Changes in Pattern of

Community Pharmacy Services

in the Philippines for
Sustainable Health
FAPA 25th Congress, Kota Kinabalu, Sabah
Malaysia, October 10, 2014

Leonila M. Ocampo, RPh, M.S.

President, Asia Pacific Institute for Medication Management, Inc.
Immediate Past President, Philippine Pharmacists Association
 Outline of the Presentation
• A Glimpse of the Philippines
• The Philippines Pharmacy Practice (Community)
> Actual vs. Ideal/Expected Practices
• Initiatives to Improve the Services for
Sustainability
• Collaboration to Ensure Sustainability of
Improved Pharmacy Services
• Future of the Pharmacy Profession in the
Philippines
 Sustainability
For the purpose of this presentation, it will refer
to:
1. Sustaining health of the individual and the
community - prevention or avoidance of
ADE and optimizing outcomes for better
health.
2. Sustaining the viability of the pharmacy
operation or business to better or improve
the services.
Philippine Demographics
• Total population (2010):
92,337,852
• Pop’ Growth Rate/year: 1.89%
• Dependency Rate: 60.52
• Literacy Rate: 88.9%
• Poor: Lowest 30% per capita
income
• Average per capita income/mo:
Php10,750 or US$238

National Statistics Office. Philippine Yearbook 2011

 Health Statistics
• Life expectancy: 73.14 (Female), 67.61 years (Male)
• Infant Mortality Rate: 12.6/1000 live births
• Maternal Mortality Rate: 96.4 /1000 live births
Leading Causes of Morbidity (2007-10) Leading Causes of Mortality (2007-10)
ALRTI and Pneumonia Diseases of the Heart
Bronchitis/Bronchiolitis Cerebrovascular diseases
Hypertension Malignant neoplasms
Urinary Tract Infection Pneumonia
Acute Watery Diarrhea Tuberculosis (all forms)
Influenza Chronic lower respiratory diseases
Tuberculosis Diabetes mellitus
Leprosy Assault (homecide)
Injuries Conditions originating in perinatal period
Acute Febrile Illness Nephritis, nephrotic syndrome, nephrosis

National Statistics Office. Philippine Yearbook 2011

Total Health Expenditure
 The Philippines Pharmaceutical
Market
• P138.63 B total market – US $ 3.08 B (IMS Health, 2013)

• High out-of-pocket payments

- no reimbursement of outpatient drugs
- limited inpatient drug coverage
Medicines is
- 40% of total health expenditures
- 30% of Philippine Health
Insurance Corporation Reimbursement (PHIC)
- 10% of Department of Health (DOH) budget
- 10-12% Public sector share of the market
 Philippine Pharmacy Services
Community Pharmacy
- is dominated by chain pharmacy operation where
58% is contributed by just 1 single chain
with more than 900 outlets
- 70 % of the 42% is from other top 5 chain
pharmacy operations

Practice is mainly dispensing with minimal

patient medication counselling or Practice has
stagnated to mere transactional in nature.

Pharmacists for Better Health Outcomes 8

 Philippine Pharmacy Services
Hospital Pharmacy

while a number of big hospitals are into

Clinical Pharmacy services; majority are
still into the plain distributive work.

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 Actual vs. Expected Practices
ACTUAL
• Poor i ple e tatio of o
prescription, no dispensing
policy
• Poor storage practices
• Medication counselling not
practiced in most dispensing
sites
• Sale of medicines
unsupervised by pharmacists
in both traditional (ghost
pharmacists) and non-
traditional medicine outlets
EXPECTED
• Strict implementation of
Pharmacy Law and related
regulations
• Adoption of Good Pharmacy
Practice standards
• Medication counselling as
part of dispensing
• Inclusion of the pharmacist
in all levels of health care

MISALIGNMENT BETWEEN EDUCATION and PRACTICE

Pharmacists for Better Health Outcomes 10

 PHILIPPINES
INITIATIVES
TO IMPROVE
PHARMACY
SERVICES

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 PHILIPPINE INITIATIVES
are aimed at improving pharmacy
services of:
1. Future Pharmacists, Pharmacy
Support Workforce and
Pharmacists
2. Patients and Patient Caregivers
3. Other Health Professionals

Pharmacists for Better Health Outcomes 12

 Initiatives aimed at . . .
• EDUCATION – reviewed and develop to align
to the Asian and Global Framework of
Education.
• PRACTICE – develop and implement standards
in all practice settings
• RESEARCH – encourage practice researches

Pharmacists for Better Health Outcomes 13

 STUDENTS. . . FUTURE PHARMACISTS
1. Curriculum revision towards patient-oriented
practice ; to become Outcome-based
curriculum (OBE) – proposed 5 years for
mandatory implementation in 2018

2. Improve internship of students with defined

competencies outcomes; only in accredited
pharmacies and other health facilities –
increased to 1200 hours

3. Greater involvement of pharmacy students in

activities on national pharmacy issues and
community-based programs

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 STUDENTS. . . FUTURE PHARMACISTS
1. YPG introduced the White Coat
Ceremony in Colleges of
Pharmacy (2010) –
professionalism and image
building
2. YPG-initiated Patient
Counselling Event (PCE) – to
gauge the counselling skills of
graduating pharmacy students

