Pharmacists in Smoking Cessation

IRELAND’S OFFICIAL PHARMACY PUBLICATION
FEBRUARY 2017
Crime against
Pharmacies
Reaching Crisis
Levels
IPU NATIONAL
PHARMACY
CONFERENCE
Role of
Pharmacists
in Smoking
Cessation
INTERVIEW WITH JONATHAN MORRISSEY | CPD: ANKYLOSING SPONDYLITIS

A maintenance bronchodilator therapy
for your symptomatic COPD patients
Don’t wait - prescribe Anoro Ellipta instead of tiotropium.
Give your patients the immediate results they need. 1-2
Visit www.anoro.ie to find out more
Anoro is contraindicated for patients who are hypersensitive to the active substances or to any of the excipients.
Anoro should not be used in patients with asthma 3
This medicinal product is subject to additional monitoring.
This will allow quick identification of new safety information. Healthcare professionals are asked to report any suspected adverse reactions.
Anoro ® (umeclidinium bromide/vilanterol [as trifenatate]) Prescribing
information
(Please consult the full Summary of Product Characteristics (SmPC) before prescribing)
Anoro ® 55/22 mcg (umeclidinium bromide/vilanterol [as trifenatate]) inhalation
powder. Each single inhalation of umeclidinium bromide (UMEC) 62.5 micrograms
(mcg) and vilanterol (VI) 25 mcg provides a delivered dose of UMEC 55 mcg and VI
22 mcg. Indications: COPD: Maintenance bronchodilator treatment to relieve
symptoms in adult patients with COPD. Dosage and administration: Inhalation only.
COPD: One inhalation once daily of Anoro. Contraindications: Hypersensitivity to the
active substances or to any of the excipients (lactose monohydrate and magnesium
stearate). Precautions: Anoro should not be used in patients with asthma. Treatment
with Anoro should be discontinued in the event of paradoxical bronchospasm and
alternative therapy initiated if necessary. Cardiovascular effects may be seen after the
administration of muscarinic receptor antagonists and sympathomimetics therefore
Anoro should be used with caution in patients with severe cardiovascular disease.
Anoro should be used with caution in patients with urinary retention, narrow angle
glaucoma, convulsive disorders, thyrotoxicosis, hypokalaemia, hyperglycaemia and
severe hepatic impairment. No dosage adjustment is required in renal or mild to
moderate hepatic impairment. Acute symptoms: Anoro is not indicated for acute
episodes of bronchospasm. Warn patients to seek medical advice if short-acting inhaled
bronchodilator use increases, a re-evaluation of the patient and of the COPD treatment
regimen should be undertaken. Interactions with other medicinal products:
Interaction studies have only been performed in adults. Avoid ß-blockers. Caution is
advised when co-administering with strong CYP3A4 inhibitors (e.g. ketoconazole,
clarithromycin, itraconazole, ritonavir, telithromycin). Anoro should not be used in
conjunction with other long-acting ß 2-adrenergic agonists or medicinal products
containing long-acting muscarinic antagonists. Caution is advised with concomitant
use with methylxanthine derivatives, steroids or non-potassium-sparing diuretics as
it may potentiate possible hypokalaemic effect of ß 2-adrenergic agonists. Fertility,
pregnancy, and breast-feeding: No available data. Balance risks against benefits.
Side effects: Common: Urinary tract infection, sinusitis, nasopharyngitis, pharyngitis,
upper respiratory tract infection, headache, cough, oropharyngeal pain, constipation
and dry mouth. Uncommon: Hypersenstivity reactions including rash; trenor, dysgeusia,
atrial fibrillation, supraventricular tachycardia, rhythm idioventricular, tachycardia,
supraventricular extrasystoles and palpitations. Rare: Anaphylaxis, angioedema,
urticaria, urinary retention, dysuria and bladder outlet obstruction. Frequency
unknown: Glaucoma. Marketing Authorisation (MA) Holder: Glaxo Group Ltd,
980 Great West Road, Brentford, Middlesex TW8 9GS, UK. MA Nr: 55/22 mcg
1x30 doses [EU/1/14/898/002]. Legal category: POM B. Last date of revision:
Oct 2016. Job Ref: IE/UCV/0063/15 (2). Further information available on request from
GlaxoSmithKline, 12 Riverwalk, Citywest Business Campus, Dublin 24, Tel: 01-4955000.
Adverse events should be reported to the Health Products Regulatory Authority
(HPRA) using an Adverse Reaction Report Form obtained either from the HPRA or
electronically via the website at www.hpra.ie. Adverse reactions can also be reported
to the HPRA by calling (01) 6764971. Adverse events should also be reported to
GlaxoSmithKline on 1800 244 255.
References: 1. Donohue JF et al. Respir Med 2013; 107: 1538–1546. 2. Maleki-Yazdi
MR et al. Respir Med 2014; 105: 1752-1760. 3. Anoro Ellipta Summary of Product
Characteristics. Available from: www.medicines.ie. Accessed: November 2016.
ANORO ELLIPTA was developed in collaboration with
IE/UCV/0075/15(2) Date of Preparation: November 2016
©2016 GSK group of companies. All rights reserved.

FEBRUARY 2017
05 A Note from the Editor
IPU News
The latest news and events from Butterfield House
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.
08 IPU Academy Spring Programme
08 IPU Academy Webinar Series
08 Pharmacy in the Media
09 Dates for your Diary
10 IPU Business Academy Spring
Programme 2017
Subscription:
€95 (Ireland North & South) and
€140 (including postage overseas).
Publisher:
Irish Pharmacy Union
(IPU Services Ltd),
Butterfield House,
Butterfield Avenue,
Rathfarnham, Dublin 14,
D14 E126
Tel: (01) 493 6401
Fax: (01) 493 6626
Email: ipureview@ipu.ie
Website: www.ipu.ie
Editor: Jack Shanahan MPSI
Editorial Associates:
Aoibheann Ní Shúilleabháin,
Jim Curran and Ciara Browne
Advertising: Aoibheann Ní Shúilleabháin
Email: ipureview@ipu.ie
Tel: (01) 493 6401
©2017
Copyright: All Rights Reserved,
Irish Pharmacy Union.
Printed by Ryson Colour Printers Ltd.
IPU Review is a Registered Trademark
of the Irish Pharmacy Union.
Features
12 Role of Pharmacists in
Smoking Cessation
16 Crime against
Pharmacies Reaching
Crisis Levels
Key findings from the IPU’s Annual
Pharmacy Crime Survey 2016
20 Stop that Thief!
A brief overview of defamation and
some practical advice as to how to
protect yourself
16
12
IPUREVIEW FEBRUARY 2017 3

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24 Interview with
Jonathon Morrissey,
Marron’s Pharmacy
Marron’s Pharmacy, Clane, Co. Kildare, recently won
the Actavis Academy Training & Mentoring Bursary
24
28 Report of PSI Public Council Meeting
8 December 2016
31 IPU National Pharmacy
Conference
36 CPD: Ankylosing Spondylitis
42 Clinical Tips: Educational Materials
44 Irish prescription market trends
46 New Year’s Resolutions for your Business
What you need to look at to ensure that the health of
your retail businesses stays in peak condition
50 New Year Resolutions to Guarantee
a more Prosperous 2017
54 Political Report
All the latest pharmacy news from
the Houses of the Oireachtas
58 Studies
This year’s conference takes place
on 5-7 May in Croke Park
46
News
60 International News
61 HIQA publishes standards
for a dispensing medication
note to support safe
prescribing
61 HIQA announces public
consultation on first EU
HTA to include e-cigarettes
as an intervention for
quitting smoking
62 Huge rise in liver cancer
rates shows need to Get
Cancer through reducing
our risk
63 Eileen Byrne appointed
Managing Director of
Clanwilliam Health
63 Intas Pharmaceuticals
completes deal to acquire
Actavis UK & Ireland
generics businesses
from Teva
66 Product Information
67 Classified Ads
IPUREVIEW FEBRUARY 2017 5

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A NOTE FROM THE EDITOR Jack Shanahan, MPSI
Working in
Dolls’ Houses
New year, new issues – or so we all hoped. Instead, this
January started off with a real kick in the rear end.
On a landscape
of supreme
consistency,
there is a
single fount of
continuous torment: our everpresent
and all-consuming
regulatory body. The PSI’s
Pharmacy Assessment System
(PAS) should now be in full
flow in most pharmacies.
It is a monumental work
for most of us. In my view,
it poses a particular and
disproportionate burden on
those pharmacies that are on
the smaller side, specifically
those that have only one
pharmacist. In an era of
secularism, we take little
comfort in the PSI having a
spiritual vision, enshrining
the divine trinity of pharmacy.
One being as superintendent,
supervising and acting, all at
the same time and yet, all as
notionally separate entities.
Like a three-headed spatula.
While we are told that the
PAS gets easier after the first
six months, I certainly can
testify that I am finding the
process stultifying. If ever
there was a case of idleness
creating the devil’s work, this
project has to be a crowning
mortal sin. It takes a very
special type of committee to
dream up such a plethora of
checklists, twice. Then there is
the nagging suspicion. If this
means that we are effectively
doing the inspector’s work for
them, the real worry is what
comes next. If we have filled
out all the usual tick boxes,
what is left for the legion
of inspectors? Of particular
concern is that the PSI will
create new ‘standards’ that are
further designed to eviscerate
the smaller independent
pharmacy. The whole thrust
of the current approach to
regulation utterly ignores
the impact of the petty,
inane and arcane regulatory
itches that are required to be
scratched. For instance, we are,
it seems, expected to have a
device in the shop capable of
measuring liquids to a level of
.05ml. Although I have been
practising pharmacy for over
30 years, I have never, ever,
ever needed to measure .05ml
of a liquid. For clarity, that is a
little over three quarters of a
drop. Indeed, come to think of
it, I have never even needed to
measure 0.5ml of a liquid. Who
dreams this up? At what point,
in a standards committee’s
deliberations, does somebody
come up with the idea of
requiring pharmacies to have
equipment that is utterly
pointless? While I am sure that
somebody, somewhere, once
had to measure .05ml of water,
this is not normal; nor is the
expectation that we should be
equipped to do it.
It is at times like this that
you need to remind yourself
that the function of the PSI
is to protect the public. It
is not clear, now, that this
translates into a proper
vision. There seems to be a
sense of disassembling, of
breaking pharmacy down
into ever-smaller atoms of
standardisation. This is the
work of those that do not
understand community
pharmacy. It is clear that the
voice of experience is shown
a deaf ear in the deliberations
that produce standards, and
expectations, that are ever
more remote from the real
world. The fear is that we end
up working in dolls’ houses,
where every placement is
dictated by a petulant child
who can, at a whim, destroy
the whole edifice and start
again, without penalty or fear
of being reigned in. If you feel
my views are excessive, have
a look at the report of the last
PSI meeting’s public session. In
a country where community
pharmacy pays some of the
highest fees in the world, they
want even more money. Where
did it all go wrong? Read the
report and weep.
While we are on the issue of
standardising, there is some
good news elsewhere. We
should soon be welcoming a
secure clinical email service
into community pharmacy.
Healthmail has been around
for a few years, primarily as a
vehicle for secure electronic
communication between GPs
and hospitals. It was a natural
extension of the standards
developed for communicating
laboratory results, evolving
into a mechanism for
transporting confidential
health information. What
separates it from regular email
is the security that surrounds
it. It is like a private network,
where only verified users can
access to send and receive
email. So, for instance, an
email from a regular Gmail
account can never be received
on a Healthmail account.
While a few pharmacies in
Kilkenny had preliminary
access, it will soon be rolled
out to all of us. One of the
immediate benefits should
be the elimination of most
faxes that contain sensitive
information. For instance, it
should be possible to send a
list of current medications to
a secure email in a hospital.
This should provide a
degree of confidentiality to
a process that is currently
fraught with risk. The
processes surrounding the
implementation should
also help with the rollout of
ePrescriptions. Watch out
for more news as this useful
facility arrives to us all.
If you have any comments, queries or issues to raise, send
your “Letters to the Editor” by email to ipureview@ipu.ie.
IPUREVIEW FEBRUARY 2017 7

PHARMACY
IN THE MEDIA
IPU Academy
Spring Programme
The IPU Academy Spring Programme 2017 is now online at
www.ipuacademy.ie. This means that you can now view the
IPU Academy Spring Programme 2017 and book your courses
online. View the IPU Academy Spring Programme and book your
courses in three easy steps:
1. Log on to www.ipuacademy.ie
2. Enter your login details
3. Book your courses
The five topics in the IPU Academy Spring Programme were
selected based on your feedback and will be delivered in venues
countrywide.
1. Oral Chemotherapy Update (Express Topic Course,
7.30pm to 9.00pm)
2. Medication Safety in your Practice
3. Paediatrics – An Update: Birth to 13 Months
4. Child and Adolescent Mental Health
5. Update on Drug Interactions and Adverse
Drug Interactions
The IPU Academy Spring Programme starts on Monday 13
February and will run until Wednesday 5 April. As a member of
the IPU, you are automatically a member of IPU Academy. This
membership benefit entitles you to attend, without charge, live
learning events in the IPU Academy Spring Programme.
IPU Academy
Webinar Series
We issued a press release reminding patients to get
the flu vaccination following reports that there had
been an increase in influenza and influenza-like cases.
There was a substantial amount of media coverage on
this matter. IPU Executive Committee member Ann
Marie Horan was interviewed for UTV Ireland and TV3’s
News at 5.30 to highlight that the best way to prevent
getting the flu is to get the flu vaccination. There was
also coverage in national newspapers, including the
Irish Independent, Sunday Independent and Irish Examiner,
as well as a significant amount of coverage in regional
newspapers and online. A number of IPU spokespersons
were was also interviewed on regional radio stations
including Tipp FM, KFM, KCLR, Northern Sound and
Ocean FM. The HSE’s website www.undertheweather.
ie, supported by the IPU, was also in the media advising
people on how to deal with minor ailments including
cold, flu, earache and other common illnesses. There
was coverage in the Irish Independent and Kilkenny People
and also in regional newspapers.
An article was published in the Sunday Independent
which looked into the fees that are paid to pharmacists
by the HSE. In response, the IPU pointed out that fees
paid to pharmacists have significantly reduced in
recent years and, with an increase in the level of items
dispensed and a reduction in fees, pharmacies are now
doing a lot more for less.
The IPU Crime Survey, which was carried out at
the beginning of January, revealed that crime against
pharmacies was at crisis levels. IPU President Daragh
Connolly commented on the survey results as
“shocking” and he was particularly concerned at the
level of violent crimes against pharmacy staff. The
survey received a significant amount of media coverage
on national and regional levels. Daragh Connolly and
Ann Marie Horan were interviewed on RTÉ Radio 1’s
The Sean O’Rourke Show and the topic was also covered
on RTÉ Radio 1’s 7.00 News. There was also coverage
in national newspapers including The Irish Times, Irish
Independent, Irish Examiner and Irish Daily Mirror. Daragh
was interviewed across numerous regional radio
stations and there was also online media coverage in
TheJournal.ie and BreakingNews.ie.
You can also take part in the IPU Academy Spring Programme
Webinar series. Log-in at 7.30pm on Wednesday 8 February
to participate in a Heart Failure Management webinar, in
association with Novartis, presented by Professor Ken Mc
Donald and Dr Margaret Bermingham MPSI.
In case you missed our webinar from last month on Healthy
Ageing/Living, in association with Pfizer, presented by Professor
Des O’Neill, the recording will be made available on
www.ipuacademy.ie during February.
8
IPUREVIEW FEBRUARY 2017

NEW
THIS
MONTH!
Letters to
the Editor
If you have any comments,
queries or issues to raise, send
your “Letters to the Editor” by
email to ipureview@ipu.ie. By
submitting a letter to the Editor,
you agree it may be published in
a future issue of the IPU Review.
All letters should include the
writer’s full name and postal/
pharmacy address.
PharmaConex.com
Let us
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your Diary
FEBRUARY 2017
RECRUITMENT
Need a permanent Pharmacist, Technician or need to fill
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the support of the PharmaConex team.
4 February World Cancer Day,
www.worldcancerday.org
7 February The 13th National
Health Summit,
healthsummit.ie/
8 February IPU Academy Webinar
– Heart Failure
Management
13 February International Epilepsy
Day, www.epilepsy.org
25 February National Saddle Up
for Epilepsy cycle
www.saddleupfor
epilepsy.com
MARCH 2017
1 March National No Smoking Day
8 March Pharmacy Growth
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8 March International Women’s
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6-12 March National Brain
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awareness_week
24 March Diabetes Ireland Study
Day, www.diabetes.ie/
dice-2017
IPUREVIEW FEBRUARY 2017
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T:+353 1 4853522
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T: +353 61530202
Emergency Number: +353 83 117 9967 - E: info@pharmaconex.com

IPU NEWS
IPU Business Academy Spring
Programme 2017
The IPU Business Department and the IPU Training Unit endeavour to provide members and
their staff with the best-in-business training programmes and workshops through the IPU
Business Academy to help you maximise your pharmacy’s performance.
Your staff are a key source in the success of your pharmacy business. Well-informed staff
that confidently interact with your customers will help to maximise the quality of service that
you offer in your pharmacy. In these challenging times, staff training should not be seen as an
expense but as an investment to your pharmacy business.
We have put together a range of workshops and courses available in our Spring Programme
2017. Further information on the training provided, application forms, training grants and
upcoming events is available on www.ipu.ie > Training & Events.
If you would like to discuss any areas of training for you or any member of your pharmacy
staff, please contact Janice or Susan in the IPU Training Unit on 01 406 1555 or Darren Kelly in
the IPU Business Department on 01 406 1558.
IPU
Review
gets top
marks
• 93% of IPU
members read the
IPU Review
• 95% find the
format clear and
easy to read
IPU Training Unit
Schedule Spring 2017
Start Date Course Location
06 February Medicines Counter Assistant (MCA) Course Maldron Hotel, Limerick
07 February Medicines Counter Assistant (MCA) Course Rochestown Park Hotel, Cork
20 March Medicines Counter Assistant (MCA) Course Red Cow Moran Hotel, Dublin
21 March Medicines Counter Assistant (MCA) Course Ardilaun Hotel, Galway
13 March Medicines Counter Assistant (MCA)
Refresher Course
Butterfield House
21 February Supervisory Development Butterfield House
21 March Award in Leadership &
Management
TBC
Continuing Professional
Development (CPD) for
Pharmacy Technicians
Butterfield House
(Locations, Venues & Dates
to be confirmed)
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IPUREVIEW FEBRUARY 2017

