Using the Slovak pharmacy retail market case, this study examines the evolving interdependency between general practitioners (GPs) and pharmacies. Traditionally, they have operated symbiotically, with pharmacy revenues heavily reliant on prescriptions. However, the development of the market structures of these providers after the liberalization of the pharmacy retail market in 2005 raises a question about the stability of this relationship. By analyzing entry thresholds as a measure of the market size required for pharmacies to cover their entry costs, the study reveals that the dependency of pharmacies on the presence of GPs has diminished over time. In the initial year following the liberalization, the presence of a GP decreased the market size sufficient to cover entry costs for the first pharmacy by about 83% compared to a market without a GP. However, in 2019, this effect decreased to approximately 65%. This could imply worsened coverage of pharmaceutical services in small and rural areas with GPs as the entry decision of pharmacies is less elastic towards their presence.
- Klíčová slova
- Complementarity, Entry, General practitioners, Market structure, Pharmacies,
- MeSH
- farmaceutické služby * MeSH
- lékárny * MeSH
- lidé MeSH
- praktičtí lékaři * MeSH
- symbióza MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
- Geografické názvy
- Slovenská republika MeSH
INTRODUCTION: The exposures to hazardous antineoplastic drugs (AD) represent serious risks for health care personnel but the exposure limits are not commonly established because of the no-threshold effects (genotoxic action, carcinogenicity) of many ADs. In this study, we discussed and derived practically applicable technical guidance values (TGV) suitable for management of AD risks. METHODS: The long-term monitoring of surface contamination by eight ADs was performed in pharmacies and hospitals in the Czech Republic and Slovak Republic in 2008-2021; in total 2,223 unique samples were collected repeatedly in 48 facilities. AD contamination was studied by LC-MS/MS for cyclophosphamide, ifosfamide, methotrexate, irinotecan, paclitaxel, 5-fluorouracil and gemcitabine and by ICP-MS for total Pt as a marker of platinum-based ADs. RESULTS: The study highlighted importance of exposure biomarkers like 5-fluorouracil and especially carcinogenic and persistent cyclophosphamide, which should be by default included in monitoring along with other ADs. Highly contaminated spots like interiors of laminar biological safety cabinets represent a specific issue, where monitoring of contamination does not bring much added value, and prevention of staff and separated cleaning procedures should be priority. Rooms and surfaces in health care facilities that should be virtually free of ADs (e.g., offices, kitchenettes, daily rooms) were contaminated with lower frequency and concentrations but any contamination in these areas should be carefully examined. DISCUSSION AND CONCLUSIONS: For all other working places, i.e., majority of areas in pharmacies and hospitals, where ADs are being prepared, packaged, stored, transported, or administered to patients, the study proposes a generic TGV of 100 pg/cm2. The analysis of long-term monitoring data of multiple ADs showed that the exceedance of one TGV can serve as an indicator and trigger for improvement of working practices contributing thus to minimizing of unintended exposures and creating a safe work environment.
- Klíčová slova
- antineoplastic drugs, hazardous drugs, monitoring, surface contamination, technical guidance values,
- MeSH
- antitumorózní látky * MeSH
- chromatografie kapalinová MeSH
- cyklofosfamid analýza MeSH
- fluorouracil analýza MeSH
- lékárny * MeSH
- lidé MeSH
- nemocnice MeSH
- pracovní expozice * analýza MeSH
- tandemová hmotnostní spektrometrie MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem MeSH
- Geografické názvy
- Česká republika MeSH
- Slovenská republika MeSH
- Názvy látek
- antitumorózní látky * MeSH
- cyklofosfamid MeSH
- fluorouracil MeSH
Fridrich Jakub Fuker (1749-1805), a physician from Košice, is the author of works on medical topics, as well as works on social life. In addition to his medical practice, he also owned a pharmacy, and his short work on a universal preventive tincture is related to this. The author argues that there is no universal medicine, but it is possible to prepare a universal preventive preparation suitable for everyone, every age and sex. Fuker has announced that he will prepare such a tincture, available in his pharmacy, along with information on its use. However, he did not divulge its composition, as supposedly, any physician knowledgeable in the matter would figure it out on his own. With the universal tincture, Fuker abandoned rational medicine, perhaps suffering from involutional depression or acting as a salesman.
