Pharmaceutical Executive Europe IMS Supplement - October 2008 - (Page 6) PHARMACEUTICAL DISTRIBUTION distribution rights for the anti-TNF therapies, Enbrel and Humira, in the UK and Netherlands. Homecare now accounts for around 8% and 6–7% of these markets respectively, and is expected to expand elsewhere in Europe. With benefits that include the delivery of medicines direct to the patient’s home, and insurance approval, treatment initiation, and specialist nursing support handled by the company, the use of homecare delivery which the value proposition of a dispensing channel can be innovated and improved for all stakeholders. As Table 2 illustrates, patients receive targeted information about their condition and treatment, and the convenience of home delivery; physicians have fewer patient issues to address and are able to free hospital resources by moving patients home; and payers enjoy the advantage of a package price and the ability to conduct post marketing surveillance. Homecare can thus deliver care with high patient satisfaction, good treatment compliance, and overall cost savings for the healthcare system. On the downside is the fact that funding of the extra services has been generated by taking advantage of certain loopholes in the remuneration system — such as then exemption of homecare services from VAT payment in the UK. Figure 5 An increasing amount of leading wholesaler Celesio’s profit is generated from its pharmacy activities. 18 16 14 12 10 % 8 6 4 2 0 01 2006 02 2006 03 2006 04 2006 01 2007 02 2007 Portugal Luxembourg Switzerland Belgium 03 2007 04 2007 01 2008 Germany Austria Spain UK Source: IMS Health Italy Finland Sweden Irekand Hungary 3. Growing pressure on community pharmacies Community pharmacies throughout Europe are also facing significant challenges, especially in terms of the new demands on their services. Screening prescriptions for potential drug interactions versus previously dispensed medications, for example, is slowly becoming standard, a trend that is consistent with the drive to make better use of pharmacist skills and raise their profile in providing healthcare advice. The UK’s Pharmacy Contract, which deemphasises the volume and throughput of prescriptions in favour of the quality and range of patient services expected of community pharmacies, is currently the most well-developed concept for the broader role of these establishments. Whatever pharmacies may feel about expanding their advisory responsibilities, the development of enhanced services requires considerable investment in systems, time and training — and the provision of additional funds to support them is not always forthcoming. In many cases, this only adds to the growing financial pressure they face from other trends in the market, as outlined below. The demise of OTC monopolies. In many European markets, pharmacies historically have enjoyed exclusive distribution of non-prescription medicines, often generating 50% of their growth margin from self-care products. But there are clear signs that the pharmacy stranglehold on OTC selling is beginning to loosen. Many countries, including recently Italy and Portugal, are now making OTC products available outside the pharmacy setting. Even in Sweden, moves are underway to end the longstanding monopoly of the stateowned pharmacy Apoteket on sales of prescription and OTC drugs. Reduced margin structures. Most markets in Europe are gradually Table 2 Homecare is delivering a strong value proposition. Patient Benefit • Support at initiation • Convenience • Specialised support (cold chain) is a clear demonstration of the Payer way in Prescriber Benefit • Less patient care time • Less administration • Satisfied patients Benefit • Lower total cost • Easier administration Producer Benefit • Influence care • Patient communication • Persistence • Information • No parallel export Indicator • Total sales Indicator • Patient satisfaction Indicator • Rate of prescribing • More patients Indicator • Approved rate Source: IMS Health 6 OCTOBER 2008 PHARMACEUTICAL EXECUTIVE EUROPE
Table of Contents Feed for the Digital Edition of Pharmaceutical Executive Europe IMS Supplement - October 2008 Pharmaceutical Executive Europe IMS Supplement - October 2008 Pharmaceutical Executive Europe IMS Supplement - October 2008 - (Page 1) Pharmaceutical Executive Europe IMS Supplement - October 2008 - (Page 2) Pharmaceutical Executive Europe IMS Supplement - October 2008 - (Page 3) Pharmaceutical Executive Europe IMS Supplement - October 2008 - (Page 4) Pharmaceutical Executive Europe IMS Supplement - October 2008 - (Page 5) Pharmaceutical Executive Europe IMS Supplement - October 2008 - (Page 6) Pharmaceutical Executive Europe IMS Supplement - October 2008 - (Page 7) Pharmaceutical Executive Europe IMS Supplement - October 2008 - (Page 8)
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