IPU NEWS
IPU Business
Programme Schedule
Spring 2017
Start Date Course Location
14 February Retail Merchandising 101 Butterfield House
16 February Customer Service Butterfield House
22 February Retail Merchandising 101 Clayton Hotel, Sligo
22 February Essential Pharmacy Store
Management
Oriel House Hotel,
Cork
23 February Digital Marketing - Beginners Hodson Bay Hotel,
Athlone
7 March Essential Pharmacy Store
Management
Clayton Hotel, Sligo
8 March Digital Marketing - Beginners Oriel House Hotel,
Cork
9 March Digital Marketing - Advanced Hodson Bay Hotel,
Athlone
14 March Essential Pharmacy Store
Management
Butterfield House
15 March Digital Marketing - Beginners Hotel Kilkenny
21 March Essential Pharmacy Store
Management
Hodson Bay Hotel,
Athlone
22 March Digital Marketing - Beginners Butterfield House
23 March Retail Merchandising 101 Rochestown Park
Hotel, Cork
6 April Customer Service Butterfield House
11 April Retail Merchandising 101 Hodson Bay Hotel,
Athlone
12 April Digital Marketing – Advanced Butterfield House
13 April Retail Merchandising 101 Hotel Kilkenny
IPUREVIEW FEBRUARY 2017

PROFESSIONAL
Role of
Pharmacists
in Smoking
Cessation
Currently, two thirds of health professionals
do not routinely discuss smoking with
patients. Many are concerned that by
discussing the issue, patients may get
upset or angry. Yet not doing so is a missed
opportunity and may also reinforce the
belief that smoking is not a problem.
Pharmacists can play
a significant role in
motivating smokers
to quit. Evidence
has indicated that
when brief, simple advice
about quitting smoking is
provided, the likelihood that
someone will make a quit
attempt and remain smoke
free increases significantly.
More intensive advice may
result in slightly higher rates
of quitting.
Most smokers attempt to
quit more than once a year.
Over time, smokers will
typically make many attempts
to quit before succeeding.
Data from the Healthy Ireland
Survey 2015 indicates that
half of those attempting to
quit smoking in Ireland do
so without help. A further
29% of smokers trying to quit
use e-cigarettes as an aid.
Approximately 16% of quit
attempts are made using some
form of pharmacotherapy (for
example NRT).
Encouraging smokers to
make the first step towards a
quit attempt is very important.
Given that many smokers visit
pharmacies each year, it is
important that pharmacists
are prepared to intervene with
smokers who are willing to
quit. The HSE has developed a
national training programme,
Brief Intervention for Smoking
Cessation (BISC). Courses
are free and run regularly
throughout the country. You
can access details and register
to attend online at http://bisc.
quit.ie/zcourses.php. Ideally,
all healthcare workers who
have contact with smokers
should be trained in BISC
and have the appropriate
skills to motivate, encourage
and support quit attempts.
A suite of training materials
is also available on the HSE
website at http://bit.ly/
IPUReviewSmokingCessation.
This initial Brief Intervention
involves opportunistic advice,
discussion, negotiation and
12
IPUREVIEW FEBRUARY 2017

encouragement, and typically
takes between three and 10
minutes. Interventions may
involve referral to a more
intensive treatment. The
approach will depend on a
number of factors including
the individual’s willingness to
quit, how acceptable they find
the intervention on offer and
the previous ways they have
tried to quit. It may include
one or more of the following:
n simple opportunistic
advice to stop;
n an assessment of the
patient’s commitment to
quit;
n an offer of
pharmacotherapy and/or
behavioural support; or
n provision of self-help
material and referral to
more intensive support.
The essential features of
individual smoking cessation
advice have been described as
the 5 As, which provide a clear
step-by-step approach.
Framework for Brief
Interventions for
Smoking Cessation
n Ask: systematically
identify all smokers
at every visit. Record
smoking status, number
of cigarettes smoked
per day/week and year
started smoking.
n Advise: urge all smokers
to quit. Advice should be
clear and personalised.
n Assess: determine
willingness and
confidence to make a
quit attempt.
n Assist: aid the smoker
in quitting. Provide
behavioural support.
Recommend/prescribe
pharmacological aids.
If not ready to quit,
promote motivation for
future attempt.
n Arrange: followup
appointment
within one week or, if
appropriate, refer to
specialist cessation
service for intensive
support. Document the
intervention.
In addition to the 5 As,
the HSE has also developed
a quick 30-second guide
to support the initial
conversation with a smoker
and a guide to treatment
options available.
30 Second
Stop Smoking
Advice
When you only have 30 seconds, the most effective
thing you can do is ASK, ADVISE and ACT.
ASK:
Ask every patient about tobacco use at every healthcare
contact and record smoking status.
ADVISE:
“Quitting is the single best thing you can do to improve
your health. We need to do two things – give you
support and start you on medication. With medication
and support you are up to 4 times more likely to be
successful.”
ACT:
Inform: “The first few days and weeks after you quit
can be the hardest. Many people will go back to
smoking unless they get extra help. You will now get
the medication and support to help you.” Refer: “I would
also like you to call the HSE Quit Team @ 1800 201
203 or visit www.quit.ie, which is a free service. They
will give you tips on dealing with cravings, withdrawal
symptoms, smoking medications and help in staying
motivated. Are you happy to do that now?”
“Make Every Contact Count”
Just three
minutes of
your time could
help to improve
the health and life
expectancy of
smokers
What tips can you give
the smoker?
n Prepare to quit smoking
Write down reasons for
stopping and keep them
close at hand. Weigh up
the pros and cons.
n Make a date to
stop smoking
Pick a date to stop
smoking and stick to it.
n Seek Support
Seek the support of family
or friends. Talk to your
doctor or pharmacist
about the best appropriate
medication to support
quitting. A combination
of Nicotine Replacement
Therapy (NRT), e.g.
IPUREVIEW FEBRUARY 2017 13

patch, as a baseline and
top up with on-demand
products such as NRT
gum, quickmist spray etc.
can greatly increase your
chances of success or
your doctor may prescribe
other medication such as
champix, if appropriate.
n Change your routine
& plan ahead
Smoking is often linked to
certain times and situations
such as the first smoke
in the morning, drinking
coffee or alcohol. Replace
these triggers with new
activities.
n Increase Physical Activity
Regular exercise
contributes to good health,
helps to manage weight
and can also improve the
body’s ability to meet the
demands and stresses of
daily living.
n Think positive
You may find you
experience withdrawal
symptoms once you stop
smoking. These are very
positive signs that your
body is recovering from the
effects of tobacco. Some
common symptoms are
coughing, irritability, sleep
disturbance and cravings.
Don’t worry, they are all
perfectly normal and
should disappear within a
few weeks.
n Learn to deal with cravings
Cravings can occur
frequently during the first
few days after stopping
smoking. A craving
increases in intensity over
a period of 3-5 minutes and
then begins to subside.
n Start saving money
Put away the amount of
money you would normally
spend on tobacco. Work out
how much you spend on
cigarettes per week, month
and year; then watch your
savings grow. The average
20-a-day smoker spends
around €330 a month and
over €4,000 a year.
n Watch what you eat
If you are worried about
gaining weight, be extra
careful with your diet. Avoid
snacking on chocolate bars
and biscuits; try some fruit,
sugar-free gum or popcorn
instead.
n Take one day at a time
Remember, every day
without a cigarette is good
news for your health, your
family and your pocket.
The health benefits
of quitting are almost
immediate and the list
below can encourage
people to stay smoke free.
More information on
how to quit smoking
is available from
www.cancer.ie/reduceyour-risk/smoking
or
www.quit.ie, or call the
Quitline, Freephone
1800 201 203.
Tips for cravings
– The 4 Ds
1. Delay at least 3 minutes and the urge will pass.
2. Drink a glass of water or fruit juice (sip slowly).
3. Distract yourself. Move away from the situation.
4. Deep breathe. Breathe slowly and deeply.
It will help you to relax.
FANCY A MERCHANDISING
PLAN TAILOR-MADE FOR
YOUR PHARMACY?
For further information on the IPU Retail Review service, please contact
Darren Kelly on (01) 493 6401 / 086 028 9825 or email: Darren.kelly@ipu.ie
IPU Retail Banners 190X45 MAR16 ART.indd 1 25/03/2016 17:54
14
IPUREVIEW FEBRUARY 2017

MINI
3
*
MINUTES
START TO RELIEVE CRAVINGS IN JUST
*4mg lozenge vs. placebo
START
TO RELIEVE
CRAVINGS
IN JUST
minutes *
*4mg lozenge vs. placebo
Mini Lozenges:
Starts to relieve
sudden cravings fast *
Patch:
Smart control technology
for 24 hour craving control
*4mg only
Product Information: NiQuitin Mini 4 mg Mint Lozenges (nicotine) and NiQuitin Clear 21mg/24hrs transdermal patches (nicotine). Indications: Treatment of
tobacco dependence by relief of nicotine withdrawal symptoms and cravings. Use with behavioural support. Legal category: GSL. PA 1186/18/12 and PA 1186/18/3.
Licence Holder: Chefaro Ireland Ltd. First Floor, Block A, The Crescent Building, Northwood Office Park, Dublin 9, Ireland. Information about this product, including adverse
reactions, precautions, contra-indications and method of use can be found at: http://www.medicines.ie/medicine/14492/SPC/NiQuitin+Mini+4mg+mint+lozenges/ and
http://www.medicines.ie/medicine/12138/SPC/NiQuitin+CLEAR+21+mg+24+hours+transdermal+patch/ Date of revision: August 2016.

BUSINESS Jim Curran, Director of Communications & Strategy, IPU
Crime against
Pharmacies Reaching
Crisis Levels
In this article, Jim Curran, Director of Communications &
Strategy, IPU, details the key findings from the IPU’s Annual
Pharmacy Crime Survey 2016, providing some insights from
members to their experiences and some potential solutions to
address the scourge, which is crime against pharmacies.
The IPU’s Annual
Crime Survey
2016 reveals that
crimes against
pharmacies
continue to rise with three out
of four pharmacies (77%) the
victims of crimes in the last
12 months, up from 74% in
the previous year. The survey,
which was undertaken at the
beginning of January, confirms
that 78% of those who were
victims of crime experienced
two or more incidents, with
a significant 23% describing
the incident as ‘violent’.
Worryingly, in one in five cases
where there was a robbery or
a raid, the perpetrators had a
weapon, with a knife used in
81% and a gun in 18% of these
cases.
The research also found that:
n 92% of pharmacies who were victims
of crime experienced shoplifting, 19%
robbery, 15% fraud and 6% experienced
a raid.
n In one in five cases (21%), cash was
taken. In 12% of cases, over-the-counter
drugs were taken and controlled drugs
in 9% of cases. Cosmetics (89%) and fake
tan (42%) are the most likely items to be
shoplifted from pharmacies.
n 71% reported the case to the Gardaí,
with 66% happy that their case was
dealt with effectively/adequately. Of
those who did not report the crime to
the Gardaí:
• 70% said there was a perception
that the crime was too trivial;
• 33% had a lack of faith that the
criminal would be charged;
• 37% had no confidence in the
Garda response; and
• 6% feared reprisals against
the pharmacy.
n 97% have invested in CCTV to protect
their staff and their businesses. 91%
have invested in an alarm system.
16
IPUREVIEW FEBRUARY 2017

n 75% of respondents are aware of the services of the Garda
Crime Prevention Officers with 80% using these services.
n 90% reported that more visible policing would be effective
in reducing crimes, 89% identified CCTV Surveillance, 87%
tougher sentencing and 86% viewed a faster Garda response
as the most effective way of deterring criminals.
The findings from the
survey were described by IPU
President Daragh Connolly
as “shocking” and he was
particularly concerned at
the level of violent crimes
against pharmacy staff, which
he described as “extremely
worrying and utterly
unacceptable”.
“Almost one in four cases
against pharmacies are
‘violent’ in nature, involving
not only a physical threat
but also a substantial
psychological threat to
victims. It is difficult enough
to run a pharmacy in
the current environment
without being the target for
criminal activity that not
only has a significant cost
factor but, more importantly,
has a detrimental impact
on pharmacy staff. It is
unacceptable that pharmacy
owners and their staff are
viewed as ‘soft targets’ where
the probability of repeat
offences is high and the risk of
apprehension and penalty is
low,” he said.
A number of respondents
to the survey had serious
reservations with regard to the
ability of the justice system
to identify and adequately
convict perpetrators of
crime. There is particular
annoyance at the judicial
system, primarily due to the
leniency in sentences and the
feeling that perpetrators are
not adequately punished as
a deterrent to prevent them
committing further criminal
acts. One respondent to the
survey said, “Very frustrating
that even when people are
charged with shoplifting, they
seem to get away with a slap
on the wrist. Furthermore,
there is never a mention of
them having to return stolen
stock.”
Other respondents were
critical of the follow-up to
reported crimes with many
confirming that they have
received no feedback. One
pharmacist commented, “It is
very difficult to obtain status
updates on reported crimes.
I have reported crimes on
many occasions but have
rarely received feedback.”
Another respondent said, “On
several occasions in the past,
I have printed off photos and
provided visual footage of
thefts taking place but have
never been informed of any
conviction.”
While there is a level of
sympathy for the Gardaí,
many respondents remain
extremely frustrated by the
Garda response times, the lack
of Garda response and followup
in some instances, and by
the general lack of visibility of
Gardaí on the ground.
Daragh Connolly added, “It
is not an exaggeration to say
that crime against pharmacies
has reached crisis levels. The
appalling level of crime should
send out a strong message to
the authorities that unless
immediate action is taken,
criminals will continue to see
retail businesses, including
pharmacies, as an easy target.
The belief that criminals
will not be charged, and the
revolving door scenario in
our Courts for the few that
are charged, is giving the
impression to thieves that
their criminal activities will go
unpunished. It is imperative
that a strong message goes
out that criminals will be
apprehended and dealt
with appropriately by the
authorities, including tough
mandatory sentencing. If not,
this sinister and frightening
pattern of crime on
pharmacies will continue to
the detriment of pharmacists
and their staff, and the local
communities we serve.”
Overall, a high level of
visibility of Gardaí and proper
sentencing were deemed by
survey respondents to be
the most effective ways of
reducing crime figures and the
amount of crimes perpetrated
against pharmacies, pharmacy
owners and pharmacy staff.
SECURITY
INFORMATION
The IPU provides advice to members regarding
pharmacy security and support for those who have
been robbed/broken into. Darren Kelly provides advice
to members on all issues around pharmacy security
and also liaises with the Gardaí. He can be contacted
at darren.kelly@ipu.ie or on the direct business line at
01 406 1558.
Aoife Garrigan deals with the reporting and
monitoring of raids and break-ins. In the event of a
raid or break-in to the pharmacy, please contact Aoife
Garrigan at aoife.garrigan@ipu.ie / 01 406 1557. Aoife
provides a Security Pack to members, which contains
information on our Member Assistance Programme.
This is a confidential counselling and specialist
information service for all fully paid members and
their families, provided by VHI Corporate Solutions.
The pack also includes information on preventing and
reducing customer theft and the Crime Prevention
Officer Contact details.
IPUREVIEW FEBRUARY 2017 17

Ostomy &
Surgical Care
“
We ensure that patients
can lead as normal a life
as possible.
”
Patient-centred focus on ostomy improves the
quality of life for thousands of Irish patients
Every year in Ireland 1,000
patients have a stoma
procedure following surgery
to deal with potentially life
threatening diseases. The
reality for these patients is
that they will have either
a temporary stoma or, for
many, a permanent one.
This life changing procedure
can be very distressing for
patients, particularly younger
people who have their
whole lives ahead of them.
Thoughts abound about the
practicalities of wearing a
pouch, how to keep a stoma
clean, what clothes can you
wear and how uncomfortable
it will be. However, there
is support and information
available to alleviate many of
these concerns.
UNITED DRUGS INNOVATIVE CUTTING
MACHINE ENSURING THE PERFECT FIT
FOR PATIENTS
“We are acutely aware of the
difficulties faced by patients,
as reported through their local
Pharmacy” said Jean Tomkins,
Business Manager for the
Ostomy Unit at United Drug.
“They want to know what
choices are available to them
in managing their condition,
but feel that they cannot
deviate from the particular
brand of ostomy product
they are initially prescribed.
Indeed, very often they are
unaware that there are other
options available at all.”
For many, the first port of call
is often the local pharmacist,
from whom they collect their
prescriptions.
United Drug are committed
to ensuring a good quality
of life for stoma patients
by delivering products and
services that make life more
dignified and rewarding for
patients. Reliable and efficient
ostomy healthcare enables
patients of all ages to achieve
greater independence.
In response to the growing
need for additional support,
United Drug has established
a dedicated ostomy unit that
provides advice, information,
training sessions and
access to dedicated stoma
nurses, employed by the
manufacturing companies,
who are available to both the
pharmacist and the patient.
Ms Tomkins is quick to
assure pharmacies that many
options are available for
ostomy patients.
“Patients should wear stoma
products that specifically
suits their needs and, to that
end, we are in regular contact
with pharmacists throughout
the country to advise
them of new products and
innovations. Last year, for
example, the PCRS allowed
a number of new companies
and products to enter the
Irish market. This meant we
could advise pharmacists
and send samples if required
and work with them to find
the product that worked best
for their patients.”
There are a lot of common
misconceptions regarding
stomas, not least that all are

of a similar shape and size
and that a ‘one fits all’ policy
for ostomy products is suffice.
In reality, the human body
does not conform in this way
and, as a result, many patients
suffer needlessly with poorly
fitting ostomy pouches.
“We recognised this problem
a number of years ago,” Ms
Tomkins said, “and set about
tailoring ostomy products for
patients, which was a first for
Ireland. We invested in hightech
cutting equipment that,
using a template specifically
taken by a stoma nurse will
ensure the pouch fits perfectly.
This template is then kept on
record for future orders and
can be altered if the size or
shape of the stoma changes,
which frequently occurs.”
United Drug operates a
same-day and/or next-day
delivery service for ostomy
products. Distributed from
its headquarters in Magna
Park, Dublin, orders placed
can be dispatched through a
nationwide delivery service
within hours, depending on
location and the time of day
that the order is placed. This
ensures that products will be
available to the pharmacist/
patient within the shortest
practical timeframe.
“At United Drug, we are
cognizant of the fact that
ostomy pouches are not the
only products required by
stoma patients,” Ms Tomkins
concludes. “We also offer a
wide range of accessories
including deodorants, adhesive
removers, stomahesive pastes,
powders, and wipes. We
are also keenly aware of the
practical limitations involved
and stock a wide range of
underwear, swimwear and
hernia supports to ensure
that patients can lead as
normal a life as possible.”
For more on United Drug’s
ostomy unit, see
www.ud-ostomycare.ie
Meet the Team
Five Most Frequent Questions
We asked Leo what are some of the most popular concerns
from Pharmacists and Patients:
1. The patient is getting a bad odour from the pouch.
The patient can use the DEODOUR 005013A TABLETS which can be
put into the pouch to prevent the odour.
2. The patient is going to a wedding and is afraid that the
pouch might leak or even fall off.
The patient can use the Coloplast 12070 Brava Elastic Tape, which will
help prevent this.
3. The Patient is using a remover spray and it’s stinging
and causing pain.
The patient can use the NILTAC SPRAY/WIPES which are sting free.
4. The patient skin is getting red due to body fluids,
excoriation and harsh medical adhesives.
The patient can use the EAKIN PROTECT SPRAY/WIPES which are
non-sting formula and means no pain on application.
5. The contents of the patients pouch is moving around
and causing an embarrassing noise.
The Patient can use the ABSORBAGEL SACHETS 9900 TABLETS
which solidifies the contents of the bag and stops the noise.
If the patient has a more serious request we will recommend a Stoma
Nurse to call out to the privacy of their home to have them reassessed.
This service is free of charge.
JEAN TOMKINS
BUSINESS MANAGER
OSTOMY UNIT
UNITED DRUG
LEO PIKE
OSTOMY UNIT
UNITED DRUG
PAUL NOWLAN
OSTOMY UNIT
UNITED DRUG
For specialised Advice and Queries
Contact:
Leo Pike – Dublin 01 463 2347
Liam.Pike@united-drug.com
Paul Nowlan – Dublin 01 463 2305
Paul.Nowlan@united-drug.com
Ostomy Business Unit Manager:
Jean Tomkins 087 913 8187
Jean.Tomkins@united-drug.com

