The community pharmacy

Judith wrote last year about the disgraceful deal between the Pharmacy Guild and Blackmores whereby so-called alternative medicines will be recommended by pharmacists in addition to mainstream products.

Today Cassandra Wilkinson has written compellingly of the confusion caused by regulating the sale of ‘complementary medicines’. This topic (and especially homeopathy) has been researched in-depth by the Australian Skeptics Association.

Pharmacists enjoy numerous benefits courtesy of the Government: they are a legal monopoly (even if they operate under individual pharmacists), they get rewarded by the gap between the wholesale and retail price of drugs, they get a separate dispensing fee, and their customers don’t often pay the full price of the products they purchase. Who wouldn’t like a shop where someone else pays most of the price?

In return for these privileges, pharmacists are supposed to be ethical, professionals who deal in evidence – by which we mean rigorous scientific evidence based on clinical trials under double-blind testing conditions.

In return for the benefits that the Government heaps upon pharmacists, isn’t it reasonable that they be  banned from selling alternative medicines which have no proven efficacy?

About Samuel J

Samuel J has an economics background and is a part-time consultant
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20 Responses to The community pharmacy

  1. Xao Ping Wang

    Absolutely. Pharmacists are some of the most dodgy business people. Ad the Pharmacy Guild are in the ear to the government and have huge political power, which they wield for their benefit, not that of the patients. Their push to dispense dangerous medication without proper facilities to examine patients or take a proper history, or have training in clinical medicine, just shows how much power the pharmacy guild have. People should be asking more questions of their power in the Australian Health scene.

  2. Louis Hissink

    Legal monopoly?

    All monopolies are legal as these are defined, sense-strictu, as a licence by government to produce something, and to price that something accordingly, what the market would bear. Absent monopoly and the bearable price would be market driven.

    All monopolies exist as a result of government interference with the market and the perjoration, “dodgy”, appropriate.

    Banning the sale of non efficacious products falls into the domain of government interference, and perhaps SamuelJ misunderstands the issues underlying his concern expressed above ?

  3. ben

    The reasoning behind the pharmacies having a monopoly is because they can be trusted but if they are peddling quack medicine along side trusted medicine then the rationale for their monopoly should be called in to question.

  4. rtp

    Rigorous scientific evidence? Double blind testing?

    Hahahahaha!!!!

    All I can say to that is Fluvax.

    And by the way, the drugs are often tested against non-inert controls. For example, the Gardasil vaccine was tested against a shot of aluminium as the control. Because (serious) side effects (there was a small group of saline recipients but they were blended with the aluminium group for the serious/systemic side effects test but because their number was so small it was overwhelmed by the aluminium recipients. The difference in side effects between them (the blended group) and the vaccine recipients wasn’t enormous so the vaccine was declared safe.

    By the way, all vaccines in common usage are tested in a similar manner, (usually the comparator is another vaccine). So if the old DPT killed 10 out of every 10,000 recipients and the new one 11 then the new one will be deemed perfectly safe (and the propaganda will be that adverse effects are roughly the same as the ‘background rate’.

    And another by the way. Here’s an essay question for you lovers of the unbelieveably socialist medical system. What does the “double” in “double-blind” mean? And when you have worked it out ask yourselves what that implies for the epidemiological evidence that purportedly shows that vaccines work.

  5. “isn’t it reasonable that they be banned from selling alternative medicines which have no proven efficacy?”

    Aha! A ban. That’s surely the free market speaking. Want the government to RESTRICT the market. Control be handed to government? The intelligent “experts” who will tell us what works and what doesn’t?

    Samuel, you are entirely wrong. The whole thing is a mess. The government should NOT regulate nor certify ANY drug. Let the market work out what works and what doesn’t.

    The reality is that A VAST MAJORITY of “prescription” drugs are not better than placebos, either. And doctors are chronically incompetent, and unable to diagnose any problem.

    Do read:
    http://sabhlokcity.com/2012/03/the-church-of-medicine-objects-to-being-questioned/

    and http://sabhlokcity.com/2012/03/evidence-piles-up-the-medical-profession-must-reform/

    and http://sabhlokcity.com/2012/03/doctors-the-rapacious-unaccountable-enemies-of-humanity/

    I’m also writing more on this subject.

    Please let the MARKET decide what works. The whole monopoly of doctors/ phramacists is anti-people and pro-loot. Stop the government from giving these people monopoly powers over citizens.

  6. .

    “Pro-looter”

    What a wonderful turn of phrase Sanjeev.

    “The LDP is not left, not right, but pro libertry and anti looter”

    Good call.

  7. John H.

    The irony being that just last week yet another meta-analysis found that supplements of some “anti-oxidants” appeared to increase overall mortality. However only yesterday a research report highlighting how some of these same “anti-oxidants” were capable of inducing DNA alterations. So I continue to have concerns about the high levels of vitamin A and\or beta-carotene in many vitamin pills. The findings though will not relate to dietary intake, near impossible with food. The finding on vitamin C does support the alternative medicine proposition that iv injections can be useful against cancers. There is evidence pointing to this in the literature and it is well known that vitamin C can be a strong pro-oxidant in the presence of free iron which does happen in inflammatory states.

    The Pharmacy Guild should be forced to consume massive amounts of blackmore’s antioxidant and vitamin rich preparations and keep doing so until dead which will be hastened by said enforcement.

