Healthy Skepticism Library item: 2163

Warning: This library includes all items relevant to health product marketing that we are aware of regardless of quality. Often we do not agree with all or part of the contents.

Publication type: news

Chemist conflict demands scrutiny
The Australian Edition 2001 May 22

Full text:

Drug wholesalers and their customers, the pharmacy profession, are about to be investigated on several fronts and so they should be. The community is rightly shocked to discover that, when a pharmacist dispenses a particular drug or suggests a certain brand of face cream, they may be doing so not because they believe the product will be better for the customer than any other but because its supplier is guaranteeing their mortgage.
Even though most people have been unaware of it, there is nothing new in the practice of drug wholesalers guaranteeing, or even making, loans to pharmacies. It is estimated that the the three big drug wholesalers -Sigma, Australian Pharmaceutical Industries and Faulding Health Care -stand behind $1.5 billion worth of loans to pharmacies nationally. That has been accepted practice for generations, and is even covered by the Pharmacy Act of 1964. What is new is the revelation in The Weekend Australian that pharmacies have agreed to purchase up to 90 per cent of their stock from the wholesaler which lends to them or guarantees their loan.
That poses problems on several fronts. A spokesman for the Australian Competition and Consumer Commission has already flagged a possible breach of the Trade Practices Act. The ACCC should investigate promptly.
The practice also puts pharmacists squarely in breach of their own code of ethics, which states that pharmacists must not agree to practise under conditions which compromise their professional independence, judgment or integrity, and must “avoid situations likely to present a conflict of interest or compromise the objectivity of their professional practice”. The Pharmacy Board is meanwhile investigating possible breaches of the Pharmacy Act, while the NSW and Victorian governments are both launching inquiries.
The public has been rightly concerned about doctors being feted on overseas junkets provided by drug companies. Indeed, consumers may wonder why they should worry about pharmacists when it is the doctors who write the scrips. But pharmacists are free to substitute an equivalent drug of a different brand in cases when the doctor does not rule it out, which is in most cases.
The early defence from pharmacists seems to be that the practice does not affect customer choice or compromise the pharmacist’s decision because the wholesalers all supply the same range of drugs from each of the manufacturers. An inquiry should clarify this. But it is in any case obvious to anyone who has walked into a pharmacy in recent years that a significant part of their turnover comes from products other than prescription drugs, from headache pills to hand creams and vitamins, many of which are sold under brand names associated with particular wholesalers. At the very least, pharmacists should be forced to make full disclosures to consumers and their ethics code should be amended to require it.