BUSINESS James Colville, Partner and
David Kennedy, Solicitor, DAC Beachcroft Solicitors
Stop that Thief!
As solicitors, we are seeing a marked
increase in the number of defamation claims
arising from retailers incorrectly accusing a
person of shoplifting. If a Plaintiff can prove
that he was defamed in such a scenario,
Judges are typically awarding damages of
between €10,000 and €15,000 per incident.
While this range is a good general guide to
awards, there have been instances of courts
awarding up to €50,000. The following
article is a brief overview of defamation and
some practical advice as to how to protect
yourself from such a claim.
Key Points
While it is not possible to
provide absolute certainty
as to how to manage this,
the following guidelines are
suggested:
n The individual should be
approached so as to not
cause embarrassment or
offence;
n Make any approach out
of the earshot of other
customers; and
n Ask the person to
accompany you to a
quiet area.
Imagine the scene. . . you
are standing behind your
counter and you see someone
in the pharmacy that is acting
unusually. You are serving
a customer but you are also
trying to keep an eye on the
suspicious individual at the
same time. You suspect that
the individual may have
shoplifted some goods. What
do you do? In reality, it is
necessary for you to exercise
extreme caution. The law of
defamation is governed by
the Defamation Act 2009 (“the
Act”). The following summary
explains the nature of the
Act and the various defences
under it. The Act seeks to
perform a delicate balancing
act between the right of
the individual to his or her
reputation and the right of
free speech.
20
IPUREVIEW FEBRUARY 2017

What is defamation?
A defamatory statement is
defined as one “that tends to
injure a person’s reputation
in the eyes of reasonable
members of society”. In
order for a statement to
be actionable, it must be
published by any means to
one or more people.
Returning to the scenario
above, if the person who was
acting suspiciously started to
leave the pharmacy and you
shouted out to the customers
nearer the door “Stop that
thief!”, and it then transpired
that the person had not in
fact shoplifted, this would
potentially be a defamatory
statement and the individual
would be able to pursue a
claim against you.
A person who has allegedly
been defamed can pursue
proceedings in either the
Circuit Court, which can
award damages up to
€50,000, or in the High Court
where such cases are still
heard by a jury. In the High
Court, a person who has
defamed an individual can
be ordered to pay damages,
Special Damages, Aggravated
Damages and occasionally
Punitive Damages. Further, if
the individual establishes that
he/she has been defamed,
you will also have to pay their
legal costs. Such a claim can
be extremely expensive.
A person who believes that
they have been defamed,
however, must swear an
affidavit verifying the
assertions of fact which they
seek to rely upon in order
to prove the case. If it is
subsequently established that
the information contained in
the plaintiff’s court pleadings
is false or misleading, then
he/she will be deemed to
have committed an offence
under the Defamation Act
and is potentially liable to
imprisonment and or a fine at
the discretion of the court. In
our view, this is the legislation
trying to balance the impact
of the Act; however, this
does not limit the need for
you to be extremely careful
about accusing someone of
shoplifting.
As mentioned above, a
defamatory statement will
not become actionable until
the moment it is seen, heard
or otherwise brought to the
attention of a person other
than the plaintiff. The Act
refers to the need for the
statement to be “published”.
Publication does not mean
that it is limited to a printed
statement. A statement
can be published orally or
in writing. Visual images,
sounds, gestures and any
other methods of signifying
meaning can also constitute a
statement.
Defences under the
Defamation Act
There are several defences
to an action in defamation
within the Act. Some of these
are relevant to the scenario
above.
1. Truth
This means that you can
successfully oppose a claim
for defamation if you can
prove that the relevant
statement was true in all
material aspects. Effectively,
it would be necessary
for you to prove that the
individual was in fact a
thief and that he had stolen
goods from your pharmacy.
It is necessary to prove the
truth of every allegation
that has been published
and show that the allegedly
defamatory statement
was “true in all
material respects”.
This defence is
rarely used as a
stand-alone defence
and would usually
be one of a number
of defences pleaded.
Were it to fail, a court or
a jury will have grounds
to make an award for
Aggravated Damages.
2. Qualified Privilege
Qualified Privilege may
be pleaded as a defence
where a statement was
published to a person
who had a legal, moral
or social duty to receive
the information, or where
the defendant reasonably
believed that the person
had such a duty or interest
and the defendant had
a corresponding duty
to communicate the
information.
The leading judgement
in this area was given by
Mr Justice Hardiman in the
Supreme Court in the case
of John McCormack v Adrian
Olsthoorn. The case arose out of
a relatively innocuous incident,
namely the alleged theft of
a tomato plant at the Milk
Market in Limerick. It was an
action for assault, battery, false
imprisonment and defamation.
Mr McCormack had bought a
tomato plant on a Saturday
shopping trip. He then went
into Limerick Milk Market
hoping to buy another plant.
He stopped at Mr Olsthoorn’s
market stall to look at his
plants. He then moved on,
taking with him the original
plant that he had bought from
another shop. Mr Olsthoorn
saw this and thought that Mr
McCormack was taking a plant
from his stall.
There was a dispute
about the evidence as to
what exactly occurred
when Mr Olsthoorn stopped
Mr McCormack; however,
there was no dispute that
Mr Olsthoorn accosted
Mr McCormack and then
upon realising his mistake,
backed off. The court had
to determine whether Mr
Olsthoorn’s comments to Mr
McCormack made in the full
hearing of everyone in the
Milk Market were protected
by qualified privilege. Mr
Justice Hardiman held that
the prevention of a suspected
theft was an occasion of
qualified privilege and that Mr
Olsthoorn “had a legal right to
protect his property”.
However, this does not give
shop owners carte blanche
as to how they deal with
suspected thieves. The defence
of qualified privilege can be
lost if there is either malice on
behalf of the maker or if there
has been excessive publication
of it. There is no definition
within the legislation as to
what constitutes “excessive
publication”.
Each scenario will turn
on its own facts and it
is impossible to give any
absolute certainty as to
how you can safely stop an
individual who is suspected of
having stolen your goods. In
reality, in order to avoid such
claims, it is most important
“ You suspect that the individual may have
shoplifted some goods. What do you do?
In reality, it is necessary for you to exercise
extreme caution.”
IPUREVIEW FEBRUARY 2017 21

that you have a defined policy
and that your staff have been
trained in what to do. It is
very dangerous to accuse an
individual of stealing some
property unless you have
absolute knowledge that he/
she did take the goods. If
you have any doubt about
this, extreme caution has to
be exercised if you propose
to stop an individual. It is
extremely important to
be discreet and polite. The
whole approach should be
done in such a way so as
not to cause any offence
or embarrassment to the
individual you are stopping.
Try to ensure that there are no
people within close proximity
who can overhear your
conversation. Unless you have
absolute certainty that the
individual has stolen goods,
it is extremely dangerous to
make any allegation that there
has been a criminal act or
wrongdoing on the individual’s
behalf.
Caution also needs to be
exercised as to how you stop
the individual or where you
ask them to move to within
the store. In the McCormack
case, Mr Justice Hardiman
did find that Mr Olsthoorn’s
comments were reasonable
under the defence of qualified
privilege. He went on to
say that these are difficult
situations that often develop
quickly and there is little
time for careful selection of
words. The mere fact that
reactions were instinctive
and hurried does not deny
the fact that there was a
desire to stop bona fide but
mistakenly suspected theft.
Effectively, you must show
that there were “reasonable
grounds or evidence before so
acting” and that you “must not
immediately jump to a rash
conclusion” if you want to rely
upon the defence of qualified
privilege. In the McCormack
case, whilst the action for
defamation was dismissed, Mr
Justice Hardiman did, however,
accept that Mr McCormack
had been falsely imprisoned,
albeit extremely briefly, and he
was awarded €3,500. This was
as a result of Mr Olsthoorn
preventing Mr McCormack
from leaving for a few
moments whilst he worked
out where the tomato plant
Mr McCormack was carrying
had come from.
Conclusion
As stated above, it is not
possible to give absolute
certainty as to how to stop
someone you suspect of
shoplifting and each case will
turn on its own facts. Your
staff should be trained about
the need to approach such
an individual very sensitively
and quietly out of earshot
of any other customers and
ask them a question which
delays the individual without
making any accusations
of theft or dishonesty. A
contemporaneous note
should be made of the
incident immediately after
it occurs and this should be
as detailed as possible. In
addition, CCTV footage of any
suspected incident should be
retained where possible. The
above steps will not prevent
a defamation claim being
pursued if you have wrongly
accused someone; however,
it will increase the prospects
of successfully defending it.
Finally, these claims are often
covered by your public liability
insurance policy; you should
confirm with your broker
whether this is something that
is covered under your policy.
James Colville (jcolville@
dacbeachcroft.co) and
David Kennedy (dkennedy@
dacbeachcroft.com) of DAC
Beachcroft Solicitors (01 231
9600) are specialists in the
defence of claims on behalf of
both insurers and their insured.
DAC Beachcroft, a global law
firm, is a recognised market
leader in dispute resolution
law. This article is for general
information purposes only and
does not comprise legal advice on
any particular matter. You should
not rely on any of the material
in this article without seeking
appropriate legal advice.
22
IPUREVIEW FEBRUARY 2017

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INTERVIEW Aoibheann Ní Shúilleabháin, Communications Manager, IPU
Interview with
Jonathon Morrissey,
Marron’s Pharmacy
Marron’s Pharmacy, Clane,
Co. Kildare, recently won the
Actavis Academy Training
& Mentoring Bursary, which
was supported by the IPU.
The pharmacy’s vision, which
won them the bursary, is to
develop their Community
Pharmacy Triage Service.
Aoibheann Ní Shúilleabháin,
Communications Manager,
IPU, spoke with Jonathon
Morrissey, Supervising
Pharmacist, about his vision
for the pharmacy.
Why did you set up the
Community Pharmacy Triage
Service in your pharmacy?
I went to the Royal College
of Surgeons Ireland and I
got an incredible education
because we trained alongside
the medical students; the
same staff that were training
pharmacists were also training
doctors.
When you work in a small
town like Clane, everyone
knows who you are so you get
people asking for antibiotics
all the time. My patients
might think they have a UTI
and ask for an antibiotic.
Obviously, you have to say,
“No, you can’t, you have to
have a prescription, that’s the
law”. But when you’re in a
community, saying no like that
is a negative – “He just always
says no” – so I thought, “I’m
going to perform a service that
will actually tell them no for a
reason”.
Now, if someone told me
they think they have a UTI, I
would ask them to bring in a
urine sample and check for
white blood cells, protein,
blood, and from that you can
then say, “You could possibly
[have a UTI] so you definitely
need to go see your doctor
now”. If they didn’t have any
of those, you’d say, “Well, your
urine is clear from all of these
things so it doesn’t look like
you have a UTI; you definitely
don’t need an antibiotic”.
That was the initial
approach and then that
expanded into people coming
in saying, “I’ve a sore throat,
I need an antibiotic”. So you
look at their throat and tonsils,
and if they look normal, are
a nice healthy colour, they
Pictured are: Desmond Marron
and Jonathon Morrissey
of Marron’s Pharmacy and
Marguerite Tierney, Product
Manager, Actavis Ireland.
24
IPUREVIEW FEBRUARY 2017

don’t look inflamed and there
are no white spots, I tell them
I think it’s just viral. So you
aren’t just simply saying no
to your customers that are
coming in, not feeling well.
Maybe they didn’t want to pay
the doctor €50, maybe it was
pre-KDOC [an out-of-hours
GP service in Kildare and
West Wicklow] times, maybe
they didn’t have a car to go
to KDOC etc. So we ended up
performing clinical services
to rationalise to people to
say, “You have to go because
you have this infection, I can
see it”, as opposed to just
saying, “I’m not giving you an
antibiotic because you need a
prescription for it; you have to
go to the doctor”.
I’ve been doing this for
years. When the free GP under
6 scheme (as well as the free
GP over 70 scheme) came out,
it was in the media that GPs
were saying their surgeries
were full. A lot of people did
go to the doctor because
they didn’t have to pay for it.
Payment can be a barrier to
attendance so they were able
to go fairly easily, which meant
the doctors who are totally
under resourced became
overwhelmed. That meant that
everyone (paying customers
and people who get in for free)
wouldn’t get an appointment
for possibly up to three or four
days around here.
I had an example with one
of my patients, who has been
a patient since we opened,
which is 60 years this year.
Her daughter rang me because
she thought her mum had a
UTI. I asked if she rang the
surgery and she had – this
was a Thursday and they
had an appointment for
her on Tuesday. Her mother
is 92! She asked if there was
anything I could do and I said,
“Of course there is – bring me
down a sample”. She did that
and I put a urine dipstick in,
which confirmed an infection.
So I told her she was now
justified to put her 92-yearold
mother in a car and go to
KDOC because there was an
infection there that could not
wait until the Tuesday. So that
was the triage working.
The same model applies to
kids. I had parents talking to
me on a Monday saying their
child wasn’t well with a sore
throat and sore ear. They’d
called the surgery but they
didn’t have an appointment
until Friday, and asked if there
was anything I could do. So
I’d have a look at their throat
and use an otoscope, very
cautiously, for their ear. If it
looked healthy (no bulging,
no hole etc.), I’d recommend
to manage it with some
painkillers while they waited
for their appointment with
the GP. If they felt better in the
meantime, they could then
cancel their appointment. Or
what could have happened
is you looked into the child’s
throat, you saw those white
spots on the tonsils and
you know that’s
definitely a
bacterial
infection and they need to go
to KDOC.
So the triage was a way of
reaffirming or telling someone
that their interpretation may
not be correct – so you’re
confirming they may need
an antibiotic or you’re saying
it’s viral, and you give your
rationale.
But as I always say to
parents, if I don’t know what’s
wrong, I’m still going to refer
you. You always give the
caveat – if this changes or this
happens, you need to go to
your prescriber.
How did you decide on what
common ailments to include in
the service?
Urine analysis is part of it
because it’s easily done but
clinically relevant. The throat
is a highly common one as
well. So many viral infections
start off with a sore throat but
can progress to tonsillitis or
strep throat. But again, it’s a
non-invasive easily accessed
part of the body that you can
have a look at and give an
opinion on it. And the ear is
the same –you’re not going
to use any instrument that
breaks the skin; it allows you
to visualise properly because
you’re
magnifying under
illumination the site that you
want to have a look at. And
again, taking a temperature
is non-invasive and easy to
do. So you encompass those
conditions where looking in a
throat or an ear is warranted
versus, say, when someone
thinks they have a chest
infection, you’re getting into
stethoscope space, which
you’re not practised at and
have never done. For me,
that’s the wrong way to go.
It was the simplicity of the
conditions that enabled me
to have a look at them which
made me pick them.
Do you envisage any objections
to providing this service to
patients?
I have never had anyone pick
up the phone and say, “You
shouldn’t be doing that”, and
any pharmacists I’ve said it
to have said, “I think it’s the
best thing I’ve ever heard
but I wouldn’t know how to
go about it”. So if I get the
training and I can train them,
then they know how to go
about it. It would be trying
to learn and package up a
framework for my colleagues
so that they could try it.
Go back 20 years,
pharmacists wouldn’t
carry out blood pressure
measurements. . . and look
how we’ve evolved. This
is the next level. Before
Dermot Twomey,
pharmacists would
never have thought
about doing an
INR and working
with their local
hospitals for the
convenience of
their patients.
” I think the biggest challenge for pharmacy
at the moment is proving our value in the
public space. Pharmacists are great; I love
our profession. We do a lot of unsung hero
work that doesn’t get recognised.”
IPUREVIEW FEBRUARY 2017 25

