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Ireland’s Official Pharmacy Publication
IPUReview
AUGUST 2014
IPU Business
Trends Q2
Survey
What are the
tax advantages
of a limited
company
Franchising,
Buying Groups
and Symbol
Groups
Charting
the Locum
experience
Outlook for
Pharmacy
Upcoming 2014 RAGMs | CPD: Female Urinary Incontinence | Prevention & Security

Time to Step Up
Improve your knowledge and help
your customers in just five weeks
IPU Medicines Counter Assistant’s Course (MCA) – Face-to-Face
This face-to-face course will increase your product knowledge and develop the
skills needed to work in a pharmacy.
The course, which runs one day a week
for five consecutive weeks, will provide
you with the skills and knowledge to
deal effectively and sensitively with
customers. It covers the classification
of medicines, abuse and misuse of
medicines, referral to the pharmacist
and product knowledge and costs
€550 to IPU Members, €750 to
non-members.
Your employer can claim up to
€1270 per pharmacy per year from the
PCRS under the Pharmacy Training
Grant Scheme.
Galway
Tullamore
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AUTUMN DATES AND VENUES
Ardilaun Hotel
September 22, 29, October 6, 13, 20
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For more information or to enrol contact Janice or Susan at
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Contents
IPU REVIEW
AUGUST 2014
12
32
49
The IPU Review is published
monthly and circulated to Irish
pharmacists. The views expressed
by contributors are not those
of the IPU nor is responsibility
accepted for claims in articles or
advertisements.
Subscription:
€85 (Ireland North & South) and
€130 (including postage overseas).
Publisher:
Irish Pharmacy Union
(IPU Services Ltd),
Butterfield House,
Butterfield Avenue,
Rathfarnham, Dublin 14
Tel: (01) 493 6401
Fax: (01) 493 6626
Email: ipureview@ipu.ie
Website: www.ipu.ie
Editor: Jack Shanahan MPSI
Editorial Associates:
Jim Curran, Wendy McGlashan
and Aoibheann Ní Shúilleabháin
Advertising: Wendy McGlashan
Email: ipureview@ipu.ie
Tel: (01) 493 6401
©2014
Copyright: All Rights Reserved,
Irish Pharmacy Union.
Printed by Ryson Colour Printers Ltd.
IPU Review is a Registered Trademark
of the Irish Pharmacy Union.
IPU
SERVICES
LTD
05 A Note from the Editor
IPU News The latest news and events from Butterfield House
06 RAGMs take place in September and October
06 IPU Business Briefing Roadshows
09 IPU Support in place for NRT switch
Features
25
08 IPU Delegation meeting with Joint Committee
on Health & Children
12 Q2 2014 Business Trends Survey
Overview of trading environment
for community pharmacies
16 CPD: Female Urinary Incontinence
20 Locum experiences
An insight into working as a locum
25 Now & Next: Reviewing your business plans
28 Tax advantages of a limited company
32 Supply v demand
Prevention and security measures
36 Epos – trouble shooting tips for your hardware
40 Political Report IPU
All the latest pharmacy news from the Houses of the Oireachtas
44 Professional Studies
46 Wines for the warmer weather
News
48 International Pharmacy News – What’s happening abroad
49 2014 Pfizer Health Index
50 New PSI President and Vice-President
50 Electronic prescribing and info flow improved
51 Irish Chemists Golfing Society News
52 Lady Pharmacists’ Golf Society News
53 Product Information
55 Classified Ads
46
28
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A NOTE FROM THE EDITOR Jack Shanahan, MPSI
Bureaucratic juggernauts
have lost the ability to
apply brakes
The collapse in the price of medicines in Ireland, while generally welcome, has
had a profound effect on the viability of many Irish pharmacy dispensaries. Most
pharmacies will have seen a substantial drop in turnover this year. As each round of
reference pricing hits, the profitability of pharmacies is affected disproportionately.
While larger
pharmacies
are
insulated
to a certain
extent, all of us that depend
predominantly on dispensing
are beginning to look very
nervously at the monthly
profit and loss accounts.
There is a continuous search
for generating turnover from
other activities. One of the
great hopes has been the
anticipation of extended roles.
Yet these, while desirable,
are frequently beset by both
bureaucratic and practical
issues. Influenza vaccination
is a case in point. While
the growth of numbers
vaccinated in pharmacies
has been encouraging, there
are still major barriers to
the efficient rollout of this
service. One major thorn
is the requirement of the
Regulator for annual training.
It would be fair to state that
the majority of pharmacists
that have provided this
service are affronted by the
insinuation that they are
incapable of continuing to
provide the service without
more repetitious training.
Indeed, many are so proficient
that they could be giving
training courses themselves.
It is not clear why such petty
constraints are put in the
way of providing an effective
vaccination service, other than
a regulatory body struggling
to define an efficient role.
Neither doctors nor nurses
are required to retrain
annually for vaccination
administration. Pharmacists
are still being held to such
stringent standards that
the majority of pharmacies
find the provision of a low
volume vaccination service
uneconomic. To add insult to
injury, there have been almost
continuous issues over the last
few years with the availability
of adrenalin injector pens.
As this column goes to press,
there is only one brand of pen
available. It has an expiry of
October this year. It is surely
time to allow pharmacists the
choice of using the same form
of adrenalin that all other
professions use, the ampoule.
While this would require
legislative change, it would
be very minor. While we can
hope and lobby for changes,
it is clear that bureaucratic
juggernauts seem to have
currently lost the ability to
apply brakes.
Whatever about extended
roles, part of our basic role
is the safe provision of OTC
medicines to the public. Thus,
it was with considerable
anticipation that attendees at
the last IPU Conference heard
the IMB, now HPRA, tell us
that they were being proactive
in deregulating medicines.
They were proposing to ask
licence holders of certain
medicines to apply for nonprescription
status for their
products. It is not clear what
the status of this request
is. Is it a polite observation
or a Marlon Brando making
an offer you can’t refuse
The more cynical in the
profession were in full selfcongratulatory
mode when the
first major announcement was
the movement of NRT into
supermarkets. Yet, in recent
times, we have seen a list of
proposed medicines released
with much fanfare. It is safe
to say that the list did not
inspire any great excitement.
Indeed, it was probably
the least inspiring list that
was possible to produce. It
beggars belief that low dose
aspirin was not on the list. It
is deeply disappointing that
oral fluconazole and topical
antibiotics for eye infections
were not included. Indeed,
the lack of these type of
products raises questions
about the mechanics of such
a process. It is not clear how
this list was formulated,
given the information the
HPRA would have received
from many sources, including
the IPU. Many of the listed
products are already on the
OTC market in some form.
Some are not. For instance,
the inclusion of penciclovir, a
product that is not currently
marketed in Ireland, raised
more than a few eyebrows.
It is currently an S1A drug
under the Medicinal Products
(Prescription and Control
of Supply) Regulations
2003. It is not clear that
there is an overwhelming
need for another OTC cold
sore treatment. There is a
necessity for the internal
procedures that can lead to
items appearing on these lists
to be more transparent. Yet,
these observations should be
taken as constructive. The
move to make more medicines
available to pharmacists, to
prescribe for the public, is a
positive move and must be
welcomed.
IPUREVIEW AUGUST 2014 5

IPU NEWS
September
and October
are RAGM
months
The Regional Annual General Meetings (RAGMs) of the
IPU will take place during September and October (see
below for dates and venues). These meetings provide
members with an ideal opportunity for discussion, to
air their views and to be briefed on all current issues
since the last AGM.
Members can attend any of the Regional AGMs and it
is in your interest to make a special effort to attend.
Pharmacy in
the media
There was media coverage at the beginning of July
on the IPU’s presentation to the Joint Oireachtas
Committee on Health and Children. Interviews were
held on regional radio stations, with IPU spokespersons
calling for an expanded role for pharmacists. The item
was also included on Irishhealth.com.
The cabinet reshuffle led to some media coverage
also, with IPU President Kathy Maher quoted on
IrishExaminer.com and Irishhealth.com.
Kathy was also quoted in national newspapers
and interviewed on regional radio stations following
the HPRA’s announcement that up to 34 medicines
previously available on prescription only could now
be available from a pharmacist without prescription.
Media coverage also included the Irish Times and Irish
Independent.
Date Region Venue
29 September South Castle Hotel, Macroom
30 September Mid-West The Strand Hotel,
Ennis Road, Limerick
01 October South East Newpark Hotel,
Kilkenny
02 October Dublin Clarion Hotel, Liffey
Valley, Dublin 22
06 October Midland Tullamore Court Hotel
07 October North East Conyngham Arms
Hotel, Slane, Co. Meath
08 October North West Mill Park Hotel, Donegal
09 October West McWilliam Park Hotel,
Claremorris
Congratulations
IPU Business
Briefing Roadshows
In July, the IPU held a number of roadshows promoting the
new state-of-the-art business intelligence service being
introduced by the IPU in association with the Portuguese
National Pharmacy Association (ANF). The service, which
will be delivered by Health Market Research (hmR) Ireland,
will allow participating members to see trends or changes in
product mix as well as transaction values across the sector,
and within their own businesses. The service was very well
received by members present (see advert on page 7) who also
heard from Economist Jim Power who gave a presentation on
the “Economic Context for Pharmacists”. See www.ipu.ie for
further dates, venues and times.
Congratulations to
Janice Burke, Training
Administrator (top left);
Susan MacManus, Training
& HR Manager (top right);
and Wendy McGlashan,
Publications & Corporate
Affairs Manager (bottom
left) who are all celebrating
30 years working with the
IPU this year.
6
IPUREVIEW AUGUST 2014

THE IPU IS ON YOUR SIDE
AND BY YOUR SIDE
The IPU will shortly be launching a new Business Intelligence
service in partnership with the Portuguese National Pharmacy
Association which will be delivered by Health Market Research
Ireland (hmR).
MAXIMISE YOUR BUSINESS POTENTIAL
This free service will provide participating members with access
to accurate, up-to-date information to assist them in running their
business more efficiently. You will have information at your fingertips
which will allow you to benchmark your performance against your
local and national markets.
The data will be completely anonymised and aggregated. No
individual pharmacist’s information will be shared with any other
person or organisation and the reports will not allow individual
pharmacies to be identified.
We are now looking for you to support
hmR Ireland to ensure that your data
is in safe hands. The IPU gives you a
commitment to always be in control of
this data. This is your new business, be
part of it.
Register your interest today
by contacting John Donnelly at:
john.donnelly@hmr.ie

Take the step
Become a qualified
Pharmacy Technician
IPU Pharmacy Technician’s Course NVQ Level 3 Pharmacy Services
This two-year programme is designed for pharmacy staff working at least
20 hours per week in the dispensary of an IPU registered pharmacy.
As a Pharmacy Technician you will be a key
member of the pharmacy staff, assisting the
pharmacist in the preparation, checking, storage
and the dispensing of medicines. This course
prepares you to support pharmacists in ensuring
the delivery of a high-quality and professional
pharmacy service.
The IPU Pharmacy Technician’s Course is
distance learning, in modular format with
continual assessment over two years.
On successful completion you will receive the
NVQ Level 3 Pharmacy Services Certificate from
the awarding body (City and Guilds). Year 1
commences September.
Cost for Year 1
€1650 to IPU members
€2050 to non-members
Employers can claim up to €1270 per pharmacy
per year from the PCRS under the Pharmacy
Training Grant Scheme.
ENROL
NOW!
Applications Close
15 August*
* All completed application forms must be received by fax,
post or email to the IPU by the Friday, 15 August 2014.
For more information contact Janice or Susan at
01 493 6401 or go to www.ipu.ie

IPU NEWS
IPU Support
in place for
NRT switch
The HPRA (Health Products
Regulatory Authority) is
authorising some Nicotine
Replacement Therapy (NRT)
products to be sold in general
retail and grocery outlets.
The IPU had anticipated
this move and had ensured
that pharmacists would be
prepared by introducing
a pharmacy-led smoking
cessation service in March. To
support you in providing the
service, we also developed a
Smoking Cessation eLearning
module on www.ipuacademy.
ie and a Smoking Cessation
module on www.ipunet.ie.
We encourage you to avail of
these resources so that you
can continue to provide this
valuable pharmacy service
to your patients as it is
recognised that the chances
of quitting successfully are
increased by engagement with
a healthcare professional.
It is very disappointing
that the first switch to be
announced by the HPRA is
taking a key product category
out of pharmacy, rather
than a POM to P switch.
The HPRA has emphasised
that this move was in line
with Department of Health
and HSE policy to push for
a tobacco-free Ireland and
to make these products as
accessible as cigarettes and
other tobacco products.
We understand that
the products affected are
Nicorette ® Gum (2mg & 4mg,
pack of 30); Lozenges (2mg
x 20); Inhaler (15mg x 4);
QuickMist Spray (1mg x 1)
and Patches. It is expected
that these Nicorette products
will be launched into general
retail at the end of August/
early September. Although
patches are included in the
switch, we have been told
they will not be launched into
general retail at that time.
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Farewell
Jill Lyons, who has worked with the IPU
for over 11 years, left the IPU at the
end of July for a new role based in
Cork. Jill began working in the IPU
Product File Department in 2003
before moving to the Contract
Department and eventually
taking over the management
of the Contract Department
seven years ago. Everyone at
the IPU would like to take this
opportunity to thank Jill for
her support and contribution
to the organisation over the
past 11 years and wish her
the best of luck in her new
role.
IPUREVIEW AUGUST 2014
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BUSINESS Jim Curran, Director of Communications & Strategy, IPU
IPU Delegation
meets the Joint
Committee on
Health and Children
A delegation from the IPU met the Joint Oireachtas Committee
on Health and Children on 1 July to discuss a number of issues
including an expanded role for pharmacists, the exorbitant
fees paid to the PSI, enforcement procedures by the PSI and
bankruptcy provisions of the Pharmacy Act
In his oral presentation
to the Committee, IPU
Secretary General,
Darragh O’Loughlin,
highlighted the role
of the pharmacist as a
healthcare professional and
the significant benefits that
can accrue to both patients
and the State from expanding
their role.
Darragh told the
Committee members that as
a result of increasing demand
for healthcare services and
the shrinking resources in
the sector, the health system
is near ‘breaking point’ with
hospitals overstretched
and GPs, as confirmed by
themselves, struggling with
their existing workloads,
which will only increase
dramatically with universal
access to GP care.
He also informed them
that the current shortage of
GPs is unlikely to be solved
in the short-term, given that
over 1,000 Irish-trained GPs
have taken up work in the
UK health service since 2009.
With an ageing population
there will be additional
pressure on an already
overstretched healthcare
service.
“Similar problems have
been experienced in other
countries and solutions have
been found. When demand
for GP services exceeded the
available capacity in England,
Scotland and Canada, the
unique skills of pharmacists
were used to enhance access
to healthcare,” he said.
He briefed the Committee
on two specific services that
pharmacists could initially
provide; Minor Ailment
Schemes and Medicines Use
Review Service.
The implementation of
a pharmacy-based Minor
Ailments Scheme in Ireland
could ease the pressure on GP
services sufficiently to allow
GPs to provide the additional
four million consultations
which they have estimated
will result from the roll-out
of free GP care.
In highlighting the benefits
of a Medicines Use Review
Service, he told Committee
members, “According to data
from Scotland, in-depth
Medicine Use Reviews (MURs)
conducted by pharmacists
with patients suffering
from chronic illnesses who
were taking a multitude
of medications reduced
hospital readmission rates
by one-third. International
evidence confirms that
the introduction of MURs
provided by pharmacists has
improved health outcomes,
enhanced quality of life and
reduced the requirement for
hospital care.”
The Committee was
informed of other services
that pharmacists could
provide including New
Medicine Services,
Health Checks, Health
Promotions, Extended
Vaccinations, Chronic Disease
Management, Anticoagulation
Service, MDS (Monitored
Dosage Systems) and
DUMP (Disposal of Unused
Medicines Properly).
“The extension of
pharmacist services in other
countries has resulted in
better access to healthcare
and substantial reductions
in morbidity and mortality
rates from illnesses such as
heart disease and diabetes”,
Darragh continued.
“It is our intention, as
a profession, to propose
positive solutions to some of
the problems and deficiencies
in the health system, with a
view to providing accessible,
convenient and cost-effective
healthcare services for
patients and members of the
public and, where possible,
relieving pressure on other
parts of the healthcare
system.”
Darragh also raised a
number of regulatory issues
of concern to pharmacists.
He highlighted, for instance,
the exorbitant cost of
registering with the PSI,
whose fees are way out of
line with other countries. The
current fitness to practise
provisions enforced by the PSI
was discussed with the IPU
calling for the system to be
fair, equitable, transparent,
efficient and cost-effective.
Finally, the IPU’s concerns
about the bankruptcy
provisions under the
Pharmacy Act were outlined.
The Committee responded
very positively to the
presentation. Senator John
Crown acknowledged the
critical role that pharmacists
have played in keeping a
‘limping’ health service
alive for so long. “We are
all grateful to them for
performing that function.
In addition, every doctor
will have had occasion to
be grateful to a pharmacist
for spotting a mistake in a
prescription and thereby
avoiding something bad
happening. Pharmacy
provides a tremendous backstop
service”, he said.
Senator Colm Burke was
particularly interested in the
merits of introducing New
Medicine Services, which
he felt should have been
10
IPUREVIEW AUGUST 2014

introduced years ago and “is a
very important proposal and
should be followed through”.
Deputy Regina Doherty
expressed frustration that
the HSE has not engaged
constructively with the
IPU in introducing new
pharmacy services. She also
questioned why the high cost
of pharmacy registration fees
and the bankruptcy issue
have not been addressed yet.
The flu vaccination and
methadone treatment
service being provided by
pharmacists was welcomed
by Deputy Catherine Conway
who also explained, “One
of the greatest assets any
community can have is a
pharmacist who knows the
people on a first name basis.
That is important because, as
the deputation has explained,
pharmacists are able to relate
to people better.”
Deputy Ciara Conway was
of the view that both the
Medicines Use Review Service
and the Minor Ailments
Scheme should be promoted.
The Chairman of the
Committee, Deputy Jerry
Buttimer, praised the
‘tremendous’ service
provided by pharmacists to
the community. “Those of
us who actively engage with
consituents recognise that
pharmacists are a very good
resource in the community.
They are very accessible and
when the generic substitution
and reference pricing started
they helped in many ways to
calm the waters and provide
good information to people,
particularly elderly people
who were concerned about
the different colour boxes.”
He concluded by
announcing that the
Committee would follow
up with the IPU proposals
on Minor Ailments Scheme,
the Medicine Use Review
Service and the New
Medicine Services with the
HSE and would contact the
Department of Health to see
what stage the bankruptcy
provision is at.
“ The implementation of a pharmacy-based
Minor Ailments Scheme in Ireland could ease
the pressure on GP services sufficiently to
allow GPs to provide the additional four million
consultations which they have estimated will
result from the roll-out of free GP care.”
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IPUREVIEW AUGUST 2014 11

