks time and practice matters

40
                                                             71   European Investment Bank (EIB) to
                                                                  provide €225 million loan to support
                                                                  roll-out of eHealth
               55 Best practice for hiring and firing        72   Have your say on HIQA’s new corporate plan
                                                             72   HIQA publishes recommendations for
                                                                  community based ePrescribing
               57 Politics – Budget 2019                     73   HIIQA to commence health technology
                                                                  assessment (HTA) on a pre-exposure
                                                                  prophylaxis (PrEP) programme to prevent
               61 Clinical Tips – Influenza virus vaccines        HIV in Ireland
                                                             73   Patient-focussed cancer initiative wins the
                  2018/2019 season                                2018 European Health Award
                                                             74   IPHA Manifesto for Better Health issues
                                                                  call to place Ireland in top seven in Europe
               63 High Tech Medicines Update –

                                               45
                                                                  for access to innovative medicines
                  Mavenclad 10mg tablets                     75   Strong public support for increased
                                                                  Government investment in Ireland’s
                                                                  mental health services
               65 Studies                                    76   NUI Galway seek participants for autism
                                                                  in healthcare research study
                                                             76   Dangers of anabolic steroids highlighted
               67 International Pharmacy News                     by new HPRA Zero Gains Campaign
                                                             77   European Commission expands labelling
                                                                  for anti-diabetic agents InvokanaR and
               68 Product Information                             VokanametR to include positive data on
                                                                  cardiovascular and renal outcomes

52
                                                             77   Uniphar CROSS Cycle raises €100,000
                                                                  for early cancer research
                                                             78   COPD Support Ireland to host Let’s Get
                                                                  Moving on COPD Patient Conference,
                                                                  15 November
                                                             79   Irish Chemists’ Golfing Society News

                                                                                          37
                                                             80   A review of the golfing year

                                                             81   Classifieds

IPUREVIEW NOVEMBER 2018                                                                                          5
Emergency Hormonal Contraception - Medicines Authentication and Pharmacy Workflow
Emergency Hormonal Contraception - Medicines Authentication and Pharmacy Workflow
A NOTE FROM THE EDITOR Jack Shanahan MPSI

We must document, report,
prove and value what we do
Ticks, ticks and more ticks were rampant last month. Unlike
the mini-vampires suspended under the rhododendron
leaves, the ticks that take my focus this month are the ones
that fill boxes. They drain energy rather than blood.

W
                 hether it is the   More importantly, it is an area      properly document what we          has still been found wanting.
                 PCRS, the PSI,     that pharmacists are actively        do, but when we do, we don’t       At the very core, our ability to
                 the Revenue        working at improving. The lack       do it very well.                   communicate value is coming
                 or whomever,       of ward pharmacists in many             Pharmacy has never been         up short. While the PSI ticks
                 we are             hospitals means that the             under more threat than now.        boxes of compliance, it is
constantly filling out forms.       role of the alert community          Looking across the pond to         important to recognise that, as
Our working lives are filled        pharmacists is vital. So, it was     the UK, recent cuts have led       much as we dislike it, the role
with compliance. While I have       with a degree of interest that       to a substantial number of         is important. Of course, they
railed and roiled against the       I read the Cochrane Review.          pharmacies closing. While this     could approach the business in
growing mountain of pointless       I was expecting to see the           has not started happening          a better fashion, but that is for
bureaucracy, there are times        benefits of pharmacists in           here yet, there is no doubt        another day.
when a grudging concession          medicines reconciliation. I was      that the inflection point is          As many of us face our
must be made. I have finally        expecting to feel a warm glow        on the way. The issue of not       IIOP practice review, again
arrived and crossed over to the     of contentment, belonging            documenting what we do is          we see the necessity of
dark side. Pharmacy, we have a      to a profession that protects        critical. While we fulminate       demonstrating quality. Even
(another) problem.                  the vulnerable every day. So,        about the biannual PSI             with FMD, that colossal waste
  I’m not sure how many             what does the evidence say?          assessment, it does something      of money and resources, we
of you have come across             “The impact of medication            we are not willing to engage in.   will be demonstrating quality.
the Cochrane collaboration.         reconciliation interventions,        It documents what we do. The       Yet, this is not enough. We
They are a big deal in              in particular pharmacist-            problem is, of course, it isn’t    must document, report, prove
evidence-based medicine.            mediated interventions, on           capturing many important           and value what we do. If we
They generally produce              medication discrepancies is          aspects of our work.               cannot do this, even at the
high quality guidance and           uncertain due to the certainty          As Amazon looms over            most basic level of medicines
reports, largely independent of     of the evidence being very           our shoulders, it has never        reconciliation, we have a
commercial bias. Last August        low.” This is shocking. More         been more important to             serious problem.
they did a report entitled,         importantly, it flies in the face    demonstrate that we are not
What interventions improve          of all current practice. But,        supply chain cogs. We have
the accuracy and continuity of      to reiterate the old adage,          spoken before of the crisis in
medication lists as patients move   anecdotes are not evidence.          recent graduates, disillusioned
between healthcare providers        More importantly, in this            by the practice of community
and settings?. Now this is one      case, absence of certainty is        pharmacy. We have looked at
area in which many of us            not confirmation of lack of          the pharmacy retail warriors,
do well. Transitions of care        efficacy. It simply tells us that,   piling ‘em high and selling
are notorious, not only for         of the 25 studies included in        as many as they can. Yet,
prescription errors, but for        the review, the quality of the       their commercial success
medication misadventure in          evidence was so poor that no         has been to the profession’s
general. Most pharmacists pay       certainty could be attributed        detriment. It has created an
particular attention. In my         to the benefit of medicines          image and an expectation
pharmacy it is pretty much          reconciliation by pharmacists.       that is far removed from
axiomatic that a discharge          This is just not good enough.        what we do. Retail is retail.
prescription will have the          As pharmacists, we know              Pharmacy is pharmacy. Ours
potential for multiple errors.      our worth. We know what we           is a profession of medicines
The arrival of the unified          do every day to improve the          knowledge, of intervention
discharge system, with              lives and the health of the          and of communication. In an
associated standardised             people we live with. But self-       era of ever more complicated
paperwork, has only slightly        knowledge does not make a            treatments, ageing populations
ameliorated this.                   compelling argument. This is         and polypharmacy, we are
  Medicines reconciliation is       now a hoary old chestnut in          never more important. Yet, our
a huge patient safety issue.        pharmacy. Not only do we not         ability to document our value

                                    If you have any comments, queries or issues to raise, send
                                    your “Letters to the Editor” by email to ipureview@ipu.ie.