Pharmacy is transitioning,
and transitioning for the best.
Pharmacists didn’t think
they would be doing the flu
vaccination service and now
it’s expanded to pneumococcal
and shingles, and hopefully it
will go on to include travel.
You’ll always have people
who secretly don’t like what
you’re doing. We have heard
GPs saying their surgeries are
full of kids and full of elderly
people, and what they do not
have time for then is their
private consultations, which
is what their practices need.
Their fees for the under 6s and
over 70s are fixed, so if they
had less of these attending,
they wouldn’t be saying
they’re overwhelmed.
Some doctors probably think
that pharmacists are putting
their hands in doctors’ pockets
for the flu jab. But the first few
years I was giving the flu jab,
when I asked people if they’d
gotten the flu jab before, they
said no; which doctor’s pocket
did I put my hand into? And
then those who said they had,
when I’d ask when they last
got it, it would be five years
ago; so which doctor did I take
that income off in the last five
years?
I think the biggest challenge
for pharmacy at the moment is
proving our value in the public
space. Pharmacists are great;
I love our profession. We do a
lot of unsung hero work that
doesn’t get recognised because
it’s always brought back to the
price of drugs, which we play
very little role in.
Do you see the service
expanding?
Yes, I do see it expanding.
There will be a time where you
listen to a chest and hear a
crackle and be able to advise
patients to go to the doctor.
But specialise in this first. My
hope is to get trained up so
that I can educate others on it,
which would improve access
to this type of service to
patients across the country.
So you think this is a service
that pharmacies nationwide
should be providing?
100%, and I know for a fact
that there are plenty of other
pharmacists who will look into
a throat in an effort to try and
see the dreaded white spots to
be able to say, “You might need
an antibiotic”. But it would be
nice to design a protocol or
a framework and put some
referral criteria to that. We’re
going to need collaboration
with medical people to do
that. But really, if we can
train parents and patients to
pop into their pharmacy first
to have a look, we can stop
them going to the waiting
room, which is holding up an
appointment for someone who
really needs to go.
What training will you and
your staff undertake in order to
provide this service?
This has been a learnt-onmy-feet
process. Pharmacists
look at rashes every day
and they know what
inflammation looks like. I
don’t need training to say,
“That’s inflammation”, but I
would love specific training
to further educate me to
be more specific about the
potentials. When someone
has an ulcer on their throat,
what does that mean; what
is the best course of action?
When you see a tympanic
membrane and you see a
bulge on that, you know that’s
abnormal; it’s swollen, that’s
like a pre-perforation that’s on
its way to bursting.
I would love the training for
myself to be able to say, “I’ve
been signed off to do that”.
Just like with IM injections.
Initially we were trained to
give the flu jab and then they
woke up and they trained
us to do intramuscular and
subcutaneous. So now if a
patient of mine asks me to do
an intramuscular injection,
nobody can say I’m not
qualified to do it – because I
am.
I just need to find someone
now who I can get the training
from. I’ve thought about
Queen’s University Belfast; I’ve
thought about my old college
professor Paul Gallagher to
see if he’d have any sugestions
on how to progress the idea.
Queen’s might be a runner
because they currently teach a
prescribing course and as part
of all that, they do your vitals,
which includes otoscope work.
What I want is someone
to formally teach me how to
properly hold an otoscope so
that, even if the patient moves
their head, you wouldn’t
cause them any harm; how to
conclusively say, “Well that’s
strep throat, that’s bacterial
tonsillitis or that’s viral
tonsillitis”. And from that I
want to design protocols that
obviously I will use but, if I
can, then go and train other
pharmacists to do it, to start
triaging people properly, so
that we can direct people
appropriately.
If I get that formal training,
then I don’t think anyone can
say that I’m not authorised to
pass that information on to
other people, which is what I
really want to do. I want every
pharmacy in every corner of
the country to offer this and
add it to their list of services
that they offer in their
pharmacy, which would help
their businesses.
The two-day mentoring
workshop with Bobby Kerr is a
fantastic opportunity included
in the bursary. What do you
hope to get from this workshop?
I’m really looking forward
to it. We’re in operation 60
years; I’m only in pharmacy 10
years so a lot of transition has
happened in that time. We are
about to undergo a huge refit
and completely transform how
we look to people. The guts of
it are going to be the same; the
staff are going to be the same,
the level of service is going to
be the same and the quality of
service is going to be the same.
When you do that refit, it’s to
freshen everything up; it’s to
make everything look good
and nice, and keep with the
times and everything like that.
We don’t turn our staff over
very much; everyone that is
here is here at least five years.
When you’re in the same
place a long time, you develop
bad habits. I’m not a retailer,
I’m a pharmacist. I have my
notions about retailing, but I’m
a pharmacist, I’m a caregiver.
I’m there to help people get
better from illness or manage
them through illness.
So I’m hoping Bobby will
come in and say, “You do that
really well; that could be
better; this needs to change”,
and just to get that insight
from someone who is very
successful in business.
The Actavis Academy Training &
Mentoring Bursary was developed
to support pharmacy businesses
to access training and mentorship
in order to be leaner, faster and
stronger. The bursary consists of
€5,000 towards training for the
pharmacy and a two-day business
mentoring workshop with Irish
entrepreneur and presenter of
Newstalk’s Down-to-Business
show, Bobby Kerr. Entries were
judged by Mary O’Meara, Head
of Regulatory Affairs, Actavis
Ireland; Bobby Kerr; and Daragh
Connolly, IPU President.
26
IPUREVIEW FEBRUARY 2017

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PROFESSIONAL Michelle McDonagh
Report of PSI
Public Council
Meeting of 8
December 2016
PSI Registration Fee
Review approved for 2017
The PSI Council has approved
a registration fee review
for 2017 after hearing of
serious concerns about
the level of deficiency in
the organisation’s annual
budget. The Chairman of the
Administration and Finance
Committee, Shane McCarthy,
told the public meeting of
the PSI Council in December
that the Committee was
recommending a fee review
due to an “unsustainable
and indefensible” level of
deficiency in the budget
figures.
Mr McCarthy told the
meeting that there seemed to
be “a budget problem in terms
of us as an organisation”. He
said a projected deficiency
of €48,000 had grown to over
€300,000 in 2016, creating
a huge concern for the
Committee. “There seems to
be a trend towards deficiencies
getting larger and larger; there
is a projected operating net
deficit of €685,000 for 2017.”
The Committee
recommended a review
commencing in January 2017,
saying it was a nine-month
process, and Mr McCarthy
stated that they would, in all
likelihood, need to recommend
a fee review in 2018 as well.
He explained that the
Committee had gone through
the budget line-by-line seeking
justification for different
cost levels and had identified
savings of approximately
€230,000 for 2017, but they
were still at an operating
deficit of €680,000 after
making that saving.
Mr McCarthy said there
certainly was not unanimity
of satisfaction among the
Committee members as to
how the PSI expedited the
management of funds. There
were particular concerns
raised about a PR contract
which cost approximately
€150,000 annually and was
renewed twice without going
to tender, he said. When the
contract went to tender, it
came in at under €30,000, a
mere fraction of what they
had been paying.
Approval of budget
He said that, having gone
through the budget line-byline,
the Committee had no
option but to recommend it
for approval. He said he did
not think a fee review was the
only option they should look
at in terms of balancing the
Budget, and recommended
that they also carry out a
comprehensive examination
of expenditure.
Registrar Niall Byrne told
Council that since he started
in his role at the end of July,
he had spent up to a third
of his time in finance. He
assured the members he came
from “the school of small
spenders” and was very happy
to work with Council and the
committees in the interests
of moving the PSI to a better
position. “A lot of work went
into this budget. It is clearly
not adding up. This is not of
my making but I understand
how this situation developed
over time given the history of
the PSI. It is timely to look at
the core funding requirements
for PSI, which only really got
going in 2009. . . I am very
clear on my responsibilities,
that the budget should be
balanced.”
Mr Byrne said the
organisation needed to cut
their cloth but not to cut it
so much that it impinged on
their fundamental role. He
noted that if the organisation
was to be run on a full
cost recovery model, new
developments would have
to be costed and these costs
made available to Council
before decisions were made.
Richard Collis told Council
that when they were in the
Council room, they were in
a bubble and isolated from
what was going on outside.
“You seem to assume there’s
a bottomless pit out there.
We don’t need all the bells
and whistles, we need a
regulatory authority that
carries out its basic functions
of inspection, enforcement
and fitness to practise. I am
not isolated outside this
room as I have to pay the
fee every December, which
is very significant,” Mr Collis
commented.
“Highest level of fees
on the planet”
Edward MacManus said they
should not lose sight of the
fact that Irish pharmacists are
paying far more in registration
fees than any other country.
He asked why the registration
fee was approximately £500 in
England and €2,500 in Ireland.
He said he did not think it
was justified to automatically
look for a fee increase when
they already had “the highest
level of fees on the planet” and
there were concerns over the
budget and value for money.
Mr McCarthy recommended
that the PSI should have
a general reserve policy
minimum level of 30% of the
annual registration fee of
€2.5 million. He said the fact
they were holding reserves
much in multiple of this did
not mean they should fling
through the reserves they
held. This recommendation
was approved.
Council approved
the funding review, the
management accounts for the
period to September 2016 and
the budget and Service Plan
for 2017.
Fitness to Practise
inquiries
Council heard that eight
fitness to practise inquiries
had been heard by the
Preliminary Proceedings
Committee (PPC) and one
before the Health Committee,
28
IPUREVIEW FEBRUARY 2017

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with two further inquiries to
be held before Christmas. One
section 45 had been heard by
the High Court, which ordered
the suspension of registration
pending the outcome of the
complaints process.
Kieran Murphy said he
felt there was a disconnect
between the complaints
procedure and the PSI Council,
largely because the Chairman
of Fitness to Practise was
not a member of Council.
He suggested it would be
helpful to have regular metrics
showing how many complaints
were currently in the system
and the average waiting length
between a complaint being
lodged and decision made.
Mr McCarthy noted that he
had made the suggestion on
a number of occasions that
there should be a proper callover
system to highlight and
explain any delays. Head of
Regulation John Byrne said
they were moving towards
a call-over system where
matters would be brought
before the disciplinary
committee as soon as possible.
DoH to meet software
companies on
electronic records
Mr Byrne outlined a meeting
he held with the Department
of Health in November during
which it was agreed that the
DoH would convene a further
discussion with software
companies to determine the
best way forward in light
of current technologies,
development in e-health and
the need to keep regulatory
records in electronic formats.
He noted that the PSI would
contribute to this engagement
from a regulatory standpoint.
Richard Collis expressed
his great disappointment that
the issue of electronic records
had been delegated to the
DoH, commenting that they
“might as well delegate it to
Methusalah. “It’s becoming
harder and harder to be the
patient-facing pharmacists
the PSI want us to be as we
are under more pressure than
ever in terms of mounting
bookwork with no real attempt
to put it into electronic format,
and I think the onus should be
on the Department to move
forward on this as soon as
possible,” he said.
Mr Byrne said the PSI’s new
strategy process needed to
commence in the new year
for substantial completion
by mid-year to comply with
ministerial submission
requirements, with final
approval by Council in
December.
Temporary absence and
pharmacy assistants
Nicola Cantwell asked the
Executive if they could provide
a timeline for clarification
of the temporary absence
situation. She said she had
spoken to a number of
pharmacists recently and there
seemed to be confusion about
what pharmacy assistants
could and could not do. Mr
Byrne said that, as a regulatory
body, there should not be
confusion among the regulated
entity and he would be seeking
clarity in all matters the PSI
was responsible for. He told
Council he had met with the
Registered Pharmaceutical
Assistants’ Association and
listened to every issue they had
and the entire history of this
situation.
Mr Byrne said he had a
much better appreciation of
some of the concerns of the
pharmacy assistants but this
did not mean he accepted
them all. He said the PSI had
written to the Association to
say the matter of the proposed
rules relating to temporary
absence would come before
Council at the January
meeting, and that, ideally, they
would be in a proper situation
as regarding clarity around
the role and function of the
assistants and some of the
terminology in the Act then.
Ms Cantwell said she felt
the pharmacists were erring
on the side of caution and
reducing assistants’ hours to
make sure they did not have a
problem.
Inspection and
enforcement
John Byrne said his
department’s main activity in
the last few months had been
the roll-out of the Pharmacy
Assessment System. He said
a folder containing a guide
to the system had been
circulated to all pharmacies
and six self-assessment
roadshows had taken place
around the country.
He told Council a
communications plan would
kick off in January, when
his staff would be advising
everybody to start the rollout
of the assessment at the
same time and complete each
section month by month.
Further roadshows will take
place in 2017 and PSI staff will
visit every pharmacy in the
country in the first six months
of the year to embed the
system nationwide.
Updated Mediation
Guidelines approved
by Council
The PSI Council has approved
updated mediation guidelines
with the aim of dealing with
Fitness to Practise complaints
at the earliest possible stage
going forward. Chairman
of the Mediation Subgroup
Hugo Bonar told Council that
they had tried to modernise
the guidelines and there was
only a small list of cases not
suitable for mediation.
The subgroup was
established to explore the
potential for using mediation
more frequently instead of
lengthy and costly Fitness
to Practise inquiries. In
their report, the subgroup
recommended adding the
Registrar to the mediation
process to represent public
health; giving powers to the
PPC to collect all relevant
information as a complaint is
made; and giving powers to
PPC to dispose of matters at
an early stage.
Mr Bonar pointed out that
the purpose of mediation
was to assist in an overall
resolution of a complaint at
the earliest possible time in
the most relevant format.
Mediation a major
step forward
He noted that the more
frequent use of mediation
would reduce legal fees if it
worked properly and take the
pressure off everybody, and
he thought it was a major
step forward on what was
there before.
Edward MacManus said the
lack of investigative powers
by the initial committee had
caused problems in the past
and he was looking forward to
seeing mediation used more
often to resolve matters.
Dr Chantelle McNamara
highlighted the amount of
stress that delays in Fitness to
Practise cases were causing.
She said she had been calling
for the use of mediation for
years as it would mean less
stress for the plaintiff and
all parties.
Richard Collis said that as
the primary advocate for the
use of mediation by the PSI, he
welcomed this move. He asked
the Executive if mediation
could go ahead now if the
Registrar and Registrant were
happy to use this format.
Council President Dr Ann
Frankish indicated that this
was possible.
Mr Bonar said he would love
to move this issue forward
through legislation at the
earliest possible time.
A more humane and
less costly approach
“There have been a number
of cases where people put
their hands up and said,
“yes, I’m guilty”. They would
have jumped at the chance
of mediation but it was not
offered. I think this will
encourage the PPC to look at
mediation; it’s a more humane
approach and will result in a
significant reduction in costs,”
Mr Collis stated.
He pointed out that the
maximum cost of mediation
was €10,000 compared to an
average cost of €46,000 for a
Fitness to Practise inquiry.
Kieran Murphy said it
was very important for
the PPC to have access to
more information to allow
them to make informed
decisions. He noted that the
Medical Practitioners Act
was being amended and the
indications were that it may
be implemented in 2017. He
suggested that the time might
be ripe for the PSI to try and
include this as a possible
amendment.
Dr Paul Gorecki said he
was sceptical of the use of
mediation in these sorts of
cases and thought it was more
appropriate for dealing with
commercial disputes. He said
the use of mediation should
be carefully monitored by PSI
and reviewed.
Shane McCarthy said
the Registrar would be the
complainant in a lot of
mediation cases, and he
said the mediator needed to
be seen as not involved in
either side of the dispute. He
would not be happy with the
Manager of the Legal Affairs
Department nominating
the mediator and felt the
nominator should be an
independent person.
30
IPUREVIEW FEBRUARY 2017

5-7 May 2017 | Croke Park, Dublin
RAISING THE BAR
IN HEALTHCARE
SUPPORTED BY
www.pharmacyconference.ie

RAISING THE BAR
IN HEALTHCARE
The annual IPU NATIONAL PHARMACY CONFERENCE is
being held on 5-7 May. The conference, now in its seventh year,
has grown immensely over the last number of years.
This year, we are bringing the conference to a
unique venue in the vibrant heart of Dublin city.
I invite you to attend this year’s conference at the
centre of Irish sports and culture, Croke Park.
The conference is a three-day event which provides
attendees with a fantastic opportunity to build on
their CPD, socialise with colleagues and network with
representatives from the pharmaceutical industry.
There will be a choice of clinical and business educational
sessions, the IPU’s AGM and this year, we are introducing
a PCRS Roundtable Discussion to the conference. This
session will provide members with an opportunity to raise
issues with the PCRS representatives in attendance. The
Tradeshow Exhibition provides an opportunity to meet with
representatives from a range of companies that support
community pharmacy and learn about their new products
and services. The IPU President’s Dinner & Ball is a key
social event in the pharmacy calendar. And to top it all off,
pharmacy staff are invited to attend the Friday evening for
free with every pharmacist booking for the conference.
The conference is the only event of its kind in Ireland and
it would not be such a success without the generosity and
support of all our sponsors; in particular, Uniphar, who is the
Platinum Sponsor again this year. All our sponsors will have a
stand in the Tradeshow Exhibition and I encourage you to visit
all the stands. I would like to take this opportunity to thank all
our sponsors for their continued support.
I look forward to welcoming you to Croke Park in May.
“It was great,
as always. Everyone
puts so much work into
the whole event and we as
guests reap the rewards.
Congratulations to the
whole team.”
“Excellent
networking
opportunity. Great
evening. Very well
organised.”
Daragh Connolly,
President, IPU
Dermot Ryan, Managing Director, Uniphar Retail Services
“Uniphar Group is committed to supporting independent pharmacy
customers and shareholders. We are delighted to have the opportunity to
support the IPU National Pharmacy Conference as platinum sponsor for
the seventh consecutive year. This annual event has become increasingly
important in all our calendars and a great opportunity to discuss the issues
our industry is facing and how we can manage them together.”

PROGRAMME INFORMATION
The IPU NATIONAL PHARMACY CONFERENCE offers pharmacists
an opportunity to build on their CPD, with innovative learning experiences
throughout the weekend. There will be 10 educational sessions held over
the weekend, commencing on Friday evening. We have worked with IPU
members, IPU Academy, financial advisers, industry representatives and
other organisations to develop a comprehensive and educational programme
to support you with your CPD. The programme features professional and
business sessions, covering a wide range of topics from investment strategies
and motivation and leadership, through to dementia and ostomy. For a full
description of the sessions, please visit www.pharmacyconference.ie.
The conference also offers invaluable networking opportunities and faceto-face
contact with peers. The conference is open to all pharmacists, nonpharmacist
pharmacy owners who are IPU members and Pharmacy Interns.
Pharmacy Staff are also invited to attend on the Friday evening. There are
numerous networking opportunities throughout the weekend, from the tea/
coffee breaks to the President’s Dinner & Ball.
The IPU Pharmacy Seminar will form part of this year’s conference and will
be held on Friday 5 May from 10.00am to 1.00pm. A number of highprofile
speakers will address topics such as the economic and social value
of community pharmacy; advances in the contribution of pharmacists
to healthcare in Canada; the patient’s perspective; and the current and
potential future role of pharmacists in Ireland.
Your registration fee includes:
■ Admission to all sessions
■ Entry to Trade Exhibition
■ Free entry for Pharmacy Staff member on Friday
■ Friday night dinner, with pre-dinner drinks
■ Daily refreshments and lunches (Saturday & Sunday)
■ Conference bag
Tradeshow Exhibition
In 2016, we introduced a tradeshow element to the conference. Over 30
companies will be available to meet with you and share their products and
services and take sales orders.
The Tradeshow Exhibition will be open at the following times:
Friday 5 May: 3.30pm-8.15pm
Saturday 6 May: 8.30am-3.30pm
Etihad Skyline Tour
Running alongside our conference programme we are providing an activity
for partners and family. The Etihad Skyline tour gives visitors an opportunity
to learn about Dublin’s history with panoramic views of the capital city from
17 storeys high on the roof of Croke Park Stadium. We are happy to be able
to offer this unique experience at the subsidised rate of €5 per person. The
tour is available at 11am on Saturday 6 May and 11am on Sunday 7 May.
Please note there is a height restriction of 1.2m for children.
HOW TO
REGISTER
You can register online
at www.pharmacy
conference.ie or by
completing the form
overleaf and fax, email or
post it back to the details
on the form.
Cancellations & Refunds
Cancellations made prior
to 6 April will be refunded
in total. Refunds will not
be processed after this
date. Accommodation
cancellations are at the
discretion of The Croke
Park Hotel.
Condition of Entry
It is a condition of
entry that you may be
photographed at the
event and that your
image may be used on
IPU and IPU National
Pharmacy Conference
material. The IPU
reserves the right to
refuse entry to anyone it
sees fit.
Hotel/Accommodation
The Croke Park Hotel
is located opposite
Croke Park stadium on
Jones’s Road, Dublin 3.
Special IPU rates are
available, which can be
booked via the enclosed
accommodation booking
form or online via www.
pharmacyconference.ie.
Please complete the form
on the reverse and return
it to the IPU to book
your place for the 2017
IPU National Pharmacy
Conference.