BUSINESS Jim Curran, Director of Communications & Strategy, IPU
IPU Quarterly
Business Trends
Survey Q2 2014
Jim Curran, IPU Director of Communications and Strategy,
outlines the results from the IPU’s Pharmacy Business Trends
Survey Q2 2014, which provides an overview of the current trading
environment for community pharmacies throughout the country.
The second
quarterly
pharmacy business
trends survey,
covering the
period March to June, confirms
that while there are signs
of improvement in business
confidence and less pessimism
among pharmacists than
previously reported, the results
indicate that the trading
environment remains difficult
for the community pharmacy
sector. This is reflected in
deteriorating levels of footfall
and the consequent impact
on sales and turnover, which
continue to decline.
Business costs remain a
concern with one in three
respondents reporting an
increase in the last quarter.
While pharmacies continue
to shed employment, the
level of job losses in Q2 has
reduced significantly in
comparison to the first three
months of the year.
Reference pricing continues
to have a major impact with
almost half of respondents
reporting this as their number
one business concern.
The survey was conducted
in the first two weeks of July.
Business Environment
Figure 1 / Are you more or less optimistic about business
prospects now compared to three months ago
As can be seen in Table
1, while the majority
of pharmacists remain
pessimistic about their
business prospects, there has
been an improvement on the
previous quarter with 55% less
optimistic compared to 67%
in Q1, resulting in an overall
reduction in the net figure.
It is also noticeable that
there has been a discernable
improvement on the same
period last year, when the
mood was particularly gloomy.
Table 1
Business
prospects
Q2
2013
Q3
2013
Q4
2013
Q1
2014
Q2
2014
More Optimistic 4% 6% 10% 13% 9%
Less Optimistic 87% 82% 57% 67% 55%
Same 9% 12% 32% 18% 35%
No Opinion 0% 0% 1% 2% 1%
Net* (83%) (76%) (47%) (54%) (46%)
* Net highlights the overall position. In the above table subtract more optimistic (9%)
from less optimistic (55%) to provide the net figure (46%).
12
IPUREVIEW AUGUST 2014

Table 2
Rate business
environment
Q2
2013
Q3
2013
Q4
2013
Q1
2014
Q2
2014
Improving 3% 5% 14% 10% 11%
Getting Worse 78% 70% 53% 61% 49%
No Change 17% 24% 31% 27% 38%
No Opinion 2% 1% 2% 2% 3%
Net (75%) (65%) (39%) (51%) (38%)
The trends with regard
to business confidence are
generally reflected in how
pharmacists rate the business
environment and these results
are no different. As we can see
from Table 2, there has been
an increase in the number
who feel that the business
environment is improving
and not getting worse, similar
to the trend idendified by
pharmacists who were
asked to rate their business
prospects.
“ 73% of
pharmacies
report that
sales/turnover
is down.”
Footfall
Figure 2 / Have you seen your footfall increase or reduce in the last three months
The level of footfall continues
to reduce, but only very
slightly in comparison to
Q1; the fact that there is
no improvement remains
worrying. The situation,
however, is not as bleak as at
this time last year.
The indications are that
there will be a slight recovery
in net terms over the next
number of months with 36% of
respondents expecting footfall
to reduce over the next three
months and 15% reporting an
anticipated increase.
Table 3
Footfall in the
last three months
Q2
2013
Q3
2013
Q4
2013
Q1
2014
Q2
2014
Increase 9% 9% 21% 15% 16%
Reduce 57% 46% 39% 41% 43%
Same 30% 45% 40% 40% 39%
Don’t Know 4% 0% 0% 4% 3%
Net (48%) (37%) (18%) (26%) (27%)
IPUREVIEW AUGUST 2014 13

Sales/turnover
The improvements reported
in business confidence and in
the business environment are
not reflected in sales/turnover,
with 73% of pharmacies
reporting that sales/turnover
is down, and 6% reporting an
increase.
When we examine the
breakdown we can see from
Figure 3 (right) that the
dispensary is particularly
impacted, with 73% reporting
a reduction. No doubt the
impact of reference pricing
is reflected here. Front of
Pharmacy, while not as badly
hit, still shows that one out
of two (51%) has experienced
a reduction in sales with 16%
reporting an increase.
There is no significant
improvement envisaged over
the next quarter, with 68% of
respondents expecting sales/
turnover to reduce and only
8% seeing an improvement.
Figure 3 / How did sales/turnover perform in the last three months
Table 4
Sales/turnover in
last three months
Q2
2013
Q3
2013
Q4
2013
Q1
2014
Q2
2014
Increased 8% 8% 17% 8% 6%
Reduced 63% 83% 62% 74% 73%
Remained the same 25% 8% 15% 10% 19%
Don’t know 3% 1% 6% 8% 1%
Net (55%) (75%) (43%) (66%) (67%)
Employment
Table 5
Levels of
employment
Q2
2013
Q3
2013
Q4
2013
Q1
2014
Q2
2014
Increased 10% 4% 11% 7% 9%
Decreased 15% 30% 19% 23% 17%
Remained the same 75% 66% 70% 70% 74%
Net (5%) (26%) (8%) (16%) (8%)
Employment figures continued
to bounce up and down over
the last 12 months, with
the number of pharmacies
reducing employment
peaking in Q3 2013. Over
the last three months there
has been an improvement,
with a net 8% reducing
their employee numbers in
comparison to a net 16% in
the previous quarter. There
is no obvious explanation for
this, particularly as sales and
footfall figures remain weak.
Worryingly, a quarter of
pharmacies (net 25%) expect
to lay staff off over the
next three months, which
would confirm the level of
uncertainty that still exists.
Business costs
36% of pharmacies (38% in
Q1) reported an increase
in business costs in the
last three months, with
energy costs, waste charges
and wages the areas most
impacted. 9% experienced a
reduction, up from 5% in the
previous quarter.
“ Worryingly, a quarter
of pharmacies (net
25%) expect to lay
staff off over the next
three months.”
14
IPUREVIEW AUGUST 2014

“ With falling medicine prices,
increasing business and regulatory
costs and reduced consumer
demand, the prospects remain
relatively bleak, with no indications
yet of any discernable improvement.”
Business concerns
Table 6
Main business
concerns
Q2
2013
Q3
2013
Q4
2013
Q1
2014
Q2
2014
As Table 6 (left) confirms,
‘Reference Pricing’ is far and
away the major business
concern for pharmacies,
which has consistently
been the case for the last
12 months. Interestingly,
there has been a fairly
large increase in those who
identified ‘Reduced Consumer
Spending’ as their major
concern, which is reflected
in disappointing footfall and
sales figures.
Reference Pricing 39% 68% 56% 57% 49%
FEMPI Cuts 50% 19% 22% 19% 16%
Reduction in
Health Budget
Reduced Consumer
Spending
Economic
Uncertainty
N/A N/A N/A 10% 11%
4% 7% 6% 7% 11%
7% 7% 6% 5% 7%
Business Costs 0% 0% 1% 1% 1%
Regulatory Burdens 0% 0% 9% 1% 4%
Losing Key Staff 0% 0% 0% 0% 0%
Conclusion
While there has been a slight
improvement in pharmacies’
perceptions of the business
environment, the reality is
that the trading environment
continues to be tough, which
is reflected in the downward
trend in sales and footfall and
the negative influence that
reference pricing continues
to have.
With falling medicine prices,
increasing business and
regulatory costs and reduced
consumer demand, the
prospects remain relatively
bleak, with no indications
yet of any discernable
improvement as has been
witnessed in other sectors of
the economy.
It remains to be seen if
the improvements being
reported in other sectors of
the economy will be reflected
in the pharmacy sector, but
based on the indicators for
the next three months, we
can only conclude that this is
unlikely.
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IPUREVIEW AUGUST 2014 15

CPD Breda Heneghan MPSI
Reflection and
self-assessment
Evaluation
RECORD
(e.g. portfolio)
Learning plan
Action
(e.g. CE)
CPD: Female Urinary
Incontinence from a
pharmacy perspective
Urinary incontinence is defined as any involuntary leakage of urine. Female
urinary incontinence is a common, debilitating and economically significant
condition, which many patients are too embarrassed to discuss.
Prevalence and
demographics
The reported prevalence of
urinary incontinence varies
widely (5-69%) because
of differences among
the populations studied,
definitions and measurements
used. The prevalence increases
up to middle age, plateaus
between 50 and 70 years of
age, and increases again with
advanced age.
Women experience
urinary incontinence more
than men. Contributory
factors include pregnancy,
childbirth, menopause, aging,
neurological damage, stroke,
birth defects and multiple
sclerosis.
Urinary incontinence
can be caused by bladder
dysfunction, urethral
sphincter dysfunction or
some of both. It is important
to diagnose the correct type
of urinary incontinence to
ensure appropriate treatment.
The main types of urinary
incontinence are outlined in
Table 1 (below).
Table 1: The different types of urinary incontinence
Type
Stress Urinary
Incontinence (SUI)
Overactive bladder
syndrome (OAB)
Mixed Urinary
Incontinence (MUI)
Chronic urinary
retention (Overflow
Incontinence)
Nocturnal Enuresis
Functional
Incontinence
Stress urinary incontinence
(SUI) and overactive bladder
(OAB) are the cause of over
90% of cases of urinary
incontinence.
When the bladder is full,
nerve impulses pass to the
pontine micturition centre,
triggering urination. The
detrusor muscle contracts as
Definition
Involuntary leakage on effort or exertion,
or on sneezing or coughing
Defined as urgency, usually with increased
frequency and nocturia, which may occur
with or without urgency incontinence
Involuntary leakage associated with both
urgency and also physical stress (exertion,
effort, sneezing or coughing)
Occurs when the bladder cannot empty
completely and becomes overdistended
Involuntary leakage of urine during sleep
Incontinence where no organic cause is
found
a result of acetylcholine acting
on muscarinic receptors.
Anticholinergic drugs block
the action of acetylcholine on
detrusor receptors. Duloxetine
mediated stimulation of
alpha-1 adrenergic receptors
treats SUI.
Assessment
It is important that all
patients presenting with
urinary incontinence have a
complete assessment to allow
for a differential diagnosis.
This should include:
n Taking a full history with
regard to pattern and
type of incontinence,
medical, gynaecological,
surgical and neurological
histories.
n If necessary, an
abdominal, vaginal
and rectal examination
should be completed.
n A three-day bladder
diary – document fluid
intake, how often urine
is passed plus volume
measured, episodes of
incontinence and pad
or clothing changes.
The normal volume of
urine passed per void
is 200-400ml and the
generally quoted average
frequency is 4-8 times
daily including once per
night.
16
IPUREVIEW AUGUST 2014

CPD overview
Reflect and Self-Assessment
o What do I know about female urinary incontinence and its
treatment
o Can I provide advice about the treatment options for urinary
incontinence
o Can I identify those who may benefit from some extra advice
and care in a private consultation
Learning Plan
Including a list of desired learning outcomes in a personal
learning plan is a helpful self-analytical tool.
o This article aims to provide an overview of female urinary
incontinence and current trends in the treatment and
management of this condition. It examines how pharmacists
can promote better outcomes for this patient group.
Figure 1: Showing the nerve pathways
associated with incontinence
Action
Activities chosen should be outcomes based to meet
learning objectives.
o Read this article.
o Consider current interactions with patients receiving
medication for urinary incontinence – could these
interactions be improved
o Evaluate professional resource material in the pharmacy and
source additional material if necessary.
o Identify the location of local continence clinic/
physiotherapy department.
Evaluate
Consider outcomes of learning and impact of learning.
o Do I now feel confident in my understanding of female urinary
incontinence and its treatment
o Do I now feel equipped to counsel patients and their carers
around concerns in relation to urinary incontinence
o Have I met my desired learning objective
Record
o Complete the short answer questions at the end of the article.
o Create a record in a CPD portfolio.
o Assess whether learning outcomes were achieved and
identify any future learning needs.
n Urinalysis – to rule out
infection.
n A residual urine
measurement is needed
to diagnose chronic
urinary retention –
overflow incontinence.
n Consider other possible
contributing factors:
Obesity; smoking;
high fluid, alcohol and
caffeine intake and
constipation.
n It is very important to
determine the effect
of the incontinence on
the woman’s quality
of life, her desire for
treatment, expectations
and motivation, as this
will help predict her
adherence to treatment.
n Review the patient’s
current medication as
some drugs increase
lower urinary tract
symptoms – see Table 2
(next page).
Treatment
Treatment varies depending
on the results of the initial
assessment and which type
of urinary incontinence the
woman has.
Stress Urinary
Incontinence (SUI)
Stress incontinence is
the most common form
of urinary incontinence.
This is the complaint of
involuntary loss of urine on
effort or physical exertion,
or on sneezing or coughing.
It can be either due to
hypermobility of the urethra
and /or intrinsic sphincter
deficiency. Both occur more
(but not exclusively) following
pregnancy with urethral
hypermobility occurring due
to weakness of the pelvic floor
support and damage to the
pubourethral ligaments.
There are numerous
treatment options
available including pelvic
floor exercises, electrical
stimulation, pharmacotherapy
and surgery – surgery is the
mainstay of treatment for
most women.
n Pelvic Floor Muscle
Training (PFMT)
Pelvic floor exercises have
been the cornerstone of
conservative treatment for
SUI (First line treatment –
NICE guidelines). Success
rates have been relatively
modest and depend on
patient adherence. Women
require an individualised
programme based on
assessment by continence
advisor/physiotherapist.
The supervised programme
should ideally last at
least three months. At a
minimum, eight pelvic floor
muscle contractions should
be performed at least three
times per day. Review after
12 weeks or as required to
assess response. The use of
weighted vaginal cones and
IPUREVIEW AUGUST 2014 17

ladder training in addition
to PFMT may improve
the outcome but require
specialist provision and
high levels of motivation in
the woman.
n Electrical stimulation
Biofeedback to the patient
may assist motivation and
electrical stimulation may
be of help to women who
cannot initiate a pelvic floor
muscle contraction.
n Pharmacotherapy
Pharmacological treatment
is usually reserved for
women unfit for surgery,
awaiting surgery, do not
want surgery or who have
yet to complete their
family. NICE recommends
duloxetine as second line
to PFMT for this group of
women. It is a combined
serotonin and noradrenalin
reuptake inhibitor and has
been shown to increase
the urethral sphincter
muscle activity during the
storage and filling phase
of micturition. There is
good evidence from RCTs
that short term use of
duloxetine in women
with SUI can reduce
incontinence, increase the
intervals between voids
and improve quality of life.
Adverse effects, particularly
nausea, are common.
Other side effects include
vomiting, constipation, dry
mouth, dizziness
and insomnia. One study
suggested starting at a
low dose of 20mg twice
daily for two weeks and
then increasing to the
recommended dose of
40mg twice daily to reduce
the incidence of nausea.
It may be more effective
when used as an adjunct to
PFMT.
n Surgery
Surgery is an option if
conservative treatments
have failed. Surgery has
much better success rates
but it has been estimated
that