Pharmacists for Better Health Outcomes 15

 Pharmacy Support Workforce
• Pharmacy Assistant training regulation and
curriculum (Technical Education and Skills
Development Authority) – done and for
implementation in 2015
• Registration and Certification of Pharmacy
Assistant – soon be mandatory
• Requirement of Continuing education in
the renewal of the Certification of
Pharmacy Assistant
• Development of the Pharmacy Technician
TR and Curriculum

Pharmacists for Better Health Outcomes 16

 PHARMACISTS - Relevant (CPD)
• Competency Enhancement
– Regular CPE seminars and
workshops conducted under the
New CPD guidelines of the
Professional Regulation Commission
– Improved Practice exposures

Pharmacists to embrace the value of

life-long learning

Pharmacists for Better Health Outcomes 17

 PHARMACISTS
Special Trainings
– One-Month Clinical Pharmacy Training
– Clinical Pharmacy Certification Program (with ACCP)
– 2-day Medication Safety Seminar and Workshop
– Counterfeit Drugs Awareness Program
– Community Externship Program
– Affiliate-initiated Trainings and Specialty Trainings

Pharmacists for Better Health Outcomes 18

 PATIENTS AND CAREGIVERS
- Educate them on the value of the
pharmacist and the services
he /she can offer to clients

-Empower patients on responsible

self-care and educate them in the
responsible use of medicines

Important because Patients have no

expectation of the Pharmacists but
provide the medicines

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Other Professionals : Doctors and Nurses,
Hospital Administrators
• Seminars and Workshops facilitated by the
Philippine Pharmacists Association
- Drug delivery systems
- Counterfeit medicines
- Polypharmacy, among others
* Today almost complete with the modules on
Collaborative Patient Management
 OTHER
INITIATIVES
TO IMPROVE
PHARMACY SERVICES

Pharmacists for Better Health Outcomes 21

 Policy Formulation and Issuance

• Lobbying for the Passage of the

New Pharmacy Law
• Policy Review, Changes and
Formulation of the DOH, FDA
A.Os.
• Formulation of the National
Antimicrobial Use Guidelines
• Vaccination by Pharmacists

Pharmacists for Better Health Outcomes 22

 Training and Practice Model Development
• Partnered with Chain Pharmacies/Hospital
Pharmacies
• Cognitive Pharmacy Services (Medication Counseing)
• Medication Review (Regular Chronic Patients)
• Compliance Program (Reminder, Compliance Packs)
• Promote the Continuity of Care

Pharmacists for Better Health Outcomes 23

 Training and Practice Model
Development
• Non-Traditional Outlets for
Medicines
Training of village store owners
(Botica ng Barangay) and
staff of retail outlets for
non-prescription drugs on
Medicines 101 and the ABC in
Dispensing OTC medicines
 STRATEGIES ENSURE SUSTAINABILITY . .
COLLABORATION
1. CPE/CPD in partnership with
selected pharmaceutical
companies and government
agencies
2. Consumer/Patient Education in
partnership with Civic and
Patient/Consumer Organizations,
Government and Non-
government organizations and
the Media

Pharmacists for Better Health Outcomes 25

 Collaboration . .
3. Strengthen Image of the
Pharmacists and promote
the Phar acists’ advocacies.
Partnered with the largest
Television/
Radio Network, ABS-CBN
4. Faculty Training
Philippine Association of Colleges
of Pharmacy.

Pharmacists for Better Health Outcomes 26

 Collaboration . .
5. Policies and Administrative Orders - Department of Health, Food and
Drug Administration and the Board of Pharmacy

Need for Phar acist’s supervisio i RONPD

Improved Medicine Management System across supply chain
Monitoring of drug outlets
Pharmacies as vaccination centers
Accreditation of Pharmacies for Outpatient Benefits of Medicines
 In summary, the pattern of change
1. Hospitals and Community Pharmacies are
strengthening their operations embarking to
start Clinical Pharmacy Services
2. Major Chain Community Pharmacies are seeking
assistance to develop programs that will
improve their services and efficiency of
operations
3. The Department of Health (DOH) in partnership
with PPhA is re-training their Pharmacists and
staff to better serve the public.

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 In summary,
4. PHILHEALTH, the Government Insurance
System had PPhA co-developed the Pharmacy
Benchbook for Community – reimburse only
medicines withdrawn from accredited
pharmacies
5. PPhA is a member of the DOH Council for
Healthcare and is involved in policy
formulation and development relative to the
use of medicines.

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 What do we need?

Pharmacy bill to be passed into law, to serve as

the legal framework to support all the changes
in services happening now.
 Why will it be this strategy?
• Introducing and implementing CHANGE needs
for the Change Leader to consider every single
element that may affect and will be affected in
the process of Change.
• Policies to serve as the Legal Framework must
be in place
• Change Leader must work well with CHANGE
CHAMPIONS; only then is
CHANGE SUSTAINABILITY IS ASSURED !
 The Future we see,
The Philippine Pharmacists Association leading
the way to
IMPROVE THE PHARMACY SERVICES OF THE
COUNTRY not only for the PATIENTS
but also to
IMPROVE THE IMAGE OF THE FILIPINO
PHARMACIST;
STRENGTHENING ITS ROLE IN THE HEALTH
CARE SYSTEM.

Pharmacists for Better Health Outcomes 32

Filipino Pharmacists who can turn
to the …

Professional Heart
Business Heart
Pharmacists for Better Health Outcomes 34