IPUREVIEW NOVEMBER 2018                                                                                                                    7
Emergency Hormonal Contraception - Medicines Authentication and Pharmacy Workflow
Pharmacy in
                                                       the Media
                                                       On 25 September, World Pharmacists Day, we issued a
                                                       press release to announce that the flu vaccination is
                                                       available from pharmacies and that people should get
                                                       their vaccine as early as possible. Our campaign was
                                                       covered on Virgin Media One’s Ireland AM and there was
                                                       coverage in the Irish Sun, Evening Echo, on BreakingNews.
                                                       ie and on IrishHealth.com. IPU President Daragh Connolly
                                                       was also interviewed on KFM and Highland Radio, and
                                                       there was extensive coverage across regional radio
                                                       stations and regional newspapers. IPU members Kathy

    Dates forry
                                                       Maher and Caitriona O’Riordan were interviewed on
                                                       LMFM and Limerick FM respectively.

    your Dia
                                                         Our Submission to the PSI on the Temporary Absence
                                                       Consultation was quoted in the Sunday Mirror and on
                                                       DublinLive.ie following the meeting of the PSI Council.
                                                         Darragh O’Loughlin was quoted in The Irish Times for
                                                       an article which addressed substandard and falsified
                     2018
    N OV E M B E R          onth,
                                                       medicines. Darragh was also quoted in The Sunday
                Movember M                             Times in an article which focused on the financial and
    November                 e
                www.cancer.i                           economic challenges facing Irish community pharmacies.
                                                         We issued a joint press release with the National
                          betes Day,
              r World Dia
    14 Novembe               s.ie                      Association of General Practitioners to call for the
                 www.dia te
                         be
                                                       Government to begin the phasing out of the €2.00
                           Antibiotic                  prescription levy paid by medical card holders, and, at
               r European
    18 Novembe        eness Day, www.                  the very least, exclude vulnerable patients from the levy
                 Awar
                               ther.ie
                 underthewea                           in this year’s Budget. There was national coverage in The
                                                       Times and Irish Daily Mirror, and also in the Evening Echo.
                             ement of
               r The Manag                               We were mentioned in The Irish Times for an article
     19 Novembe           Living with
                 Patients                              which addressed legislation for conscientious objection
                                inar
                 HIV/AIDS web                          when it comes to abortion services.
                             cademy.ie
                  www.ipua                               Darragh O’Loughlin was quoted in the Sunday Business
                             ement                     Post in relation to Brexit and the potential impact on
                r The Manag
      27 Novembe          mon  Eye                     medicines in Ireland.
                  of Com
                    onditions w ebinar,                  We issued a press release after Budget 2019 was
                  C
                             cade my.ie                announced stating that the prescription levy should
                   www.ipua
                                                       have been abolished entirely, the reduction in the DPS
                                                       threshold does not go far enough, and that a Minor
                 018
       DECEMBER 2
                                                       Ailment Scheme remains a missed opportunity. There
                                                       was coverage in the Irish Examiner and Evening Echo.
                                       ay,
                      World Aids D                       Daragh Connolly was quoted in the Irish Independent for
        1 December         .w  orld  aidsday.org
                      www                              an article which highlighted why your pharmacist should
                                       l Day           be the first port of call for healthcare.
                      Internationa
        3 December       Pe rson   s w  ith
                      of
                                ties , w  ww.bit.ly/
                       Disabili
                                         swith
                       DayofPerson
                       Disabilities

8                                                                                               IPUREVIEW NOVEMBER 2018
Emergency Hormonal Contraception - Medicines Authentication and Pharmacy Workflow
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Emergency Hormonal Contraception - Medicines Authentication and Pharmacy Workflow
IPU NEWS

Budget 2019
On 9 October, we welcomed the decision to reduce the
prescription levy to €1.50 per item for the over 70s,
however, we feel that the levy should be removed in its
entirety especially for those in vulnerable patient groups,
such as homeless people, those in residential care settings,
patients with intellectual disabilities and palliative care
patients. We also welcomed the €10 fall in the Drugs
Payment Scheme (DPS) threshold to €124 from €134,
but expressed disappointment that a more meaningful
reduction was not announced.
   Daragh Connolly, President of the IPU, said, “While a
prescription charge of €1.50 may seem insignificant, it is
important to remember this is a charge on the healthcare
of the vulnerable in our society. The Budget has clearly
demonstrated our economy has recovered to a point where
we don’t need such blunt and unfair taxes.”
   Mr Connolly also said that while “the €10 reduction in the
DPS threshold is welcome, it is clearly not enough to have a
significant impact on hard pressed families. The Government
should set out a roadmap to significantly reduce this
threshold to a more bearable level over the next number of
Budgets.”
   Mr Connolly concluded by criticising the continued failure
to introduce a Minor Ailment Scheme in pharmacies. “The
failure to introduce a nationwide Minor Ailment Scheme is a     introduced whereby marginalised people are exempted from
missed opportunity for the tax payer, the health system and     fees which they frequently cannot afford. Eliminating this fee
most of all the patient. This would involve enabling medical    would significantly help these vulnerable patients, and the cost
card patients to receive treatment for common illnesses, free   to the exchequer would be negligible.”
of charge, directly from their local community pharmacy in        Mr Connolly said, “Putting economic barriers in the way of
a timely manner and without the need to pay for a visit to      vulnerable patients taking their medicine doesn’t make sense.
the GP. The introduction of a pharmacy-based Minor Ailment      People living with heart disease, or at risk of the disease,
Scheme would save nearly 950,000 GP consultations                    should be focusing on getting better and keeping well,
every year, ensuring that this investment would                       not worrying about how they will pay for their next vital
serve patients with more complex cases. The IPU has                   prescription. Poor adherence to treatments, especially
already piloted this scheme with the HSE but has                      in the case of chronic illness and long-term patients,
received no indication on when it will be rolled out.”                 will mean more hospital stays, more pressure on our
   On 3 October, ahead of the Budget announcement,                     already struggling health service, and more costs to
Daragh Connolly, along with Dr Maitiú Ó Tuathail,                       the Exchequer in the treatment of these patients
President of the National Association of General                         in the long run.
Practitioners, jointly called on the Government to                         “Pharmacists and GPs would like to see a phasing-
begin the phasing out of the €2.00 Prescription Levy                    out of the levy and, at the very least, exemptions
paid by medical card holders, and, at the very                            for especially vulnerable patients, including those
least, to exclude vulnerable patients from the                                in residential care settings; homeless patients;
levy in this year’s Budget.                                                          patients receiving treatment under the
   Dr Ó Tuathail, a GP at Safetynet Primary                                            Methadone Treatment Scheme in
Care (a medical charity for marginalised                                               respect of other medication that they
in society) said, “This fee for medications                                            may require; patients with intellectual
is unjust and is a significant barrier to                                              disabilities, and palliative care patients.
the accessing of vital medicines for                                                    Patients need to be supported, not
marginalised patients. A system must be                                                 penalised,” concluded Mr Connolly.