medication and behavioural
therapy because all
surgical procedures are
accompanied by associated
risk and complications.
With the increasing
popularity of botulinum
toxin this option is now
rarely used.
Nocturnal enuresis
This may result from detrusor
overactivity. Therapies follow
the same lines as for OAB.
Desmopressin can be used
more specifically for nocturnal
enuresis. Patients need to be
closely monitored for fluid
retention and hyponatraemia.
It is not suitable for patients
>65 years old, who have
renal impairment or
cardiovascular disease.
Tricyclic antidepressants can
also be used.
Overflow incontinence
A failure to empty the bladder
efficiently can lead to urinary
retention, which ultimately
can result in overflow
incontinence. Such problems
are associated mostly with
prostatic hypertrophy in
men and are rarely seen in
women unless associated
with previous incontinence
surgery or neurological
disease. Drugs have little or
no role in correcting voiding
disorders in women. The
mainstay of treatment is the
use of clean, intermittent selfcatheterisation.
Pharmacist’s role
1. Be familiar with the two
main types of urinary
incontinence and the
differing treatment regimes.
Use this knowledge to
review all patients on
medication for urinary
incontinence.
2. Counsel patients starting
new antimuscarinics for
OAB – that some adverse
effects such as dry mouth
and constipation may
indicate that the treatment
is starting to have an
effect; they may not see
full benefits until they have
been taking the treatment
for four weeks; all new
treatments should be
reviewed after four weeks.
3. Pharmacists can provide
lifestyle advice that will
benefit patients with
urinary incontinence –
weight loss if BMI>30;
advise patient to avoid
drinking excessive or small
amounts, of fluid each day.
The recommended daily
intake is six to eight glasses
of water (or other fluid);
reduce alcohol & caffeine
intake; stop smoking.
4. The pharmacist can offer
to carry out a Medication
Use Review for patients
presenting with urinary
incontinence, to identify
any medication associated
with increased lower
urinary tract symptoms
(see table 2).
5. The pharmacist should
recommend pelvic floor
exercises in combination
with duloxetine for SUI,
as studies have shown
the combination is more
effective than each of these
interventions alone. If the
patient not familiar with
PFMT then the pharmacist
should refer the patient
to the local physiotherapy
department (patient does
not have to be referred by
doctor).
6. Discreet notices can be
placed in the area selling
incontinence products,
advising patients that a
private consultation area
is available to discuss any
concerns they may have;
also information available
on lifestyle measures that
can help.
AttendsIPN_Advert2014_Layout 1 10/07/2014 09:13 Page 1
Your 5-minute
assessment
Answer the following questions
– true or false:
1. An ACE inhibitor may cause cough with
relaxation of the pelvic floor leading to SUI.
2. Alpha–blockers like doxazocin prevent SUI.
3. Surgery is the mainstay of treatment for most
women with SUI.
4. Nocturnal enuresis is associated with detrusor over-activity
in many women.
5. The normal volume of urine passed per void is 600-1000ml
and the generally quoted average frequency is 8-10 times
daily including once per night.
Dryness You Can Rely On
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“I first started having symptoms of stress
incontinence following a hysterectomy. Initially,
I ignored the symptoms because they were
quite mild. However, the symptoms became
progressively worse and I became too
worried to venture farther than my
own garden. Miserable and fed up, I
went to the doctor. We discussed
my options and she suggested I try
incontinence briefs to help manage
it. My Pharmacist recommended
Attends® and helped me choose
the right size, absorbency and
even style to suit my needs. To
say my life completely changed
is an understatement. After
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my own home, I finally feel in
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*
Answers:
1. True. 2. False, alpha-blockers cause urethral relaxation and decreased
resistance thereby causing stress urinary incontinence. 3. True, surgical
management has changed dramatically in recent years with minimally invasive
treatments becoming available. 4. True, investigations reveal a picture of detrusor
over-activity and therapies follow the same lines as for OAB. 5. False, normal
volume of urine per void is 200-400ml between 4-8 times daily including once
per night.
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IPUREVIEW AUGUST 2014 19

PROFESSIONAL Ciara Ní Faoláin, MPSI
Locum
experiences
As the sun makes brief appearances and employers plan holidays
and annual leave, the locum pharmacist prepares to fill up their
diary. In this article, Ciara Ní Faoláin, a Cork-based locum, gives an
insight into the bumpy road that is locum pharmacist work.
Locum work has certainly
been an eye-opening
experience. For the past six
months I have been working
as a locum pharmacist in
Cork city and its surrounds.
It’s been a bumpy road and as
I’m sure many of my newly
qualified colleagues will be
faced with similar difficulties,
I thought that sharing my
experiences regarding the
locum struggle may help them
and employers alike.
I received my pharmacy
degree from De Montfort
University in Leicester and
completed my pre-registration
in University Hospital
Leicester, a large, intensive
teaching hospital. After a
long difficult time away it
was fantastic to be back on
Irish soil. However, after my
trip to Dublin to register, a 10
minute lecture on pharmacy
schemes in Ireland and a
booklet regarding pharmacy
regulations, I found myself
very overwhelmed.
The first difficulty was
getting my name out there.
I found that the IPU Locum
List, going door-to-door with
business cards and setting
up a comprehensive LinkedIn
profile was the best way
to do this. Signing up with
various locum agencies can
also be a good way of making
connections.
The second and most
daunting difficulty was getting
to grips with the various
Irish schemes. It is one
thing reading about the
schemes in theory
but another entirely
when it comes
to processing
prescriptions.
Which one to
code Which one
to photocopy
How is it entered
in the software
Do you have
the High
Tech
Scheme
fax number These are various
questions that, if learned
through trial and error, could
cost your employer time,
effort and money setting it
right. I come from a hospital
pre-registration background,
but anyone with an industry
background or an English
community background
will be faced with the same
problems. I was lucky in that
I had a wonderful regular
community job when
I came home
throughout my
degree with
fantastic
training but
even then
I found it
difficult to make
the transition
from UK to Irish
schemes.
My limited experience
has taught me that being a
locum can be an extremely
stressful experience. Some
areas that can prove to be
tricky include staff failing
to turn up, being unfamiliar
with the software and getting
to grips with new processes
in a busy environment. It’s
tough being the ‘new girl’
and trying to get to grips with
certain pharmacies’ way of
doing things. However, the flip
side of the coin is that it can
also be a fantastic way to get
invaluable experience and, by
seeing how each pharmacy
operates, you can use the
knowledge gleaned to shape
the type of pharmacist you
would like to be.
20
IPUREVIEW AUGUST 2014

“ A clear set of locum-specific SOPs is not
always available but is extremely valuable to
a locum pharmacist who is unfamiliar with
the pharmacy. It is not realistic to expect
a locum to read the entire suite of SOPs in
place in any pharmacy in a single day.”
In my six months as a
locum I have worked in many
different pharmacies and
no two pharmacies are the
same. This is not a problem
if you have a very hands-on
employer who is willing to
take some time to run through
things with you, but I can
understand how this would
not suit everyone. A clear
set of locum-specific SOPs is
not always available but is
extremely valuable to a locum
pharmacist who is unfamiliar
with the pharmacy. It is not
realistic to expect a locum to
read the entire suite of SOPs
in place in any pharmacy in a
single day.
I am very passionate
about making this process
more seamless and safer for
locums and employers alike.
I attended the Seminar for
Pharmacy Interns in April,
which was an invaluable
resource and addressed some
great issues such as dealing
with difficult customers and
staff. If offered again next year,
I would highly recommend it.
It’s not easy walking into a
new job with new staff and we
do this regularly. I would like
to call on employers to take a
stronger hand in making this
transition easier for locums
and for locums to speak out
when they feel they are in
need of more support.
Get organised
Tips for locums
Get yourself a diary, the IPU Yearbook & Diary is a good size and also contains very
useful information regarding the Irish medicines schemes and useful contact numbers.
Have a contact
Every pharmacist went through a tough time at the start of their employment so try
and have the number of an experienced colleague that you can contact for advice.
Software training
Hone your skills by becoming familiar with the various software systems. Some
software companies even offer free software training.
Personal checklist
Before accepting a job I always like to establish what support staff I will have and
what the software is. Once in the door I have a checklist of things I’m quickly looking
to establish, such as the location of the duty register, the dispensary handover book,
CD keys etc. The locum checklist located on the IPU website is a good checklist
base and a great template for employers in writing a locum SOP.
Know your stuff
We can’t know everything, but to increase efficiency in your working environment
there are some things that you should know at a first glance such as, maximum
doses for commonly prescribed painkillers and sleeping tablets, antibiotics and
notable interactions.
Money
Most of the employers I have dealt with are fantastic in terms of paying wages but
to make this process easier for the employer have your payment details to hand.
If you are working for an extended period in one place, or doing regular locum
work, ask for your employer’s registration number and contact Revenue to sort out
assigning of credits. (See the Locum Issues folder in the Employee Pharmacists
section of www.ipu.ie for more information regarding payment).
Helpful resources
The IPU website – www.ipu.ie – contains some great useful resources, such as a
good recap of the Irish pharmacy schemes.
22
IPUREVIEW AUGUST 2014

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2012/ADV/PAR/076

Get the retail
factor in your
pharmacy
With the latest set of cuts to your dispensary
income, a bespoke retail review of your
front-of-pharmacy will give your pharmacy
a facelift to boost your sales without
overstretching your budget.
Our One-Day Review will include:
■ Expert advice on your retail offering
■ A complete review of the front-of-pharmacy
including category management and
promotion planning
■ Providing training in sales techniques
■ Re-merchandising displays (interior and
window) to enhance the retail experience
in your pharmacy
■ Helping you and your sales team develop
new sales ideas
■ Using key performance indicators to help
you increase front-of-pharmacy business
■ Motivating your sales team to be
innovative, sales focused and up to
speed on product knowledge
Darren Kelly, IPU Business Development Manager,
has almost 20 years of retail experience. If you would like
further information on this service or would like to book
a Retail Review, please contact Darren on (01) 493 6401 /
086 028 9825 / email: Darren.kelly@ipu.ie
How we helped one pharmacist
The idea that the IPU could offer me a retail expert to come to my
pharmacy and help me to get the “retail” factor into a pharmacy that
has massive competition from two retail multiples was a great idea.
Oonagh O’Hagan, Meaghers Pharmacy Group

BUSINESS Brian Hyland and Edel Dempsey, Baker Tilly Ryan
Now & Next:
Reviewing
your business plans
In this, the third article in
a ‘Now & Next’ series, Brian
Hyland, Partner and Edel
Dempsey, Consultant, with
Baker Tilly Ryan Glennon,
looks at the changing
operating environment
of retail pharmacies now,
with several pharmacies
becoming involved in
Franchising, Buying Groups
and Symbol Groups.
Historically, retail
pharmacies in
Ireland were
predominantly
operated
by independent owner
pharmacists. While this
still remains the case, there
is a current shift towards
affiliation, both formal
and informal, through the
emergence of franchises,
buying groups and symbol
groups in the market by
long established and next
generation pharmacies.
Many are seeing
these affiliations as the
modernisation of the retail
pharmacy sector as they
make sense in a market that
is increasingly driven by
branding and margins, while
maintaining and often times
increasing, the level and
quality of care and service
provided to the community.
While there are clear
advantages to such
affiliations, there is always a
price to be paid. The decision
faced by many is whether that
price is just too much to pay.
The difficulty therein is that
there is no black and white
answer to this question. It is a
question for the individual to
address; it is an answer that
is driven by personality, prior
experience and the vision of
that individual.
This decision should be
made during the development
of a Business Plan – Where we
want to go next and How are
we going to get there
Like all decisions, the devil
is in the detail, an informed
decision will always be a
good decision, based on the
information that is available
at the time. But where to
begin First we need to
understand what is meant by
a franchise, buying group and
symbol group within the retail
pharmacy sector
Franchise
“A franchise is the agreement
or license between two legally
independent parties which gives:
n a person or group of people
(franchisee) the right to
market a product or service
using the trademark or
trade name of another
business (franchisor)
n the franchisee the right
to market a product or
service using the operating
methods of the franchisor
n the franchisee the obligation
to pay the franchisor fees
for these rights
n the franchisor the obligation
to provide rights and
support to franchisees”
(Source: International Franchise
Association, 2014)
For example, Lloyds
Pharmacy and Life Pharmacy
offer franchise opportunities
in the Irish retail pharmacy
sector.
Buying Group
The concept of a buying group
was developed to open up the
IPUREVIEW AUGUST 2014 25

enefits of group purchasing
to local pharmacies while not
impacting on the integrity
and service levels of the
community pharmacy.
Examples of buying groups
in the Irish retail pharmacy
sector would include
Healthwise and Axium.
Symbol Group
These groups appear to
have stemmed from buying
groups within the retail
pharmacy sector. They retain
all the characteristics of the
buying group, with the added
feature of operating through
a recognisable brand that
further strengthens the ethos
and vision established by the
original buying group.
This structure appears to
be gaining strength within the
Irish retail pharmacy sector
as not only are more and
more buying groups moving
into this arena, the branding
now offered by these groups
is becoming very visible
and recognisable across the
country. Examples of these
would include Totalhealth and
Haven.
Now that the meaning of
these structures has been
established, one must then
use that knowledge to address
the following personal
questions;
n Where do you see the
business in the next five
years
n What is important to you
and the care and service
you want to provide to
the community
n What is currently
operating in your
locality
n What options are
available to you, given
your location and the
market therein
The answers to these initial
questions will determine
the decision to be made, but
sometimes they may not
be immediately apparent
and some knowledge of the
sector and the market may
be required. This is an area
that should be addressed
during the initial stages of the
development of a Business
Plan, when it is established
‘Where we are Now and How
we got here
Once the options have been
identified, each scenario must
be adequately assessed to
determine the most suitable
structure for the individual
pharmacist, their location,
the market therein and the
care and service they wish to
deliver.
The real difficulty is that,
as it currently stands, the
lines have become blurred
as to where many of these
groups, currently operating
in the retail pharmacy sector
sit. Are they franchises,
buying groups or symbol
groups and what are the real
life implications of these
structures How does the
operation of these structures
influence the options available
to other pharmacists from a
geographical and competitive
standpoint For example, with
most franchise agreements
there is a guarantee that no
other franchised outlet will be
established within a specific
geographical radius; this in
itself may limit the options
available to any perspective
franchisee.
A simple and effective
primary exercise may be to set
out the perceived advantages
and disadvantages of the
various options:
Independent Pharmacy
Franchised Pharmacy
Advantages
Disadvantages
Advantages
Disadvantages
Notoriety – The outlet will
operate under the name chosen
by the individual.
Autonomy – You make your own
decisions as to the look, feel &
operation of your outlet.
There is the opportunity to carve
out a niche in the market for your
outlet through the products and
services offered.
Relatively easy and inexpensive
to set up either as a Sole Trader
or Limited Company.
Cannot order in large enough
quantities to avail of bulk
discounts.
Difficult to launch new products
and ranges in the absence of
large bulk orders.
Difficult to gain exclusive
distribution of products in the
absence of large bulk orders.
Advertising is expensive, does
not have the advantage of
nationalised add campaigns.
Relatively easy to set up based
on a tried and tested formula,
helps to avoid the errors and
pitfalls often associated with
start-ups.
Management training usually
provided to shorten the learning
curve and allow the outlet to
operate smoothly from the
beginning.
Pre-established suppliers and
ordering channels for more
efficient purchasing.
Loss of notoriety – outlet to be
operated under the branding of
the franchise.
Loss of autonomy – the look,
feel and operation of the outlet is
determined by the franchise.
No opportunity to carve out a
niche in the market that does not
adhere to the vision and direction
of the franchise.
No buy-in fees or annual
contributions based on turnover to
be paid.
Does not have the financial
support and assistance of a group
in terms of IT systems & support
and training resources etc.
Opportunities to stock exclusive
product lines within the franchise
chain.
Financial support and assistance
of a group in terms of IT systems &
support and staff training etc.
Can be very expensive to set up
with considerable buy-in money.
Can be expensive to operate with
a sizeable percentage of turnover
to be paid to the franchise.
Benefit of nationalised/
globalised ad campaigns.
“ While there are clear advantages to such
affiliations, there is always a price to
be paid. The decision faced by many is
whether that price is just too much to pay.”
26
IPUREVIEW AUGUST 2014

