Too many community pharmacists are subsidising professional services from their own pockets, according to the International Pharmaceutical Federation (FIP). This is according to a new report, 'Sustainability of pharmacy services: Advancing global health', which gives an international overview of remuneration models for community and hospital pharmacy, published today (September 29).

The report, produced primarily by pharmacists and health economists, is based on data from 49 countries. It reveals a common concern among pharmacy associations worldwide over the long-term financial viability of community pharmacies – independent pharmacies in particular – owing to successive price and margin cuts.

There is general interest from governments and other stakeholders in increasing the services offered by pharmacists, the survey found, with evidence of more service-oriented roles with greater public health responsibilities. However, the report’s authors say that despite a “philosophical shift” towards a more service-focused model of care, community and hospital pharmacy remuneration models remain largely product-focused.

They say that this in itself constitutes a barrier towards new services. For example, only two responding countries confirmed systems of remuneration that provided incentive for expanded services from hospital pharmacies. Moreover, as payments based on the volume of medicines dispensed decrease, there will be “an urgent need to find other sources of revenue to support quality, comprehensive pharmacy services”.

Another finding is that, in most countries, dispensing fees relate to the product and include the provision of advice but do not always value this advice giving appropriately. Re-evaluation is needed, the authors say. For example, if the provision of advice were to be remunerated as a service in its own right, this would also give further incentive to pharmacists always to give appropriate and comprehensive advice.