10                                                                                                            IPUREVIEW NOVEMBER 2018
IPU NEWS

Pharmacists
key to driving
successful self                                                          For he
                                                                                 a
                                                                         Be We lth advice..
                                                                              ll This      .
care strategy                                                            - Think      W  inter
                                                                                   Pharm
                                                                                        acy

The role of community pharmacists is pivotal to the
successful development of self care and its more widespread
adoption, according to the Irish Pharmacy Union and the Irish

                                                                            IPU welcomes
Pharmaceutical Healthcare Association (IPHA), who on 16
October launched a new self care awareness campaign, entitled

                                                                            migraine relief now
Be Well This Winter – Think Pharmacy.
   The campaign was rolled out through the extensive
deployment of social media, as well as a series of posters to be

                                                                            available without
displayed nationwide in retail pharmacies.
   This campaign builds on the previously highly successful IPU/

                                                                            prescription
IPHA joint initiative launched earlier this year, Self Care: Taking
charge of your health, which placed a major emphasis on the
role of the pharmacist as a key component in helping people to

                                                                            at pharmacies
manage their own health.
   Self care is a healthcare philosophy which emphasises the

                                                                            nationwide
role of ordinary people in taking ownership of their health and
wellbeing and includes taking actions to prevent and decrease
the likelihood of disease and to restore health after illness or
injury. It is the first step and first choice for Irish people who are
taking an increasingly active role in their healthcare and looking
to improve their health and wellbeing.                                      From 22 October, Irish people who suffer from
   Research from Behaviour & Attitudes confirms that there is               migraine will, for the first time, be able to access
a clear desire from the majority of people (92%) to be involved             a highly effective treatment, without prescription,
in decisions about their own health and medication, with 80%                directly from their pharmacy. This follows a
expressing their view that they see their pharmacist as a key               reclassification of the medication, sumatriptan,
partner in maintaining their health.                                        which now allows it to be made available without
   Daragh Connolly, President of the IPU, said, “Promoting                  prescription, a change which had long been called for
increased levels of self care in Ireland would lead to a far                by migraine sufferers and by the IPU.
more efficient and effective system of healthcare. Embracing                   Welcoming the move, President of the IPU, Daragh
a philosophy of self care can lead to real, measurable savings              Connolly, said, “Migraine is a severe neurological
in healthcare expenses and better outcomes for patients,                    condition that affects 15% of the world’s population.
and pharmacists can play a critical role in this area. Allowing             It is estimated that as many as half a million Irish
pharmacists to work to their full scope will help to deliver better         people suffer from migraine. The symptoms can be
patient outcomes by utilising our accessibility and professional            extremely debilitating for those who suffer from
capabilities to benefit patients, in partnership with our                   migraine and we warmly welcome the fact that
healthcare colleagues and the pharmaceutical industry.”                     pharmacists will now be able to help sufferers get
   Dave Barrett, Chairman of the Irish Pharmaceutical                       relief by providing this highly effective medication.
Healthcare Association, said, “As well as the obvious benefits                 “Treating migraine as soon as it appears is often
for individuals in taking a greater role in maintaining healthy             the key to effectively managing a migraine. When
lives, adoption of self care principles could also help the State           sumatriptan was prescription-only, people were
manage the financial challenges of an ageing population and                 often unable to obtain it when it was most needed.
strained healthcare budgets. As people take care of their own               Pharmacies are the most accessible component of
health and self-treatable conditions, more healthcare resources             our healthcare system and making sumatriptan
can be used for patients with severe and chronic diseases. Our              directly available from pharmacists will greatly
industry is committed to working with healthcare professionals,             increase our patients’ abilities to get the treatment
especially pharmacists who are often the first port of call for             they need when they need it.”
health information and advice, to support consumers to identify                The IPU is urging anyone who is concerned that
the most appropriate channel within the healthcare system.”                 they may be experiencing the early symptoms of a
   Self Care – Taking charge of your health can be downloaded from          migraine to visit their local community pharmacy
www.ipu.ie and www.ipha.ie.                                                 for advice.

IPUREVIEW NOVEMBER 2018                                                                                                             11
IPU NEWS

IPU Academy
Webinar Series
Log into IPU Academy this month to participate in the Autumn
Programme Webinar series.

Date                Topic                                      Speaker(s)
Monday              The Management of Patients Living          Dr Lambert, Infectious Disease Consultant,
19 November         with HIV/AIDS – what can a Community       Mater Hospital, and Mairead O’Connor,
7.30pm – 8.30pm     Pharmacist do?                             Acting Pharmacy Lead for Infectious Diseases,
                                                               Mater Hospital
                    in association with

Tuesday             The Management of Common Eye Conditions    Dr Aoife Doyle, Consultant Ophthalmic
27 November                                                    Surgeon, Royal Victoria Eye and Ear Hospital
7.30pm – 8.30pm     in association with                        and St James’s Hospital

More information is available on www.ipuacademy.ie.

     IPU Training Courses
     – Spring 2019
     IPU Basics in Health and Nutrition Course
     Date                                           Location
     Wednesday 16 January, 10.00am – 5.00pm         Butterfield House, Dublin

     IPU Supervisory Development Course
     Date                                           Location
     Day 1: Tuesday 29 January, 9.30am – 5.00pm     Butterfield House, Dublin

     Day 2: Tuesday 26 February, 9.30am – 5.00pm

     IPU Introduction to Employment Law
     and Employment Rights
     Date                                           Location
     Day 1: Tuesday 5 February, 9.30am – 5.00pm     Butterfield House, Dublin

     Day 2: Tuesday 5 March, 9.30am – 5.00pm

12                                                                                                             IPUREVIEW NOVEMBER 2018
IPU NEWS

IPU Statement of Strategy
Progress Report
July - September 2018

                             JCG Meeting with HSE                            IPU Pilot to Detect Hypertension and
                             The Joint Consultative
                                                                             Atrial Fibrillation in Community
                             Group (JCG) met with the                        Pharmacy
                             HSE in September to

                 Sector
                             address a number of items
                             on behalf of members
                             including the PCRS
                                                                                                     1,000+
                             Pharmacy Interface
                             Project, PCRS High Tech                        The IPU pilot to detect hypertension and atrial
                             Ordering Hub, Phased                           fibrillation saw over 1,000 patients screened in
                             Dispensing and the                             pharmacies around the country in July and
                             centralisation of the Drugs                    August
                             Payment Scheme

                            IPU Pharmacy                     eCommunications Survey                          Retail
                            Technician Course                                                                Reviews
                                                                    Use the IPU website

                                    Enrollments on to
                                                             91%                                             6
                                                                                                                 Retail
                                                                                                                 reviews
                             230    Year 1 of the IPU
                                    Pharmacy Technician
                                                             Find the eNewsletter clear
                                                             and easy to use              96%
                                                                                                                 were
                                                                                                                 carried out
                                    Course