Advantages
Notoriety – The outlet will
operate under the name chosen
by the individual.
Autonomy – You make your own
decisions as to the look feel &
operation of your outlet.
Relatively easy and inexpensive
to set up either as a Sole Trader
of Limited Company.
Can avail of bulk discounts due
to the size of orders placed by
the group.
BuyingGroup
Disadvantages
Difficult to carve out a niche in
the market that does not adhere
to the buying strategy of the
group.
Perceived loss of competitive
edge with direct competitors
within the group.
Risk of strong personalities
taking the group in a direction
that is at odds with the initial
ethos of the group.
Risk of overfamiliarity within the
group, regarding the individual
outlets: their client base,
successful product lines etc.
Symbol Group
– as distinct from Buying Groups
Advantages
Can continue to trade under their
own name with the added benefit
of the symbol associated with the
group.
Can take advantage of the
goodwill associated with the
brand of the symbol group.
Benefit of nationalised/
globalised ad campaigns.
Relatively easy to leave the
group with minimal disruption to
operations.
Disadvantages
Partial loss of notoriety – outlet
to be operated under the
branding of the symbol group.
Loss of autonomy – the look,
feel and operation of the outlet is
determined by the symbol group.
Can often have the support of the
group to assist with IT systems &
support and staff training etc.
Can build a support network of
fellow pharmacists.
Relatively easy to leave the group
with no disruption to patient care
and service.
This will help to focus
on what is important to
the individual and their
operations, particularly if the
options available are ranked
in order of preference. With
this in mind, an in-depth
analysis of the preferred
option should be undertaken
to ensure it meets the criteria
set out at the initial planning
stage. This can often become
quite technical and may often
require the assistance of a
consultant with both technical
and sectorial knowledge, as
the true costs of the various
options are teased out to
ensure there are no surprises
once an arrangement has
been agreed and is put in
place.
The important factor to note
is that any structure adopted
by a pharmacist in the
operation of their outlet must
be one that is in keeping with
them as an individual, their
management style, vision and
their ethos regarding the care
and service provided to their
community.
If you require further information
on any of the details contained
in this article, please contact
Brian Hyland or Edel Dempsey
at Baker Tilly Ryan Glennon on
01 496 5388 or email bhyland@
bakertillyrg.ie or edempsey@
bakertillyrg.ie.
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IPUREVIEW AUGUST 2014 27

BUSINESS Stuart Fitzgerald, Business Advisory Director, Fitzgerald Power
The tax
advantages of a
limited company
In this article, Stuart
Fitzgerald, Business
Advisory Director of
Fitzgerald Power, outlines
the benefits of trading as
a limited company.
Incorporating a sole trade
pharmacy can result in
significant tax savings
for individuals whose
drawings are lower than
their taxable profits.
Corporation tax at 12.5%
applies to trading profits in a
pharmacy company, compared
to the maximum marginal
rate of 55% (Tax, PRSI and
USC) for profits in a pharmacy
sole trade.
The following example
highlights the tax savings
that may be available from
incorporating a pharmacy sole
trade:
n Jack bought a pharmacy
in 2007 for €2,500,000.
He leases the business
premises from the
former owner.
n The former owner
operated as a sole trader
and Jack has continued
with this structure.
n The pharmacy has a
turnover of €1,750,000
and a taxable profit of
€385,000.
n Jack is 50 years old. His
wife Mary, who is also 50,
is a qualified pharmacist
and works in the shop
for an annual gross
salary of €25,000.
n Jack’s annual drawings
(to include income tax
payments and pension
contributions) are
€125,000 per annum.
Under the current structure,
Jack and Mary have the
following annual income tax
liabilities (before credit for
withholding tax and for the
purposes of this example
ignoring tax relief on pension
contributions):
Jack Mary Total
Taxable Income €385,000 €25,000 €410,000
Income Tax / PAYE €147,700 €3,350 €151,050
Universal Social Charge €34,800 €1,070 €35,870
PRSI €15,400 €1,000 €16,400
Total €197,900 €5,420 €203,320
28
IPUREVIEW AUGUST 2014

ConvenienCe
• The only once-monthly*
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• Unlike combined pills
NuvaRing does not require
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1
RING
* In a given 1-month period, NuvaRing must
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Actual NuvaRing user.
The unique delivery system of NuvaRing 1,2,†
Nuvaring 0.120 mg/0.015mg per 24 hours vaginal delivery system® (See SPC before Prescribing) Etonogestrel and
ethinylestradiol • Presentation: Vaginal ring. Uses: Contraception. Dosage and Administration: A ring should be inserted into the
vagina and left in for 3 weeks. Strictly follow insertion instructions. Contraindications: Presence/history of venous thrombosis,
with/without the involvement of pulmonary embolism. Presence/history of arterial thrombosis or prodromi of a thrombosis.
Known predisposition for venous/arterial thrombosis, with/without hereditary involvement or the presence of severe/multiple
risk factors. History of migraine with focal neurological symptoms. Diabetes mellitus with vascular involvement. Pancreatitis
or history thereof if associated with severe hypertriglyceridemia. Presence/history of severe hepatic disease if liver function
values abnormal. Presence/history of liver tumors. Known/suspected sex-hormone dependent tumors. Undiagnosed vaginal
bleeding. Hypersensitivity to any ingredients. Precautions and Warnings: No epidemiology data available on vaginal
administration but the warnings for combined OCs (COCs) are considered applicable. Risk of breast cancer possibly similar
to that associated with COCs. This may be due to earlier diagnosis in COC users, the biological effects of the COC, or a
combination of both.. Use of any combined hormonal contraceptive (CHC), including NuvaRing, carries an increased risk of
venous thromboembolism (deep vein thrombosis and pulmonary embolism) compared with no use. The excess risk of VTE is
highest during the first year a woman initially starts using a CHC or when she restarts CHC use after an interval of no use of at
least one month. • Remove ring in event of a thrombosis and before long-term immobilisation. Council patients on symptoms
of thrombosis. Increased risk of cervical cancer in long term COC users has been reported, but this may be confounded
by other factors. Abnormal liver function or liver tumors. Increased risk of pancreatitis in women with hypertriglyceridemia
taking hormonal contraceptives. Hypertension. Diabetes. Crohn’s disease/ulcerative colitis. Chloasma. Sickle cell disease.
History during pregnancy/previous use of sex steroids: jaundice and/or pruritis related to cholestasis, gallstone formation,
porphyria, SLE, HUS, Sydenham’s chorea, herpes gestationis, otosclerosis. Remove ring if there is increased frequency/
severity of migraine. Increased risk of thromboembolism in the puerperium. May not be suitable for women with a prolapse or
severe constipation. Consider incorrect positioning in case of cystitis. Occasional vaginitis. Very rarely it has been reported
that the ring adhered to vaginal tissue, necessitating removal by a healthcare provider.If ring accidentally expelled follow
SPC instructions. Interactions: Possible interactions with phenytoin, phenobarbital, primidone, carbamazepine, rifampicin,
oxcarbazepine, topiramate, felbamate, ritonavir, griseofulvin, penicillins, tetracyclines, ciclosporin, lamotrigine and St John’s
Wort. Use of antimycotic ovules may increase the chance of ring disconnection. Pregnancy and Lactation: Not recommended.
Common Undesirable effects: Vaginal infection, depression, decreased libido, headache, migraine, abdominal pain, nausea,
acne, pelvic pain, breast tenderness, genital pruritis, female dysmenorrhoea, vaginal discharge, weight increased, discomfort,
device expulsion. See SPC for full details of other uncommon side effects. Overdose: No reports of serious effects from
overdose. Legal Category: Prescription Medicine Product Authorisation Number: PA 61/29/1. Product Authorisation holder:
Organon Ireland Limited, P.O. Box 2857, Drynam Road, Swords, Co. Dublin, Ireland. © Merck Sharp & Dohme Ireland (Human
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Oak North, South County Business Park, Leopardstown, Dublin 18 or from www.medicines.ie. Date of Preparation: May 2014.
† The only vaginal contraceptive ring in Ireland
References: 1. Nuvaring Summary of Product Characteristics August 2010 2. MIMS Ireland, Dec 2011 3. Novák A, de la Loge C,
Abetz L, van der Meulen EA. The combined contraceptive vaginal ring, NuvaRing: an international study of user acceptability.
Contraception. 2003;67(3):187-194.
www.talkoptions.ie
Red Oak North, South County Business Park, Leopardstown, Dublin 18, Ireland
WOMN-1120830-0000

Jack and Mary have received
professional advice which
indicates tax savings are
possible if they incorporate
their business. The details
of this incorporation are as
follows:
n Jack sells the pharmacy
trade to a newly formed
limited company, Newco
Limited.
n As with many
pharmacies, the value
of the trade has fallen
since 2007 and, following
a valuation, the arm’s
length value of the
trade is established at
€1,750,000.
n As the new company
does not have funds, a
loan account is created
on the balance sheet
of Newco Limited for
€1,750,000. It is agreed
that the company will
make annual payments
of €100,000 to Jack for
17.5 years until this loan
is cleared.
n Selling the trade to the
newly formed limited
company creates a
Capital Gains Tax event.
However, as this results
in a loss, there is no
liability to CGT (note as
this loss arose between
connected parties, there
are restrictions on how
this can be utilised):
Sale price €1,750,000
Purchase price (€2,500,000)
Capital loss (€750,000)
CGT @ 33%
Nil
Under these circumstances,
each year Newco Limited
makes the following
payments:
n €100,000 loan repayment
to Jack. The repayment
of this loan is not within
the scope of income
tax. This loan is created
by the Capital Gains
Tax event noted above,
which does not attract a
CGT liability.
n €35,000 gross salary
to Jack, which
approximates a net
salary of €25,000 per
annum. Therefore, Jack
still draws €125,000
annually from the
business.
n €25,000 gross salary to
Mary, as before.
The following tax liabilities
will apply:
By incorporating their
business, Jack and Mary have
reduced their overall annual
tax bill (to include income
taxes and corporation tax)
by €145,630 without reducing
their annual drawings.
In addition to this annual
tax saving, Jack and Mary can
avail of the following benefits:
n Limited liability: Jack
and Mary are no longer
personally responsible
for the liabilities of the
business.
n Retirement relief: In 10
years’ time, providing
all conditions are met,
Jack and Mary can avail
of retirement relief.
Current retirement
relief exemptions mean
that Jack and Mary can
sell their shares in the
company in 10 years’
time for up to €1,500,000
without incurring
a Capital Gains Tax
liability.
n Pension planning:
A limited company
structure allows for
greater tax efficiency
when Jack and Mary
are providing for their
pensions.
In the above example, the
annual loan payments of
€100,000 to Jack will cease
after 17.5 years as the loan
will be repaid. To maintain
Jack’s net income, the salary
will increase; when this
occurs the overall annual tax
liability would increase by
€72,000 meaning the annual
tax saving from incorporation
would reduce from €145,000
per annum to €73,000 per
annum.
This example is
standardised and condensed
and may over-simplify the
issues involved but, in the
circumstances outlined, it
clearly demonstrates that
incorporation can result
in significant income tax
savings. As incorporation
would impact on future plans
for retirement and succession
planning, care is needed to
ensure that tax reliefs are
preserved for future exit
strategies.
If you would like to discuss the
matters raised in this article,
please contact Stuart Fitzgerald of
Fitzgerald Power at 051-870152
or sfitzgerald@fitzgeraldpower.ie.
This article is general in nature
and does not purport to be a legal
guide or offer professional advice.
If you wish to act or refrain from
acting on the basis of the above
information, you should seek
independent professional advice.
Jack Mary Newco
Limited
Total
Taxable Income €35,000 €25,000 €350,000 €410,000
Income Tax / PAYE €5,350 €3,350 – €8,700
Universal Social Charge €1,770 €1,070 – €2,840
PRSI €1,400 €1,000 – €2,400
Corporation Tax – – €43,750 €43,750
Total €8,520 €5,420 €43,750 €57,690
“ As incorporation would impact on future
plans for retirement and succession planning,
care is needed to ensure that tax reliefs are
preserved for future exit strategies.”
30
IPUREVIEW AUGUST 2014

IRELAND’S N O 1
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Adults and children 12 years and over: 2 tablets in water three to four times in 24 hours as required; not more frequently than once every four hours. Maximum 8 tablets in
24 hours. Children under 12 years: Not recommended. Do not take for more than 3 days without consulting a doctor. Do not take any other paracetamol or codeine containing
products concurrently. Avoid excessive caffeine intake. Can cause addiction. Use for 3 days only. In case of overdose, seek immediate medical advice, even if the patient feels well.
Contraindications: Lactation, acute asthma, known hypersensitivity to ingredients, known CYP2D6 ultra-rapid metabolisers, patients under 18 years who undergo tonsillectomy
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liver disease, obstructive bowel disorders, previous cholecystectomy, acute abdominal conditions, pregnancy, hypertension, oedema. Interaction with coumarins (including
warfarin), domperidone, metoclopramide, colestyramine, monoamine-oxidase inhibitors. Side effects: anaphylaxis, bronchospasm, dependency or worsening of headache
following prolonged use, dizziness, GI disturbances, hepatic dysfunction, thrombocytopenia. PA 1186/11/1. MAH: Chefaro Ireland Limited, 1st Floor, Block A, The Crescent Building,
Northwood Business Park, Dublin 9. RRP (excl. VAT): 12s €4.99, 24s €7.99, 60s (GMS) €12.15. SPC: www.medicines.ie/medicine/6826/SPC/Solpadeine+Soluble+Tablets.

BUSINESS Aisling Daly
Supply v
demand
What happens in a business when supply of an item in demand is disrupted
Alternative means of obtaining supply of the item is achieved. In this article,
Aisling Daly, MSc in Security and Risk Management and Director at Tonic
Consultancy Ltd, gives advice on prevention and security measures.
An increase in
armed robberies
targeting craved
medicines across
a number of both
retail pharmacy chains and
independent pharmacies in
the previous 12 months has
become cause for concern.
Looking at the root cause
of the rise in these types of
incidents I came across recent
news articles by journalists
and feedback from An Garda
Síochána providing key
insights into the possible
causes for the rise in these
types of incidents. Reports
include that key medicines
which are being targeted
during pharmacy armed
robberies have become a hot
commodity with offenders
and organised crime gangs
in the past 18 months. This
may be in part due to the
lack of effective laws for
non-prescribed possession
of prescription medicines,
which allows offenders to
carry or be in possession of
these medicines with little
consequence when caught.
Also reported has been an
increased successful focus on
the seizure of these medicines
over the last 18 months as
follows:
n Reported increase of
seizure of prescription
medicines during Class
A drugs seizures.
n Clamp-down on illicit
mail order pharmacies
and importation of
prescription medicines
with many illicit online
sources closed down.
n Substantial increase in
seizure of prescription
medicines by customs
in last 18 months.
Increased demand for these
medicines and interruption
of supply by focused activity
of Garda, HPRA and Customs
may be displacing offenders
into other sectors, with the
most accessible being retail
pharmacy in order to obtain
these medicines.
At present, there is no
formal focus by relevant
bodies in attempting to
reduce the number of
successful armed robberies
in pharmacies. The possibility
of upcoming amendments
to the Misuse of Drugs Act,
which will increase the
accountabilities of prescribers
with regards to Z drugs will
likely add to this trend of
incidents. Therefore, it is vital
that the retail pharmacy
sector takes control of security
measures within their own
locations.
Most common factors
The focus of armed robberies
over the previous 12 months
has primarily targeted the
craved medicines, which
can be sold on for profit.
Retail pharmacy medicines
are unique in that craved
medicines are the only
retail items which are worth
more at street on-sale than
at retail value. This makes
them an attractive reward for
offenders.
By identifying the
contributing factors of
historic incidents, pharmacies
can produce controls and
processes to reduce the
likelihood of being perceived
as a soft target for offenders.
Known factors compiled
from post incident reviews
conducted over the previous
12 months have shown
patterns in incidents:
32
IPUREVIEW AUGUST 2014