5-7 May 2017
Croke Park, Dublin
REGISTRATION FORM
Please complete this form in BLOCK LETTERS.
NAME:
PHARMACY:
ADDRESS:
PHONE NUMBER:
EMAIL:
CONFERENCE FEE
Early Bird Rate* €100
Non-Members €185
Additional Pharmacy Staff** €30
Name of Pharmacy Staff attending:
PRESIDENT’S DINNER & BALL
Dinner €35
Name of Dinner Guest attending:
Dinner Guest €35
Payment can be made by cheque or by supplying your credit card
details below. Please make cheques payable to Irish Pharmacy Union
and return with this form.
ETIHAD SKYLINE TOUR
Tickets are €5 per person (Height restriction of 1.2m applies).
Please note that there are a limited number of tickets available.
Saturday 6 May: 11.00am
Attendance Fee €130
Pharmacy Interns €40
* The early bird rate is for members only and is valid if booked
and paid for by 24 March 2017.
** One non-Pharmacist Pharmacy Staff member is included
in the full attendance fee.
No. of tickets required:
Please mark below which events you would like to
attend. Please ensure you only select one option
where there are parallel sessions.
FRIDAY 5 MAY
10.00am ❏ IPU Pharmacy Seminar
4.30pm ❏ Future Proof: Unlocking the potential of
pharmacy through innovative retail solutions
6.00pm ❏ AGM Reports
8.15pm ❏ Dinner
SATURDAY 6 MAY
9.00am ❏ Investing in Volatile Times
OR
❏ Dementia – Understand Together:
Transforming services through integration,
partnership and innovation
10.45am ❏ PCRS Roundtable Discussion
12.30pm ❏ The Public’s Usage & Attitude towards
Pharmacy and Pharmacy services
OR
❏ A Straight Forward Approach to Ostomy
Appliances in a Retail Pharmacy Environment
1.30pm ❏ Lunch
3.30pm ❏ Leadership, Communication and Teamwork
– the 3 key platforms to taking you and
your business to the next level
4.30pm ❏ AGM Motions
SUNDAY 7 MAY
10.00am ❏ Nutrition, Lifestyle and Functional Medicine
in Chronic Illness
OR
❏ Funding Pharmacy Growth
11.15am ❏ Methotrexate - the myths and truths
OR
❏ Making your Numbers Count
12.30pm ❏ Pharmacy Benevolent Fund Meeting
1.15pm ❏ Lunch
Sunday 7 May: 11.00am
No. of tickets required:
CREDIT CARD DETAILS
Name of
Cardholder:
Card
Number:
Expiry
Date:
CVV
Number:
Please return all forms to: Irish Pharmacy Union,
Butterfield House, Butterfield Avenue, Rathfarnham,
Dublin 14, D14 E126. If paying by credit card, you
can also fax the form back to 01 493 6407. You will
receive an email to confirm your registration and
sessions booked. Alternatively, you can register
online at www.pharmacyconference.ie.
TEAR HERE

IPU – The voice of
community pharmacy
As a valued member of the IPU, you belong to the
representative and professional body for community
pharmacists in Ireland. Membership of the IPU provides you
with the professional support and advice you need in your
day-to-day practice as a community pharmacist.
To make sure you are getting the most out of your membership,
we’ve put together the top 10 membership benefits.
1
2
3
4
5
6
7
8
9
10
SOPs, Guidelines and Protocols to assist you in complying with the
Pharmacy Act 2007.
Support with Fitness to Practise proceedings.
The IPU Product File, an indispensable resource to run your pharmacy efficiently.
Business advice and support on issues such as business regulations, business
intelligence, retailing, data protection, insurance and much more.
Individual assistance on claiming/payment issues with the HSE PCRS.
A voice in influencing policies and strategies that affect your profession.
HR Know-How – advice on all issues affecting employers and employees,
including a mediation service.
Reduced rates on IPU training courses and events, as well as free membership
to IPU Academy.
Real savings on a range of services, including insurance and energy bills.
Networking opportunities to meet your peers, exchange ideas and renew
contacts face-to-face at IPU events.
Our sole focus is on protecting, promoting and strengthening the pharmacy profession, now and
long into the future, and advising and supporting you in your professional and business lives.

CPD Fearghal O’Nia MPSI
Self-appraisal
Evaluate
Document your
learning
Personal plan
Action
Ankylosing
Spondylitis
Ankylosing Spondylitis (AS) is a form of spondyloarthritis
which predominantly affects the axial structures (spine,
sacroiliac joints and anterior chest wall). Persistent
inflammation in the joints causes the body to try to repair
tissue damage by forming new bone (ossification). This
new bone formation is what leads to the stiffness patients
can experience and can cause fusion (ankylosis) of the
vertebrae. AS is also characterised by inflammation where
tendons and ligaments attach to bone (enthesitis).
Prevalence
Up to 1% of the Irish
population has AS. It is three
times more common in males
than females. 80% of patients
will experience first symptoms
before the age of 30. Early
treatment is associated with
better outcomes but there is
often a delay between onset of
symptoms and diagnosis.
Diagnosis
Diagnosis involves evaluating
symptoms, a physical
examination, imaging
techniques to identify evidence
of sacroiliitis (inflammation
36
of the sacroiliac joint where
the lower spine and pelvis
connect) and blood tests.
Signs and Symptoms
n The most common
symptom is inflammatory
back pain, which is
characterised by:
• Back pain for more
than three months
plus at least four of the
following:
– Age at onset

nd Immune
r Life

n 90% of patients with AS will
test positive for the genetic
marker HLA-B27 but not
all people with HLA-B27
will develop AS. Less than
5% of HLA-B27 positive
subjects will develop AS
so it is thought that some
environmental factor, e.g.
pathogens, may trigger the
inflammatory cascade and
the development of AS.
n Raised erythrocyte
sedimentation rate (ESR)
and C-reactive protein
are indicators of active
inflammation.
Imaging
The use of Magnetic
Resonance Imaging (MRI)
can be useful for the early
diagnosis of AS, as in early
stages of AS, X-rays can
appear normal.
Treatment
There is currently no cure
for AS. The main treatment
objectives are to maximise
long-term health-related
quality of life through
control of symptoms and
inflammation, prevention of
progressive structural damage,
preservation/normalisation
of function and social
participation.
Non-pharmacological
management
Muscle strengthening and
weight loss have been
shown to be of great benefit.
All patients should see a
physiotherapist and follow
their exercise programme with
an aim to increase the range
of motion. Home exercises
are effective but supervised
exercises (land- or waterbased)
have been found to be
more effective.
NSAIDs
NSAIDs improve the
symptoms of the disease
by reducing pain and
inflammation. The full
anti-inflammatory dose
should be taken. These
drugs are associated with
gastrointestinal, renal and
cardiovascular side effects.
Usually a patient with just
axial symptoms is considered
suitable for anti-TNF
treatment if they have failed
two courses (12 weeks) of full
dose NSAIDs.
DMARDS
The DMARD most commonly
used in the treatment of
peripheral arthritis in AS
patients is sulphasalazine.
This is only effective
for peripheral arthritis.
Sulphasalazine may also be
useful if there is co-existing
inflammatory bowel disease.
Patients should be advised
that it can take some time
before results are seen. Advise
patients to attend for regular
blood tests and to report any
signs of infection.
Corticosteroids
There is no evidence
to support systemic
glucocorticoids for treatment
of AS. Local injections of
corticosteroids may be
considered.
Biologic DMARDs
Tumour Necrosis Factor
Inhibitors (anti-TNFs) were
the first biologic treatments
licensed for the treatment
of AS. Currently, there are
five licensed: infliximab,
adalimumab, etanercept,
certolizumab and golimumab.
TNF is a cytokine produced
by inflammatory cells which
controls the production of
other mediators involved in
inflammation. It promotes
inflammation to create an
environment to allow cells to
heal or repair but if too much
TNF is in circulation it can
damage healthy tissues.
These treatments have been
shown to improve clinical
measurements of disease
activity, improve function
and improve quality of life.
They cannot reverse damage
done so the earlier a patient
is started on them the better.
If a patient is started on a
biologic at the early stage of
the disease, it may slow the
progression of the disease.
If a patient has no response
at all after 12 weeks of
treatment, this is referred to
as a primary non-response.
If there is a response at first
but then the treatment stops
working, it is referred to as a
secondary non-response. In
both cases, a different anti-
TNF will usually be tried.
Common side effects of
anti-TNF therapy include
infection and injection site
reactions. Other side effects
reported are vasculitis and
increased risk of melanoma
and other skin cancers.
Because anti-TNFs reduce
the immune response,
patients must be assessed for
tuberculosis before starting
treatment. They should
be advised that treatment
should not be given when
they have an active infection
and should be aware of
symptoms that may suggest a
blood disorder, such as a sore
throat, fever, bruising and
bleeding.
Patients should also be
screened for hepatitis,
congestive heart failure,
demyelinating diseases or
blood disorders as there
is a risk of reactivation or
exacerbation.
Recently, secukinumab
(Cosentyx ® ) has been
licenced for the treatment
of active AS. This is an IL-
17A inhibitor. It inhibits the
proinflammatory cytokine
interleukin-17A, which is
involved in inflammatory
and immune responses. The
frequency of IL-17-producing
cells has been found to be
significantly higher in AS
patients. Secukinumab has a
similar side effect profile to
anti-TNFs. If patients have
not seen a response after
16 weeks, it will usually be
discontinued.
Osteoporosis
Bisphosphonates may be
prescribed to patients as
there is an increased risk of
osteoporotic spinal fractures
with AS.
The role of the
pharmacist
Facilitating early diagnosis
Pharmacists may be able
to identify patients with
features of inflammatory back
pain (IBP) who ask for antiinflammatories.
Any patients
collecting prescriptions for
uveitis should be checked for
any symptoms of IBP.
Advice for patients with AS
n If a patient has been
newly diagnosed and has
researched AS on the
internet, they may have
seen reference to “bamboo
spine” in advanced cases
of spinal fusion. It is
important to reassure
them about the advances
in treatments available
and that most people with
the disease do well and
continue to enjoy normal
productive lives.
n The recommended exercise
and stretching programme
should be followed. Patients
should adopt a good
posture and avoid staying
in the one position for long
periods of time.
n Advice should be given on
weight loss, if necessary,
as this reduces load on
the joints.
n Smoking cessation should
also be encouraged as lung
capacity can be reduced
in AS.
n A good quality firm bed
helps prevent curving
of the spine and as few
pillows as possible
should be used.
n Heat therapy can help
with pain and stiffness.
n Avoid manipulation of back
or neck by chiropractors
and masseurs due to
risk of spinal fractures.
n Avoid back braces as they
restrict movement of the
spine and so worsen the
condition.
n Any pain in the eye
should be referred for
assessment as it may be
uveitis and should be
treated as soon as possible.
Medication counselling
n Counsel patients about
their medication therapy.
Certain biologics have
recently given new
guidelines for alternative
storage, e.g. Humira®.
When needed (for example
when you are travelling), a
single Humira® pre-filled
syringe may be stored at
room temperature (up
to 25°C) for a maximum
period of 14 days – be
sure to protect it from
light. Once removed from
the refrigerator for room
temperature storage, the
syringe must be used
within 14 days or discarded,
even if it is returned to the
refrigerator.
38
IPUREVIEW FEBRUARY 2017

CPD overview
Self-appraisal
What do I know about ankylosing spondylitis
and how it is diagnosed?
Am I familiar with the features of inflammatory
back pain?
Am I familiar with the available treatment options?
Can I counsel patients and their carers effectively
on their AS drug therapy?
Can I provide appropriate self-care advice to a
patient with AS?
Personal Plan
Including a list of desired learning outcomes in a personal
learning plan is a helpful self-analytical tool.
Create a list of desired learning outcomes.
How will I accomplish these learning outcomes?
Identify resources available to achieve learning
outcomes.
Develop a realistic timeframe for the plan.
pharmacy to ensure that you have appropriate
guidelines in place to ensure they are offered
appropriate advice and counselling.
Evaluate professional resource materials available
in the pharmacy and source additional material if
necessary.
Evaluate availability of patient support materials
and source additional material if necessary.
Evaluate
Consider outcomes of learning and impact of learning.
Have I met my desired learning outcomes?
Do I now feel confident to be able to distinguish
between mechanical back pain and inflammatory
back pain?
Do I now feel confident to engage with and counsel
patients with AS?
Am I and my team now able to fully support
patients with AS?
Have further learning needs been identified?
Action
Activities chosen should be outcomes based to meet
learning objectives.
Implement plan.
Read this article on AS.
Review how you manage AS patients in your
n Ensure patients on
DMARDs and biologics are
getting regular blood tests
and that they know they
should stop or reduce their
dose in the case of adverse
events including infection.
n Each year, offer flu
vaccination to all
patients on DMARDs and
biologics. Also encourage
other vaccinations,
e.g. Pneumococcal and
Hepatitis B.
n For patients on biologics,
recommend periodic skin
analysis because of risk
of skin cancers. Advise
on use of sun screen and
avoiding the sun – see Irish
Cancer Society website for
guidelines.
AVAILABLE ONLINE
AND IN-STORE!
n Advise patients on biologics
to avoid live vaccines, e.g.
yellow fever.
Document your learning
Create a record in my ePortfolio.
Complete the true or false questions at the end of
this article.
As part of this record, complete an evaluation, noting
whether learning outcomes were achieved and
identifying any future learning needs.
Your 5-minute
assessment
n Encourage patients to carry
their patient alert card
Digestive
with them.
and Imm
Answer the following five questions
true or false:
Signposting
1. Women are more likely to develop ankylosing spondylitis.
The Ankylosing Spondylitis
Association of Ireland
and Arthritis Ireland
provide information and
support to patients and
2. When sitting, patients should move their spine regularly
Support
(e.g. by stretching
for
their back and pulling
Life
their shoulders back).
3. Patients with AS test positive rheumatoid factor.
healthcare professionals.
4. Anti-TNF therapy should not be started without screening
SUAS (Supporting and
for TB first.
Understanding Ankylosing
Spondylitis) is a booklet that
can be downloaded from
www.ankylosing-spondylitis.ie.
5. AS patients have an increased risk of osteoporosis.
Answers:
1. False. 2. True. 3. False. 4. True. 5. True.
40
IPUREVIEW FEBRUARY 2017

une

CLINICAL TIPS Tara Kelly, IPU Product File Pharmacist
Education Materials
Educational materials
associated with
specific medicinal
products are now
available online on
the HPRA website and should
prove a useful resource for
pharmacists. The HPRA has
advised that pharmacists
should be aware of these
educational materials where
they exist for a particular
medicinal product and use
them to enhance the safe and
effective use of these products
in practice.
Educational materials
form part of what are called
‘additional risk minimisation
measures’. Routine risk
minimisation measures apply
to all medicinal products and
include the information that
we routinely refer to in order
to learn about how to use the
product safely and effectively.
These include the SmPC, the
product labelling, the package
leaflet and the prescription
status of the product.
Sometimes, additional riskminimisation
measures are
required to manage risks
identified with the use of
the product; educational
materials can form part of
these additional risk-reducing
measures.
The aim of these measures
is to prevent or reduce
the occurrence of adverse
reactions associated with
exposure to a medicine,
or to reduce their severity
or impact on the patient
should such adverse
reactions occur. These
materials may be directed
at pharmacists (and other
healthcare professionals)
or may be directed towards
the patient. The company
responsible for placing the
product on the market is
required to distribute these
educational materials in
hard copy to either the
healthcare professional or
the patient. Now that these
materials are published on
the HPRA website, this gives
pharmacists greater access
to them should they be
required. They can either be
downloaded for use in the
pharmacy or alternatively,
hard copies can be requested
from the marketing
authorisation holder.
Some examples of
Educational materials that
may prove useful include:
n Combined oral
contraceptives:
Information Cards and
Q&A Leaflets for Patients
(Risk of Blood Clots);
n Epilim: Healthcare
professional booklet,
Patient booklet, Patient
Cards (Risks of Valproate
in Pregnancy);
n Fastum Gel: Leaflet
for Patients (Risk of
Photosensitivity);
n Eliquis, Pradaxa,
Xarelto, Lixiana:
Patient Alert Card
(Risk of Bleeding);
n Exelon Transdermal
Patch: Patient Diary
(Instructions for use and
Record Sheet); and
n Humira: (Patient
Information Cards).
These documents are
located on the HPRA website
alongside the SmPC and
PIL when you ‘Search for
a Medicine’. A full listing
of products that have
educational materials
associated with them can be
found by using the ‘Advanced
search’ function and selecting
‘Only Medicines with
Educational Materials’.
IPU PRODUCT FILE
The IPU Product File has been in existence
for more than 30 years and is an indispensable
resource for community pharmacists.
It was designed for pharmacists by pharmacists
and is also used by doctors and hospital
personnel. It is a vital support tool for
prescribing, dispensing, claiming with PCRS,
stock ordering, stock taking, price checking
and product sourcing.
What is in the File?
The File contains information on over 63,000 products,
including:
Licensed medicinal products
Unlicensed medicinal products
Medical devices and sundries (bandages, dressings,
ostomy equipment etc.)
Nutritional products, including foods for special diets
Veterinary products
Photographic products
Cosmetic products
Front of Shop products (shampoos, vitamins etc.)
In addition to pricing information, barcodes etc.,
the IPU Product File provides valuable professional
information on health products. The professional
information provided includes the Medicinal Product
Name, PA/EU number, Generic Name, Pharmaceutical
Form, Strength and Legal Status.
ISO Certified
In 2016, the IPU Product File achieved
ISO Certification for 9001 (Quality)
ISO 9001
Registered
and 27001 (Information Security).
Quality
The audit and certification process for
Management
ISO Certification emphasises the robustness of the
IPU Product File and underpins its position as the
definitive medicinal product catalogue in Ireland.
ISO 27001
Registered
Information Security
Management
Easy to Use
The IPU Product File is an open system, so no matter what
vendor you choose, the file can be adapted for your needs.
The IPU Product File is available by electronic download,
where you can log-in and download your monthly update.
Contact Us
The IPU Product File team are available to answer your
queries, whether it’s on sourcing a product, pricing queries
etc., the team will be able to assist you.
For any queries relating to the IPU Product File, please
contact a staff member on 01 406 1550 or datainfo@ipu.ie
42
IPUREVIEW FEBRUARY 2017