                                                                     Rate the eNewsletter                        Retail
                   Member                                     89%    content as excellent or
                                                                     very good
                                                                                                             4   consultations
                                                                                                                 were
                                                                                                                 completed
                                                             Find our SMS Service
                                                             useful                 89%
                            IPU Academy Autumn                        Contract Unit Assistance
                            Programme
                                                                      The Contract Manager
                            Launched in September                     accompanied a number of
                            with 5 topics delivered                   individual pharmacists to
                            by 19 tutors in 21                        meetings with the PCRS to
                            venues nationwide (63                     assist them in resolving
                            courses)                                  outstanding issues

                            Advertising Campaigns
                            The target audience had the opportunity to view the Think
                            Pharmacy TV ad 4 times and our radio ad featured in 8 spots
                            during Ireland’s top 5 listened to radio programmes. We also
                            launched the first week of our Flu Vaccination campign

                            Submissions to the PSI                         Framework for Handling
               Advocacy/    We made submissions to                         Medicine Shortages
               Activities   the PSI on Temporary
                            Absence, Registration
                                                                           We worked with the HPRA and
                                                                           other supply chain stakeholders to
                            Rules and Code of                              develop a Framework for Handling
                            Conduct                                        Medicine Shortages, which was
                                                                           published in September

                            Garda Vetting                                  National Media
                                        Applications                               Press releases issued this
                            6,000+      processed to
                                        date
                                                       700   Disclosures
                                                             issued this
                                                             quarter
                                                                               8   quarter gaining extensive
                                                                                   national coverage including
                                                                                   items on RTÉ and Virgin
                                                                                   Media One

IPUREVIEW NOVEMBER 2018                                                                                                          13
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PROFESSIONAL

HSE launches
Emergency Hormonal
Contraception (EHC)
awareness campaign,
in partnership with IPU
The HSE Sexual Health and Crisis
Pregnancy Programme (SHCPP)
is implementing a national public
awareness campaign this month, in
partnership with the Irish Pharmacy
Union (IPU). The campaign aims
to increase awareness about the
availability of Emergency Hormonal
Contraception (EHC) directly from
a pharmacy. The campaign will
launch on 12 November 2018.

I
       ndependent market           n Half of self-reported
       research, carried out         crisis pregnancies
       in December 2017,             are associated with
       found that one in five        contraceptive failure;
       women are not aware
                                   n Half of self-reported
that EHC is available directly
                                     crisis pregnancies are
from pharmacists, without a
                                     associated with non-use
prescription. The report, Sexual
                                     of contraception;
Health in Ireland: What Do We
Know?, published by SHCPP in       n Half of those failing to
June 2018, also highlights that:     use contraception were
                                     unaware of the risk of
                                     pregnancy at that time.

IPUREVIEW NOVEMBER 2018                                         15
The EHC campaign will          which will run primarily via
focus on informing women         digital media. Social media
that if they have unprotected
sex or their contraception
                                 posts and adverts will be
                                 created with key messages
                                                                  Key campaign messages
fails, they can avail of EHC     and Google Search AdWords
directly from their community    will direct people to www.       n EHC is available without
pharmacist. The target           sexualwellbeing.ie for further     prescription from pharmacies.
audience is all women of         information. A media kit,
child-bearing age.               including suggested posts and    n The sooner you take emergency
  The IPU and the HSE SHCPP      images, will be provided via       contraception, the more effective it is.
previously worked together on    the IPU website, prior to the
a successful EHC campaign        campaign launch.                 n You can avail of emergency
in 2012. This campaign             A window sticker and             contraception that is effective up
was promoted across all          poster will be posted to all       to five days after sexual intercourse.
community pharmacies and         IPU pharmacy members
the campaign message was         prior to the campaign launch     n Women with medical cards can
well received. The HSE and IPU   to complement the online           get EHC free-of-charge directly from
are using the same messaging     messaging and to further           the pharmacy, without the need
for this year’s campaign.        raise awareness that EHC is
  There are a number of          available in your pharmacy.        for a prescription.
elements to the campaign,
                                                                  What can you do?
                                                                  Pharmacists have an important role to play in
                                                                  ensuring that women have access to EHC in a timely
                                                                  manner. You can get involved in this campaign and let
                                                                  your patients know that they can visit your pharmacy
                                                                  if they require EHC by:
                                                                    n Displaying the campaign materials – display
                                                                      the window sticker and / or poster prominently
                                                                      in your pharmacy window, or door, so that your
                                                                      patients know that you provide EHC; and
                                                                    n Sharing the message – support the campaign by
                                                                      sharing the key campaign messages and content
                                         re

                                                                      on your social media channels. This will help to

                    Av a           H e                                increase the number of people who will see the

                            ilable
                                                                      messaging.
                                                                     Pharmacists play a pivotal part in communicating
                                                                  broader sexual health messages to the public.
                                                                  If a woman requires EHC from you, it is a good
                                                                  opportunity to discuss contraception with her. The
                                                                  www.sexualwellbeing.ie website covers all aspects of
                                                                  sexual health and wellbeing including the different
                                                                  contraception options available.

     “The EHC campaign will focus on
      informing women that if they have
      unprotected sex or their contraception
      fails, they can avail of EHC directly
      from their community pharmacist.”

16                                                                                                      IPUREVIEW NOVEMBER 2018
Relax -
we’ve got it
all in hand

At United Drug Elements we offer a swift and efficient
service for supplying and sourcing Exempt medicines and
pharmaceutical supplies not normally available through
regular pharmaceutical distribution channels. We operate in
line with HPRA Regulation and HSE reimbursement.
Begin by registering online
or calling us on (01) 463 2300

www.ud-elements.ie
CONTRACT Derek Reilly, Contract Manager, IPU

IPU Contract
Unit – how can
we help you?
What should you do if you are called to a meeting with
the HSE PCRS to discuss what they characterise as
‘unsupported’ or ‘potentially invalid’ claims from your
pharmacy? What course of action do you take if you are
subject to a claims investigation? What do you do if you
are confronted with a HSE inspector in your pharmacy?
The first thing to do is pick up the phone to us; it’s what
we’re here for. In this article, Derek Reilly, Contract
Manager, IPU, outlines the services and advice that the
IPU Contract Unit can offer to IPU members.