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n Targeting of prescription
medicines and, in most
cases, cash from tills
takes place, rarely is
the CD safe or cash
safe targeted, leading
us to deduce that the
craved medicines are the
primary target.
n Most popular craved
medicines targeted are:
• Diazepam
• Anxicalm
• Zimovane
• Valium
n All cases involved one or
two offenders.
n No or little ‘obvious’
homework completed by
offenders and, in most
cases, offenders have
travelled outside of their
own living and operating
areas to commit the
offences.
n Times of incidents
were, in the majority
of cases, late night or
close to closing times,
usually in low footfall
areas. Times of incidents
targeted quiet times,
with minimal customers
in the premises.
n Successful offences
where the offenders
were not apprehended
have led to repeat
offences in some cases.
n High street location
pharmacies with no
barrier parking outside
or where ease of access
to motorway are
targeted.
n Average time taken is
one minute to complete
the offence.
n Mainly all female staff
base targeted.
Unfortunately, these types
of crime cannot be 100%
deterred as the offender type
may be driven by withdrawal
symptoms or desperation.
Bearing this in mind,
minimalising the negative risk
to staff safety must have been
addressed. The training of
staff in management of armed
robbery, basics of conflict
management and serious
criminal incidents will ensure
that their safety is maintained
during possible incidents.
Prevention and
control measures
Risk locations, which operate
with a number of the above
contributing factors, can be
managed by implementing
controls such as Situational
Crime Prevention Techniques1.
This entails reviewing and
addressing requirements in five
different areas, which provides
an overall security strategy
specific to that location.
A decision on which
action(s) is most suited to
the risk location is made and
the action applied. Finally,
the risk locations should
be constantly monitored or
evaluated to identify changes.
Changes in risk locations
can then be addressed
by completing the risk
management process again.
The five areas to be reviewed
to identify adequate control
measures.
1. Reduce or control of
reward to offender.
2. Increase the perceived
risk to the offender.
3. Increasing the perceived
effort to the offender.
4. Reducing provocation.
5. Removing excuses.
Reduce or control
of reward
The target of these incidents
are specific medicines utilised
for on-sale by criminal
offenders and cash from
till points. Possible controls
may include:
n Education on minimal
ordering and carrying of
targeted medicines.
n Removal of targeted
rewards by placing in
areas not visible to the
public.
n Education regarding
importance of cash lifts
prior to high risk times.
n Signage regarding timelock
safes and access to
cash by staff.
Increasing the
perceived risk
The perceived risk to an
offender of being caught is
centred on being identified or
caught in the act of the crime.
Possible controls used to
increase this perception may
include:
n Increase of natural
surveillance. Both
outside the pharmacy in
areas where an offender
can conceal themselves
and inside the pharmacy,
so offenders can be
“ By identifying the
contributing factors
of historic incidents,
pharmacies can
produce controls
and processes
to reduce the
likelihood of being
perceived as a soft
target for offenders.”
viewed by footfall
outside the pharmacy.
n External lighting
increases the possibility
of offenders being seen
prior to entering the
pharmacy by members
of the public.
n Formal surveillance
techniques such as
CCTV controls.
n Immediate dispatch of
Garda through mobile RF
Panic Alarms.
n Immediate dispatch
of Garda through
monitored total security
RF systems linked to
CCTV systems (signage
is required for this to
act as a deterrent as
this may not be obvious
to an offender prior to
entering the pharmacy).
Increasing the
perceived effort
This is location-specific and
must take into account how
‘easy’ an offence is perceived
by the offender. Possible
control measures include:
n Access control systems.
Controlled access to
the public during high
risk times, such as after
6pm or minimal footfall
times.
n Restriction of access to
the dispensary areas. Use
of counters and barriers.
n Restricting access to
targeted reward.
n Manned guarding.
Reducing provocation
Managing an incident as it
takes place is vital to ensure
the safety of staff in these
situations. As it cannot be
guaranteed that adequate
measures will eliminate
this type of crime, adequate
training must be provided to
staff in high-risk locations
to ensure that their safety is
maintained and that they do
not provoke violence during
these incidents. Possible
measures include:
n Training, such as threat
recognition, basic
34
IPUREVIEW AUGUST 2014

conflict management
and personal safety
techniques can aid staff.
n SOPs and Policy
documents for all
locations covering the
basic security and
safety points.
Removing excuses
This area covers the
management of policies,
procedures and controls by
the locations management
team and staff. Ensuring
support is provided to the
team to aid compliance of
these measures increases
the likelihood that they will
be adequately enforced and
maintained. Possible measures
may include:
n Allowing adequate
staffing levels to ensure
key security and safety
tasks are completed.
n Providing support
regarding training and
additional clarification.
n Setting of clear rules,
which are reviewed
regularly and
communicated to all
staff.
n Providing clarity
regarding benefits
of compliance and
consequences of noncompliance.
Also important is following
up on suspicious behaviour,
or offenders doing their
homework. All suspicious
activity must be reported
to the Garda as this could
successfully deter an incident.
In the event that your
pharmacy is victim of an
armed robbery, it is vital that
your staff have been given
the knowledge and skills to
deal with such an incident.
The objective of offenders
is to get into the pharmacy
unseen, get what they want
and get away as quickly as
possible. Ensuring that staff
members do not impede
the offender’s objectives
will ensure their safety is
maintained. As a minimum,
staff members should be
briefed on the principles
of the Garda programme
of COOP:
C-operate: Stay calm
and do what the
offender wants.
O-bey: Provide the
offender with what
they want.
O-bserve: Obtain
description and listen
for names used.
P-reserve: Secure
premises, call Gardaí
and never follow an
offender.
Never forget that your staff is
your most valuable asset and
should be protected.
1 Clarke, R.V. & Homel, R., (1997) A Revised Classification of Situational Crime Prevention Techniques in Lab, S. (ed), Crime Prevention at a Crossroads, Cincinnati, OH,
Anderson Publishing Co.
7th All Ireland Pharmacy Conference
7th All Ireland Pharmacy Conference
The 7th All Ireland Pharmacy
Conference is being held on
26 and 27 January 2015 at
Ballymascanlon House Hotel,
Dundalk. This Conference is
held biennially and is funded
by a number of pharmacy
organisations. Its focus is
to share good practice in
pharmaceutical care and
practice development across
the primary and secondary
care sectors. Pharmacists,
technicians and qualified
assistants will be encouraged
to exchange ideas for
pharmaceutical service
development in Northern
Ireland and in the Republic of
Ireland.
Call for abstracts
Abstracts that deal with a
broad range of pharmacy
practice are invited, including
(but not limited to) the
following areas:
n Collaborative initiatives
n Leading innovation
n Medicines management
n Medicines safety
n Service development
Abstract format
Conference abstracts should
be submitted via the Irish
Institute of Pharmacy website
(www.iiop.ie) using the courses
and events link.
Applicants should clearly
indicate the corresponding
and presenting author(s)
and whether they wish their
abstract to be considered for
poster or oral presentation (10
minutes plus 5 minutes for
questions).
The closing date for receipt
of abstracts is Friday 26
September and authors will be
notified regarding acceptance
by Friday 10 October.
IPUREVIEW 7th AUGUST 2014 All Ireland Pharmacy Conference 35

BUSINESS Enda Harte, Sales & Marketing Manager, JustScan Ltd
Trouble
shooting tips
for your Epos
hardware
In the July edition, I
went through the various
considerations when
deciding on a website
for your pharmacy. This
month, we are going
to focus on some basic
trouble shooting tips for
your Epos hardware.
While you
feel that
you may
be too busy
to troubleshoot
a problem or perhaps
that you do not have enough
technical knowledge,
understanding the basics
about your Epos hardware
may save you time and money
when something goes wrong.
Computer/integrated
computer
All Epos solutions include
some form of computer – it
could be a tower unit similar
to what you are using in your
dispensary or an all-in-one
‘integrated’ unit. As you may
already know, computers can
slow down over time so it’s no
harm to restart your unit(s)
once a week. This refreshes
everything on the computer.
Be careful when restarting
your computers as they may
need to be done in a certain
sequence. For example, if the
main unit (or server) has to
be restarted, you should exit
out of the Epos software on
all units to avoid potential
problems.
If the till is not working and
there is no power light, make
36
IPUREVIEW AUGUST 2014

Formerly known as:
Services and Products
PharmaSource is Ireland’s leading
supplier of unlicensed medicines.
PharmaSource can help reduce
the valuable time our customers
are spending searching for
medicines that are currently in
short supply or discontinued in the
national market. We can source
these products for you.
PharmaSource supply our
customers with an extensive range
of manufactured specials including
liquids to meet the needs of
geriatric and paediatric patients
with unique swallowing
requirements.
PharmaSource supply a range of
creams, ointments, gels, powders,
suppositories, tablets and capsules
tailored to the unique needs of
your patients.
PharmaSource have an
unparalleled range of products in
stock including cold chain and
controlled drugs. We have
immediate access to a database of
more than 1 million medicines
worldwide all of which can be
easily ordered via our website.
PharmaSource have expertise
in logistics, national and
international regulatory affairs,
HSE reimbursement
policies and quality
control.
Why partner with PharmaSource
We are an Irish company with a
combined history of serving Irish
pharmacies since 2006.
We offer a tried and tested service you
can rely on. The Pharmasource team is
made up of qualified pharmacists and
technicians who understand the
importance of delivering your order on
time every time to meet the needs of
your valued patients.
Market leading price structures.
Multichannel ordering options: Via our
website, fax or email makes placing
your order very easy.
The majority of customer orders are
dispatched with their next scheduled
delivery*.
Contact details:
4045 Kingswood Road,
Citywest Business Park, Co. Dublin.
Free Phone: 1800 440 440
Free Fax: 1800 441 441
Email: Pharmasource@uniphar.ie
Web: www.uniphar.ie
Pharmasource is a division of the Uniphar Group.
*In some cases products that are difficult to source may take longer, please call 1800 440 440 for more information.

sure to first check that nothing
has tripped on the fuse board.
If it has, flick the trip switch
and power on all units, again
in the correct sequence. If your
till system is connected to a
UPS (backup power supply/
surge protector), make sure
that it is powered on. If there is
still no power, the final option
before calling your supplier is
to use a different power cable.
All computers use a similar
power cable (like a kettle lead).
Keep IT clean
Epos hardware (because of
the environment) can attract
a lot of dust. It is important
that you keep the hardware
itself clean, but also you must
keep the area around the till
clean and free of clutter. This
is especially important if you
have a PC under the counter.
Sometimes it is quicker and
easier, to carefully vacuum
the dust rather than using a
cloth. Dust can clog up fans,
which affect the performance
of the unit and may cause
parts to blow. Make sure also
to keep the area around the
PC/till clear from obstructions.
If there are items blocking the
fans or vents on the PC, it may
cause it to overheat.
Blades are often used in
pharmacies to open boxes in
a delivery. These blades are
usually left lying around on
top of keyboards and tills. It
is important to store these in
a safe place away from the
tills as they can fall down into
the units or under keyboards
and cause problems with
performance.
Monitors/touchscreen
monitors
If your screen is blank, the
power lead could be slightly
out of the socket at the back of
the monitor, the plug may be
loose or the VGA cable could
be loose. Check both ends of
all cables coming out of the
back of the monitor. If all
seems ok, try a different power
cable. Again, the power cables
for all monitors are similar to
that of the PC (kettle lead).
Over time, touch screens can
go a little off centre. While your
finger may be touching one
part of the screen, the software
may be pressing the button
above this. All touch screen
monitors have software that
lets it know what part of the
screen you are touching. There
should be a program called
ELO at the bottom of your
screen just beside the ‘Time’.
If you open this program, you
will see a calibrate option.
Select this option and follow
the instructions to calibrate
the screen. This will most likely
include pressing the centre of
‘Target Icons’ as they appear
on the screen. Once this is
done (usually four times),
the screen is more accurate.
I would highly recommend
that you do not use a pen or
any other object, which could
damage or mark the screen.
Cash drawers
Nearly all cash drawers are
plugged into the back of the
receipt printer. A loose cable
may cause a cash drawer not
to open when it should. The
cash drawer connection looks
like an ordinary phone cable.
If reconnecting this cable does
not fix your problem, there
may be an issue with your
receipt printer.
Receipt printers
Many receipt printer problems
are resolved by simply
powering the printer off and
on again, a ‘re-set’ as such.
The power button is usually at
the front or side of the printer.
There are usually three cables
going into the rear of your
receipt printer; one is for the
cash drawer, the next is for
power and the last one is a
data cable which allows the
computer to talk to the receipt
printer. If the ‘re-set’ has not
resolved your issue, ensure
that all cables are plugged
securely and restart the printer
again. Check to see that there
is paper in the receipt printer
and that the door is closed
firmly on it. (There may be a
red light flashing to indicate
‘Paper Out’). Most receipt
paper has a pink/red back on it
as it nears the end. When you
notice this, have a new till roll
ready to drop in. Most receipt
printers use 80 x 80 thermal
till rolls and are available from
stationery supply companies.
Barcode scanners
If the barcode scanner is
not working, the cable may
have come loose. Plugging
the cable out and in again
usually resolves this problem.
If the scanner has a rounded
PS2 connection, this must
be plugged into the round
purple keyboard socket of
the computer. If this does not
work, you may need to restart
your computer.
Broadband
If you are changing broadband
provider or getting a new
router, please make sure to
contact your Epos provider.
A router change may affect
internet access on the tills
or may affect your supplier’s
remote support access.
Backups
It is important to check your
backups regularly as it is only
when something goes wrong
that you realise how important
your data is.
If a piece of equipment
stops working, check and see
if something changed. Did
someone unplug something
in the dispensary or move
something which may have
loosened a cable These
are the basic questions to
ask when trouble shooting
hardware problems. If you
still can’t resolve your issue,
contact your Epos provider
who will be able to help you
troubleshoot the issue. If you
are unsure about something,
always contact your provider
first. Most customers upgrade
their hardware every five to
seven years to take advantage
of newer technologies and to
speed up the transaction times
at the tills.
Enda Harte is Sales & Marketing
Manager with JustScan Ltd who
develop and sell their own Epos
solution, PharmEpos. PharmEpos
has been tailored for the specific
needs of the Irish pharmacist.
For more information or a free
consultation, contact Enda on 071-
9130488 or visit www.justscan.ie.
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38
IPUREVIEW AUGUST 2014

POLITICS Stephen O’Byrnes
Calls for introduction
of maximum prices
for emergency
contraception products
Concern about the price of emergency contraception products was raised in the
Dáil and Seanad recently and there were calls for the introduction of maximum
prices. The role of pharmacists in reviewing patient medications was also
discussed in the context of according them a greater role in this area.
Alex White, Labour
Brendan Griffin, Fine Gael
Michael Healy-Rae, Independent
Colm Burke, Fine Gael
Contraception
drugs on Irish
market
There are currently two
levonorgestrel emergency
hormonal contraception
products licensed for sale on
the Irish market, Levonelle
and NorLevo. Levonelle is a
prescription-only product,
which is currently included
on the list of reimbursable
items for the GMS and other
community drug schemes. This
product is therefore available
to medical card holders under
the GMS Scheme, subject to
the prescription charge, once
they have a prescription from
their GP.
The other levonorgestrel
emergency hormonal
contraception product
licensed for sale on the Irish
market is NorLevo, which
the Irish Medicines Board
approved for sale without
prescription in 2011. Therefore,
this product may be supplied
from pharmacies without a
prescription by or under the
personal supervision of the
pharmacist.
This information was
outlined in the Dáil recently by
the then Minister of State for
Health, Alex White (Labour,
Dublin South) in response to
Deputies Brendan Griffin (Fine
Gael, Kerry South) and Michael
Healy-Rae (Independent, Kerry
South) who raised questions
about the cost of emergency
contraceptive products.
Deputy Healy-Rae had
asked the Minister to set a
maximum price for NorLevo
to be paid by patients and to
consider making emergency
contraception available free
to medical card holders,
without prescription. Deputy
Griffin called for regulations
to impose maximum price for
emergency contraception.
The Minister of State said
that the HSE advises the
public that if they are being
charged prices which exceed
the reimbursement price
listed on the HSE website, plus
a dispensing fee of between
€3.50 and €5, then they should
discuss the differential with
their pharmacist to ensure
that they get the best possible
price for the medicine
concerned.
“In addition, measures have
been taken to increase price
transparency among retail
pharmacies. In March of this
year the Pharmaceutical
Society of Ireland issued
guidelines to pharmacists on
procedures and minimum
standards of information to
be provided to customers,
including a requirement to
provide an itemised receipt of
purchase of medicines.”
The subject was also
raised in the Seanad recently
by the Fine Gael Health
Spokesperson, Sen. Colm
Burke, who said it had been
brought to his attention by the
Union of Students in Ireland,
which claimed that “the cost
of the relevant medication can
vary quite substantially, from
€9 to over €45”.
Replying on behalf of
the Department of Health,
the Minister of State for
Health, Deputy Kathleen
Lynch (Labour, Cork North
Central), said that the
Pharmaceutical Society of
Ireland had issued guidelines
under the Pharmacy
Act 2007 to pharmacists
requiring that the emergency
hormonal contraceptive
may only be supplied to a
patient by the pharmacist
personally, following a private
consultation between the
patient and pharmacist in
order that the pharmacist can
determine the appropriateness
of the supply and to provide
an opportunity to meet
the appropriate patient
counselling requirements. This
consultation is required to
take place in the pharmacy’s
patient consultation area.
“However, as NorLevo is an
over-the-counter product it
no longer complies with the
40
IPUREVIEW AUGUST 2014