BUSINESS Filipe Infante, Country Manager, hmR Ireland
Irish
Prescription
Market Trends
In this article, Filipe Infante, Country Manager, hmR Ireland,
gives an overview of the total prescription market in Ireland
for 2016 and identifies some key market trends.
The Irish
prescription
market
experienced
modest growth
in 2016, with increases across
the different market segments.
The analysis, conducted
by research consultancy
specialists Health Market
Research Ireland (hmR), found
that the total market grew
in value by 2.3% nationally,
with the pharmaceutical
market enjoying 2.6% growth,
the branded market growing
by 3.1% and the generic
drugs market increasing by
0.8%, when compared to the
previous year.
The analysis is derived from
information received from
more than 1,000 of the 1,800
pharmacies across the State.
Commenting on the findings,
Filipe Infante, said, “The total
trade value of the market at
the end of 2016 was €1,840
million from over 118 million
units that went through the
dispensary of the State’s
pharmacies. Both metrics
have increased since the
previous year by 2.3% and 0.2%
respectively.”
The research also reveals the
top five prescription market
drugs ranked by their trade
value: in first place comes
Humira, the drug mainly
used in dermatology and
rheumatology applications,
with sales in 2016 of just under
€114 million. In second place
was also another biological
drug, Enbrel, with sales of just
over €63 million. These were
followed by Versatis, Gilenya
and Kalydeco, making up the
top five that represent 14% of
the market and which all had
growth rates of between 5%
and 25%.
Mr Infante said, “When
looking at markets by
Anatomical Therapeutic
Class (ATC), we could see
that the Biological, Mental
Health and Respiratory areas
were clear leaders. Anti-TNF
market (L04B) was the leader
with a share of 11% of the
Pharmaceutical Market. This
market is then followed by
the Anti-Epileptics (N03A),
B2 Agonist and corticoid
Combinations (R03F) and
Anti-Depressants and Mood
Stabilisers (N06A).”
The companies with
the highest sales of drugs
dispensed in retail pharmacies
in 2016 were Pfizer with a trade
value of over €141 million;
Abbvie with sales of €118.5
million; Novartis with almost
€94 million; GSK with close to
€90 million; Teva with almost
€89 million and MSD with €69
million.
Currently, the top performing
generic medications in retail
pharmacy are Rosuvastatin,
Atorvastatin, Esomeprazole
and Sertraline, which together
represent 20% of the generics
market sales. In the generics
market, the top performing
generic companies in terms
of value were Teva (26%) and
Rowa (18%).
Although the market
experienced value growth at
a national level during 2016,
the same cannot be said for all
county regions. Co. Sligo had
the greatest decrease with a
fall of 4.5%, while Co. Laois had
the largest growth with 5.5%.
“ The total trade value of the market at the
end of 2016 was €1,840 million from over
118 million units that went through the
dispensary of the State’s pharmacies.”
44
IPUREVIEW FEBRUARY 2017

IPU PRODUCT FILE
The IPU Product File has been in existence for more than 30 years and is an indispensable resource
for community pharmacists. It was designed for pharmacists by pharmacists and is also used by doctors
and hospital personnel. It is a vital support tool for prescribing, dispensing, claiming with PCRS, stock
ordering, stock taking, price checking and product sourcing.
What is in the File?
The File contains information on over 63,000 products, including:
Licensed medicinal products
Unlicensed medicinal products
Medical devices and sundries (bandages, dressings, ostomy equipment etc.)
Nutritional products, including foods for special diets
Veterinary products
Photographic products
Cosmetic products
Front of Shop products (shampoos, toothpastes, vitamins etc.)
In addition to pricing information, barcodes etc., the IPU Product File
provides valuable professional information on health products. The professional
information provided includes the Medicinal Product Name, PA/EU number,
Generic Name, Pharmaceutical Form, Strength and Legal Status.
ISO Certified
In 2016, the IPU Product File achieved ISO Certification
for 9001 (Quality) and 27001 (Information Security).
The audit and certification process for ISO Certification
emphasises the robustness of the IPU Product File and
underpins its position as the definitive medicinal product
catalogue in Ireland.
ISO 9001
Registered
Quality
Management
ISO 27001
Registered
Information Security
Management
Easy to Use
The IPU Product File is an open system, so no matter what vendor you choose,
the file can be adapted for your needs. The IPU Product File is available by
electronic download, where you can log-in and download your monthly update.
Contact Us
The IPU Product File team are available to answer your queries, whether it’s
on sourcing a product, pricing queries etc., the team will be able to assist you.
For any queries relating to the IPU Product File, please contact a staff member
on 01 406 1550 or datainfo@ipu.ie

BUSINESS Darren Kelly, Business Development Manager, IPU
New Year’s
resolution for
your business
So the New Year is upon us. We have
hopefully sold all the Christmas stock
and should have our pharmacies back in
shape. Every year we approach the New
Year with resolutions about losing weight
or giving up alcohol but do you make
any resolutions about how you want the
business to look? With the apparent rise in
consumer sentiment and expected growth in
the economy, we have to remain optimistic
about what 2017 will hold for our businesses.
In this article, Darren Kelly, Business
Development Manager, IPU, looks at what we
need to look at to ensure that the health of
our retail businesses stays in peak condition.
The pharmacy
world is changing
and to stay in
touch we need to
evolve and move
with the changes. Do you
have a plan for the business
on an ongoing basis or do
you believe that it will keep
plodding along the same
way? The retail element of
pharmacy is growing year-onyear
and in order to capitalise
on this, we need to ensure
that we have the staff, the
premises and the plan to
succeed.
Many independent
pharmacy owners ask me how
they can be as proactive with
their pharmacies as some
of the bigger chains appear
to be on a retail footing. I
always refer back to planning.
The larger chains have
46
IPUREVIEW FEBRUARY 2017

departments that look after
these areas for them and even
the symbol groups are bringing
this cohesion into the market;
you can be as proactive as you
wish to be with some clever
planning and delegation with
your own teams.
Promotional planning
It sounds like a lot of work
but a simple structure will
help you and your team know
where you want to market the
business this year. Some key
points to consider are:
n Highlight the main
holidays and health
awareness campaigns,
taking into account any
local or regional events
that may be happening
in your area. Use the IPU
Wallplanner to highlight
the events and keep all
the team in the loop;
n When you are buying
stock of special offers,
look at the different
types of offers you want
to have and break it
down into men/ladies/
children or bath/shower/
hair. Once you break
it down, pick the best
offer that is available for
each category and order
accordingly. Sometimes
you need to walk away
from an offer if it will
lead to overstocking;
n ‘One in, one out’ policy.
Your shelves are not
elastic so make sure
that there is a plan for
where the stock will go.
Remember, nothing sells
from the stockroom;
n Agree a promotion
cycle timeframe with
the team. Plan out
promotions to ensure
that you can avail of the
best value. By having
a specified promotion
cycle, customers will be
waiting to see what are
the next “unbelievable
offers” available in
their local pharmacy.
Remember, most ‘2
for €3’ or ‘2 for €5’ are
available in the grocery
multiples so having
these will give your
customers the message
that they can get just as
good value in their local
pharmacy;
n Identify where in the
pharmacy you will
do the promotions,
i.e. window displays,
gondolas or hot spots;
and
n Draw out the areas
of the pharmacy and
plan the promotion
on paper before any
stock is ordered or
merchandised. This takes
away any confusion with
regards to ordering or
dealing with reps. Once
you have this in place, all
staff should be singing
from the one hymn
sheet.
Merchandising
I am always asked what are
the best special offers to
have. My reply is “the ones
that sell”. It sounds simple
but how many times do you
see products mixed together
because they are banded
packs? The perception is that
that is all the customer needs
to see. Customers like to see
a pattern to the display. The
customer’s concentration
will only hold so long, so,
if there are 10 promotions
all squeezed together and
no real clear message, the
customer will walk away.
This is probably the biggest
area of concern that I see
around “selling” the message
to your customers in the
pharmacy sector. Effective
merchandising is so important
in ensuring that you maximise
the retail sale, whether it be
an impulse sale or a “decision”
purchase.
Remember, your shelves
are not elastic so try not to
squeeze everything onto
them. When an offer is over,
it’s over; take the sales and
move on. Do not order a pile
of stock when you are at the
end of the cycle just so you
can have it in stock in case
a customer is looking for it.
If you are planning correctly,
you are buying better; if you
are not planning out your
promotions, you are buying
your next special offer while
you still have stock of the
previous promotion, which
will undoubtedly sit in the
stockroom or on a shelf
generating no sales and
creating a cluttered feel
to any promotion.
Staff planning
Everyone plans out the staff
rosters to ensure that you
have the correct cover for
the week but how many
plan to ensure that their
pharmacy staff are up-to-date
on the latest trends in retail
pharmacy? Annual reviews
should be part of this plan to
meet with staff and identify
what the individual staff
member requires to ensure
that they are taking your
business where you want it
to go. Encourage the staff to
want to learn more.
Do you know where to look
for training if a staff member
shows interest in progressing
in your business? We provide
a range of business training
courses from category
planning, merchandising,
retail sales, social media,
“ Effective merchandising is so important
in ensuring that you maximise the
retail sale, whether it be an impulse
sale or a “decision” purchase.”
IPUREVIEW FEBRUARY 2017 47

security and PCRS claims
handling, to name but a few.
Most courses are delivered in
classroom situations but we
are looking to develop more
online training programmes
so that staff will not have to
travel; keep an eye out for
these developments.
Staff planning is also a huge
aid in keeping the levels of
theft low in the pharmacy.
The Garda Analysis Unit has
identified that most theft from
pharmacy happens between
1.00pm-6.00pm. These are the
times when you are rotating
staff on lunches and you are
not at full strength. Identify
through your figures when the
busier times of day are for you
to ensure that you have the
optimum number of staff on
duty, ensuring the best service
to your customers.
Customer service
Draw up a plan of action
for your pharmacy for a
consistent message from
entering the pharmacy till
leaving the pharmacy. With
all areas of the business being
examined for cuts, staffing
is always an area looked at.
If you have had to reduce
your staff numbers, service
levels may have dropped.
Make a plan to speak to
all your customers, within
reason, who enter your
pharmacy. I am sure that
you are giving that personal
touch to your customers but
their perception of you and
of your staff and premises
will lead them to tell other
people of the service that you
provide. Do not be afraid of
coming out from behind the
dispensary and dealing with
your customers. If your staff
see you leading the way, they
will follow suit and there will
be a consistency of service
throughout the pharmacy. Use
customer surveys to find out
how your service levels really
are. Template surveys are
available on the IPU website
in the Business Section under
Customer Service & Retention.
Communication planning
Do you have regular staff
meetings throughout the
year or are they just ad
hoc, normally when there
might be an issue? Regular
communication with the staff
empowers them to feel they
can approach you, the owner,
if perhaps a product is not
selling or they have an idea
that might work to sell an
item. When I am reviewing
pharmacies, I encourage
the staff members to think
about what they would do
and how they would do it.
There are many good ideas
just waiting to be tapped into
and maybe one of them is in
your pharmacy. Encourage
these ideas and develop them
by talking them through.
If you agree to go with an
idea, follow through with
it, take a hands-on role in
it and implement it. If it is
successful, reward the staff.
These are the true elements of
a successful manager.
Store layout
The majority of customers
now expect to get a retail
experience when they enter
any pharmacy. Take a look at
the layout of your pharmacy
and think like a customer.
Are products easily seen
and found? Is there clutter
around the pharmacy? Is it a
pleasant experience to be in
the pharmacy? These are the
questions you need to ask.
If you can see that there are
issues in the pharmacy, be
pro-active and deal with them.
There are options available
with regard to category
management or business
reviews but you need to have
a clear picture in your head
as to where you want the
business to go to.
Stand in front of the
pharmacy and look in. See
what your customer sees. Look
at the layout of the pharmacy
and see if there is a natural
flow to the product layout.
If it looks untidy, cluttered
or the flow is all wrong, your
customers probably think the
same. Try to create a flow in
the pharmacy that creates
different experiences for your
customers.
Marketing your pharmacy
Marketing your pharmacy is
the sure fire way to get extra
customers in. But how do you
do it? Effective signage inside
and outside your pharmacy
is a must. Remember not to
go for overkill but to highlight
the value and service that you
provide.
Ensure that any signage that
goes on your pharmacy door
or window is relevant and is
highlighting something about
your business. Do not overload
window displays that lead
a customer to think “is this
a pharmacy or an electrics
shop”? Draw up a timeline
plan for your window displays.
Don’t just give the space
away, look at what message
you want to portray to your
customers and those passing
customers, to entice them to
come into your pharmacy.
Inside the pharmacy, the use
of signage is a must. I have
seen overkill on this, which
just confuses customers,
and ultimately leads to no
sale. Signage should be clear,
concise and placed at the
correct products. Using A4
signs stuck up with sellotape
makes your pharmacy
look unprofessional. There
are a number of solutions
available to help you provide
a professional look to your
signage. Remember, customers
expect a retail experience.
In order to move with
changes, you need to have a
business plan for all aspects
of the pharmacy. To many,
this seems like hard work but
by putting the work into a
complete business plan, you
and your team can reap the
benefits. Put a plan in place,
work through it, get involved
with the staff on the plan and
lead your business to where
you want it to be.
If you would like further
information on anything
discussed in this article or would
like to get help with the retail
element of your pharmacy,
contact Darren in Butterfield
House on 01 493 6401.
GET THE RETAIL
FACTOR IN YOUR
PHARMACY.
For further information on the IPU Retail Review service, please contact
Darren Kelly on (01) 493 6401 / 086 028 9825 or email: Darren.kelly@ipu.ie
IPU Retail Banners 190X45 MAR16 ART.indd 4 25/03/2016 17:55
48
IPUREVIEW FEBRUARY 2017

Tailor-made
just for your
pharmacy
A bespoke retail review of your front-ofpharmacy
will give your pharmacy a
facelift to boost your sales without
overstretching your budget.
Our One-Day Review will include:
n Expert advice on your retail offering
n A complete review of the front-of-pharmacy
including category management and
promotion planning
n Providing training in sales techniques
n Re-merchandising displays (interior and
window) to enhance the retail experience
in your pharmacy
n Helping you and your sales team develop
new sales ideas
n Using key performance indicators to help
you increase front-of-pharmacy business
n Motivating your sales team to be
innovative, sales focused and up to
speed on product knowledge
With over 25 years’ experience in FMCG
and Pharmacy, IPU Business Development
Manager Darren Kelly can help your
business get the retail factor.
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...
Extremely impressed with
the service provided by
Darren on merchandising
advice both pre- and
post-refit.
Laura Addley
Haven Greenes Pharmacy
Rathfarnham
And another...
Very organised, little
disruption to the day
to day working in
the pharmacy.
Anne O’Rourke
The Mall Pharmacy
Sligo

BUSINESS Killian A. Neville, QFA, Managing Director, Neville & Partners Ltd
New Year Resolutions
to Guarantee a more
Prosperous 2017
Knowledge is power and the problem for many is that they
lack any personal knowledge where financial products and
planning are concerned. In this article, Neville & Partners
hopes to debunk some of the myths that surround personal
financial planning and the advisers and institutions that
make their living in this arena.
As a medical
practitioner said
to me many
years ago, “I
had 22 years
of formal education and not
one hour to teach me about
money”, and as this is true
for practically all, it means
that we end our educational
careers ill-prepared for the
financial world. Because
of this, we need financial
guidance and help, but then,
it is often difficult to tell
genuinely impartial advisers
from those paid to sell us prepackaged
financial products.
In 2009, the HSE means
tested every 70+ year old
in Ireland and found that
95% were too poor to pay
for their own medical needs.
It is hard to argue that we
have a functioning financial
advice system when this is the
result for so many. One of the
main reasons for these poor
results is a lack of joined-up
thinking when it comes to
personal finances and that is
caused by the habit of taking
isolated advice. This article
will focus on some of the more
common errors people make
so that if these “errors” exist
in your world, you can resolve
today to go and fix them
immediately.
Resolve to stop borrowing
your own money
No one reading this is, I hope,
silly enough to walk
into a bank and
borrow, say, €10,000
at 7% and then
walk across the
foyer and put it on
deposit at 1%. We
all see this for what
it is, a guaranteed
loss. However, separate
these decisions by time and
adviser/institution and, if IPU
members are typical of the
folks we meet every day in
our professional lives, then
two-thirds of you reading this
are doing this right now. If you
have savings on which you are
receiving a lesser return than
you are paying for debt, then
you are losing far more
than you should.
Take for example
a person who has
a new five-year car
loan of €20,000 at
7%. They will pay
€394 per month
or €23,640 over the
term. This same person
has €10,000 on deposit with
another institution and are
receiving a net 1% per annum
return, which will value the
€10,000 at €10,510 in the same
five-year period.
50
IPUREVIEW FEBRUARY 2017