- Klíčová slova
- Fridrich Jakub Fuker, pharmacy in the 18th century, universal preventive,
- MeSH
- dějiny 18. století MeSH
- dějiny 19. století MeSH
- lékaři * MeSH
- lékárny * MeSH
- lidé MeSH
- Check Tag
- dějiny 18. století MeSH
- dějiny 19. století MeSH
- lidé MeSH
- mužské pohlaví MeSH
- Publikační typ
- biografie MeSH
- časopisecké články MeSH
- Geografické názvy
- Slovenská republika MeSH
The concept of pharmaceutical care (PC) has existed as a professional philosophy for more than 30 years. However, for a long period of time, little had been done for its integration into the regular practice of healthcare provision. The COVID-19 pandemic and the resulting increase in patient influx in the community pharmacies (CP) encouraged the exploration and establishment of new healthcare services provided within the CP. Nevertheless, these services of PC are still novel, and more can be done to expand the community pharmacists' current role in primary healthcare. This can be achieved by improving and expanding the newly established services, all while incorporating new ones, for the benefit of public health and the reduction of avoidable healthcare expenditures. This article reviews information about the benefits of this service regarding patient health and the reduction of financial expenses pertinent to adverse drug events within the setting of the CP. Adverse drug events account for significant healthcare expenses and patient distress due to relevant symptoms, emergency doctor visits, and increased hospitalization rates. Several studies conducted internationally have investigated the positive impact of PC practiced by community pharmacists. In spite of results sometimes presenting a non-continuous pattern, PC applied under specific conditions has tangible positive outcomes. Congestive heart failure and type 2 diabetes mellitus patients presented fewer hospital admissions, better symptom control, and higher adherence in comparison to control groups, while a study on asthma patients revealed improved inhalation techniques. All intervention groups reported psychological improvement and a better understanding of their treatment. Special reference is made to the importance of this service for patients receiving anti-cancer treatment and how community pharmacists can have a crucial role in designing, monitoring, and re-designing these therapeutic schemes whose complexity and related adverse drug events negatively affect patient adherence. The role of community pharmacists was very important, especially for primary care, for both patients and healthcare systems during the pandemic, and it seems that it will remain decisive in the post-COVID era as well. The increased complexity of therapy and polypharmacy creates the need for organized, active participation of pharmacists in healthcare provision so that they can use their knowledge and skills under continuous cooperation with other healthcare professionals, thus providing coordinated services for the benefit of the patient.
- Klíčová slova
- Healthcare system, Pharmaceutical Care, community pharmacy, drug therapy plan,
- MeSH
- COVID-19 * epidemiologie MeSH
- diabetes mellitus 2. typu * MeSH
- farmaceuti psychologie MeSH
- lékárny * MeSH
- lidé MeSH
- nežádoucí účinky léčiv * MeSH
- pandemie MeSH
- veřejné lékárenské služby * MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
- přehledy MeSH
This study provides new empirical evidence on the changes in competition and entry decisions of pharmacies after regulatory changes. It investigates the development of the retail pharmacy market in Portugal, which underwent major regulatory changes in 2004 and 2007. Sale of OTC drugs and ownership of pharmacies were liberalized while entry restrictions related to market size and the location of new pharmacies prevailed. Our empirical strategy was based on entry models and provided indirect information on the toughness of competition and entry decisions of firms in the market. We estimated and compared the entry thresholds and their ratios before and after liberalization. Such a comparison allows to see if competition got tenser with OTC drugs deregulated. There were three main findings from the study. First, the entry thresholds decreased regardless of the number of pharmacies in the market, suggesting that room for the realization of profits is broader than it was in the past. Second, although the entry thresholds were lower in value, their increase was steeper with each incumbent in 2020, suggesting harsher price competition with new entrants. Third, the current rule of 3,500 patients per pharmacy is likely overly restrictive, pharmacies could break-even even in smaller markets.