M
                  any members
                  may be
                  unaware that
                  there is help
                  and advice
available to them at the end of
the line. Sometimes you may
only need some assurance
that in fact you are doing
everything completely right,
and other times it may be that
you do need additional help
and support. The important
thing is to call us. It’s the first
step to addressing the issue –
whatever that issue might be.
  Since the lifting of the
recruitment embargo in the
public service in 2014, the
HSE PCRS has been hiring
again. This means there is

18                                                    IPUREVIEW NOVEMBER 2018
an increase in the number of      of claims for individual          terms of your contract with          All individual queries are
staff scrutinising pharmacy       pharmacists. In other words,      the HSE, you have a right to       dealt with in the strictest
claims. A significant increase    this forum is where we, in        enjoy fair procedures in the       confidence. We also have lots
in the number of pharmacy         the Contract Unit, meet the       conduct of that inspection. In     of useful information relating
inspectors is also expected       PCRS face to face in an effort    the event of an inspection, you    to your contract, the HSE PCRS
in the coming year. This          to resolve payment issues         should always contact the IPU.     and Department of Health on
ever-increasing probity and       on your behalf. The Contract         In rare but serious             the members’ section of our
scrutiny means pharmacists        Manager is also Secretary to      circumstances, a pharmacy          website, which you should
are more likely than ever         the Pharmacy Contractors’         contractor may receive             avail of. In short, we’re here
before to receive a letter from   Committee (PCC). The PCC          correspondence from the            to help you, the member, so
the HSE PCRS examining or         is responsible for all matters    office of the Director General     please avail of our services.
querying claims. We can assist    relating to the Community         of the HSE stating that there
you in drafting your response     Pharmacy Contractors’             is reason to believe that          You should contact
to these letters and are happy    Agreement and pharmacy            the contractor has failed to       Derek or Aoife in the
to review any correspondence,     contract, and negotiating with    comply with the terms of their     IPU Contract Unit:
on your behalf, before you        the Department of Health and      contract and allowing 14 days
                                                                                                         n For advice on all aspects
send it to the HSE PCRS.          the HSE on remuneration and       to respond to the allegations.
                                                                                                           of processing claims;
   If there are circumstances     policy issues.                    Anyone receiving one of these
where you are requested to           The Joint Consultative         letters, who has not already         n For advice on all aspects
meet with the HSE PCRS,           Group (JCG) meets four or five    done so, should immediately            of the pharmacy
we can advise you on              times a year. Members of the      seek the advice of the IPU and         contract;
whether you should attend         PCC, the Secretary General        indeed legal advice before
                                                                    responding. The likelihood           n For assistance in
and the most appropriate          and the Contract Manager
                                                                    is that a Committee of                 responding to direct
representation to bring with      meet with officials from the
                                                                    Investigation, as set out in the       correspondence from the
you and, should you need          HSE PCRS through this forum.
                                                                    CPC Agreement under Clause             HSE PCRS;
it, point you in the direction    The JCG was established with
of further professional/          the objective of maintaining      16, could be established on          n If you are called to a
legal advice. In some             stable contractual relations      foot of your response. The             meeting with the HSE
circumstances, we will attend     between the parties. The          Committee, which is chaired            PCRS;
the meeting with you and          terms of reference for the        by a legally qualified person
advocate on your behalf.          JCG and JOG are set out in a      nominated by the Minister for        n If your pharmacy is
It cannot be emphasised           Relationship Values Charter,      Health in consultation with            inspected by the HSE
enough, however, that you         signed by the IPU and HSE         the PCC, can, if a complaint           PCRS;
should always contact the IPU     in 2016. The Charter may          is upheld, result in the             n If you are subject to a
for advice if you are called to   sometimes seem at odds with       termination of your contract;          claims investigation; and
a meeting – then make your        our day-to-day interaction        hence, the importance of
decision on what to do next.      and current strained relations    seeking legal advice as early        n If you are subject to an
   The Contract Unit can also     with the HSE PCRS, but the        as possible.                           investigation under the
advise you on all aspects         JCG does provide us with a           One thing pharmacists must          pharmacy contract.
of processing claims for          regular forum where we can        never do is bury their head
payment. It can often happen      highlight the concerns of our     in the sand hoping a problem
that a pharmacy is not            members to senior officials       will go away. The problem          How to contact/access
reimbursed correctly, generally   within the PCRS. At our most      rarely, if ever, resolves itself   the IPU Contract Unit
for an unusual or expensive       recent meeting in September,      on its own. We have seen
item, or is not happy with the    the agenda included the           issues that potentially could      Telephone: 01 406 1557 /
HSE’s response to a payment       Pharmacy Interface Project,       have been resolved through         01 493 6401
query. In those cases, we         phased dispensing approvals,      a negotiated settlement, but
can advise you on how to          the High Tech Hub and HSE         have instead been escalated to     Derek Reilly
proceed and, if necessary,        reimbursement prices – any of     a Committee of Investigation       Contract Manager
raise the matter directly with    which would merit an article      because of a pharmacy              derek.reilly@ipu.ie
the PCRS on your behalf.          in themselves.                    contractor’s failure to seek
Every six to eight weeks, we         What to do in the event        help when concerns were first      Aoife Garrigan
meet with the HSE under the       of an inspection of your          raised by the HSE PCRS. The        Contract Administrator
auspices of what is known as      pharmacy by the PCRS              earlier you seek advice or help,   aoife.garrigan@ipu.ie
the Joint Operational Group       was covered in detail in an       the better able we are to
(JOG). The purpose of the         article in the IPU Review in      assist you in reaching a
JOG is to allow direct liaison    July and this is available in     resolution.
and discussions between           the HSE Contract section of
the IPU and the PCRS on           our website. Remember, it
matters of an administrative/     is important to be prepared
operational nature with a         for an investigation at any
view to resolving, where          time and, while you have to
possible, issues with payment     facilitate inspectors under the

IPUREVIEW NOVEMBER 2018                                                                                                             19
Growing Together

            The trade mark Actavis is used under licence by Teva
                       Pharmaceuticals Europe B.V.
PROFESSIONAL

The first paid
patient education
at pharmacy
service launched
Pharmacycare is a platform for paid
services in community pharmacy.
Patient Support Programmes (PSPs)
are offered by pharma companies to
many patients to support compliance
and adherence, and now pharmacists
can have an enhanced role in
providing these services.

E
           xpanding paid for     What is the background
           patient services      to Pharmacycare and
           within community
           pharmacy is on the
                                 who is behind it?
           radar of everyone     There are many potential
involved in the profession       services, from vaccines to
in Ireland. An expansion         health screening, that can be
of the scope of practice of      safely delivered in community
pharmacists is not only          pharmacy, but Hibernian
desirable from a professional    Healthcare has brought this
and commercial perspective,      innovative patient support
but also contributes to easing   service to the market at a
the burden on primary            really opportune time. Many
care services across the         of you will know Hibernian
country. Pharmacists know        Healthcare from its support
the medications, know the        and delivery of vaccination
patients and are ideally         and medicines administration
equipped to play a key role in   training since 2009, but
enhanced patient support.        it also works with many

IPUREVIEW NOVEMBER 2018                                          21
Pictured at the
     Pharmacycare launch
     of the Nordimet patient
     education service, L-R:
     Pamela Logan, Director of
     Pharmacy Services, IPU;
     Olive Kelly, Key Account
     Manager Nordic Pharma;
     Guen Kelly, Marketing
     Manager, Nordic Pharma;
     and Alan Moran, Group
     Managing Director,
     Hibernian Healthcare.

