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Vol16 - Nov 2010

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IPSF Education Supplement

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International PharmaceuticalInternational Pharmaceutical

Students FederationStudents Federation

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Message From IPSF

Dear IPSFers,

It is my pleasure to present to you Phuture 2010

with the theme A look into the Future - Where is

the profession moving towards?. Through Phu-

ture we are trying to fulfill the IPSF objective: Toencourage full dissemination of scientific and pro-

fessional knowledge.

This year we focus on the direction our profes-

sion is heading and what it holds for variousareas of pharmacy. We focus on the areas ofHospital Pharmacy, Pharmaceutical Sciences,

Community Pharmacy and Pharmacy

Education. Through this we hope to give you a

glimpse of the future.

I would like to thank the authors for their invalua-

ble contributions, Pharmacy Education Sub Com-mittee, Shirley Yeung, Lena Kojukarov and

Bastien Venot for their contributions.

Viva la pharmacie,

Satyanarayana Murthy ChittooryIPSF Chairperson of Pharmacy Education

2009 - 10

Contact us:

www.ipsf.org

IPSF SecretariatPO Box 84200, 2508 AE

Den Haag, The Netherlands

3Phuture - Issue 16 - Nov 2010

Table of Contents

A look into the Future - What is the Future InPharmaceutical Sciences?Dr. Tathagata Dutta

4

A look into the Future Where is HospitalPharmacy heading?

Lea Knez

8

A look into the Future Where is CommunityPharmacy moving? What should we do?Raj Vidya

10

A look into the Future - Where is PharmacyEducation heading globally?

Andreia Bruno13

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Dr. Tathagata Dutta graduated with a PhD in

Pharmaceutical Sciences from Dr. Hari Singh

Gour University, Sagar and Postdoctoral studies

from School of Pharmacy, University of

Queensland, Brisbane, Australia. Currently, he

is the Deputy Director- Formulation Develop-

ment and Research of Aizant Drug Research

Solutions Pvt. Ltd., a premier drug discovery

and formulation research organization. He is an

expert in Nanotechnology and Dendrimer based

drug and gene delivery. He has published more

than 33 international papers in reputed journals,authored several book chapters and serves on

the editorial board member of several internatio-

nal journals on drug delivery research.

Looking back into the past century, it isclear that medical science has madeground-breaking advances and pharmaceutical

companies have made tremendous progress in

treatment of many illnesses like cancer andAIDS. This is shown, for instance, by the fact that

life expectancy has risen to about eighty years,

compared fifty-five years in early twentieth cen-

tury. However, remaining at the cutting edge of

technology in the face of such rapid advance-

ment is becoming increasingly expensive. Des-

pite the enormous progress that has been made,

developing a new drug is still a bit like looking for

a needle in a haystack, only one in 10,000 subs-

tances screened eventually becomes a fully fled-

ged product that can be used to treat patients.

And as I have said, it takes ten to fifteen years to

achieve that. That costs an average of about one

billion USD for each drug brought onto the mar-

ket, including opportunity costs and the cost of

failures. Over the past twenty years, the cost of

developing new drugs has increased by a factor

of eight. Therefore, pharmaceutical companies

are focusing less on discovering new chemicalentities and more on newer technologies to make

novel formulations of existing drugs for better sa-

fety and efficacy. With the generics market get-

ting crowded with more and more companies

each day and the number of molecules getting off

patent decreasing, generic companies are focu-

sing more on biosimilar/follow on biologics formu-

lation development. Development of novel drug

delivery system (NDDS) and nanotechnology

based formulations is also gaining tremendous

importance.

Biosimilar or Follow on Biologics

Formulations:

Biosimilars, or fol-low-on biologics,are new versions of existing

biopharmaceuticals whose pa-

tents have expired1-3. They are

produced using the same core genetic

material and are approved on the basis that they

are equal to the reference product in terms ofboth safety and efficacy. Biosimilars are large,

complex molecules produced by living orga-

nisms, which are sensitive to manufacturing

changes; generics are small molecules, produ-

ced by chemical synthesis, which are usually

very stable. Biosimilars is the official term used

by the European medical authorities; the US ter-

minology is follow-on protein products (FOPPs).