applicable reimbursement
criteria for the GMS scheme
and the community drugs
schemes, as a prescription
is not normally required
for its supply to a patient.
Therefore, for all recipients
of this product, the supply
process is essentially a private
transaction between the
patient and the pharmacy”,
she added.
Pharmacists’ role in
reviewing patients’
medicines
Also in the Seanad, the Fine
Gael Health Spokesperson,
Sen. Burke, supported what
he said had been a proposal
of the Irish Pharmacy Union
to operate a new medicine
service for people with a longterm
illness who experienced
complications with new
medications, but were
reluctant to go back to their
GPs.
Sen. Burke said “pharmacists
are offering to provide a
follow-up service where the
person could come back to the
pharmacy within a three to
five day period, to ensure that
the medication prescribed is
working and that they do not
have difficulties with it, and if
difficulties arise they will be
dealt with at an early stage”.
Deputising for the then
Minister for Health, Minister
Leo Varadkar said that
under the 2007 Community
Pharmacy Contractor
Agreement and prior to
dispensing a prescription,
“a community pharmacy
contractor must ensure
that a pharmacist reviews
the medicine therapy of the
individual for whom the
prescription is issued. The
review shall include screening
for any potential drug therapy
problems which may arise out
of the use of the medicines
prescribed, including
therapeutic duplication; drugdrug
interactions, including
serious interactions with
non-prescription or over-thecounter
medicines or food;
incorrect dosage or duration of
drug treatment; drug allergy
interactions; and clinical
abuse and-or misuse.
“The review shall also
include an examination
of the rationale and costeffective
use of the medicine
prescribed, including the
choice of the medicine and
the potential for wastage.
Following the completion of
the review the pharmacist
shall offer to discuss with
the individual for whom
the prescription was issued
all such matters as the
pharmacist, in the exercise
of his or her professional
judgment deems significant,
including any special
directions and precautions
for correct preparation,
administration and use of the
medicines; the importance of
compliance and the directions
for use; any common severe
side-effects and adverse
reactions or interactions and
therapeutic contra-indications
that may be encountered,
including their avoidance and
the action required should
they occur; techniques for
self-monitoring during therapy
and the need for patient
compliance; prescription
repeat information, as
necessary; and, as necessary,
any other matters which may
be included or referred to in
the patient information leaflet
supplied with the medicine”.
He said that the existing
agreement, therefore,
“provides that pharmacists
deliver a comprehensive,
ongoing support service
to their patients in terms
of ensuring they are fully
informed of all issues
pertaining to their prescription
medicines”.
Referring to the
government’s Future Health
strategy document, Minister
Varadkar said that as part
of its implementation,
“pharmacists will be expected
to identify and contribute to
implementing evidence-based
and cost-effective solutions
to ensure the effectiveness
and sustainability of the
healthcare system, by
addressing key medication
issues such as medicines
wastage, inappropriate usage
of medicines, supporting and
improving chronic disease
management and patient
adherence to medication.
The Minister for Health looks
forward to working closely
with pharmacists who will
have an important role to play
in delivering on the goals of
Future Health”.
Drug would cost
€437,247 per
patient per year
Deputy Sean Fleming (Fianna
Fáil, Laois-Offaly) asked the
Minister for Health when
the Health Service Executive
expected to reach a decision
on the approval of eculizumab
in the community drugs
scheme.
Minister of State White
said the HSE had received an
application for the inclusion
of eculizumab (brand Soliris)
in the community drugs
schemes. The National Centre
for Pharmacoeconomics
(NCPE) had conducted an
evaluation of the drug, “and
concluded that, at a total
cost per patient per year of
€437,247 and a cumulative
gross budget impact over
five years estimated at €33
million, the therapy did not
represent value for money
for the treatment of patients
in the Irish healthcare
setting. In addition, the
manufacturer did not include
an economic model as part of
their submission and failed
to demonstrate the costeffectiveness
of this therapy.
“Consequently, the NCPE
was unable to recommend
reimbursement of the product
under the community drug
schemes”. The HSE was
carefully considering all
the issues in relation to the
proposed benefits and costs
of this medicine and expected
to reach a decision in the near
future, he added.
Central purchasing
of drugs not
feasible
There is no scope for
introducing a central
procurement arrangement
for the most expensive and
the most commonly used
drugs, Minister of State
White told the Sinn Féin
Health Spokesperson,
Deputy Caoimhghín Ó
Caoláin (Cavan-Monaghan),
who called on the Minister
to quantify the full-year
savings from sourcing the
20 most expensive and 20
most common on-patent
pharmaceuticals from the
Kathleen Lynch, Labour
Leo Varadkar, Fine Gael
Sean Fleming, Fianna Fáil
Caoimhghín Ó Caoláin, Sinn Féin
IPUREVIEW AUGUST 2014 41

Gerry Adams, Sinn Féin
Thomas Pringle, Independent
Catherine Murphy, Independent
Bernard Durkan, Fine Gael
Michael Lowry, Independent
State where the cost of the
drug was the lowest in Europe.
Minister of State White
said that most drugs and
medicines which are paid for
by the HSE were supplied to
patients through over 1,800
community pharmacies who,
in turn, purchase them from
wholesalers or, to a lesser
extent, directly from drug
manufacturers. “The current
pharmacy-based model
results in over 70 million items
being dispensed annually
through local pharmacies
across the State, including low
population centres in rural
areas.
“It enables pharmacies to
receive deliveries each day
from multiple wholesalers
ensuring that all patients have
continued access to essential
medicines without delay.
Under this model, as the drugs
are purchased by individual
pharmacies with no direct
input by the HSE, there is no
scope for the type of central
procurement arrangement
envisaged by the Deputy”.
127 pharmacies in
needle exchange
programme
The Pharmacy Needle
Exchange Programme (PNEP)
has continued to expand
needle exchange services
outside the Dublin area,
creating accessible harm
reduction services within the
community pharmacy setting.
By the end of 2013, there were
97 pharmacies participating
in the PNEP and a further
30 pharmacies have been
recruited to the programme
in 2014, bringing the total
participating to 127.
This was stated in the Dáil
recently by Minister of State
White when responding to
a question from Sinn Féin
Leader, Deputy Gerry Adams
(Louth), who asked the
Minister to refocus spending
in the area of drug policy on
public health interventions
“in view of the need for
comprehensive needle
and syringe programme
coverage, and the fact
that the pharmacy needle
exchange programme does
not meet the needs of all that
require needle and syringe
programme services”.
Minister of State White said
that the Department of Health
has no plans to introduce
medically supervised injecting
centres at present. “My focus
is on ensuring that there is
an increased emphasis on
providing the opportunities
for people to move on from
illicit drug use, through drug
treatment and rehabilitation,
to a drug-free life where that
is achievable”. He said that the
HSE had completed a review
of needle exchange provision
in Ireland, which will be
published shortly.
People with LTI
and GMS eligibility
to be reimbursed
prescription
charges
The HSE is actively working
to identify people who had
eligibility under both the longterm
illness (LTI) scheme and
the medical card scheme, but
who had to pay prescription
charges prior to 1 December
2013 for drugs, medicines,
medical and surgical
appliances related to their
qualifying long-term illness,
or illnesses, with a view to
refunding them the money
they paid in prescription
charges.
This was stated in the Dáil
recently by Minister of State
White, who confirmed that
arising from a policy change
last year, the HSE had decided
that persons who had both a
medical card and an LTI book
could now access medication
for their qualifying long-term
illness condition or conditions
under the LTI scheme.
Up to that date, in the
case of persons who had
both a medical card and an
LTI book, it had been HSE
policy that they should use
their medical card to access
medicines, thereby incurring
prescription charges. “The
main reason for this was that
when a retail mark-up of 20%
was payable to pharmacists
for items supplied under
the LTI scheme, it cost the
HSE considerably more to
supply medicines under that
scheme than under the GMS
scheme”, the Minister of State
explained.
The matter had been raised
by Deputy Thomas Pringle
(Independent, Donegal South-
West), who asked when “the
HSE would reimburse patients
on the LTI scheme, who are
also medical card holders, the
prescription charges they were
wrongly charged as a result
of having to use their medical
cards to obtain prescription
items, rather than their LTI
card”. He also complained that
the HSE had not yet disclosed
how many people were
affected.
The Minister of State said
that prescription charges had
been introduced in 2010 and
that the HSE was collating
details of the numbers
affected and how much they
will be refunded.
Wider availability of
adrenaline pens
The Department of Health
was currently examining the
feasibility, taking account
of policy and patient safety
considerations, of amending
the Prescription Regulations to
facilitate wider availability of
adrenaline pens in emergency
situations, by persons trained
in the administration of these
pens, the Minister of State for
Health, Deputy White, told
the Dáil.
“This is a complex area
and includes consideration
of a wide range of issues
such as appropriate training,
including in the identification
of anaphylaxis, conditions
attached to use of the
adrenaline pen, product
availability and product
shelf life. My Department is
working closely with the Irish
Medicines Board (IMB) and
the Pharmaceutical Society of
Ireland (PSI) on these issues”.
The Minister of State was
responding to a range of
questions on the matter from
deputies, including the Sinn
Féin Leader, Deputy Adams,
and Deputies Catherine
Murphy (Independent, Kildare
North), Bernard Durkan
(Fine Gael, Kildare North) and
Michael Lowry (Independent,
Tipperary North).
42
IPUREVIEW AUGUST 2014

Systane Ultra Systane Gel Drops Systane Balance

STUDIES
Vfend ® (Voriconazole) new indication is approved for children aged 2 years
and above and adults in oral and IV formulations
Pfizer Healthcare Ireland recently announced that Vfend ® (voriconazole) received European Commission approval on 24 June 2014
for a new indication in prophylaxis of invasive fungal infections (IFIs) in high-risk allogeneic hematopoietic stem cell transplant
(alloHSCT) recipients.
The European Commission’s decision to approve Vfend ® for prophylaxis of IFIs in high-risk alloHSCT recipients is based on phase
III clinical trials (IMPROVIT and VOSIFI studies) showing the effectiveness of Vfend ® for primary and secondary prophylaxis of IFIs in
alloHSCT recipients.
Vfend ® is available in both oral and IV formulations, making it convenient for patients and clinicians, and the recommended
dosing for prophylaxis is the same as the well-established regimen for Vfend ® in the treatment of IFIs.
In the prospective, randomised, open-label, multicentre IMPROVIT study of primary antifungal prophylaxis in alloHSCT recipients,
success of prophylaxis in patients receiving Vfend ® was superior to itraconazole (48.7% vs 33.2%, p

STUDIES
IPF Phase III trial results published in New England Journal of Medicine (NEJM) show
nintedanib slows disease progression by approximately 50% compared with placebo
Results from the Phase III INPULSIS trials, published online in the New England Journal of Medicine, show nintedanib significantly
slowed disease progression in patients with idiopathic pulmonary fibrosis (IPF). Nintedanib is the first targeted treatment for IPF to
consistently meet its primary endpoint in two international Phase III trials with identical design.
Idiopathic pulmonary fibrosis (IPF) is a progressive and severely debilitating lung disease with a high mortality rate. It causes
progressive scarring of the lungs, resulting in continual and irreversible deterioration in lung function and difficulty breathing. In
patients with IPF, lung function loss is measured by a decline in a patient’s forced vital capacity (FVC), the maximum volume of
breath that can be exhaled. The average IPF patient has lung volume loss of between 150-200ml per year, compared to a normal
adult lung volume decline of approximately 50ml per year.
In the two, 52-week INPULSIS trials, involving 1,066 patients, nintedanib significantly reduced the annual decline in FVC by
approximately 50% compared to patients taking placebo. The annual rate of decline in each identical arm of the trial were:
- INPULSIS-1: -114.7mL (nintedanib*) vs. -239.9mL (placebo)
- INPULSIS-2: -113.6mL (nintedanib*) vs. -207.3mL (placebo)
Both key secondary endpoints were met in the INPULSIS-2 trial. There was significantly less deterioration in quality of life
(as measured by the St. George’s Respiratory Questionnaire) and a reduced risk of a first acute exacerbation in patients taking
nintedanib, compared to placebo.
In INPULSIS-1, there was no statistically significant difference between the nintedanib and placebo groups in the key secondary
endpoints.
In both trials, the most common adverse events were gastrointestinal in nature, of mild to moderate intensity, generally
manageable and infrequently led to treatment discontinuation.
The most frequent adverse event in the nintedanib groups was diarrhoea, reported in 62% of patients vs. 19% in the placebo
arm (INPULSIS-1) and 63% vs. 18% (INPULSIS-2). Less than 5% of those who experienced diarrhoea in the nintedanib groups of
INPULSIS-1 and INPULSIS-2 discontinued treatment due to this event.
The proportion of patients with serious adverse events was similar in all groups.
Rheumatoid arthritis patients given more treatment choice with new self-injection
formulation of abatacept
Abatacept solution for subcutaneous injection (SC Orencia ® ) is now available in Ireland, in combination with methotrexate (MTX),
as a first-line biologic agent for adults with severe rheumatoid arthritis (RA), after failure with conventional disease modifying
anti-rheumatic drugs (DMARDs), including methotrexate (MTX) or a tumour necrosis factor (TNF)-alpha inhibitor. Abatacept is the
only biologic available for both the self-injectable SC and intravenous (IV) formulations, for the treatment of RA, therefore giving
physicians and RA patients in Ireland more choice in treating and managing their condition.
Abatacept has a unique mode of action and combines sustained efficacy and a well-established safety profile to enable patients
with RA to reach their treatment goals. The new SC formulation gives patients the convenience and freedom to self-administer at
home, removing the need to take time off work or travel to receive IV formulations that are usually administered in hospital.
Around 40,000 people are affected by RA in Ireland with associated treatment costs estimated at around €544 million including
medical costs, drug costs, non-medical costs, the costs of informal care and other indirect costs. The new SC formulation of
abatacept which will be available under the Hi-Tech scheme enables patient care to be transferred to the community, dispensed
through local pharmacies rather than hospital pharmacies and it may offer an opportunity to reduce the burden on secondary care
and improve patient experience.
The European marketing authorisation approval of the SC formulation is based on the ACQUIRE study, the single largest phase
III registrational trial of biologics in RA patients, as well as long-term efficacy and safety data from supporting phase II studies. In
ACQUIRE, the SC and IV formulations of abatacept were compared and shown to be similar in terms of efficacy and safety (noninferiority
comparison).
Johanna Mercier, General Manager, Bristol-Myers Squibb, UK and Ireland, said, ‘This is an important milestone for clinicians and for
patients in Ireland as they now have an option to self-inject abatacept to treat this disabling chronic condition.’
Abatacept, in combination with MTX, is indicated for the treatment of moderate to severe active RA in adult patients who
responded inadequately to previous therapy with one or more DMARDs, including MTX or a tumour necrosis factor (TNF)-alpha
inhibitor.
LINK-banner-ad.qxp_Layout 1 16/05/2014 16:57 Page 1
Our new look Link guide is now available.
Not a member
of Link
To join contact your Uniphar Representative.
Details available on www.unipharcontact.ie
Open to ALL Community Pharmacies.
IPUREVIEW AUGUST 2014 45