major pharma companies to                 short in supporting the                 The initial Pharmacycare              How do we sign up and
provide best-in-class Patient             patient on their journey              service consisted of a sharps           what does it cost?
Support Programmes (PSPs)                 with a life changing chronic          service for injectable devices
for medications including oral            illness. The PSP services are         for Pfizer (Enbrel), Roche              Signing up to Pharmacycare is
medications and injectables.              typically front-ended and can         (RoActemra), Novo Nordisk               very simple and free of charge.
Typically, these programmes               leave the patient to their own        (Norditropin) and Biogen                Register your details on www.
include Patient Education,                devices for several months            (Benepali). Now, Nordic Pharma          pharmacycare.ie or call the
Nurse Support, Sharps Service             until their next consultant           has launched the first patient          Hibernian Healthcare office on
and Compliance Support.                   appointment at the hospital.          education service for Nordimet,         01 460 4820.
                                          What Pharmacycare offers              the injectable methotrexate.              Pharmacycare has the
                                          is a range of pharmacist-led            The Pharmacycare roadmap              exclusive backing of the
What does the                             services that bridges those           includes the rollout of many            IPU. The time for new paid
service involve?                          gaps, improves engagement             other services, as seen in the          for services is now and we
                                          with the medication and               table below:                            encourage you to be part of it.
Hibernian Healthcare
                                          supports compliance and
recognised one of the areas
                                          adherence.
where PSPs can often fall

 Service                     When can I offer the service?             What is involved?                           What fee can I expect?

 Sharps and Waste            Initial service which is up and running   Patients will bring their full sharps bin   The fee for a swap out and
 Management                                                            to your pharmacy and be provided with       replacement is €15.00 – €20.00
                                                                       a swap out.

 Script Updates              As new services are added                 The pharmacist will update the patient      The fee will be €3.00 for each script
                                                                       record on the Pharmacycare system           updated via the portal.
                                                                       each time the script is dispensed.

 Patient Education           Now for Nordimet. Others are in the       Helping patients learn how to deal          This will depend on the length and
                             pipeline                                  with their condition and safely self-       complexity of the training but for
                                                                       administer their Nordimet.                  Nordimet the fee is €40.00.

 Compliance                  As new services are added                 Pharmacists will receive training in        This will also depend on the length of
 Coaching                                                              compliance coaching and will conduct        the consultation but we expect this to
                                                                       compliance coaching by appointment          be approx. €30.00.
                                                                       with patients. The script will vary but
                                                                       each meeting will follow an agreed
                                                                       pathway.

 Patient Outcome             Mid-2019                                  This will include testing of various        This will depend on the complexity of
 Measurement                                                           health metrics to establish post-           the testing to be completed.
                                                                       medication efficacy.

22                                                                                                                                   IPUREVIEW NOVEMBER 2018
BUSINESS Jim Power, Economist

Economic
backdrop to
pharmacy sector
The Irish economy               Consumer spending

continues to perform            In the eight months of 2018,
                                the volume of retail sales
                                                                 in new car registrations is
                                                                 occurring despite the very
strongly. Quarterly             expanded by 3.3% and the
                                value of sales expanded by
                                                                 positive, and in theory,
                                                                 supportive economic
National Accounts show          2.1%. When new car sales are
                                excluded, the volume of retail
                                                                 backdrop for new car sales.
                                                                 In the first nine months of
that in the first six months    sales expanded by 3.7% and
                                the value of sales expanded
                                                                 the year, 77,277 used cars
                                                                 were imported, which was
of the year, GDP was 10.5%      by 2.3%. The gap between the     9.1% ahead of the first nine
                                value and volume metrics is      months of 2017. Sterling
higher than a year earlier,     continuing to suggest price      weakness is the key driver of

and GNP was 9.1% higher.        resistance from the stretched
                                personal sector.
                                                                 this trend, with 96.3% coming
                                                                 from the UK. Imported used
Modified final domestic           In the first nine months of
                                the year, 123,099 new cars
                                                                 cars are displacing new
                                                                 car sales and creating a
demand, which excludes          were registered, which is
                                4.2% lower than the first nine
                                                                 challenging environment
                                                                 for the new car industry.
the impact of trade in          months of 2017. The decline

aircraft by aircraft leasing
companies and trade in
research and development
and intellectual property,
was 6.3% higher than
a year earlier.