Biosimilars are formulations of highly uns-table proteins produced in living organisms often

provided with an application device, therapeutics

equivalence with the innovator product establi-

shed by extensive clinical studies. Biopharma-

ceutical drugs have outperformed the

pharmaceutical market as a whole largely due to

two factors: they address areas of clinical need

that are unmanageable with conventional thera-

peutics, including many cancers and genetic di-

seases, and they are able to command a

premium price. Usually, the imminent expiry of a

drugs patent leads to companies developing

cheaper, bioequivalent versions of the original

4

A look into the Future: What is the Future in Pharmaceutical

Sciences?

Dr. Tathagata Dutta, Aizant Drug Research Solutions Pvt. Ltd.,

Phuture - Issue 16 - Nov 2010

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brand, generics, followed by intense price com-

petition. This approach to the biopharmaceuticals

market can yield significant reward: according to

Frost & Sullivan, the biosimilars markets in Eu-

rope and the USA has the potential to generate

sales of $16.4 billion by 2011 at an average an-

nual growth rate of 69.8%. However, the com-

mercial and scientific hurdles facingbiopharmaceuticals hinder the entry of generic

biopharmaceuticals, so called biosimilars and,

less accurately, biogenerics, and mean that com-

panies that want to develop biosimilars will need

to rethink some fundamental assumptions about

the generics market and work according to new

business models. Companies that are likely to

succeed in the biosimilar market need to have an

appropriate marketing structure as well as the fi-nancial resources to develop the products and to

accept higher upfront risks in development, com-

mercialisation and capital investment, a major

shirt in skills for most generic players. This skills

shift means that biosimilars players will need to

evaluate their strategic options and to adopt dif-

ferent business models and skill sets to conven-

tional generics companies. This is new territory

for most generic players and the likely commer-cial rewards of entering most biosimilars markets,

in the short-term at least will probably be small.

Nanotechnology in Drug Deliveryand Novel Drug Delivery Formula-tions

Nanotechnology deals with the design,production, characterization and ap-

plication of sub-micron-sized particles. The popu-

larity and effectiveness of small-sized particles

can be extended to broad areas in pharmaceuti-

cal, medical, chemical and engineering applica-

tions mainly due to their unique properties. The

main goal of developing a nanotechnology based

NDDS formulation of a drug is either to alter is

pharmacokinetics, or to reduce its toxicity by tar-

geting to specific cellular targets thereby impro-

ving its safety and efficacy. Nanocarriers can

carry poorly soluble, unstable, or systemically

toxic drugs with extended blood half-lives and re-

duced side effects. In addition, intravenously in-

jected nanovehicles travel along the bloodstream

without blocking vessels. Floating nanoparticles

are accumulated at the inflamed site having leaky

blood vessels by the enhanced permeability and

retention (EPR) effect. The presence of targeting

molecules at the surface of nanocarriers in-

creases the targeting ability, resulting in higheraccumulation at the target site.

Predicting the future of nanotechnology in

drug delivery systems is not simple because the

technology is moving forward fast and dynami-

cally changing, and we are in the middle of such

changes. One could, however, find possible clues

from the efforts to overcome the problems facing

the research community today. One of the first

things that can be predicted is the minimalisticdesign of drug delivery systems. Multifunctional

drug delivery systems have been reported, but

only few of them were used successfully in small

animal models. The future of nanotechnology in

drug delivery is very bright, as

combined efforts of scientists in different disci-

plines are bound to make nanotechnology prac-

tical.

Liposomes

Liposomes are spherical vesicles thatare prepared using one or more am-phiphilic phospholipids (such as phosphatidylcho-

line) and cholesterol that self-associate into

bilayers that have aqueous interior. Li-

posomes may be formulated into

small structures (80100 nm) that

encapsulate either hydrophilic

drug in the aqueous interior or li-

pophilic within the lipid bilayers.

Drug release, in vivo stability and

biodistribution are determined by

the size, surface charge, surface hydrophobicity

and membrane fluidity.

Some of the highly successful commer-

cially available liposomal formulations are AmBio-some (Gilead sciences/ Fujisawa Healthcare),

containing membrane-intercalated amphotericin

B; DaunoXome (Gilead Sciences), containing


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encapsulated daunorubicin; Myocet (Elan),

containing encapsulated doxorubicin; and Doxil

(J&J Alza), containing doxorubicin encapsulated

in PEGylated liposomes. A critical evaluation of

pharmacokinetic parameters of Myocet and

Doxil clearly shows that PEGylation of lipo-

somes has increased the area under the curve

(AUC) of doxorubicin by 100 folds while decrea-sing its clearance by 80 folds4-6.

