The insidious rise of corporate pharmacy

The insidious rise of corporate pharmacy


Dr Michael Page
AMA (WA) Councillor

Friday 16 August 2019

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The Pharmacy Guild has for many decades done an extraordinary job of preventing supermarket operators and other non-pharmacists from owning pharmacies.

 

Its central argument is that restricting ownership to trained pharmacists and placing caps on the number of pharmacies in which they can have a financial interest (four in Western Australia; previously two) ensures maintenance of professional standards, thereby protecting the public from harm. This argument is reflected in government policy and enshrined in legislation.

 

Where the Guild has harmed the broader pharmacy profession, including its traditional independent pharmacy owner members, is in its silence and inaction on the rise of pharmacists who, through complex, opaque management agreements and equity structures allegedly hold controlling interests in tens or even hundreds of pharmacies.

 

This has been an open secret in the pharmacy industry for decades, but is rarely identified in official reports.

 

It is creditable that the Department of Health has brought it to light in its Review of Community Pharmacy Ownership in Western Australia.

 

The question becomes: does pharmacist-ownership guarantee the delivery of a high-quality service when a Western Australian pharmacy is (strongly rumoured to be) controlled by a likely non-practising pharmacist in another State who controls dozens of other pharmacies?

 

Further, if the pharmacy’s puppet master is purposely hidden, how can any kind of meaningful clinical governance be implemented to ensure the safe and accountable delivery of clinical services?

 

Unfortunately, an expanded range of pharmacy-delivered clinical services is supported by the Review, despite its clear reservations around the opacity of pharmacy control and its vulnerability to external influences. It has made recommendations around enhanced probity of pharmacy ownership, but it would be surprising if these brought any of the well-established, seriously well-financed chain operations to heel.

 

The de facto corporatisation of pharmacy ownership has facilitated another phenomenon that the Guild has failed to meaningfully resist – the discount pharmacy chain. These often unprofessional-appearing, low-service environments further undermine the Guild’s arguments against deregulation of pharmacy ownership.

 

In addition, it is patently self-evident that unproven and alternative therapies have found a firm foothold in community pharmacies as a rule, rather than an exception.

 

At least one pharmacy chain – Chemist Warehouse – has achieved such heft that, with its own interests not entirely aligned with those of the Guild, it argues for changes to the rules that restrict pharmacy locations. Such changes would represent an existential threat to many of the Guild’s members, who would face stiff competition from Chemist Warehouse outlets opening in their immediate vicinities, and would diminish the Guild’s standing.

 

These trends in the pharmacy industry have been a slap in the face to many hard-working, professional employed pharmacists who increasingly face poor working conditions and uncertain futures, as well as those independent pharmacy owners attempting to deliver high-quality pharmaceutical services. They seriously throw into question the ability of the community pharmacy network as it stands to deliver expanded clinical services, despite the intentions, some of which may be inherently worthy, of the profession’s leaders at the Pharmaceutical Society of Australia.

 

The Pharmacy Guild may ultimately have cause to regret its inaction on the degradation of professionalism in community pharmacy.

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