IPUREVIEW NOVEMBER 2018                                                                     23
Consumer spending continues        Figure 1: Consumer confidence
to steadily improve. However,
there continues to be two          140.0
caveats. There is still a
significant gap between the        120.0
volume and value of growth in
retail sales, and weaker new       100.0
car sales are impacting on the
overall retail sales numbers.       80.0
These trends have been a
feature of the retail market
                                    60.0
over the past couple of years.
                                    40.0
Consumer confidence
                                    20.0
Consumer confidence has
recovered strongly over the
                                     0.0
past three years, but has
                                           Feb 96
                                                    Dec 96
                                                             Oct 97
                                                                      Aug 98
                                                                               Jun 99
                                                                                        Apr 00
                                                                                                 Feb 01
                                                                                                          Dec 01
                                                                                                                   Oct 02
                                                                                                                            Aug 03
                                                                                                                                     Jun 04
                                                                                                                                              Apr 05
                                                                                                                                                       Feb 06
                                                                                                                                                                Dec 06
                                                                                                                                                                         Oct 07
                                                                                                                                                                                  Aug 08
                                                                                                                                                                                           Jun 09
                                                                                                                                                                                                    Apr 10
                                                                                                                                                                                                             Feb 11
                                                                                                                                                                                                                      Dec 11
                                                                                                                                                                                                                               Oct 12
                                                                                                                                                                                                                                         Aug 13
                                                                                                                                                                                                                                                  Jun 14
                                                                                                                                                                                                                                                           Apr 15
                                                                                                                                                                                                                                                                    Feb 16
                                                                                                                                                                                                                                                                              Dec 16
                                                                                                                                                                                                                                                                                       Oct 17
                                                                                                                                                                                                                                                                                                Aug 18
plateaued over the past
18 months and is proving
quite volatile from month
                                                                                                                                                                                                                                                                             Source: ESRI
to month. For example, in
October, confidence dipped to
a 21-month low. Issues such
as Brexit, rapidly escalating      announced spending increases                                                       The increase in the VAT                                                                    The success or failure of any
house prices, higher fuel costs,   that will take total spending                                                   rate for the hospitality sector                                                            budget in terms of achieving
the high personal tax burden,      up to €66.5 billion, which                                                      from 9% to 13.5% is the most                                                               its aims and objectives is
and subdued wage growth            represents an increase of 5.8%                                                  noteworthy feature of a                                                                    heavily dependent on the
are combining to have a            or €3.65 billion on the previous                                                budget that granted generous                                                               economic environment. The
somewhat sobering influence        year. Current spending will                                                     increases in government                                                                    economic forecasts underlying
on the personal sector. Despite    increase by €2.26 billion or                                                    expenditure. This expenditure                                                              Budget 2019 look quite
the economic recovery, the         4% and capital spending will                                                    is being funded by a sector                                                                realistic, based on what we
personal sector is still quite     increase by €1.39 billion or                                                    that creates and sustains jobs                                                             currently know about what is
fragile.                           23.6%. Gross current spending                                                   all over the country and which                                                             going on in the economy and
                                   accounts for €59.3 billion of                                                   faces a serious threat from                                                                the external risks that exist.
                                   total spending.                                                                 Brexit. This move is difficult                                                             Real GDP is projected to grow
Labour market                        In relation to health, the key                                                to understand.                                                                             by 4.2% in 2019, following
                                   measures were:                                                                                                                                                             growth of 7.5% in 2018.
In the year to June, the number
of people in employment              n An increase of €1.05
increased by 74,100 or 3.4% to         billion in health funding                                                   Table 1: Economic Forecasts Underlying Budget 2019
reach 2.255 million. This is the       for 2019, bringing the
highest level of employment            health budget to €17                                                                                                                                  2018f                                 2019f                                     2020f
on record. The level of                billion;
unemployment declined
                                     n €25.00 increase in the                                                         GDP                                                                     7.5%                                  4.2%                                     3.6%
by 26,800 in the 12-month
period to September and the            weekly income threshold                                                        GNP                                                                    5.9%                                   3.9%                                     3.3%
unemployment rate has fallen           for GP Visit cards;
to 5.4% of the labour force.                                                                                          Consumption                                                            3.5%                                   3.0%                                     2.6%
                                     n 50 cent reduction in
Since the weakest point of
                                       prescription charges                                                           Investment                                                            -8.9%                                       7.1%                                 5.7%
the labour market in January
                                       from €2.00 to €1.50 for
2012, the number of people                                                                                            Exports                                                                7.0%                                   5.6%                                     4.8%
                                       all medical card holders
unemployed has declined
                                       over the age of 70;                                                            Imports                                                                0.9%                                   6.2%                                     5.3%
by 226,600 from 356,000 to
129,400.                             n €10.00 reduction in the
                                                                                                                      Employment (Average)                                                   2,259                                 2,321                                     2,373
                                       monthly Drugs Payment
                                       Scheme threshold from                                                          Unemployment Rate                                                      5.8%                                   5.2%                                     5.0%
Budget 2019                            €134 to €124;                                                                  (Average)
The focus of Budget 2019             n €84 million for mental                                                         Inflation (Average)                                                    0.7%                                   1.5%                                     1.7%
was very much on Health                health services;
and Housing. The Minister                                                                                             General Government                                                    -0.1%                                   0.0%                                     0.3%
for Finance announced tax            n National Treatment                                                             Deficit (% GDP)
increases that will raise              Purchase Fund (NTPF)
€825.4 million in a full               to get an extra                                                                General Government                                                    64.0%                                 61.4%                                  56.5%
year and tax cuts that will            €20 million; and                                                               Debt (% GDP)
cost €458.9 million in a full
year. The net withdrawal in          n €150 million more                                                                                                                                                 Source: Department of Finance, Budget 2019
taxation was €366.5 million.           for disability services
On the expenditure side, he            bringing the total
                                       funding to €2 billion.

24                                                                                                                                                                                                                                            IPUREVIEW NOVEMBER 2018
®

                                                            SOLUBLE TABLETS
                                              Paracetamol, Codeine and Caffeine

                                                                                                                                                                                               ND’S
                                                                                                                                                                               b
                                                                                                                                                                                IRELA
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                                                           NE

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                                                       ALO

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               THA

                   N                                                                                                                                                                                             IEVER
                                                                                                                                                                                                          IN REL
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                                                                                                   *IMS Data July 2018

                                                                                                     ESSENTIAL
                                                                                                   INFORMATION

Solpadeine Soluble Tablets contain paracetamol, codeine phosphate hemihydrate and caffeine. For the treatment of acute moderate pain which is not relieved by paracetamol or ibuprofen alone, including migraine,
headache, backache, menstrual pain, musculoskeletal pain, toothache, common cold, influenza. Adults and children 12 years and over: 2 tablets dissolved in water 3 – 4 times a day. Max 8 tablets in 24 hours. Do not
give to children under 12 years. Do not take for more than 3 days without consulting a doctor. Do not take any other paracetamol or codeine containing products concurrently. Can cause addiction. Use for 3 days only. In case of
overdose, seek immediate medical advice, even if the patient feels well. Contraindications: Acute asthma, known hypersensitivity to ingredients, lactation, known CYP2D6 ultra-rapid metabolisers, patients 0-18 years who
undergo tonsillectomy and/or adenoidectomy for obstructive sleep apnoea syndrome. Precautions: Renal or hepatic impairment, non-cirrhotic alcoholic liver disease, obstructive bowel disorders, previous cholecystectomy, acute
abdominal conditions, pregnancy, prostate hypertrophy, the elderly. Pregnancy and lactation: Not recommended during pregnancy and breastfeeding. Side effects: Thrombocytopenia, anaphylaxis, cutaneous
hypersensitivity reactions, hepatic dysfunction, GI disturbance, dependency or worsening of headache following prolonged use. PA 1186/11/1. Pharmacy Only. MAH: Chefaro Ireland Limited, 1st Floor, Block A, The
Crescent Building, Northwood Office Park, Dublin 9. Date of preparation August 2018. http://www.hpra.ie/img/uploaded/swedocuments/LicenseSPC_PA1186-011-003_29112017162036.pdf
Tax forecasts                                                                                 increased by a strong 5.2%, but                                                                       Table 2: Tax Forecasts 2019
                                                                                              in value terms, the growth was
Following the tax changes                                                                     a much more modest 0.9%.
announced in the Budget,                                                                                                                                                                                                                                                       2018f                           2019f          %
                                                                                              The continued gap between                                                                                                                                                         €m                              €m          change
overall tax revenues in 2019 are                                                              value growth and volume
projected to expand by 5.2% to                                                                growth remains an important
reach €57.9 billion. Corporation                                                                                                                                                                     Customs                                                                              345                    365         +5.8%
                                                                                              facet of the market.
tax receipts are projected to                                                                   Price compression remains a                                                                          Excise Duty                                                                   5,620                        5,940        +5.7%
decline by 1.3%, reflecting the                                                               feature of the retail pharmacy
once-off boost to revenues                                                                    sector. In the first eight months                                                                      Capital Gains Tax                                                                     945                  1,000        +5.8%
this year from changes to                                                                     of 2018, the average consumer
accounting standards. Income                                                                                                                                                                         Capital Acquisitions Tax                                                              470                   495         +5.3%
                                                                                              price of Pharmacy products
tax will account for 38.9% of                                                                 declined by 3.8%, the price of                                                                                                                                                       1,575                                     +6.3%
                                                                                                                                                                                                     Stamp Duties                                                                                               1,675
total tax revenues this year                                                                  Prescribed Drugs declined by
and 39.5% in 2019.                                                                            6.2%, and the price of other                                                                           Income Tax                                                                  21,445                        22,905        +6.8%
                                                                                              medicines increased by 0.2%.
                                                                                                                                                                                                     Corporation Tax                                                               9,605                        9,480        -1.3%
                                                                                              In the 12-month period to
Trends in the retail                                                                          August, the average consumer                                                                           VAT                                                                         14,090                        15,140        +7.5%
pharmacy sector                                                                               price of Pharmacy products
In the first eight months of the                                                              declined by 2.9%, the price of                                                                         Motor Tax                                                                             980                    945        -3.6%
year, the volume of retail sales                                                              Prescribed Drugs declined by
                                                                                                                                                                                                     Total Tax Revenue                                                           55,070                        57,945        +5.2%
of Medical, Pharmaceutical                                                                    3.9%, and the price of other
and Cosmetic Articles                                                                         medicines declined by 1.1%.
                                                                                                                                                                                                                                                                                              Source: Department of Finance, Budget 2019