Nanoparticles

Nanoparticles made of biocompatibleand biodegradable polymers are gai-ning importance, especially in pharmaceutical

areas, and have proved to be good candidatesas novel drug delivery devices. Nanoparticles are

solid colloidal particles, ranging in size from 1 to

1000 nm, consisting of various macromolecules,

in which the therapeutic drugs can be adsorbed,

entrapped or covalently attached. Solid nanopar-

ticles offer distinct advantages in drug develop-

ment, which can be ascribed to their physical

stability and the possibility of modifying the for-

mulating materials in order to achieve controlledrelease characteristics. The ability to formulate

nanoparticles to achieve sustained release offers

an opportunity for product life cycle management

by developing formulations with decreased do-

sing frequency for drugs that are going off patent.

There has been a variety of materials used to en-

gineer solid nanoparticles both with and without

surface functionality. Perhaps the most widely

used are the aliphatic polyesters such as

poly(lactic acid) (PLA), the more hydrophilic

poly(glycolic acid) (PGA), and their copolymers

poly(lactide-coglycolide) (PLGA). The degrada-

tion rate of these polymers and often the corres-

ponding drug release rate can vary from days, for

PGA, to months, for PLA. The effectiveness of

nanoparticles in drug delivery can be attributed

to many factors, such as physical and biological

stability, good tolerability of the components, sim-

plicity of the manufacturing process, possibility offacile scale-up of the manufacturing process,

amenability to freeze drying and sterilization7-12.

Dendrimers

Dendrimers have generated a greatdeal of interest as controlled and tar-geted drug/gene delivery systems due to their ex-

ceptional structural properties such as

monodispersity (1.0), high density of peripheral

functional group, and well-defined globular shape

and multivalency. Dendrimers are globular, nano

scaled macromolecules with a particular architec-

ture constituted of three distinct domains: (i) a

central core that is either a single atom or a group

having at least two identical chemical functiona-

lities; (ii) branches emanating from the core, com-

posed of repeat units having at least one junction

of branching, whose repetition is organized in ageometric progression that results in a series of

radially concentric layers called generations (G);

and (iii) many identical terminal functional groups,

generally located in the exterior of the macromo-

lecule, which play a key role in their gene-com-

plexing or drug-entrapping ability. Because of

their molecular architecture, dendrimers show

some unique physical and chemical properties,

which make them particularly interesting for drugand gene delivery applications. Dendrimers are

widely explored in the field of controlled and tar-

geted drug delivery, gene delivery and genetic

immunization, transdermal and topical drug deli-

very, peptide and vaccine delivery, and delivery

of diagnostic agents. Starpharmas lead product

VivaGel, is a dendrimer based vaginal microbi-

cide gel, which is effective in preventing sexually

transmitted disease including HIV is currently un-

dergoing clinical trials13-15.

Conclusion

Nanopharmaceuticals are

emerging complex drug

delivery systems that are

being shown to be bene-

ficial for therapeutic use

with their targetability andimproved bioavailability. However, they might pre-

sent new and unusual risks, and there is very little

information from sponsors about how the risks


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can be identified, assessed, and controlled. Safe nanopharmaceuticals will not become a reality un-

less proper risk management and mitigation tools are utilized.

References

1. EMEA guideline on similar biological medicinal products2. EMEA guideline on similar biological medicinal products containing biotechnology-derived proteins

