‘If you fight technology, you will lose’ — pharmacists debate ditching dispensing

In the impassioned debate at the 2018 International Pharmaceutical Federation (FIP) Congress in Glasgow, Darrin Baines, professor in health economics at Bournemouth University, argued that in order to keep its place in the healthcare system, community pharmacy needs to be the “go-to place for health technology” and should give up dispensing.

“If you want to find a growth area for pharmacy, go to health technology,” Baines reasoned. Using pharmacists’ origins as compounders as an example, he explained that pharmacists were experimenters and only became dispensers in the past 70 years. With dispensing potentially becoming automated, he argued that pharmacists should become technologists. “No one else in the healthcare system has the time or access to patients,” he reasoned.

However, not all of the expert panel agreed that it was time to let go of dispensing. Eeva Teräsalmi, a community pharmacist and pharmacy owner from Finland, argued that dispensing is the core function of community pharmacy and all services are based on it. But conceded that “we can discuss how we define dispensing”.

Similarly, Paul Sinclair, a community pharmacist from Australia, argued that since dispensing is the key link to the patient, community pharmacy should retain dispensing and “leverage it to greater benefit for the patient and greater professional opportunity and satisfaction for the pharmacist”. He also acknowledged that in Australia, community pharmacies are very reliant on the dispensing fee under the current Australian funding model.

Remuneration for community pharmacy was also a concern for FIP president Dominique Jordan. From what he has seen in other countries and other health budgets, he explained that his fear for the future of community pharmacy was that “[we] will not have the money to pay for the services that we can offer”.

While Brendan Murray, an independent contractor from Ireland, argued that we have to let go of some dispensing: “If you fight technology, you will lose.”

Although no consensus about the future of dispensing in community pharmacy was reached, the panel was in agreement that community pharmacy has a bright future, but it needs to evolve and technology will feature greatly in this evolution.

“We need to prove the added value of pharmacy,” said Jordan. “But don’t be afraid — we have time to adapt.”