Now, this saver has learned
the lesson and so immediately
uses the €10,000 to reduce
the loan to just €10,000
and as they can afford the
€394 monthly, they repay
this too, which means the
loan is repaid in two years
and four months. Now they
can continue to save the
€394 for the remaining two
years and eight months and
they will have total cash on
deposit of €10,700 by that
time. Resolving to no longer
pay for debt when savings
are underperforming lowers
the interest cost on the car
loan in our example by close
to €3,000 when compared to
the original. The change also
delivered a slightly increased
deposit lump sum.
This is but one simple
example and far greater
savings are enjoyed, of
course, when the numbers
are bigger. We have met some
professionals where the
savings from this relatively
simple alteration run into the
tens of thousands and more.
Resolve to review
your debts
It would seem almost
blindingly obvious, but the
quicker anyone can
repay their most
expensive debts,
the better, and
so you might
think that our
lenders arrange
our finances in this
manner. However,
what is good for
borrowers is not necessarily
good for the lender and so, in
truth, lenders often have us
repaying our least expensive
debts quickly and our more
expensive ones slowly, sizeably
increasing our real costs as
they do so.
Most people we meet have
two major debts in their lives,
a home loan and some form
of business or investment
loan. Typically, lenders will
lend us money for our homes
over long periods of time
(20-30 years) and for our
businesses (or investments)
over relatively shorter periods.
However, as the latter loans
attract substantial tax relief,
while for most, a home
loan no longer enjoys such
benefits, the reality is that
the business/investment loan
is cheaper to repay, yet it
typically requires repayment
in a far shorter time scale.
Take another example
where someone has just
recently borrowed €200,000
for a home purchase, as well
as also borrowing another
€200,000 for an investment
property purchase. The home
loan is over 25 years at an
interest rate of 3.8% and
the net cost will be €1,023
per month; the total cost to
repay this loan is €306,900.
This borrower also has the
other €200,000 loan, on
which 80% of the interest is
tax deductible (figures here
assume a top rate tax-payer)
and assuming a 4.95% interest
rate and a 10-year repayment
term, the net monthly
repayment will be €2,106
per month; the total cost of
repaying this loan is €252,720.
If, for example, this
borrower had known
of the benefits he/
she would enjoy
by altering the
terms, and for
this example we
will assume the
home loan was
taken over 10 years
and the other loan over
25 years, then the net cost of
repaying these loans would
fall by approximately €18,715
(rounded to nearest €5). This is
the same total borrowing, over
the same total term with the
same headline interest rates,
but altering how and when
you repay these loans lowers
the costs by close to €750 per
annum.
Once again, the savings
you could enjoy by reviewing
your existing loans may be
far greater than the numbers
illustrated here. One thing is
for sure, you will not enjoy
savings if you do not act.
Your lenders will not do this
for you, as the restructuring
outlined does not deliver their
agenda, which is to lower the
bank’s risks, not yours. Only
you can ensure you pay as
little as possible for your loans
so resolve today to review
them; the savings could be
huge. If you have neither the
time nor personal expertise
to self-review, meet a truly
impartial adviser and see if
they may be able to help. You
will pay a fee to such a person
but with the savings to come,
any fee should be more than
self-financing.
Resolve to de-tax your
long-term savings
Tax, plain and simple, is the
greatest liability in our lives
and tax, therefore, is the
greatest obstacle to
any of us achieving
our long-term
ambitions. Most
people are saving
for their future,
but this is how they
do so. . .
They earn money
Pay tax on that money
Save the after-tax amount
Then pay MORE tax on the
returns
However, there is a piece of
legislation on the Irish Statute
Books that allows any of us
to. . .
Earn Money
Pay no tax on the amount of
income being saved
Save this amount before
tax is paid
Then pay no tax on the returns
When we compare these
two methodologies, even
when we add back all taxes
that may be payable later, the
same money, invested in the
same place, producing the
same annual returns, delivers
total returns to you of at
least 50% more; by changing
how you save money you can
increase the value of your
long-term savings by more
than half.
What I am referring to here
is “retirement legislation” but
not necessarily a pension.
Pensions are insurance
policies, sold by commissionremunerated
salesmen and
the tax benefits granted are
often completely eroded by
the various fees and charges
levied within these off-theshelf
products. However,
private retirement plans are
available, which provide far
superior security to savers
than the insurance policies
and allow investment into all
types of assets, including cash
deposits, property and direct
equities.
If you have any form of
long-term savings, be that
inside an existing
insured pension
or elsewhere, you
may be able to
effectively bolt a
“turbo charger”
to those savings
by changing how
they are made.
Again, resolve today to
investigate this potential for
yourself; speak to someone
who can give you the
information you need and,
where possible, make sure you
claim the tax benefits that
retirement legislation allows
you to claim.
Kilian A. Neville, QFA, is
Managing Director at Neville
& Partners Ltd. Neville &
Partners has been approved as
a Preferred Supplier to the IPU.
For further details, email ask@
nevilleandpartners.ie.
IPUREVIEW FEBRUARY 2017 51

SAVE
THE DATE
United Drug
for the
Pharmacy Show
2017
The annual United Drug
Pharmacy Show takes place
at the Aviva Stadium, Dublin,
from 23rd to 25th April 2017

Dates have just been announced for
United Drug’s Pharmacy Show 2017,
which will take place at the Aviva
Stadium, Dublin from Sunday, 23rd April
to Tuesday, 25th April 2017.
The Pharmacy Show is the number one exhibition event in the
pharmacy retail sector, attracting sell-out crowds every year. It is
a great platform for pharmacists to meet with manufacturers and
suppliers, and take advantage of exclusive products and promotions.
Now in its 11th year, the Pharmacy Show is the premier event in the
pharmacy retail calendar. Looking forward to this year’s event, Ann
Walsh, Marketing Manager at United Drug, said: “The Pharmacy
Show is a key event for us and our industry each year. It is a wonderful
opportunity to meet with industry colleagues, to showcase new
promotions, learn about new products and launches and spend
valuable time networking and developing important relationships.
“Moreover, the Pharmacy Show gives us the chance to meet and to
discuss the challenges and opportunities facing us in our sector each
and every day. And let’s not forget the very important commercial
aspect, which is at the forefront of all of our minds in today’s
increasingly challenging marketplace. At United Drug, we are proud
to be the only wholesaler in Ireland to provide this important forum
to our sector.”
Each year the Pharmacy Show offers an engaging and interactive
experience for pharmacists and pharmacy retail staff. For example,
in previous years, attendees could walk through a state-of-the-art
‘pharmacy of the future.’ Last year, the focus was on technology and
on the innovation that was driving future trends in retail as seen in
the US and Europe.
This year’s Pharmacy Show will continue the focus on digital
innovation, showcasing United Drug’s continuing investment in
technology to maintain its high standards in terms of stock range,
customer service and delivery.
A €15m investment in technology and automation has already
increased United Drug’s distribution efficiency by almost two-thirds.
A further €1 million investment is being made in upgrading the
warehouse HVAC system.
These investments support United Drug’s commitment to deliver on
DATES
for your
DIARY!
its business promise ‘to deliver the products you need, when you
need them, at a fair price.’
Ann continued: “At United Drug, we are very proud that our tote
ordering system, based in our Dublin depot, delivers an average
of 15,000 totes nationwide to more than 2,000 customers per day.
Each tote travels a distance of 1km from warehouse shelf to delivery
truck – combined, that’s a total distance equivalent to a journey from
Dublin to Perth,
Australia.”
The Havelock
Suite at the
Aviva Stadium
will tell this story
throughout
the Pharmacy
Show, showing
pharmacists
what happens
from the time
they place their
order, through
to delivery to
the pharmacy.
“Our system is far more technologically advanced than any
competitors and allows us to consistently deliver on our customer
promise,” said Ann. “We are offering pharmacists and retail staff an
opportunity to experience this first-hand by showcasing our tote
system. As the number one pharmaceutical wholesaler in Ireland,
our investment in technology, particularly automation, has been
enormously helpful and indeed critical to maintaining our high
standards in terms of stock range, customer service and delivery. It
will be great for the pharmacy community to see this for themselves.”
At this year’s Pharmacy Show, attendees can look forward to a
sumptuous dining experience in the Presidents Area at the Aviva
Stadium, with accommodation provided in the nearby Clayton Hotel
Burlington Road (formerly the Burlington Hotel).
The Pharmacy Show is expected to attract large numbers again this
year and space is limited; closing date for exhibitors is 24 February
and for pharmacists is 16th March 2017.
For more information on the
Pharmacy Show 2017,
contact Ann Walsh at United Drug
on 01 463 2545 or email
ann.walsh@united-drug.com or
Roisin Kelly on 01 463 7316 or email
roisin.kelly@united-drug.com
PHARMACY SHOW
Sunday, 23rd April 2017: 9am – 6pm
Monday, 24th April 2017: 9am – 6pm
Tuesday, 25th April 2017: 9am – 4pm

PROFESSIONAL
POLITICS Stephen O’Byrnes
Potential of
Community
Pharmacy Services
The Minister for Health said that, in the context of the
Programme for Government, he was examining the potential
“that our contracted pharmacists deliver to public patients,
including in the areas such as vaccination, treatment of
minor ailments and supply of emergency contraception”.
Simon Harris
Fine Gael
John Brassil
Fianna Fáil
Catherine Murphy
Social Democrats
He added that the HSE
was currently assessing
the outcomes of the Minor
Ailment Scheme Pilot run
by the HSE last year in
conjunction with the IPU,
where medical card patients
were treated for minor
conditions directly by the
pharmacist. He was replying
to a Parliamentary Question
from Deputy John Brassil
(Fianna Fáil, Kerry).
Comprehensive
Regulations
governing
dispensing
of Ritalin
Deputy Catherine Murphy
(Social Democrats, Kildare
North) asked the Minister for
Health what were the rules
for prescribing and dispensing
Ritalin, including “the duration
of usual prescriptions; the
restrictions there are on
pharmacists dispensing
numbers of individual Ritalin
doses; and if this varies by
region in respect of dispensing
or prescribing”.
The Minister for Health,
Deputy Simon Harris, said
that Ritalin (methylphenidate)
was indicated as part of a
comprehensive treatment
programme for attention
deficit hyperactivity disorder
(ADHD) in children aged six
years and over, when remedial
measures alone prove
insufficient, and treatment
must be under the supervision
of a specialist in childhood
and/or adolescent behavioural
disorders.
“Under the Misuse of
Drugs Act 1977, as amended,
methylphenidate is a Schedule
2 controlled drug and as such
can only be supplied on foot of
an original valid prescription,
which must be physically
presented to, and reviewed
by, the pharmacist prior to
dispensing to the patient. The
prescription must be signed
and dated by the prescriber.
The prescriber must be a
registered practitioner with an
address within the State.
“The prescription must
specify, in the prescriber’s
own handwriting: full name
and address of the person
for whom the prescription is
issued; form and strength,
where appropriate, of the
preparation; amount/total
quantity prescribed in words
and figures and the dose to
be taken. Methylphenidate
prescriptions must also
contain the name, address and
telephone of the practitioner
and detail the type of
practitioner.
“A prescription for a
methylphenidate is valid for
14 days from the date of issue
indicated on the prescription.
Repeat prescriptions are
not permitted. However,
prescriptions may be
prescribed and dispensed in
instalments, if the practitioner
specifies the amount of the
instalment and the intervals
at which the instalments
are to be dispensed. The first
instalment must be dispensed
within 14 days and no
instalment may be supplied
later than two months after
the date specified on the
prescription. A pharmacist
supplying a controlled drug
must be satisfied as to the
identity of the patient and the
signature of the practitioner.
Dispensed medication may
only be supplied to the
patient or to a bona fide
representative of the patient.”
The Minister added that all
prescriptions for Ritalin were
required to comply with these
legislative requirements.
54
IPUREVIEW FEBRUARY 2017

EHC to be made available to Medical Card holders
for free in pharmacies
The Minister for Health has instructed Department officials “as a matter of urgency” to
remove the requirement for Medical Card holders to obtain a doctor’s prescription before
they can avail of emergency hormonal contraception for free in their local pharmacy, and
advised that work on developing service and clinical structures to facilitate this is already
under way.
This was stated in the Dáil recently by the Minister of State for Health Promotion,
Deputy Marcella Corcoran Kennedy (Fine Gael, Offaly), during a debate on the final stages
of a Miscellaneous Health Provisions Bill, which was passed.
The matter had been raised by Deputy Clare Daly (Independent Socialist, Dublin North)
who said that the Irish Pharmacy Union had made a proposal to the Department of
Health “to make the morning-after pill available without prescription to women on
Medical Cards in June 2015. That was more than a year and a half ago.”
The morning-after pill, she added, had become available through pharmacies without
prescription in 2011. “It is 95% effective if taken within the first 24 hours of unprotected
sex, with its effectiveness falling dramatically the longer time goes on. We know from the
National Association of General Practitioners that there is an average waiting time for a
GP appointment of 34 hours. In essence, a woman with a medical card will not be able to
gain access to the pill within the 24-hour window, as indicated by best practice.”
Deputy Daly said the flu vaccine was available to Medical Card holders without
prescription and pharmacists had a system for claiming back the costs of this since
2011. “Emergency contraception should be freely available over-the-counter to all women
rather than from behind the counter, as is the case at present. It can be costly for private
patients. Nonetheless, the IPU pointed out over 18 months ago that the scheme could
be implemented easily and quickly from a professional perspective. There is no further
training required. The procedure in place for recording and claiming the reimbursement
of fees could be the same as for other medicines dispersed under the community drugs
scheme,” she added.
Replying to the debate, Deputy Corcoran Kennedy said that any person could
enter a pharmacy and buy emergency contraception without a prescription. In the 12
months to August this year, she said, there were just under 13,000 emergency hormonal
contraception prescriptions dispensed under all schemes, of which more than 12,000
were for Medical Card holders.
“Timely access is not an issue for the more than 12,000 people per year who present to
their doctors and then their pharmacies for emergency contraception, rather the issue is
for people who need emergency contraception but who cannot get a prescription in time,
for example, at the weekend, or if they are unable to obtain an urgent appointment with
a GP and cannot afford to buy the product.”
Saying she agreed with the principle of Deputy Daly’s amendment, the Minister of
State said she shared the concerns raised about timely access to emergency hormonal
contraception for Medical Card holders and accepted that there should not be
unnecessary barriers to women receiving this treatment.
She said that Department officials had engaged with the IPU and the HSE about the
necessary processes to ensure this happened. “Many of the IT and service processes
needed were trialled in the Minor Ailments Pilot Scheme this year under which
pharmacies treated patients directly for minor conditions with over-the-counter
medicines and without prescriptions.
“In line with the Minister’s instructions, the HSE is developing operational structures to
provide an over-the-counter emergency hormonal contraception service for GMS patients
professionally, safely and effectively, including clinical standards to ensure patient safety,
pharmacy compliance with these standards (as with the vaccination programmes) and
secure claiming and verification processes. Development will continue to build on the
work already done, including the IPU’s professional practice guidelines for dispensing
over-the-counter emergency hormonal contraception and existing structures for specific
pharmacy services such as the vaccination programme,” the Minister of State said.
Supply of emergency hormonal contraception was a professional clinical service set
out by the Pharmaceutical Society of Ireland and further discussion would be required
with the IPU on service design, which Department of Health officials would pursue. “The
IPU has previously indicated its willingness to provide this as a professional service and
the Pharmaceutical Society of Ireland has issued professional practice guidelines on
dispensing emergency hormonal contraception and advising patients.”
In reply to further questions from Deputy Daly, the Minister of State said the matter
would be concluded as quickly as possible. “It is affordable for the HSE; therefore, it is
not down to cost. There is still some IT architecture to design which we believe will take
approximately three months to complete.”
Marcella
Corcoran Kennedy
Fine Gael
Clare Daly
Independent Socialist
IPUREVIEW FEBRUARY 2017 55

POLITICS
Michael Moynihan
Fianna Fáil
Weekend
Pharmacy
Services
Deputy Michael
Moynihan (Fianna Fáil,
Cork North-West) asked
the Minister for Health
if his Department has
a structure in place
to provide weekend
pharmacy cover in
rural areas where the
only pharmacy stores
were often closed from
Saturday afternoon
until Monday morning.
The Minister said
this was an operational
matter for the HSE
which, in a subsequent
reply to the Deputy,
said that “while there
is no formal rota
structure in place,
business imperatives
in the pharmacy
marketplace have
ensured that most
large towns and cities
have at least one
pharmacy open on a
Sunday. Furthermore,
GP out-of-hours centres
hold small quantities
of emergency
pharmaceuticals to
ensure that patients
can start antibiotic
treatment or pain relief
treatment immediately,
if required.”
Calls to extend
availability of CF
drug to younger
children
The National Centre for
Pharmacoeconomics
(NCPE) reported to the
HSE last October that,
following its assessment of
a pricing proposal from the
manufacturer of Ivacaftor
(Kalydeco) for the treatment
of cystic fibrosis patients
aged two years and older
weighing less than 25kg,
the manufacturer failed
to demonstrate costeffectiveness
of the drug for
the intended cohort of 18
eligible patients.
This was stated in the Dáil
recently by the Minister
for Health in reply to a
Parliamentary Question from
Deputy Jan O’Sullivan (Labour,
Limerick City), who asked
what negotiations were taking
place with the company
that produces Kalydeco “to
reimburse the drug costs for
children aged from two to five
years in view of the fact that
it is already being reimbursed
for persons aged six years
and over”. A series of related
questions on the issue were
also tabled by the Sinn Féin
Leader, Deputy Gerry Adams
(Louth).
The Minister added that
since the HSE was responsible
for the negotiations with
manufacturers, he had asked
them to respond directly to
the deputies on the status
of negotiations with the
manufacturer and on the
issue of the number of
patients currently receiving
Kalydeco, and the cost per
patient.
Wider availability
of emphysema
drug urged
The NCPE was conducting an
assessment of Respreeza as
maintenance treatment of
emphysema in adults with
documented severe alpha1-
proteinase inhibitor deficiency
and, once completed, the HSE
would consider it as part of
its decision-making process
when considering the drug for
reimbursement.
The Minister was replying to
the Fianna Fáil Spokesperson
on Disability, Deputy
Margaret Murphy O’Mahony
(Cork South-West), who
asked if the clinical trial of
Respreeza would continue
to be made available to the
21 patients involved and if it
would be made available to
40 more patients if current
assessments were favourable.
A related question on the
issue was raised by Deputy
Peter Fitzpatrick (Fine Gael,
Louth).
The Minister said that for
patients currently accessing
Respreeza on a compassionate
use basis, the company CSL
Behring would continue
to provide and administer
the drug until the end of
the year. “However, the
operation of compassionate
access schemes are at the
discretion of manufacturers.
I have previously asked
manufacturers to show
compassion to reopen or
maintain compassionate
access schemes to patients
during the assessment process
by the HSE,” he added.
Jan O’Sullivan
Labour
Gerry Adams
Sinn Féin
Margaret Murphy O’Mahony
Fianna Fáil
Peter Fitzpatrick
Fine Gael
” I have previously asked manufacturers
to show compassion to reopen or
maintain compassionate access
schemes to patients during the
assessment process by the HSE.”
Simon Harris, TD, Minister for Health
56
IPUREVIEW FEBRUARY 2017