WINE James Tobin, Wine Taster and Lecturer, O’Briens Wines
Here in Ireland, with our gloriously unpredictable
climate, there is certainly no guarantee of warm
sunny weather in the summer months. However,
when the weather is good we need to be prepared
to seize our opportunity for al-fresco dining. With
this in mind, James Tobin has put together a few
tips and recommendations for Summer Sipping.
In warmer weather, we
are more likely to be
eating lighter foods,
cold dishes and salads.
In a wine, this means
we should be looking for
refreshment, crispness and
juiciness; also, because quite
often these dishes will tend
to be dressed with vinaigrette
rather than a sauce, we need
to look at wines with fairly
high to high acidity.
Texture and body-wise, I
would lean toward something
juicy and not too heavy,
viscous or full-bodied. Lower
alcohol wines are often a
better choice as, for many
people, the heat accentuates
the influence of the alcohol.
Taking all of this into
account, it should come as
no surprise that I will be
recommending a number
of white, rosé and sparkling
wines as the idea of big
chunky reds in summer
weather can be quite
daunting.
For those who don’t want
to deny themselves their
red wine, don’t worry, I will
be suggesting some suitable
alternatives.
First off, I
think we should
look at some
fizz. Rizzardi
Prosecco
Frizzante
(€14.99 or two
for €25 for
the month of
August) is a
gently sparking
white made
from the
Glera grape
variety grown
in vineyards
near Venice. It has flavours of
ripe pear and white peach on
the palate and is not too dry,
too fizzy or too acidic, so it
tends to suit most tastes. It’s
the ideal aperitif to kick off a
summer garden party, or even
just to sip while watching the
sun go down. Pop a raspberry
into the glass for a touch of
luxury.
With the current craze for
Prosecco, it is easy to forget
just how delicious a good
bottle of Cava can be. La Rosca
Cava (€14.99 down from €17.99
for the month of August) is
made using grapes picked
from high altitude vineyards
in Penedès
and is bottledfermented
(just
like Champagne).
All in all, this
leads to a very
modern, fruit
driven Cava,
which is zesty
and lively and
with loads of
fresh apple and
lemon fruit. Not
in any way sharp,
it is soft and
rounded, making
for a very easy to drink
sparkler.
There are certain white
grape varieties and wine
regions that I always associate
with summer days, such as
Sauvignon Blanc from France’s
Loire valley, Albariño from
Galicia in Northern Spain,
dry Riesling from Germany
and the mineral-driven
whites, which emanate from
Campania in southern Italy.
Whilst I have enjoyed
many an oaked white wine in
summer, my tendency is to
buy un-oaked, as they usually
taste lighter and are easier to
drink.
Petit Bourgeois
Sauvignon Blanc
2012 (€11.99
down from €15.99
for the month of
August) is made by
renowned Sancerre
producer, Henri
Bourgeois. This
‘baby Sancerre’, as
it is affectionately
dubbed, attracts
huge plaudits
each year for its
quality and value.
It is beautifully
fragrant with ripe citrus
fruit aromas and flavours
along with mouth-watering
minerality, striking the perfect
balance between New World
aromatic intensity and Old
World restraint.
Pazo Señorans 2012
(€18.99 down from
€20.49 for the month
of August) is a very
classy wine from
arguably the finest
estate in the Rias
Baixas region. This is
a perfect example of
premium Albariño,
delicately floral on
the nose with hints
46
IPUREVIEW AUGUST 2014

of lemon and pear. This opens
up on the palate to reveal a
complex, mineral-driven white
with an incredibly long finish.
Above all else, the purity of
fruit is extraordinary!
The comeback
of Riesling is truly
underway and
with excellent dry
German Rieslings
like Schönborn
Riesling Trocken
2013 (€14.49 down
from €16.49 for the
month of August)
on the market
it’s no wonder.
Medium bodied,
with deliciously pure
green apple fruit and
great minerality this
is a classic dry Riesling from
the oldest estate in Germany,
under continuous family
ownership – 21 generations
spanning over 660 years. No
other estate in the Rheingau
possesses such a selection
of fine vineyards as this
highly traditional property
in Hattenheim.
From volcanic
soils in the hills
of Campania,
Terredora
Falanghina IGT
2011 (€15.49 down
from €17.49 for the
month of August)
justifiably takes
its place among
the greatest white
wines Italy makes
today. This has
everything a top
quality white
should have; depth,
richness, complexity and
thrilling minerality. A ‘must
try’ wine.
Rosé offers the perfect bridge
between white and red wines
and these wines really come
into their own in the summer
months. For me, nothing says
summer quite like a crisp
refreshing glass of rosé.
Now, there was a time not
so long ago when rosé wines
were considered deeply
unfashionable, mainly due
to preponderance of overly
sweet, pink lemonadestyle
rosé emanating from
California among other
places. Today, however, rosé is
one of the most vibrant and
interesting wine categories,
thanks mainly to the influence
of the many delicious dry rosé
wines produced in the south
of France.
Like all proper rosé wines,
these wines are made using
the saignée method, whereby
the freshly picked black grapes
are left to stand in a vat and
the weight of the grapes does
the crushing. This free-run
grape juice is only in contact
with the black grape skins for
a very short period resulting
in a very pale pink wine. These
rosés usually share some of
the presence and structure of
red wines, only written with
a lighter hand. To enjoy them
at their best, chill them, but
don’t freeze them to death
and you have a great summerweight
substitute for many
red wine situations.
Where rosé’s star really
shines though, is when it
comes to food-matching,
probably because of the fact
that it expresses some of the
character of both red and
white wines. Whether you are
serving Asian cuisine, tapas
or a salad, hot or cold dishes,
meat, fish, or vegetables, or
even with a BBQ, rosé will
offer a tasty match. In fact,
very few other wine-styles are
quite so versatile.
It is no secret
that the most
prestigious
rosés come from
Provence and
Château Riotor
Rosé 2013 (€16.49
buy 1 get 2nd
½ price), is a
superb example.
Wonderfully
pale in colour
but with superb
depth of fruit, this
structured food
style is ideal for
summer lunches.
Supremely elegant in style,
Château De Sours 2013 (€16.99
buy 1 get 2nd ½ price) is a
stunning Bordeaux
Rosé, which has
a nose of red
berries and rosepetal,
leading to
mouth-watering
strawberries and
cream on the palate.
It is surprisingly
full and rich yet
balanced by lovely
refreshing acidity
and a long dry finish.
Now, I’m sure the thought of
drinking Rosé will give some
red fans the shudders, but it is
possible to enjoy full-flavoured
reds without being weighed
down.
Some red grape varieties
lend themselves to the idea of
summer drinking more than
others. Pinot noir in particular
provides the sort of throttledback
red that suits summer
situations. Now that his Pinot
Noir vines have reached
full maturity,
acclaimed
winemaker
Simon Waghorn
is fashioning
superb, almost
Burgundian
Pinot Noir at his
Marlborough,
New Zealand
estate. Fragrant,
complex and with
a great purity of
ripe wild berry
fruit, Astrolabe
Pinot Noir 2010
(€22.49 down from €25.49 for
the month of August) is an
utterly delicious summer red.
We should also consider
that some red wines are
designed to take a chill, It’s
amazing what a difference
a light chill can make; but
remember, cold is the enemy
of aroma and flavour in wine,
so be careful not to overdo
it. These wines are usually
fruity (but not sweet) reds
with low levels of tannin, the
benchmark for this style is a
Beaujolais Cru such as Fleurie,
made using the carbonic
maceration method, which
doesn’t extract much tannin
from the Gamay grapes. Also
worth trying chilled, are the
Cabernet Franc based wines of
the Loire.
Château de Fleurie 2012
(€16.99 down from
€19.49 for the
month of August)
is made from a
single 13 hectare
estate covering
some of the best
terroir in Fleurie,
this is one of the
finest Cru’s in the
region. A complex,
Burgundian Fleurie,
this is a serious cut
above just about
every other Fleurie
on the market –
quite simply, velvet in a glass.
Quality is paramount at
Langlois-Château – owned and
run by Bollinger
Champagne, there
is nothing spared in
ensuring this is one
of the region’s best
producers. Their St.
Nicolas de Bourgueil
2012 (€14.99 down
from €19.99 for the
month of August)
is a classic Loire
Cabernet Franc,
light in body but
with wonderfully
juicy red berry fruit.
All wines are available at
O’Briens stores nationwide
or online at www.wine.ie.
IPUREVIEW AUGUST 2014 47

INTERNATIONAL NEWS Roisin Molloy, Membership & Secretary General’s Office Manager, IPU
International
pharmacy news
UK
Report on
contribution
community
pharmacy can
make to care of
asthma sufferers
The Pharmaceutical Services
Negotiating Committee
(PSNC) has published a report
outlining the significant
contribution that community
pharmacies could make
to the care of people with
asthma to help improve their
care, manage their condition
and reduce avoidable
complications.
The report pulls together
evidence from a number
of local pilots and services
to show the impact that
community pharmacies
can make in this area. For
example, by helping people
to understand and use
their inhalers correctly,
pharmacies can help people
to better manage their
conditions, reducing hospital
admissions and even deaths
caused by asthma.
Building on PSNC’s vision
published last year, it also
outlines how the gradual
development of asthma
services, building on MURs
and the NMS, could enable
pharmacies to provide
longitudinal care for people
with asthma, taking over
the key role in leading
their management to free
up capacity in general
practice.
The report is focused in
particular on the recently
published National Review
of Asthma Deaths (NRAD)
which highlighted the need
for improvements in care
to help avoid unnecessary
complications and deaths due
to asthma. Key findings from
the report included that:
n nearly half of those
included in the study
had not received any
medical help during
their last attack;
n the standard of care
received was less than
satisfactory in a quarter
of those who died; and
n there was widespread
under-use of preventer
inhalers and excessive
over-reliance on reliever
inhalers.
PSNC’s report outlines
how community pharmacy
could help with many of the
NRAD’s recommendations
for care, and it forms part of
their ongoing work to develop
community pharmacy services
and the sector’s role in the
NHS.
Alastair Buxton, PSNC Head
of NHS Services, said: “The
NRAD showed once again the
need to develop services to
better support people with
asthma to manage their
medicines and conditions. We
already have evidence to show
that community pharmacy
can do exactly that in a way
that is convenient for patients
and affordable for the NHS
and we hope that our report
on this topic will help to
convince policy-makers and
commissioners of that.
“Of course, what we
would like to see is national
action to enable community
pharmacies across the country
to provide the care we describe
to asthma patients and we will
continue to make the value
of that clear in our ongoing
discussions with the NHS and
others. However, we recognise
the current direction of travel
towards local commissioning
within the NHS and so we
are also looking to work with
stakeholders to develop a
commissioning framework
that could be adopted by
CCGs (Clinical Commissioning
Groups) to initiate these sorts
of services at a local level.
In the meantime, we hope
the report may be of use in
helping Local Pharmaceutical
Committees (LPCs) with
any local discussions on
community pharmacy asthma
care that they have already
begun.”
Source: www.psnc.org.uk
Healthy Living
Pharmacy
Programme a
success, says
RSPH report
Community-based ‘health
champions’, including those
in pharmacies, have a clear
potential to improve public
health, according to a report
published last week by the
Royal Society for Public Health
(RSPH).
The report, ‘Tackling health
inequalities: the case for
investment in the wider public
health workforce’, highlights
the success of the Healthy
Living Pharmacy (HLP) model,
which employs a tiered
framework for delivering
high-quality services through
community pharmacies.
The RSPH argues that
introducing public health
training for the “wider public
health workforce” – including
police officers, firefighters
and housing officers – and
making it a core aspect of
their continuing professional
development, could help
address the financial burden
of health inequalities, which it
puts at nearly £60bn.
The RSPH is a multidisciplinary
membership
organisation for professionals
who share an interest in
public health. It has more
than 6,000 members.
Source: PGEU Monthly Report
June 2014
EU
European Health
Insurance
Card: almost
200 million
Europeans
already carry one
Almost 200 million Europeans
already have the European
Health Insurance Card (EHIC),
according to the latest figures
available for 2013. This
represents more than half
of the insured population in
the EU. The number of EHIC
holders is steadily increasing,
with 8 million more citizens
carrying it in 2013 compared
to the previous year (+4%).
László Andor, Commissioner
for Employment, Social
Affairs and Inclusion,
commented: “Just as many
people are planning to leave
on their summer holidays,
it is encouraging to see that
more and more people have
a European Health Insurance
Card. This allows them to
get necessary treatment
when travelling within the
European Union, Switzerland,
Liechtenstein, Norway and
Iceland. The increasing
number of citizens obtaining
the Card demonstrates the
confidence in the EHIC system
and the recognition of the
protection it provides.”
Source: PGEU Monthly Report
June 2014
48
IPUREVIEW AUGUST 2014

NEWS
2014 Pfizer Health
Index finds more
than half (53%) the
population believe
health cutbacks have
had greatest impact
Cost H of living
a
p
pPension
i
n
e
s
s
Budgets
F
u
t
u
r
Looking ahead
Health
Impact
Disposable income
Older people
Medical Card
Spending less
Behaviour
Job security Stress
Families
e
Work
Cutbacks
Education
Mental health
THE 2014 PFIZER HEALTH INDEX
Attitudes
Welfare
Prioritising spend
Unemployment
Austerity
P
r
i
v
a
t
Smoking
Entitlements
Exercise
Health screening Illness
Luxuries
Medicine
Health insurance
F
u
n
d
i
n
g
Disability
Prescriptions
Looking forward
Hospital
Hospital beds
Universal healthcare
GP
Access
Doctor
e
P
u
b
l
i
c
R
e
c
e
s
s
i
o
n
At the launch of the 2014 Pfizer Health Index were (L-R):
Paul Reid, Managing Director, Pfizer Healthcare Ireland, with
speakers at the event, Prof Charles Normand, Edward Kennedy
Chair of Health Policy and Management at Trinity College Dublin
and Dr Anne Nolan, Research Director, The Irish LongituDinal
Study on Ageing (TILDA), Trinity College Dublin.
Results of this year’s Pfizer
Health Index reveal the
impact that years of recession
and austerity budgets have
had on people and shows a
broad consensus that cuts in
health have had the greatest
impact when contrasted with
other cuts in social welfare,
education, state pension and
transport.
More than half (53%) of the
1,000 people in the survey
nominated health as the area
in which cutbacks have had
the greatest impact, with
health mentioned first, second
or third by more than 9 in
10 (93%). This year the Index
looked at the effect austerity
measures have had on Irish
people, their health and, with
signs of economic recovery,
where people’s priorities lie.
Almost three out of four
adults (72%) believe that
families with young children
have been impacted by
austerity budgets, with more
than a third (36%) suggesting
they have been the hardest
hit. The impact on families
with young children is sensed
more by those aged between
35 and 49, essentially the core
family life stage. Older adults
were nominated as the group
second most likely (47%)
to have been impacted by
austerity.
Since 2010, the proportion
of adults holding private
medical insurance has
declined from 44% of the
population to 33% in 2014.
The rate of decline was more
pronounced between 2010
and 2012, but has slowed in
recent years. Over the same
time period, the number of
people with medical cards
had climbed to a high of 44%
in 2012, at just under 1.6
million people, but has since
retracted to 1.4 million or 39%
of the population in 2014. As
numbers with both private
cover and medical cards has
fallen, we see a growth in the
number of people who have
neither private insurance nor
a medical card; this group
constituted 23% of adults
in 2011 but has risen to 31%
in 2014.
When asked to assess their
own personal health out of 10,
where 10 is excellent health
and one is very poor health,
the average volunteered score
is 7.9 out of 10. The number
of people smoking is at an alltime
low with 25% of adults
(aged 16 years plus) currently
smoking, down significantly
from 33% in 2012.
Mr Paul Reid, Managing
Director, Pfizer Healthcare
Ireland, said; “The Index
is now in its ninth year
and during these nine
years we have gone from
boom to bust, and are now
emerging from recession
into economic recovery and
hopefully sustained growth.
This presents a new set of
challenges for public policy
and government strategies –
what should be prioritised
Investment in healthcare
has delivered results for Irish
patients – in terms of health,
life expectancy at birth in
Ireland is now 81 years – this
has increased a full four years
since the year 2000 and is
higher than the EU average
and above the OECD average.
As we move out of austerity
in Ireland, we must start to
shift the focus away from cost
cutting and on to investment
in healthcare to fuel sustained
recovery.”
The Pfizer Health Index
details the findings of a
nationally representative
quantitative market research
survey of the health and
wellbeing of the Irish
population.
IPUREVIEW AUGUST 2014 49

NEWS
New President of the
Pharmaceutical Society
of Ireland
The Council of the
Pharmaceutical Society of
Ireland (PSI), the pharmacy
regulator, has elected a new
President, Ms Leonie Clarke
and a new Vice-President, Dr
Ann Frankish.
Leonie Clarke (pictured left)
has served on the PSI Council
since 2010, studied pharmacy
in Trinity College Dublin and
holds an MSc by research and
diplomas in legal studies and
accounting and finance. She
runs her own pharmaceutical
consultancy, focusing
primarily on compliance
with medicines legislation,
corporate governance and
quality management. She
started her career as Assistant
Registrar of the PSI in 1991,
has several years’ experience
in the pharmaceutical
industry and also spent time
in academia. Leonie follows
Eoghan Hanly as President.
Ann Frankish (pictured
right) has also previously
been on the PSI Council and
has served as Vice-President
and President prior to the
introduction of the Pharmacy
Act of 2007, which established
the current regulatory system.
She graduated from the UK
and first registered with the
PSI in 1982. For the past 26
years she has served as Chief
Pharmacist in the Rotunda
Hospital, Dublin, a post from
which she has recently retired.
Ann has had a long career
in pharmacy, in a variety of
settings including community,
hospital, and academia and
has recently taken up a role
in industry. Ann follows Noel
Stenson as Vice-President.
Electronic prescribing and information
flow between GPs and other health
professionals improved
General Practice Messaging
Standard Version 3.0
Outline Summary May 2014
Electronic prescribing and
the safety of electronic
communication between GPs
and healthcare services has
been improved with the
publication of an update to
the Health Information and
Quality Authority’s General
Practice Messaging
Standard (GPMS).
The GPMS specifies the
structure and content
of electronic messages.
It aims to standardise
the transmission
of these electronic
messages between
general practices,
secondary care and
out-of-hours care,
leading to safer better health
information in Ireland.
The GPMS outlines the
way patient information,
ranging from blood test
results, diagnosis information,
referrals and X-rays can
be more accurately and
safely transferred between
healthcare services.
This Standard was first
approved by the then
Minister for Health and
Children in May 2010. This
new version, 3.0, has been
developed to include the
messaging requirements for
the electronic transfer of
prescriptions between GPs
and community pharmacy. It
is also relevant for prescribing
in outpatient departments of
hospitals. This new version
of the Standard goes further
to reduce medication errors,
leading to safer, better care.
This Standard forms part
of HIQA’s work through its
health information function
to ensure that high quality
health and social care
information is available to
support the delivery, planning
and monitoring of services
throughout Ireland.
An outline summary and
a full copy of the Standard is
available on www.hiqa.ie.
50
IPUREVIEW AUGUST 2014

