Personalized Medicine and The Pharmacist

comments on the current pharmacy practice and personalized medicine

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1. Corporations create an environment incompatible with pharmacy practice


Large surface stores are modelled on high volume sales, low profit margins, simple products and low consumer interaction. Pharmaceutical care, on the other hand, centers around the needs of individual patients as well as complex and potentially dangerous technologies (i.e. pharmaceutical drugs). Selling warfarin in a one-stop location next to the toilet paper, chocolate and big screen televisions subconsciously conveys to the patient that their prescription is like any other consumer good; it should be cheap and it should be fast. This practice endangers the safety of the patient by trivializing the risks associated with pharmacotherapy and the information provided by the pharmacist during pharmaceutical counselling.


Additionally, the corporate environment imposes on the pharmacist unattainable goals which compromise pharmaceutical care. The performance of employed pharmacists is not assessed on their merits as good healthcare providers but rather on the number of prescriptions processed in any given day. Under such circumstances, medication review, pharmacovigilance, pharmaceutical counselling and continuation of care are set aside in order to maximize sales per hour.          


2. Corporations are inflexible entities


Pharmaceutical needs of individual patients are varied and unique. A given patient may require a compounded medicine, a veterinary product, a brand name medication, a prescription delivered after hours or simply social interaction. Such characteristics are incompatible with the inflexible large corporation model of chain-assembled goods. The real-life result is that patients are routinely refused pharmaceutical care, or referred elsewhere, due to high cost-to-profit ratios and time constraints. As pharmacy students, many of us have witnessed or heard about the atypical patient which the pharmacy staff would rather avoid servicing.        


3. Private enterprise stimulates quality of service and innovation


Pharmacy is unavoidably linked with consumerism. When corporate monopolies are removed, free enterprises in a competitor-rich environment must rely on a distinctive edge other than simple price differentiation. Individual pharmacies must then fight for the satisfaction and loyalty of patients (aka consumers) or die. As a result, business-wise entrepreneurs emerge and thrive by offering better and newer services/goods (i.e. quality care, medication review, disease specialization, compounding, injection services, etc) and enrich the environment and practice. Eventually, these become standard practices until the next great innovation perpetuating the cycle of innovation and enterprise.     


4. Pharmacy ‘store-in-stores’ erodes pharmaceutical care and commodotizes the pharmacy


Pharmacies located within grocery stores, department stores, etc. relegate the service to merely another aisle or service counter in the store, allowing the service to decrease at the pharmacy without being acted on by the consumer. Because of the added convienience of shopping while a perscription is filled the lack of service may be overlooked as an opportunity cost of the convienence. As this happens, a decrease in care creaps into society and overall negatively affects both patient care and the profession.


What is personalized medicine? Should pharmacists be involved, and what should they be doing?What is personalized medicine?

Personalized medicine differs from the modern medicine that we know of in that it is completely tailored to every individual patient. The medicine that is practiced today in hospitals and other care facilities revolves around treatment decision made based upon guidelines, and studies, all of which look at the impact on a representative group of our population. The fact is, everyone is different! This raises the question: can every person be treated the same way with the same results? No. Every person is different and everyones response to different treatments and medication is different. This is why the concept of personalized medicine was developed. Imagine having your genome sequenced so that we are able to predict which diseases you are at risk for. Also, it would be possible to determine which enzymes are more prevalent in your body, allowing us to determine the perfect dose of medication to use.

Should Pharmacists be involved?

Of course pharmacists should be involved. While doctors spend their time determining diseases patients are at risk for, or what type of a certain disease a patient has, pharmacists can work on the best way to treat that patient based on their “personalized” information.

What should they be doing?

Pharmacists can play a role in determining the exact dosing of medications depending on a person’s CYP enzymes for example. By doing so, they will eliminate almost all adverse effects, allowing for better patient compliance and better efficacy.


by: group 22.

Written by Kevin

February 2nd, 2012 at 1:06 pm

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