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Sales of OTC medicines are up 20 per cent over the past decade, yet many pharmacists seem to value this side of their business much less than they do NHS services. Asha Fowells reports from this year's SMART conference

Pharmacists are in danger of placing too much emphasis on services they are paid for by the NHS and risk neglecting the important €“ and lucrative €“ OTC market, delegates were told at last month's SMART conference.

Peter Dawson, locum pharmacist and columnist for The Guardian newspaper, blamed pharmacy's current remuneration model, pointing out that payments were based €on the quantity of services rather than the quality€. Mr Dawson said he would much rather be on the counter talking to people, but the fact that 80-90 per cent of a pharmacy's business lay in dispensing meant he wasn't able to. €It all comes down to money,€ he said.

Strong market

The criticism levelled at the sector was particularly relevant given that, earlier in the day, SMART conference delegates had learned about the strength of the OTC market. Martin Wood, business unit director of data tracking company IRI UK, explained that OTC sales €“ in unit terms €“ have been increasing since 2000, although the rate of growth had slowed over the last few years.

All of the major categories €“ pain, skin, gastrointestinal, vitamins, cough and cold €“ had grown, but the biggest leap had been in 'others', he said.

This boom was largely down to electronic cigarettes, said Mr Wood. €In 2011, there were hardly any sales of e-cigarettes.€ Yet in 2013, sales had hit nearly £100m, with the figure pre- dicted to hit £300m in 2015.

Given that tobacco sales were down but sales of OTC nicotine replacement therapies continued to grow, the data analysis expert suggested that a different group of customers to would-be quitters were buying e-cigarettes, and hence this was an area that offered a great opportunity for pharmacy.

This is particularly relevant given how poor the OTC pipeline is at the moment, as illustrated by the small number of POM to P switches that have taken place in recent years, Mr Wood said. €Electronic cigarettes are clearly meeting a consumer need and pharmacy clearly has something to say.€

Katy Parsons, president of the British Pharmaceutical Students' Association, agreed that non-NRT nicotine- containing products (NCPs) offered an ideal opportunity for pharmacists to promote the self-care message. €At the moment, they are supplied by people who are only trained to market them, not provide any advice on the products,€ she said, adding: €Stocking e- cigarettes gives [pharmacists] the opportunity to intervene.€

Duty of care

Ash Soni, vice-chair of the RPS's English Pharmacy Board, said that the RPS had released guidance to pharmacies to not stock electronic cigarettes because they are not licensed, but added: €There's nothing to say that we can't support people who want an alternative [to NRT].€

The ethical dilemma faced by pharmacists in terms of wanting to help smokers but only using licensed products would soon be over, he said, thanks to plans announced by the Medicines and Healthcare products Regulatory Agency to regulate nicotine-containing products as medicines by 2016.

Katy Parsons summed up the feeling of most conference attendees by issuing a reminder that pharmacists had a duty of care regardless of how someone was accessing pharmacy. €It doesn't matter if the customer is buying a product over the counter or getting medicines in return for a green piece of paper.€

Pharmacists should be on the counter so they are able to provide information and advice, she said. €They shouldn't be cowering in the dispensary or hiding behind dispensing assistants.€