as active substance: quality issues3. EMEA guideline on similar biological medicinal products containing biotechnology-derived proteinsas active substance: non-clinical and clinical issues.4. Weissig, V., Boddapati, V.S., Cheng, M.S., DSouza, G.M.G. (2006) Liposome and liposome likevesicles for drug and DNA delivery to mitochondria. J. Liposome Res.16, 249-264.5. Nagayasu, A., Uchiyama, K., Kiwada, H. (1999)The size of liposomes: a factor which affects theirtargeting efficiency to tumors and therapeutic activity of liposomal antitumor drugs. Adv. Drug Del.Rev. 40, 75-87.6. Zuidam, N.J., Lee, S.S.L., Crommelin, D.J.A. (1992) Sterilization of liposomes byheat treatment. Pharm. Res. 10, 15911596.7. Kayser, O., Lemke, A., Hernandez-Trejo, N. (2005) The impact of nanobiotechnologyon the development of new drug delivery systems. Curr. Pharm. Biotech. 6, 358. Jung, T., Kamm, W., Bretenbach, A., Kaiserling, E., Xiao, J.X., Kissel, T. (2000)Biodegradable nanoparticles for oral delivery of peptides: is there a role forpolymers to affect mucosal uptake? Eur. J. Pharma. Biopharm. 50, 1471609. Hu, J., Johnston, K.P., Williams, R.O. (2004) Nanoparticle engineering process forenhancing the dissolution rates of poorly water soluble drugs. Drug Dev Ind. Pharm. 30, 23324510. Alle`nmann, E.,Gurny,R.,Doelker, E. (1993) Drug-loaded nanoparticles-preparationmethods and drug targeting issues. Eur. J. Biopharm. 39, 173191.11. Kipp, J.E. (2004) The role of solid nanoparticle technology in the parenteraldelivery of poorly water-soluble drugs. Int. J. Pharm. 284, 109122.12. Lockman, P.R., Mumper, R.J., Khan, M.A., Allen, D.D. (2002) Nanoparticle technology for drugdelivery across the blood-brain barrier. Drug Dev. Ind. Pharm. 28-32.

13. Dutta, T and Jain, N.K. (2007) Targeting potential and anti HIV activity of mannosylated fifth ge-neration poly(propyleneimine) dendrimers. Biochim. Biophys. Acta. 1770, 681-686.14. Dutta, T., Garg, M., and Jain, N.K. (2008) Targeting of efavirenz loaded tuftsin conjugatedpoly(propyleneimine) dendrimers to HIV infected macrophages in vitro. Eur. J. Pharm. Sci. 34 (2-3),181-189.15. Dutta, T., Garg, M., and Jain, N.K. (2008) Poly(propyleneimine) dendrimer and dendrosomebased genetic immunization against Hepatitis B. Vaccine. 26 (27-28), 3389-3394.


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Lea Knez is a young pharmacist embracing the

path of clinical pharmacy in Slovenia.

She graduated in 2006 from the Faculty ofPharmacy, University of Ljubljana. Lea conti-

nued practicing in the field of clinical pharmacy

at the same institution and started her PhD at

the Faculty of Medicine, University of Ljubljana

and is studying the impact of pharmacogeno-

mics of multidrug resistance on chemotherapy

outcomes. Lea tries to implement the principles

of evidence-based practice, contributing evi-

dence also through her own research which

was presented in the form of papers and pre-sentations on national and international confe-

rences as ESOP and FIP congress.

Through the undergraduate pharmacycurriculum, the first idea of hospitalpharmacy is created, an idea that is later eluci-dated and refined through clinical practice and,finally, coloured when experiences are sharedand mixed with pharmacy colleagues worldwide.The final picture is indeed very bright and colour-

ful; and this is the image I have of hospital phar-macy at the very time of writing. Although it ishard to imagine a common future for such diver-sity and describing this in 1000 words seemsnearly impossible, I am convinced that the ideaon where hospital pharmacy is heading wasnever as clear as it is today. Why? Keep rea-ding...

The ultimate goal of hospital pharmacyis unequivocally clear: to provide thebest patient care in a hospital setting. However,unequivocal is also the diversity found in the ser-

vices provided by hospital pharmacists, the diver-sity in the availability of human and other re-

sources, and the level of recognition of the roleof hospital pharmacists; all contribute to the he-terogeneity in the level of practice of hospitalpharmacy among and within different countries.

And as each of us is struggling to improve patientcare in our own hospital setting, can we be surethat we are taking the profession to the nextlevel? To do so, each small step needs to bestreamlined toward a common goal to achieveglobal impact.

The need for a consensus on future direc-tions for hospital pharmacy practice was recogni-sed and served as a drive for the organisation ofthe Global Conference on the Future of HospitalPharmacy. The conference was organised by FIPHospital Pharmacy Section just preceding the68th FIP congress in Basel, Switzerland in Au-gust 2008. The conference produced a shared vi-sion among hospital pharmacy leaders aroundthe world about the preferred future on hospital

pharmacy practice. The Basel Statements offerguidance on the cornerstone elements in hospitalpharmacy and further evaluates in detail six to-pics: medicine procurement, prescribing, prepa-ration and distribution, administration andmonitoring, and human resources and training inhospital pharmacy. Since the Basel Statementsare freely available on FIP website and the pro-ceedings of the conference were published as asupplement in the March 1, 2009, issue of the

American Journal of Health-System Pharmacy,only few overarching statements of strongconsensus, as selected by the editors of the abo-vementioned conference proceedings, are high-lighted herein.