Figure 2: Retail Sales of Medical, Pharmaceutical & Cosmetic Articles
130.0
125.0
120.0
115.0
110.0
105.0
100.0
 95.0
 90.0
 85.0
 80.0
                    Jan 15

                             Mar 15

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                                                                                                                                 Value                                                   Volume
                                                                                                                                                                                                                                                                               Source: ESRI
Figure 3: Consumer Price Trends in the Pharmacy Sector

                   115.0

                   110.0

                   105.0
(Jan 2005 = 100)

                   100.0

                    95.0

                    90.0

                    85.0

                    80.0

                    75.0
                               Jan 05
                                        Jul 05
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                                                                                              Pharmaceutical                                                           Prescribed                                                Other
                                                                                              products                                                                 drugs                                                     medicines
                                                                                                                                                                                                                                                                               Source: CSO

26                                                                                                                                                                                                                                                                                                                IPUREVIEW NOVEMBER 2018
PROFESSIONAL Jack O’Connor, Country Manager, Movember Foundation

Movember:
10 years of
fundraising
in Ireland
Community-based health professionals can help
Movember to spread awareness around the issues men
face and encourage men to stay healthy in all areas of
their life, with a focus on staying socially connected
and becoming more open to discussing their health.

T
             his year, Movember   health and suicide prevention.     seven men in Ireland will          action is needed to raise
             will mark 10 years     Our fathers, partners,           be diagnosed with prostate         awareness about men’s health.
             of fundraising       brothers and friends are facing    cancer in their lifetime.
             in Ireland. By       a health crisis that isn’t being   Testicular cancer is the most
             prioritising the     talked about. Men experience       commonly diagnosed cancer          How does the Movember
funding of three of the biggest   worse longer-term health than      in boys and men aged between       campaign work?
health issues faced by men,       women and die on average           15 and 40 years.
                                                                                                        From humble beginnings
Movember ensures that it has      six years earlier. There is no       Men are also impacted by
                                                                                                        back in Melbourne in 2003,
a long-term, global impact.       biological reason for this; it’s   poor mental health and this is
                                                                                                        the Movember movement
   The Movember Foundation is     largely down to attitudes,         highlighted in the high rates of
                                                                                                        has grown to be a truly global
the only charity tackling men’s   awareness and behaviour.           suicide in men. Each week in
                                                                                                        one, inspiring support from
health on a global scale year-      The impact of prostate and       Ireland, on average 10 people
                                                                                                        over five million people across
round, with a singular goal       testicular cancer on lives of      die by suicide. Of these, eight
                                                                                                        the world who have funded
to stop men dying too young.      men is substantial. Prostate       are men, with the most at-risk
                                                                                                        over 1,200 innovative projects
Movember addresses some           cancer is the second most          being those aged between 45
                                                                                                        across 20 countries worldwide.
of the biggest health issues      common cancer in men               and 52 years. These are just
                                                                                                        Since 2008, Movember has
faced by men – prostate cancer,   and accounts for 11.1% of          some of the statistics that
                                                                                                        been funding solutions to
testicular cancer, mental         all cancer deaths. One in          show exactly why urgent

IPUREVIEW NOVEMBER 2018                                                                                                             27
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the most pressing health          also help Movember to spread      Irish Cancer Society. These      campaign around World
issues that impact Irish          awareness around the issues       initiatives have ranged from     Suicide Prevention Day in
men, and this year will mark      men face and encourage men        financial support for patients   September. While other
Movember’s 10th year in           to stay healthy in all areas      and their families, to ground-   charities are at the sharp
Ireland.                          of their life, with a focus on    breaking research that has       end of the issue, Movember’s
  Movember is an annual,          staying socially connected        united the prostate cancer       strategy is to keep men
month-long fundraising and        and becoming more open to         community, in an effort to       socially connected and
awareness campaign that           discussing their health.          improve outcomes and the         prevent their mental health
takes place every November.                                         quality of life for men. Funds   deteriorating in the first
For the month of Movember,                                          are also committed to men’s      place. Movember invests in
men effectively become            Where the money goes              mental health initiatives        awareness and education
walking, talking billboards       Movember has become the           and programmes, supporting       campaigns that aim to
for men’s health, sparking        largest non-governmental          testicular cancer through our    change the attitudes around
both public and private           contributor to prostate cancer    Global Action Plan initiative.   mental health.
conversations. These are          initiatives in Ireland, funding      For the past three years,
conversations that raise          over 30 programmes through        Movember has delivered a
awareness and educate men         its Men’s Health Partner, the     mental health awareness
and women of the key health
issues men face, helping
to change behaviour and
prompting men to engage in
their health and know when
to take action.
  People can raise funds by
registering and either growing
a moustache, hosting a Mo-
ment, or by joining the Move
challenge and committing
to running or walking 60
kilometres over the month.
That’s 60 kilometres for the 60
men we lose to suicide every
hour.
  There are also a number of
industry challenges, such as
the Pharmaceutical Challenge,
where any company or
person in the pharmaceutical
industry can unite under the
banner of men’s health and
compete against one another
for first place in the country.
  Community-based
health professionals in the
pharmaceutical industry can

   “People can raise funds by registering and
    either growing a moustache, hosting
    a Mo-ment, or by joining the Move
    challenge and committing to running or
    walking 60 kilometres over the month.”

IPUREVIEW NOVEMBER 2018                                                                                                        29
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