Michael Foley (L) being
presented with his prize by
Captain Michael Foley.
Irish Chemists
Golfing Society
News
The results of the ICGS golf outing at Carlow, which was
sponsored by United Drug, were:
Class 1
1st prize Robert Falconer
2nd prize Pat Downey
3rd prize Michael Foley
Class 2
1st prize Kevin O’Gorman
2nd prize Pat McGee
3rd prize Michael Fogarty
Class 3
1st prize Percy Delaney
2nd prize David O’Farrell
3rd prize Michael Hennessy
The next outing is in Dun Laoghaire on Monday 11
August, followed by the final two-day outing in Adare on
14-15 September.
Reminder – Fun
Bridge Weekend
September 12-14
If you intend participating in the Bridge Weekend
and have not booked, please contact Ann Moynihan
– annglennonmoynihan@eircom.net (087 7755128) or
Paddy Colleran MPSI (086 0880513) before 1 September
to guarantee a place.
The emphasis will continue to be in providing an
opportunity to enjoy a game of bridge at your own level
but the weekend also provides a Gala Dinner on the
Saturday evening, with entertainment afterwards. Do
not let the lack of a bridge partner put you off. Mention
it to Ann when booking and she will arrange one for you.
Mary O’Rourke, pictured with Lisa McLaughlin and Ian Pitcher, Sanofi Pasteur
MSD, is calling on people over 50 to know their risk of developing shingles.
New shingles and Post
Herpetic Neuralgia (PHN)
vaccination now available
in Ireland for patients over
50 years of age
The first vaccination for the
prevention of shingles and
post herpetic neuralgia (PHN)
is now available for private
patients over the age of 50 in
Ireland. Zostavax, from Sanofi
Pasteur MSD, is a one-dose,
live attenuated vaccine for the
prevention of shingles (herpes
zoster) and herpes zosterrelated
PHN.
This is the first vaccine
available for the prevention
of shingles in Ireland. 95% of
adults have had chickenpox,
caused by the varicella-zoster
virus (VZV), and therefore
have the potential to develop
shingles. If a person has not
had chickenpox they will not
develop shingles. One in four
people will have shingles
during their life-time and two
out of three cases occur in
people over 50 years of age
due to the natural age-related
weakening of the immune
system.
Sanofi Pasteur MSD
has launched a shingles
public awareness campaign
specifically targeting people
aged over 50 years and
supported by Age Action and
Chronic Pain Ireland. This
at-risk population will be
encouraged to become more
aware of shingles and its
complications and urged to
go to their GP or healthcare
professional should they
recognise the symptoms or
require further information
about the disease. A new
website developed by Sanofi
Pasteur MSD, www.shingles.
ie, is a useful resource for
more detailed information on
shingles.
IPUREVIEW AUGUST 2014 51

NEWS
Actavis named
one of the world’s
greenest companies
Actavis Ireland is pleased to
report that Actavis Ltd. have
been named by Newsweek
magazine (American weekly
news magazine) as one of the
World’s Greenest Companies.
An annual list compiled
and published by the
magazine ranks the world’s
largest companies on their
corporate sustainability
and environmental impact
initiatives. A position on
this list is a true indicator
of Actavis’ commitment to
sustainably performance.
Speaking of the honour,
Tony Hynds, Managing
Director, Actavis Ireland,
said: “Actavis prides itself
on leading in innovation
and striving year on year
to better our company and
this award is a sign of that
commitment paying off.
We work hard every day
to create medicine for a
healthier world so it is only
natural that sustainability
and environmental impact is
high on our agenda. We would
like to congratulate all of our
Global EH&S teams and our
employees here in Ireland and
around the world whose hard
work and dedication made
this possible.”
Actavis was ranked on this
year’s list as the 44th greenest
company in the United
States and the 71st greenest
company in the world,
ahead of such leading global
companies as Apple, Toyota
and Microsoft, among others.
The full results can be viewed
online at www.newsweek.com/
green-2014.
New RATE campaign designed
to educate and inform people
of the need to reduce heart
rate and improve mortality
for HF and CAD patients
Servier Laboratories Ireland
recently launched “Know Your
Heart RATE”, a campaign to
empower and educate patients
on Heart Rate management
so they can lead a longer and
better life. The RATE campaign
was influenced by the results
of recent research which
revealed that heart rate in
cardiology patients is regularly
measured by healthcare
professionals (HCP) but is not
actively treated.
Study findings show that
while heart rate is measured
routinely by GPs in patients
with heart failure (93%) and
coronary artery disease (86%),
only about half of GPs aim to
actively treat Heart Rate in
these patients. In secondary
care, 50% of cardiology doctors
consider Heart Rate in HF
patients to be high at 70-75bpm
and aim to treat these patients
to the target of 55-60bpm.
As part of the “Know Your
Heart RATE” campaign,
Servier has invested in a
new HCP education pack,
which will be distributed
nationwide to provide HCPs
with additional information
on Heart Rate management
and treatment. As HF patients
are a higher risk patient
population they will be the
initial focus of the campaign.
The packs are designed to
help HCPs quickly optimise
their HF patient care and will
include posters, heart failure
patient checklist, summarised
checklist stickers to put on
each patient’s chart and a
new HF information booklet.
It will help patients play an
active role in their treatment;
understanding their disease,
knowing how to monitor
Heart Rate, BP and weight,
and making lifestyle choices.
Lady
Pharmacists’
Golf Society
News
President’s Prize outing, 24 May, Glasson GC
1st prize Ciara Marmion (34)
2nd prize Celeste O’Regan (33)
3rd prize Jean O’Donnell (33)
Category 1 Marie Donnellan (26)
Category 2 Diana Hogan Murphy (31)
Category 3 Marie Walsh (27)
Front 9
Back 9
Nearest the pin
Par 3s
Longest drive
Norma Ferriter
Anne Murphy
Mary Mellet
Ann Walsh Ryan
Celeste O’Regan
Cavan County GC, 19 July
1st prize Majella Brady (35)
2nd prize Ann Nolan (32)
3rd prize Jean Brogan (32).
Front 9 Anne Hillary (17)
Back 9 Anne Murphy (15)
LPGS President Ann O’Driscoll
presenting the President’s Prize to
Ciara Marmion in Glasson on 24 May.
Category 1 Marie Donnellan (28)
Category 2 Mary Jordan (27)
Category 3 Marie Walsh (30)
The next outing is on 13 September in
Mount Wolseley, Tullow, Co Carlow.
For further information, contact Veronica
Treacy, Competition Secretary,
on 086 8099275.
52
IPUREVIEW AUGUST 2014

PRODUCT INFORMATION
Clonmel Healthcare
launch Aspirin 75mg
gastro-resistant tablets
Omega
Pharma
re-launches
Zantac for
long-lasting
relief from H&I
Clonmel Healthcare is delighted to announce the launch of
Aspirin 75mg gastro-resistant tablets x 28. The product is
subject to medical prescription.
Aspirin film-coated tablets are indicated for:
n Secondary prevention of myocardial infarction.
n Prevention of cardiovascular morbidity in patients
suffering from stable angina pectoris.
n History of unstable angina pectoris, except during the
acute phase.
n Prevention of graft occlusion after Coronary Artery
Bypass Grafting (CABG).
n Coronary angioplasty, except during the acute phase.
n Secondary prevention of transient ischaemic attacks (TIA)
and ischaemic cerebrovascular accidents (CVA) provided
intracerebral haemorrhages have been ruled out.
Full prescribing information is available on request, or on
www.clonmel-health.ie. Please contact Clonmel Healthcare on
01 620 4000 if you require any additional information.
Omega Pharma is re-launching
H2 Antagonist, Zantac in
Ireland this month. Combining
heavyweight above and below
the line activity with pharmacy
education, the campaign will
highlight the number 1 H2
Antagonist’s 30-year heritage
in providing long-lasting relief
from heartburn and acid
indigestion (H&I).
The re-launch will include
a robust ATL campaign
including TV advertising,
Video On Demand and a
digital presence along with PR
support. Educational resources
will also be made available
to pharmacies, which will
include information and
online tools that help refresh
pharmacy knowledge on
the Heartburn and Acid
Indigestion category and
ensure pharmacists are able
to provide in-depth support to
customers.
H&I is one of the largest
OTC categories in pharmacy.
With 44% of the population
suffering from H&I in Ireland,
affecting both men and
women, pharmacists are
ideally placed to offer both
lifestyle and treatment advice.
Fiona Keenan, Omega
Pharma said: “This significant
investment in Zantac
reflects our commitment to
supporting pharmacists in
delivering effective solutions
for their customer needs.
We know heartburn and
acid indigestion affects a
huge amount for people in
Ireland and Zantac is ideally
positioned to provide longlasting
relief through the day
or night.”
Zantac is fast acting and has
the power to relieve heartburn
and indigestion for up to 12
hours, thereby providing all
day or all night relief. Zantac
75 is available in pharmacy in
12s and 24s.
For all enquiries please
contact customer.service@
omegapharma.co.uk or call
01 879 0600.
Solpadeine supports pharmacists in finding
right pain relief solutions for customers
Omega Pharma, the
distributors of Solpadeine
in Ireland, is investing in a
new educational campaign
aimed at helping pharmacists
provide the right pain relief
advice to their customers.
The campaign includes the
development of new training
booklets and online tools
that help refresh pharmacy
knowledge on the pain
management category and
ensure pharmacists are able
to provide in-depth support
to customers suffering from a
range of different pain types.
Supplementary resources
also provide advice on the
Solpadeine range, helping to
facilitate recommendations
for finding an appropriate
pain relief option for each
customer.
Pain management is one
of the most vital services
provided by pharmacies today.
Pharmacists are ideally placed
to offer lifestyle and treatment
advice as well as tackle
some of the key pain relief
challenges such as reluctance
to treat, choosing the wrong
treatments, subtherapeutic
dosage and incorrect or
overuse of treatments. Poor
management of pain can have
a range of negative personal
and societal effects, including
€252 million lost to the Irish
economy per year through lost
work days and productivity
due to migraine.
Solpadeine includes a range
of pain solutions to address
different customer needs,
including Solpadeine Soluble
Tablets, which contain a triple
acting set of ingredients,
including codeine to block
pain messages, paracetamol
to relieve pain symptoms
and caffeine to help speed up
absorption of the paracetamol.
For all enquiries, including
trade and to request training
or POS materials please
contact: customer.service@
omegapharma.co.uk.
IPUREVIEW AUGUST 2014 53

PRODUCT INFORMATION
Rowex
launch
Brupro
for Children
Rowex Ltd has announced the
launch of Brupro for Children
100mg/5ml Oral Suspension
(Ibuprofen).
Brupro for Children is
used for the short-term
symptomatic treatment of:
n mild to moderate pain.
n fever.
The details are as follows:
n Brupro for Children
100mg/5ml Oral
Suspension x 100ml
n Brupro for Children
100mg/5ml Oral
Suspension x 150ml
The presentations are OTC
medicines.
For further information
contact Rowex Ltd. on
Freephone 1800 304 400 or
email rowex@rowa-pharma.ie.
Bioxsine – Major
TV advertising
campaign announced
Bioxsine is scientifically
proven to reduce hair loss and
increase hair growth in men
in women. Recently launched,
Bioxsine Femina is a shampoo
and conditioner that has
been specifically developed
to treat female hair loss. The
active ingredients in Bioxsine
shampoo encourage hair
growth, strengthen and add
volume by thickening the hair,
nourish the scalp, improve
blood circulation to the scalp
and reduce hair loss.
In August and September,
Bioxsine will be supported by
a heavyweight TV advertising
campaign on RTE & TV3.
Window display and product
training material is available
from Ocean Healthcare.
Bioxsine is available from
Ocean Healthcare, United
Drug & Uniphar. For further
information and POS material
please contact Ocean
Healthcare on 01 296 8080 or
visit www.bioxsine.ie.
Vichy
introduce
Aqualia
Thermal
The Aqualia Thermal range
is designed for women of
all ages with dehydrated
and sensitive skin looking
to rediscover smoothed
features, re-plumped
skin and a fresh, radiant
complexion. Dermatologically
tested and rich in Vichy
Thermal Spa Water the
products hydrate, soothe
and care for up to 48 hours,
leaving users with beautiful,
healthy-looking skin.
Aqualia Thermal Light
is suitable for normal to
combination skin and
Aqualia Thermal Rich is for
dry to very dry skin
Contact your Vichy
representative for further
details.
Are there medicines
currently unavailable to
your patient in Ireland
We can help...
www.medisource.ie | Call 1-890 2866366 | Fax 01 2866288 | Email info@medisource.ie
227548-DPS-MEDISOURCE-AMA-IHCA.indd Medisource Ad Sept 2013.indd 1 2 05/09/2013 06/09/2013 10:06:11 12:17:14
54
IPUREVIEW AUGUST 2014

CLASSIFIEDS
PHARMACY
GROUP SEEKING
TO EXPAND
All areas considered,
especially Dublin, Cork
or Limerick Cities.
Funding available.
Replies to PO BoxSA033
TO ADVERTISE HERE, PLEASE
CALL WENDY ON 01 493 6401
LEINSTER REGION - PHARMACY WANTED
Approved funding to purchase pharmacy for
enthusiastic young pharmacist. All options
considered and confidentiality is guaranteed.
Replies to Box No SA030.
PHARMACY OWNER LOOKING TO PURCHASE PHARMACY
IN KERRY/CORK/LIMERICK. Funding Available. All turnovers
considered. Confidentiality assured. Replies to Box No. 1614
PHARMACY FOR SALE – CORK CITY SOUTHSIDE. Close to
many amenities, including doctors’ surgeries. This is an excellent
opportunity to acquire an established profitable business with
excellent turnover. Financial accounts available on request.
Replies to Box No.1514.
PHARMACIST WISHING TO PURCHASE A PHARMACY IN THE
SOUTH/SOUTH EAST REGION. Will consider all turnovers/ net
sales figure. Serious sellers only please. Confidentiality assured.
Replies to Box No. 1414.
PHARMACIST SEEKING TO PURCHASE PHARMACY IN GALWAY/
CLARE AREA. All turnovers considered. Funding in place,
confidentiality assured. Replies to Box No. 1314.
PHARMACY FOR SALE IN LIMERICK SUBURB. Established
pharmacy with good turnover in prominent location in Limerick
Suburban location for sale. Replies to Box No. 1214.
PHARMACIST WISHING TO PURCHASE A PHARMACY IN THE
GALWAY/MAYO REGION. All areas and turnovers considered.
All enquiries treated with the strictest of confidence.
Replies to Box No. 1114.
LINK-banner-ad.qxp_Layout 1 16/05/2014 16:57 Page 1
MUNSTER AND LEINSTER REGIONS. Pharmacies with turnover
in excess of €1.5m required. Serious sellers only. Confidentiality
assured. Replies to Box No. 1014.
LOOKING TO SELL YOUR PHARMACY Pharmacist with funds
wishes to purchase pharmacy in Leinster area. Replies to
Box No 914.
ENTHUSIASTIC PHARMACIST SEEKING TO PURCHASE a pharmacy
in Leinster region, preferred locations anywhere in Co Kildare, North
East/East Offaly. Confidentiality is guaranteed. Replies to Box No 814.
All Box Number Replies should be to:
Irish Pharmacy Union, Butterfield House,
Butterfield Avenue, Rathfarnham, Dublin 14.
This independent service is free to IPU members.
Entries will be deleted after three months.
Advertisements should be forwarded to:
Wendy McGlashan, IPU, Butterfield House,
Butterfield Avenue, Rathfarnham, Dublin 14.
Tel: (01) 493 6401. Fax: (01) 493 6626.
Email: ipureview@ipu.ie
Our new look Link guide is now available.
Not a member
of Link
To join contact your Uniphar Representative.
Details available on www.unipharcontact.ie
Open to ALL Community Pharmacies.
IPUREVIEW AUGUST 2014 55

Tailored to You
Take Control
with Actavis
Simplifying your business and maximising
profitability is fundamental to Pharmacy
growth. That is why, at Actavis, we have
launched a new innovative purchasing model
for customers called the ‘Accumulator’.
The ‘Accumulator’ is a simple pack replacement
scheme offering transparency and consistency
together with excellent customer service.
The ‘Accumulator’ puts you in the driving
seat, offering the best margins and excellent
value across our portfolio which will allow you
to develop your business with confidence.
THE ACTAVIS ‘ACCUMULATOR’ GIVES YOU MORE:
Transparency – of Pricing, Margins and Invoicing.
Consistency – of Supply, Purchasing and Customer Service.
Value – across Generics, OTC and Branded Medicine.
Control – over your Purchasing, your Profits and your Business.
Actavis and You – The partnership that adds up.
Contact us at 021 461 9040 or on www.actavis.ie to see
how the ‘Accumulator’ can be put to work for you.
Date of Preparation: April 2014. NA-019-01.