    It is ridiculous to request a ban on the sale of these products. Some of them are very bloody useful if you do your homework. There is plenty of peer reviewed literature of the herbs and stuff. You can even use some ginseng species to push yourself into a hypomanic state but don’t do it for too long.

  8. Keith

    I will make the same comment here as I made on Andrew Bolt’s blog (where I first saw mention of this):

    I have no doubt that most alternative medicines are ineffective but this does not mean that they all are, or that medical science knows now which do and don’t work.

    And there are conditions (which I have experienced) for which conventional medicine currently has no effective treatments (and I am referring here to conditions which medical science does recognize as legitimate). Such conditions may not be life threatening but they may be debilitating or painful. (In some cases, an effective treatment may exist but have unacceptable side effects.)

    In such circumstances, it is quite reasonable to turn to alternatives, in the hope of finding something that will help. And, in fact, medical science does test some of these alternatives, finds that they do work and they then stop being “alternative”.

    I will add that the fact that something is “not proven to work” does not mean that it is known to not work.

    And, as one comment says, some so-called “proven” products or procedures subsequently turn out to be no more effective than placebos (a number of anti-depressants appear to fall into this category).

  9. Also read what I’ve just written “The MASSIVE failure of “modern” medicine explains the market for alternative medicine” at http://sabhlokcity.com/2012/03/the-massive-failure-of-modern-medicine-explains-the-market-for-alternative-medicine/

  10. john malpas

    Being a pharmacist can’t be all that profitable or they wouldn’t need to stock vast amount of perfumes , hair dyes and nail varnish etc .
    On the plus side they often employ pretty young women.

  11. Mother Hubbard's Dog

    What a pity that homeopathy doesn’t work. If it did, we could fill our cars up with water.

  12. Jazza

    I use Inner Health Plus and Fish Oil capsules, both of which were recommended by a doctor.

    I even have a prescription mix for skin moisturiser, after wasting money on proprietary products that do no good.

    Other wise,as far as my pocketbook is concerned, the pharmacists can stick to pushing cheaper script items upon us in the name of “Aussie brands”,and then I often say NO and stick to exactly what was prescribed.

  13. No Sanjeev, I will not read what you have written. I can smell something from here, and I would recognise the smell of evidence and well researched arguments if that were what I was detecting..

    Some Pharmacists do not stock crap. Some have no Homeopathy and limited vitamin stock.. A clear sign that the evidence is so weak as to be unconvincing, even in spite of a financial incentive to stock bogus products..

    Why are there no cases of Homeopaths sueing for defamation?

  14. kae

    I take a blood pressure prescription drug. A pack of 30 which lasts me 60 days is about $16 from the local chemist. If I get them from a discount chemist they’re only $5.80.

    That is what I’d call a ripoff.

  15. kae

    Yes, Sanjeev. We shouldn’t have any regulation of medicine. Let the market decide what works. /sarc

  16. sam

    Kos Sclavos is a very good Canberra lobbyist…thats why the guild is a self regulated and arrogant insulated group of people that put profits before people.

  17. Andre S

    The “Pharmacists” you are critical of are function of the state. You ought to be criticising the system that created them. The state has consistently for many years bought off the health system through incentivisation schemes. The fact that they have powerful lobby representation is a function of lobbyist quality and state compulsion.

    As far as I am concerned Pharmacist should be allowed to sell whatever they want and claims of dodgy Pharmacists are irrelevant. There are always a few bad apples that will rot whilst there is some element of the free ‘market” in the system.

    This blog has some libertarian elements to it for which I am grateful but this social conservative emotional and trashy commentary is suggesting that government ought to take a bigger role in alternative medicines. More information and knowledge and less regulation is better.

    You can hate and despise the Pharmacist if you so choose (tall poppy syndrome) but I would have thought that most on this blog would agree that Pharmacists would have the right to sell as they please within their ethical standards, not the states ethical standards.

    Samuel J

    you say

    “In return for the benefits that the Government heaps upon pharmacists, isn’t it reasonable that they be banned from selling alternative medicines which have no proven efficacy?”

    how about

    “In return for the benefits that the Government heaps upon some KEYNESIAN ECONOMISTS, isn’t it reasonable that that FREE MARKET ECONOMISTS be banned from selling alternative free market economics which has no proven efficacy?”

    So the Keynesians can say this all day long but it does not make it a truth.

    the hypocrisy is genuinely irritating.

  18. .

    I don’t envy pharmacists for their high disposable incomes and salubrious abodes. I have a term of endearment for their thievery – magnificent bastards.

    You want us to whither the state? Please, I am well acquainted with this lore. First thing we do is enter term limits, sortition and sunset clauses on legislation.

    Effectively, we’d be outlawing lobbysists by proxy.

  19. Tony

    I think we need to be careful in apportioning blame here.

    The Pharmacy Guild do the deals and they are the people that represent only the pharmacy owners.

    The pharmacists themselves have no say in the matter and are often forced to up-sell these products by teh Guild and the owners.

    And for that they get paid as little as $20 per hour!

    And even worse than that it seems that 34 per cent of pharmacy owners don’t even pay pharmacists their legal entitlements.

    http://www.apesma.com.au/groups/pharmacists/

    Its an absolute scandal.

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