The overreaching goal of hospital pharma-cists is to optimise patient outcomes through the

judicious, safe, efficacious, appropriate, and cost-effective use of medicines.

All prescriptions should be reviewed, interpreted,and validated by hospital pharmacist before me-dicine is dispensed and administered.The five right (right patient, right medicine, rightdose, right route, right time) should be fulfilled in

8

A look into the Future Where is Hospital Pharmacy heading?

Lea Knez, University Clinic Golnik, Slovenia


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all medicine-related activities in the hospital.Thus, the Basel Statements definitely answer thequestion posed in the title: where is hospitalpharmacy heading. The primary message of theGlobal Conference on the Future of HospitalPharmacy is for hospital pharmacists to orientatetheir efforts towards an improvement in patientcare, minimising the risks associated with medi-cines use in hospitals and accepting the respon-sibilities for all medicines, everywhere in thehospitals, and at all times. Moreover, the BaselStatements do not only provide guidance on whatshall we aim to, but in doing so, it is not restrictingits applicability due to the different levels of prac-tices by defining the way of how to do it.

And, as the Basel Statements indicatesthe way forward, hospital pharmacists from all

over the world have to take leadership in impro-ving hospital pharmacy practice in their country.They need to transform the vision into clinical ser-vices to improve the health of patient treated withmedicines. In these initiatives, while evaluatingcurrent practices and implementing new services,research should be integrated at all times to pro-vide evidence on the need and importance ofhospital pharmacy contribution to patient care.

Overwhelmed by the hectic rhythm ofeveryday practice, research is oftenneglected as being something on top of otheractivities, while it should be recognised as an es-sential tool for convincing hospital boards andhealthcare policymakers about the need forchanges and bringing these changes to life.Thus, well-designed and well-conducted re-search of clinical practice that focuses on impor-tant clinical outcomes, ultimately, quality of lifeand survival, is of outmost importance. Moreover,while advocating for hospital pharmacy, the gai-ned evidence should be reported and publishedin order to reach a broad pharmacy audience,other healthcare professionals, healthcare poli-cymakers and the general public.

Being more futuristic in looking at whatawaits the profession, new challenges for hospi-tal pharmacists will emerge as patient-centredcare is entering the era of personalised medi-

cines, where the one fits all principle will besubstituted by an individual approach. For exam-ple, dose selection will not be based solely on pa-tients health condition but will consider also the

genetics of enzymes involved in drug metabo-lism, and the choice between different treatmentmodalities will be based on the presence of diffe-rent molecular biomarkers. These principles arealready being implemented in the treatment withspecific medicines in the field of oncology. Asthese ideas are finding their way into clinical prac-tice, all healthcare professionals are required toacquire extensive knowledge and understandingof pharmacogenetics. In a hospital setting, phar-macists have the best position to assist the trans-lation of new discoveries from laboratory benchesto patients bedside with the appropriate clinicalinterpretation as no other healthcare professionalhas a more comprehensive understanding ofboth, basic research and its clinical applicability.Personalised medicine is, indeed, an area of newchallenges for hospital pharmacists.

Thus, where is hospital pharmacy hea-ding? Towards the realisation of theBasel Statements and beyond. For sure, the fu-ture of hospital pharmacy was never before so fo-cused and goal oriented as it is today, andhospital pharmacists were never so passionateand motivated to improve their profession as theyare today. And while constant improvement is im-perative in providing best patient care, hospitalpharmacists are fulfilling their role as they couldnever have before.


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Mr. Raj Vaidya is a Master of Pharmacy. As a

community pharmacist he has been actively in-

volved in the activities of IPA at the state andnational level for a decade and a half. He is the

team leader and active resource person of GPP

Project of IPA and has been the major contribu-

tor in framing the GPP guidelines. He is also

part of the FIP GPP working group. He is also

the Vice Predident of IPA and Chair of the Com-

munity Pharmacy Division of IPA. Mr. Vaidya is

Co-ordinator of Peripheral Adverse Drug Repor-

ting Centre, Goa.