- Klíčová slova
- entry model, market competition, regulation, retail pharmacy,
- MeSH
- farmaceutické služby * MeSH
- farmacie * MeSH
- lékárny * MeSH
- lidé MeSH
- obchod MeSH
- vlastnictví MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
The consumption of hazardous antineoplastic drugs (ADs) used in anticancer chemotherapies is steadily increasing representing thus risks to both human health and the environment. Hospitals may serve as a contamination source, and pharmacists preparing the antineoplastic drugs (ADs) as well as nurses administering chemotherapy and caring for oncology patients are among the healthcare professionals being highly exposed. Here, we present the results of systematic monitoring (2018-2020) of surface contamination by 13 ADs in the pharmacies and hospitals in the Czech Republic (CZ; large-scale monitoring, 20 workplaces) and Slovak Republic (SK; pilot study at 4 workplaces). The study evaluated contamination by three commonly monitored ADs, i.e., 5-fluorouracil (FU), cyclophosphamide (CP), and platinum (total Pt representing cis-, carbo-, and oxaliplatin) together with ten less explored ADs, i.e., gemcitabine (GEM), ifosfamide (IF), paclitaxel (PX), irinotecan (IRI), docetaxel (DOC), methotrexate (MET), etoposide (ETOP), capecitabine (CAP), imatinib (IMAT), and doxorubicin (DOX). Floors and desktop surfaces in hospitals (chemotherapy application rooms, nurse working areas) were found to be more contaminated, namely with CP and Pt, in both countries when compared to pharmacies. Comparison between the countries showed that hospital surfaces in SK are generally more contaminated (e.g., CP median was 20 times higher in SK), while some pharmacy areas in the CZ were more contamined in comparison with SK. The newly studied ADs were detected at lower concentrations in comparison to FU, CP, and Pt, but some markers (GEM, IF, PX, and IRI) were frequently observed, and adding these compounds to routine monitoring is recommended.
- Klíčová slova
- 5-fluorouracil, Antineoplastic drugs, Cyclophosphamide, Gemcitabine, Hospital pharmacy, Occupational exposure, Platinum derivatives, Surface contamination,
- MeSH
- antitumorózní látky * analýza MeSH
- cyklofosfamid analýza MeSH
- fluorouracil analýza MeSH
- ifosfamid analýza MeSH
- kontaminace zdravotnického vybavení MeSH
- lékárny * MeSH
- lidé MeSH
- monitorování životního prostředí metody MeSH
- nemocnice MeSH
- pilotní projekty MeSH
- pracovní expozice * analýza MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
- Geografické názvy
- Česká republika MeSH
- Slovenská republika MeSH
- Názvy látek
- antitumorózní látky * MeSH
- cyklofosfamid MeSH
- fluorouracil MeSH
- ifosfamid MeSH
OBJECTIVES: The 2018 EAHP European Statements Survey focused on sections 1, 3 and 4 of the European Statements of Hospital Pharmacy. Statistical data on the level of implementation and on the main barriers to implementation of the Statements were collected. A further aim was to identify barriers in general, such as lack of awareness. METHODS: An online questionnaire was sent to all hospital pharmacies in EAHP member countries. Data were analysed at Keele University School of Pharmacy, UK. As with previous reports, the survey was divided into three sections: section A, asking general questions about the hospital pharmacy; Section B, addressing questions about the current activity of pharmacists around each statement from Sections 1, 3 and 4; and Section C, focusing on their ability to implement the statements. RESULTS: 719 complete responses were obtained from a sample of 5164 hospital pharmacies, giving a response rate of 14% (719/5164). Section A results indicated that 45% (323/719) of responders worked in teaching hospitals, 79% (568/719) of hospital pharmacies had 10 or fewer pharmacists, and 48% (345/719) of hospital pharmacies served over 500 beds. Section B results found a high percentage of positive responses for activity in section 1 (introductory statements and governance) and section 3 (production and compounding). However, responses to questions in section 4 (clinical pharmacy services) were more variable, with 6 of the 15 questions being answered positively by less than half of respondents. The five questions that revealed the lowest implementation levels were then analysed in greater detail. These questions corresponded to Statements 4.4, 4.5, 4.8, 1.1, and 4.2, which need the greatest effort for implementation. The major identified barriers to implementation were 'lack of capacity' and that 'other health professionals in the hospital fulfil the tasks'. CONCLUSIONS: This survey provides useful information on the implementation status (and the barriers to, and drivers of implementation) of sections 1, 3 and 4 of the Statements. This will allow the EAHP to plan its implementation support programme for its members. To increase the quality of data, as well as the feedback to hospital pharmacies, the EAHP is planning to combine the survey with the self-assessment tool of the European Statements of Hospital Pharmacy.