Community pharmacy is making giantstrides in the developed countries ofthe world. It is moving from strength to strengthand pharmacists have professionalized and arealso innovating towards improving their servicestowards patient benefit. Pharmacy is seen as aprofession with a business outcome. Communitypharmacists are one of the highest paid pharma-cists in these countries. It is a rewarding as wellas a professionally satisfying career. Majority of

pharmacists in these countries go into communitypharmacy, followed by hospital pharmacy, butvery small percentage of pharmacists go into in-dustry, research, academics, etc.

The professional practice has beenbacked by the small beginning in the late 1960s,where the focus first slowly but steadily startedshifting from product to patient. Today, the pro-duct aspects are being looked into more by thetrained technicians, whilst the pharmacists look

more into the patient aspects. Providing informa-tion about their medicines through verbal andwritten instructions, and backed by patient coun-selling.

Other health care professionals, doc-tors and nurses, have well acceptedthe roles of pharmacists, as equal partners in de-cision making for patient care, with the onus ofmaking choices for medicines and medicine ma-nagement slowly shifting towards the pharma-cists. That the pharmacists have attainedknowledgeable and professional levels aregrounded in the practice oriented curriculum andthorough training and exposure to practice orien-ted learning, compulsory internships in practicesettings, and the need to pass a pre-registration

exam. In short, one needs to be thorough, wellversed and knowledgeable with pharmacy prac-tice before being allowed a license to practice!

The developing and the underdevelopedcountries unfortunately remain far behind in allthese areas. Unfortunately, most people seepharmacy as a business with no need of profes-sionalism! In many of these countries, there aresevere shortages of healthcare manpower, andthat includes pharmacists also. Large number ofpharmacies can function without a pharmacist

most of the times. Even if a pharmacist is pre-sent, the professional backing and touch is oftenmissing. Access to health care and essential me-dicines also remains a problem. In many of thesecountries, there is no pre-registration exam, andthus not much can be judged of the quality ofpharmacists being churned out.

Today, in most places in India, and soalso in large areas of south east asia,community pharmacies largely operate as trade

merely doing buying and selling. Most prescrip-tion medicines are available without a prescrip-tion. The regulatory authorities have failedmiserably in implementing the important provi-sions, presence of a pharmacist in the pharmacy,and sale of prescription medicines only againstan authorized doctors prescription. The maincrux of the issue lies in these two very importantaspects. The third issue is of trained pharmacists

executing a professional task in the pharmacy.Other problems are include, too many pharmacylicenses concentrated in some areas too close toone another, cut throat competition with large dis-counts, expiry problems, pharmacies reluctant to

A look into the Future - Where is Community Pharmacy mo-

ving? What should we do?

Raj Vidya, Indian Pharmaceutical Association


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hire or pay pharmacists well, etc. Public are notmuch aware of the role of the pharmacist, theyare unidentifiable, nor do pharmacists have confi-dence in discussing medicines management eyeto eye with doctors. Another vital ingredient in thisunprofessional cocktail is the ignorance of the au-thorities and politburo who have even madestrong recommendations that a pharmacist is notnecessary to run pharmacies! And the icing onthe cake has been the pharmacists lack of awa-reness of their true potential in community phar-macy and a strong resistance to change!

The scenario is of course changing andoptimists feel that they can see a shim-mer of light at the end of the long winding tunnelwe have to traverse. The consistent work doneby professional pharmacy associations, educa-

tional institutions, pharmacy stalwarts and profes-sionals across the world in the past fifteen totwenty years has slowly generated the impor-tance of community pharmacy and slowly awa-kened the pharmacists in community that theyneed to do something.The FIP with its international presence and its va-rious Forums in the six regions of the world havebeen able to go strong on policies and documentthe role of the pharmacist, education material for

pharmacists, need for inter-professional interac-tion and working together, and promoting goodpharmacy practice (GPP) across continents. Ex-periments of Accreditation of pharmacies in Uru-guay and Thailand have certainly helped to laydown the platform for further spread of thisconcept, and improve community pharmacy prac-tice.