- Klíčová slova
- EAHP statements of hospital pharmacy, clinical pharmacy, health services administration & management, pharmacy management (personnel), survey,
- MeSH
- farmaceuti MeSH
- farmacie * MeSH
- lékárny * MeSH
- lidé MeSH
- nemocniční lékárny * MeSH
- průzkumy a dotazníky MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
The paper deals with developing the national part of the Czech Pharmacopoeia 2017 (CL 2017) in its supplements from 2018, 2019, and 2020. It focuses on the preparation of medicinal products in pharmacies. The possibilities of further developing the national part of the CL 2017 to accelerate the necessary changes in its content are also discussed.
- Klíčová slova
- Czech Pharmacopoeia 2017, content of the national part, preparation of medicinal products in pharmacies, supplements 2018, 2019, 2020,
- MeSH
- lékárny * MeSH
- příprava léků MeSH
- Publikační typ
- časopisecké články MeSH
- Geografické názvy
- Česká republika MeSH
The article describes the supply and distribution of medicines in the Terezín (Theresienstadt) ghetto (1941-1945). The delivery of medicines for the ghetto took place in several ways. At the beginning of the ghettos existence, doctors brought the most medicines in their suitcases. Some of the drugs came from incoming prisoners (confiscated). Later, the German doctor Krönert from Litoměřice (Leitmeritz), supplied medicaments. The Prague Jewish community, with the help of a member of the SS Bartels, procured medicines, too. The drugs were also supplied by nearby pharmacies in Roudnice nad Labem and Budyně nad Ohří. At the end of the war, the Red Cross brought drugs to Terezín, among other things. Distribution omedicines in the ghetto took place from the central drug store to individual pharmacies in health facilities. Here the nurses compiled a list of required drugs. Doctors approved this list and wrote a request. Patients received medication in surgery or during hospital care.
- Klíčová slova
- ghetto Theresienstadt, infection, medicaments, pharmacy,
- MeSH
- chudé oblasti MeSH
- léčivé přípravky * MeSH
- lékárny * MeSH
- lidé MeSH
- Židé MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
- Názvy látek
- léčivé přípravky * MeSH
Medicines for self-medication (over-the-counter, OTC) are available through pharmacies, in some countries they are also available in supermarkets and other outlets. The use of OTC in European Union countries shows some differences at national level, in pharmacies and in patients preference. This study aimed to completing the lists of marketed OTC in Czech Republic and Greece. Next topics are: finding out the real range of OTC products offered by pharmacies, finding and evaluating number of packages sold in pharmacies in 20 particular common OTC in 2016, and indentification of factors influencing the sales. Web pages of national drug authorities (Czech Republic, Greece) were searched to complete lists of marketed OTC in each country. Data on range of OTC drugs and sales of them were extracted from computer systems (Czech Republic) and other types of documents (Greece) kept in pharmacies. The percentage of the real range of OTC products in pharmacies was calculated as the ratio to the number of OTC in national lists. Numbers of sold packages were compared among pharmacies. Classification system ATC (anatomical/therapeutical/chemical) was employed to present findings in all parts of the research. The Czech list contained 1,160 of marketed OTC in 10 ATC (1st level), with the maximum in ATC R (243 drugs). The Greek list contained 1,254 OTC in 13 ATC (1st level), with the maximum in ATC D (272 drugs). In lists of both countries, there were detected 86 drugs identical in 9 ATC (1st level). At least one OTC in each of 10 listed ATC was found in Czech pharmacies as a part of range of products, the range of OTC in Greek pharmacies comprised 11 ATC. The highest sales (year 2016) were found in ATC R (drug ACC long tbl eff) in CR and in ATC A (drug: Imodium cps) in Greece. The differences in the range of OTC drugs and in their sales were found between Czech Republic and Greece, and between types of pharmacies inside each country. Factors influencing them were detected: ownership of the pharmacy, locality (number of inhabitants). OTC drugs pharmacy Czech Republic Greece.
- Klíčová slova
- Czech Republic, Greece, OTC drugs, pharmacy,
- MeSH
- lékárny * MeSH
- léky bez předpisu zásobování a distribuce MeSH
- Publikační typ
- časopisecké články MeSH
- srovnávací studie MeSH
- Geografické názvy
- Česká republika MeSH
- Řecko MeSH
- Názvy látek
- léky bez předpisu MeSH