I

n India, the Indian Pharmaceutical Asso-ciation (IPA) and the All India Organiza-

tion of Chemists & Druggists (AIOCD ) areinvolved in training of pharmacists, promotingGPP. Pharmacists are trained through patientcounselling courses (PCC), opening their innerwindows, which explores their own potential forprofessionalism, playing a crucial role in societyand ultimately professional satisfaction. Currently,the PCCs are conducted in Maharashtra, forowner-pharmacists, and very shortly, pharma-cists in other parts of the country will come under

the training radar. The challenge for countries likeIndia is huge considering it has more than half amillion pharmacies

Some steps which need to be taken inunderdeveloped and developingcountries to gear up community pharmacy in their

countries are:

1. Sensitization and awareness of authorities andpolitburo about the role of the pharmacist and im-portance of professionalizing pharmacies acrossthe country.

2. Proper implementation of drug laws uniformlyacross the country.

3. Upgrading the curriculum and making it more

practice oriented along with better exposure atundergraduate level.

4. Orientation & training of pharmacy teachers to-wards practice, and introducing the concept ofteacher practitioners.

5. Continuous training of pharmacists in the coun-try, helping them to professionalize

6. Sensitization of pharmacy owners (especiallynon-pharmacists) to professionalize their phar-macies, importance of pharmacist, and need toimplement GPP in their pharmacy.

Students role: Community pharmacy is in theneed of heroes. In the public eye, the credentialsand professionalism of a pharmacist are reflectedfrom the community pharmacies. If pharmacistsare not present in them, or if they are present but

not noticeable, if they do not function other thanplain selling of drugs, it in no way will conveywhat role of pharmacist in health care can be!


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Who are the pharmacists in the phar-macies? They are non-other thanstudents of Pharmacy Colleges once upon atime. Had they been well captured, and well trai-ned, and well oriented towards community phar-macy and the concepts of taking the health of thepublic in their hands, we could have had betterpharmacist interfacing with the public. The seedsof professionalism have to be planted in the phar-

macy colleges! The Good Pharmacy Studentsof today will be Good Pharmacist of tomorrow.

The future of pharmacy thus lies in theHANDS of our pharmacy students. Itis the student who can make or break the profes-sion of pharmacy. It is time now to take the tre-mendous task of development of the truepharmacy profession, into your hands! The timeto act as now, for tomorrow will always be toolate!

The pharmacy profession cannot growand gain recognition unless we, pharmacists,give back something. The profession will benefitthe most when we, the pharmacists, venture outinto the community pharmacies and enlightenedthe patient pharmacy interface. Only whenmore and more interested, dedicated and know-ledgeable pharmacists venture into this field ofpharmacy, will the possibility arise of influencingand impressing the community...

To gain something we have to sacrifice alot! Do we have young pharmacist willing to dothat? Its time to inspect, and...

...act!

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Andreia Bruno graduated from the Instituto Su-

perior de Ciencias de Saude Egas Moniz in

Portugal. At this time she is doing her PhD inthe FIP Collaborative Centre | School of Phar-

macy, University of London in the Competency

domain of the Pharmacy Education Taskforce,

developing a Global Competency Framework

for pharmacy workforce. She was involved in

IPSF for three years, 2003 to 2006, as a

Contact Person and part of the Public Health

Sub-committee while a student; and now she is

still involved as a coordinator in the Moving On

II project. She has attended many internationalevents and congresses (FIP Congresses,

ISPW, and several IPSF congresses).

According to Wikipedia (a tool use bymany as an online encyclopaedia),the pharmacy profession links the healthsciences with the chemical sciences and is char-ged with ensuring the safe and effective use ofmedicines. It further explains that the scope ofpharmacy practice focus has shifted from a tra-

ditional role (compounding and dispensing medi-cation) to a more modern role which includesclinical services, reviewing medication for safetyand efficacy and providing medicines information.It also states that pharmacists, therefore, are theexperts in medicines therapy and are the primaryhealth professionals who optimise medicationsuse to provide patients with positive health out-comes.

Pharmacy education relates to what ismentioned above, but confusion isoften present when we try to think globally. Onecan argue that there is a need to have pharma-cists that are competent and fit-for-purpose whenleaving universities, but how do we assess it?What is the appropriate path to follow in educa-tion? Is there only one path? This article will tryto provide a global perspective on what is in prac-tice nowadays and also to extrapolate what willhappen in the future.

The challenges facing the profession re-late to the shortage of qualified phar-macists to provide pharmaceutical care andpatient-focused practice to meet the demands ofour society. Unfortunately, this happens not onlyin low human development countries, such asMalawi, as possibly expected, but also in the me-dium human development ones, such asChina1,2. New opportunities within the profes-sion have shaped our professionals to becomemore involved with patients; this is a tendency

that we can observe worldwide. As technologyand medicines become more complex pharma-cists need to keep up-to-date with the latesttrends and arm themselves with new and/or im-proved skills to face new challenges - here iswhere education can step in. This is valid for bothundergraduate education and continuing profes-sional development as education underpins ourpursuit of continually expanding our knowledgeand professional performance.

As humans we are a complex speciesand do not always share the sameopinion when it comes to education. In differentcountries, different pharmacy programmes aretaught with the same common goal producingquality pharmacists, and even within one countrydifferent degrees are awarded2,3. This makes itdifficult to unify a profession that at the startingpoint is already divided, but not all is lost and I do

believe that we will reach a consensus in the fu-ture.

A look into the Future - Where is Pharmacy Education heading

globally?

Andreia Bruno, FIP Collaborating Centre | School of Pharmacy, University of London

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Despite many differences, Europe de-veloped the Bologna Process, withthe purpose of creating the European HigherEducation Area (EHEA). EHEA makes academicdegree standards and quality assurance stan-dards more comparable and compatible throu-ghout Europe. In a press release from theEuropean Commission, the students also had avoice in what is happening at the moment:A new Europe-wide survey among studentsshows that they want wider access to higher edu-cation and that universities should open up co-operation with the world of work and to lifelonglearning. A large majority agree that it is importantfor higher education institutions to foster innova-tion and an entrepreneurial mindset among stu-dents and staff, and that there should be thepossibility to undertake work placements in pri-

vate enterprises as part of a study programme.More students want to study abroad and a majo-rity want more information about the quality of hi-gher education institutions in order to inform theirstudy choices. 4

It is a growing trend for students andpractitioners to seek other countries dif-ferent from their own to pursue further studies,

expand their knowledge and skills, and bringwhat they have learned back home.

Pharmacists wish to reinforce their roleas medicines experts and educationprogrammes need to ensure that they are com-petent to undertake these new responsibilities.Competency-based programmes are alreadybeing used in some countries such as Australia5, and are possibly the future for pharmacy edu-

cation. The term competency is a challengingone, since there is no universally accepted com-petency framework or performance standard atthe point of graduation or post-registration forpharmacists in the same way there is for doc-

tors6, who have a method to ensure uniformity ofcompetency-based skills. Why not develop anagreement on the core competencies and beha-viours for the pharmacy profession in a globalsense that would be adapted according to thespecificities of the country?

An emergent role for pharmacists thatwe are currently witnessing in the Uni-

ted Kingdom8 is the introduction of supplemen-tary and independent prescribing. Such new roleshave to be supported by appropriate training andcontinuing professional development.

To think about the future of pharmacyeducation, one has to think about thefuture of the profession as these cannot be dis-sociated one from the other. To support a unified

pharmacy profession worldwide focused on theinterests of patients and their health outcomes, Iforesee developments in education that will ex-pand among other things the use of problembased learning, objective structured clinical exa-mination and competency-based outcomes. Ialso foresee strengthened mobility of students,researchers, staff and pharmacists that will en-able a shared vision of the pharmacy profession.

References

1. Wuliji T. 2009 FIP Global Pharmacy work-force report. 20092. Ryan M, Shao H, Yang L, Nic XY, Zhai SD,Shi LW, Lubawy W. Clinical Pharmacy Edu-cation in China. American Journal of Pharma-ceutical Education. 2008; 72(6): 129.3. Kheir N, Zaidan M, Younes H, Hajj M, Wil-bour K, Jewesson P. Pharmacy Educationand Practice in 13 Middle Eastern Countries.

American Journal of Pharmaceutical Educa-tion. 2008; 72(6): 133.

4. Last assess 13th of July 2010 - http://eu-ropa.eu/rapid/pressReleasesAction.do?refe-rence=IP/09/618&format=HTML&aged=0&language=EN&guiLanguage=fr5. Marriott J, Nation R, Roller L, Costelloe M,Galbraith K, Stewart P, Charman W. Phar-macy Education in the Content of AustralianPractice. American Journal of PharmaceuticalEducation. 2008; 72(6): 131.6. World Federation of Medical Education.WFME Global Standards for Quality Improve-ment in Medical Education: 2003.7. Sosabowski M, Gard P. Pharmacy Educa-tion in the United Kingdom. American Journalof Pharmaceutical Education. 2008; 72(6):130.


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