ME drug not authorised by
European Medicines Agency
John Brassil
Fianna Fáil
Marc MacSharry
Fianna Fáil
Kathleen Funchion
Sinn Féin
John Curran
Fianna Fáil
Ruth Coppinger
Anti-Austerity
Alliance
TDs want new diabetes treatment
included in Long-Term Illness Scheme
A number of TDs have called on the Minister for Health
to make the new Freestyle Libre glucose monitoring
system for diabetes patients available under the Long-
Term Illness Scheme. These include Deputies John
Brassil (Fianna Fáil, Kerry), Marc MacSharry (Fianna Fáil,
Sligo-Leitrim), Kathleen Funchion (Sinn Féin, Carlow-
Kilkenny), John Curran (Fianna Fáil, Dublin Mid-West) and
Ruth Coppinger (Anti-Austerity Alliance, Dublin West).
The Minister for Health said the manufacturer of the
product must make a completed application to the HSE
for reimbursement of the device under the Community
Drugs Schemes and a health technology assessment may
then be required to assess its clinical benefits and costeffectiveness.
Rintatolimod (brand name Ampligen), which
is an experimental drug in development
for the treatment of a variety of chronic
diseases and viral disorders, including
Chronic Fatigue Syndrome, or Myalgic
Encephalomyelitis (ME), has not been
authorised by the European Medicines
Agency for the treatment of ME in the
European Union.
This was stated by the Minister for Health
in the Dáil recently when he was replying to
a question about the drug from Deputy Peter Burke (Fine Gael,
Longford-Westmeath).
He said that if the drug received marketing authorisation in
Ireland, it would then be open to the marketing authorisation
holder to make the drug available for prescribing and to apply
to the HSE to have the product reimbursed under the State
drugs schemes. “I understand that the US Food and Drug
Administration (FDA) has declined to approve rintatolimod for
use in the US despite conducting several reviews of the drug
over the last decade,” he added.
€300 million rebate under
pharmaceutical deal
The Labour Party Health Spokesperson,
Deputy Alan Kelly (Tipperary), asked the
Minister for Health how the rebate scheme,
which forms part of the current medicine
pricing agreement between the Department
and the Irish Pharmaceutical Healthcare
Association, would operate; the total
revenues that the Department anticipated
would be generated by these rebates over
the lifetime of the agreement; the amounts
expected to be raised each year of the
Peter Burke
Fine Gael
Alan Kelly
Labour
agreement by this rebate scheme; and how these moneys would
be collected.
Replying, Minister Harris said the estimated value of
the rebate under the agreement was €300 million and the
breakdown of the amounts expected to be raised each year were
as follows:
“My Department, in consultation with the HSE and the
Department of Public Expenditure and Reform, is currently
monitoring the implementation of the Agreement and
associated savings, and will give consideration to the publication
of the savings achieved on a yearly basis,” he added.
Year 1 Year 2 Year 3 Year 4
Estimated Value
of the Rebates
€65m €70m €80m €85m
* Rounded to the nearest €5m
IPUREVIEW FEBRUARY 2017 57

STUDIES
First of its kind cancer stem cell research unlocks clues to treatment resistance
Researchers at Trinity College Dublin have made exciting new findings that could offer a means of fighting resistance to treatment
for people with oesophageal cancer. Resistance to radiotherapy is a major stumbling block in the treatment of this cancer.
For the first time, the research team, led by Dr Stephen Maher, Ussher Assistant Professor in Translational Oncology at Trinity,
has discovered that a molecule lost from cancer stem cells, called miR-17, is important in driving oesophageal tumour resistance to
radiotherapy.
The team of scientists, which incorporated specialists from Trinity, St. James’s Hospital Dublin, the Coombe Women and Infant’s
University Hospital and the University of Hull in the UK, demonstrated that populations of tumour cells that had higher numbers
of cancer stem cells formed larger, more aggressive tumours. They also demonstrated that the cancer stem cells were more
resistant to radiation-induced cell death.
The findings from this ground-breaking research were recently published in the international peer-reviewed journal Oncotarget.
Many oesophageal cancer patients receive radiotherapy and chemotherapy to shrink their tumour prior to surgery and this forms
a key part of their treatment. Unfortunately, while a subset of patients have excellent responses to treatment, the majority of
patients are actually resistant to various degrees, and are subjected to treatment side effects and an unnecessary delay to surgery,
which can worsen their overall prognosis. To date there hasn’t been a way to test which patients will respond well to radiotherapy
or to reduce resistance to radiotherapy.
Cancer stem cells are a tiny population of tumour cells that exist inside most tumours and acquire some of the features of
normal stem cells. Normal stem cells are unspecialised cells that can be characterised by the ability to change into mature,
specialised cells, like the normal cells that make up the normal oesophagus. When normal tissues are damaged, through injury for
example, stem cells in the local environment help to repopulate and rebuild the normal tissue. However, in a tumour, cancer stemlike
cells, the tumour cells that have acquired stem cell-like abilities, are able to drive and maintain the growth of tumours and
repopulate the tumours following the damage caused by radiotherapy and chemotherapy.
The work, predominantly performed by Dr Niamh Lynam-Lennon, an Irish Research Council-funded Senior Research Fellow with
Trinity’s Department of Surgery, showed that the population of cancer stem cells could be further broken down into smaller groups,
which had distinct radiation sensitivity profiles. Further genetic analysis revealed that the levels of a powerful gene-regulating
molecule, called miR-17, were particularly low in the cancer stem cells that were most resistant to radiation. In patient samples,
miR-17 was found to be much lower in the tumours of patients who did not respond to treatment.
Oesophageal adenocarcinoma, a cancer of the food-pipe, is a major problem in Ireland, the UK and the rest of the western world.
Its incidence has increased by 600% over the past three decades, representing the largest increase in incidence of any disease of any
kind over the same time period, and rates are projected to continue increasing over the next 20 years.
The work was largely funded by the Health Research Board (HRB) and involved research on cells grown in the lab, in vivo research
and tumour samples from oesophageal cancer patients.
Suliqua approved in the European Union for the treatment of adults
with type 2 diabetes
Sanofi has announced that the European Commission has granted marketing authorisation in Europe for SuliquaTM, the once-daily
titratable fixed-ratio combination of basal insulin glargine 100 Units/mL and GLP-1 receptor agonist lixisenatide for the treatment
of adults with type 2 diabetes. Suliqua is authorised for use in combination with metformin to improve glycemic control when this
has not been provided by metformin alone or metformin combined with another oral glucose lowering medicinal product or with
basal insulin.
The decision to grant marketing authorisation in Europe for Suliqua was based on data from two Phase 3 studies, LixiLan-O
and LixiLan-L, which enrolled more than 1,900 adults with type 2 diabetes worldwide to evaluate the efficacy and safety of the
fixed-ratio combination when used in patient populations insufficiently controlled after OADs and after basal insulin therapy,
respectively. Suliqua demonstrated statistically superior blood sugar (HbA1c) reduction versus lixisenatide (-0.8%, p

Nivolumab approved in Europe for treatment in blood cancer as new data shows
promising results of cancer reduction
Bristol-Myers Squibb has announced that the breakthrough immunotherapy Opdivo®q (nivolumab) has been approved for the
treatment of classical Hodgkin lymphoma (cHL), a rare and often-aggressive blood cancer. Specifically, the approval is for patients
whose cancer is progressing (relapsed or refractory) despite autologous stem cell transplantation (ASCT) and treatment with
brentuximab vedotin (BV). The approval comes as new data presented at the American Society for Hematology (ASH) congress
shows that nearly 95% of patients in this setting were still alive at one year. At this advanced stage, Hodgkin lymphoma is a
terminal condition with limited therapy options currently available – the announcement highlights nivolumab as an important new
option for these patients.
The primary endpoint of the study showed that considerable cancer reduction was seen in over two-thirds of patients on
nivolumab (68%, 95% CI: 56%, 78%), measured as objective response rate (ORR). In addition, 8% (95% CI: 3%, 16%) of these patients
saw a complete response (CR), where no recognisable sign of cancer remained.
Nivolumab has an innovative mode of action that works by harnessing the ability of the immune system to fight cancer. In
the CheckMate 205 study, presented at the ASH Annual Meeting in San Diego, USA, 12-month progression-free survival (PFS) was
demonstrated in over half of patients (54.6%, 95% CI: 40.9%, 66.4%) with the median duration of response lasting for over a year
(13.1 months, 95% CI: 8.7, not reached). The safety profile of nivolumab was consistent with previously reported data in this tumour
type. Grade 3/4 drug-related adverse events occurred in 29% of patients, the most common were increased lipase (8%), neutropenia
(5%) and increased aspartate aminotransferase (4%).
Hodgkin lymphoma (HL) is a cancer of the lymphatic system. Generally, lymphoma cells grow in lymph glands (nodes) and this
causes the glands to get bigger or swell. HL can start in any part of your body but the most common place for it to start is the neck,
armpit or chest. The lymphoma cells can sometimes spread to other lymph glands. They can also get into your bloodstream and
spread to other organs, for example in your liver, stomach or bowel. HL incidence rates have increased in Ireland, with 133 people
diagnosed with the cancer in Ireland in 2013. Approximately half of all patients with HL are under 35 years old when diagnosed,
only 16% of all patients with HL are 65 years old or over. The disease is the fourth most common cancer in patients aged 15-34
(after testicular cancer, melanoma and breast cancer).
Nivolumab for the treatment of cHL will now undergo a review by the National Centre for Pharmacoeconomics (NCPE) to
determine a recommendation on the cost effectiveness of reimbursement of the drug by the HSE. Nivolumab is currently licensed
in Europe as a monotherapy under the brand name Opdivo ® q for the treatment of adults with:
n Advanced (unresectable or metastatic) melanoma;
n Locally advanced or metastatic non-small cell lung cancer (NSCLC) after prior chemotherapy; and
n Relapsed or refractory cHL after autologous stem cell transplantation and treatment with brentuximab vedotin.
In addition, nivolumab is licensed in combination with ipilimumabq for the treatment of adult patients with advanced
(unresectable or metastatic) melanoma.
Novartis announces AMG 334 significantly reduces monthly migraine days in
second pivotal Phase III episodic migraine study
Novartis has announced positive top-line results from the global Phase III STRIVE study, evaluating the efficacy and safety of the
fully human monoclonal antibody AMG 334 (erenumab) in episodic migraine prevention. Once-monthly subcutaneous AMG 334
was evaluated at 70mg and 140mg doses, with both doses meeting the study’s primary endpoint, demonstrating a statistically
significant reduction from baseline in mean monthly migraine days at six months versus placebo. AMG 334 is specifically designed
to target and block the Calcitonin Gene-Related Peptide (CGRP) receptor that is believed to have a critical role in mediating the
incapacitating pain of migraine.
Patients enrolled in STRIVE were randomised to receive either placebo, or one of two AMG 334 doses, 70mg or 140mg,
subcutaneously, once monthly, for six months. Patients experienced between four and 14 migraine days each month, with an
average of 8.3 migraine days per month at baseline. Over the last three months of the double-blind treatment phase, patients in the
70mg and 140mg AMG 334 treatment arms experienced a statistically significant 3.2-day and 3.7-day reduction from baseline in
mean monthly migraine days, respectively, as compared to a 1.8-day reduction in the placebo arm.
The safety profile of AMG 334 was comparable to placebo across both treatment arms over the six-month, double-blind
evaluation. The most frequently reported adverse events were nasopharyngitis, upper respiratory tract infection and sinusitis.
Further analysis of the STRIVE data is ongoing.
IPUREVIEW FEBRUARY 2017 59

INTERNATIONAL NEWS Roisin Molloy,
Membership & Secretary General’s Office Manager, IPU
International
Pharmacy News
UK
Clinical
Services
Review sets
direction for
community
pharmacy
NHS England has published
the report of the Community
Pharmacy Clinical Services
Review that has been carried
out by Richard Murray,
Director of Policy at the
Kings Fund. The review
was informed by a steering
group but was carried out
independently.
The report concludes that
there needs to be “renewed
efforts to make the most of
the existing clinical services
that community pharmacy can
provide and to do so at pace”.
It sets out how the skills of
community pharmacists and
their teams can be used to
help people to manage longterm
conditions and to embed
medicines optimisation within
care pathways. This may
require national action through
the Community Pharmacy
Contractual Framework, as
well as local progress on
integrating pharmacies into
evolving models of care, the
report states.
The report sets out a
number of recommendations
for the future development of
community pharmacy services
including:
n Incentivising use
of electronic repeat
dispensing so that this
becomes the default for
repeat prescribing;
n A redesign of MURs to
develop them into full
clinical reviews including
ongoing monitoring and
follow-up of patients,
consideration of
prescription duration,
and utilising independent
prescribing as part of the
care pathway;
n Consideration of making
smoking cessation
services an element of
the national contractual
framework;
n Use of the Vanguard
programmes to develop
the evidence base for
community pharmacists
including integrating
community pharmacists
into long-term condition
management pathways,
involving them in casefinding
programmes
and using new ways of
contracting that mitigate
any perceived conflicts
of interest;
n Support from NHS
England and national
partners to help STP
leads to integrate
community pharmacy
into their plans and
local commissioners to
contract for services; and
n Joint work by PSNC, the
Royal Pharmaceutical
Society and national
GP representatives to
explore what practical
steps can be taken to
unravel professional
boundary issues and
ensure closer working
between community
pharmacists and GPs.
The report also called for
NHS England to set out how
it intends to deliver on its
commitment to ensure that
minor ailments services are
commissioned across England
by April 2018. It stressed
the need for community
pharmacists and their teams
to share information with
clinical records held by other
healthcare professionals.
The report recommends that
a formal group be established,
including representatives
of community pharmacy, to
have oversight of progress and
recommend further action
where needed.
The independent review
was commissioned by the
Chief Pharmaceutical Officer
of NHS England earlier this
year. NHS England has set
out its intention to use the
recommendations of the
review to inform its approach
to the commissioning of
NHS community pharmacy
services. A rapid review of
the evidence for community
pharmacy services, carried out
by Professor David Wright, was
published alongside the report.
PSNC Chief Executive Sue
Sharpe said, “This review
includes some positive
and welcome proposals for
developing the community
pharmacy service. We are
ready and keen to work to
implement these as soon as
possible. The events of the
last year have badly dented
the confidence of pharmacy
contractors but energy in
moving forwards will do a lot
to restore it.”
Source: http://psnc.org.uk/
Romania
Aims
to slow
parallel trade of
medicines when
supplies run low
The Romanian Health Ministry
published a draft order
designed to curb the so-called
parallel trade of medicines.
The order would require that
when supplies of medicines
run low nationwide for seven
days, the government must
track them and their export
would be banned. The health
ministry wants to ensure
that drugs are not taken
out of Romania, where they
are priced low, to be sold for
higher prices in richer EU
countries at the expense of
Romanian patients.
Romania, Greece and
Slovakia have complained
about medicine shortages
due to the legal practice of
parallel export. Drugs and
other items can cross borders
in the EU because of the
principle of free movement of
goods. National governments
cannot completely ban the
practice but can restrict it if it
creates shortages of medicines
locally and poses a risk to
patients. EU Health and Food
Safety Commissioner Vytenis
Andriukaitis stressed this
during a visit to Romania in
September 2015.
Romania’s proposal would
take effect after the National
Medicines and Medical
Devices Agency confirms that
the reason for the evaporating
supply isn’t related to
some kind of extreme
situation, such as quality or
safety issues or temporary
production issues. The drugs
would be taken off the list
if stocks recover nationally
and supplies remain stable
for at least 14 consecutive
days, according to the draft
order. Romania’s incoming
government could dial back on
the order before it takes effect,
which would most likely be in
March.
Source: PGEU Monthly Newsletter
December 2016.
60
IPUREVIEW FEBRUARY 2017

NEWS
HIQA publishes
standards for
a dispensing
medication note
to support safe
prescribing
In an important step in Ireland’s eHealth strategy,
the Health Information and Quality Authority
(HIQA) has published the National Standard for
a Dispensing Note including a Clinical Document
Architecture specification. This standard will support
the implementation of ePrescribing in Ireland.
Multiple standards are required to enable the
roll-out of ePrescribing nationally. To support
ePrescribing, HIQA has previously developed a
data model for prescribed medications and an
ePrescribing standard. This new standard supports
the sharing of information when a patient is
fulfilling a prescription. The standard details the
minimum amount of information that should be
recorded on a patient summary care record to
support the safe dispensing of medication.
HIQA’s Director of Health Information Rachel
Flynn said: “These Standards pave the way for
improved health services by reducing medication
prescription and transcription errors, leading to
increased quality and efficiency and safer services
for patients. Medication errors are one of the most
common adverse events in Irish healthcare, with
medication safety incidents accounting for up
to 8% of clinical incidents reported to the State
Claims Agency. ePrescribing gives health providers
an important tool to safely and efficiently manage
patients’ medications. The standard published
today supports the electronic sharing of information
regarding medications dispensed to a patient and
provides a mechanism for safely exchanging this
information in electronic documents.”
The National Standard for a Dispensing Note
including a Clinical Document Architecture specification
is available online at http://bit.ly/2jOmKlP.
National Standard for a Dispensing Note
including a Clinical Document
HIQA announces public
consultation on first EU
HTA to include e-cigarettes
as an intervention for
quitting smoking
HIQA has commenced a national public consultation on a health
technology assessment of smoking cessation interventions.
This independent analysis by HIQA identifies what improvements could
be made in the mix of interventions offered by the HSE to increase overall
quit rates at an acceptable cost. The findings will inform the development
of a national clinical guideline to guide healthcare professionals and
smokers on how best to quit smoking successfully.
HIQA’s Director of Health Technology Assessment Dr Máirín Ryan said,
“This analysis examines the safety, effectiveness and cost-effectiveness
of the smoking cessation interventions available in Ireland that can
be used to help smokers quit for good. These include medicines such
as nicotine replacement therapy, varenicline and antidepressants, as
well as e-cigarettes and behavioural interventions, such as counselling
and telephone support. HIQA also specifically examined the clinical
effectiveness of therapies in pregnant women, and those attending
secondary mental health services.”
The HIQA assessment is the first of its kind in the EU to examine the
cost-effectiveness of e-cigarettes.
Significant changes have taken place in smokers’ choice of cessation
support since the arrival of e-cigarettes on the market five years ago. This
analysis looks at current uptake rates of e-cigarettes among those trying
to stop smoking in Ireland, as well as trends in other countries, while
acknowledging that research into e-cigarettes is only beginning.
Dr Máirín Ryan said, “This HTA found a high level of uncertainty
surrounding both the clinical and cost-effectiveness of e-cigarettes. While
the long-term effects of using e-cigarettes have not yet been established,
data from Healthy Ireland reveals that 29% of smokers currently use
e-cigarettes as an aid to quitting smoking. HIQA’s analysis shows that
increased uptake of e-cigarettes as an aid to quitting would increase
the number of people who successfully quit compared with the existing
situation in Ireland and would be cost-effective, provided that the currently
available evidence on their effectiveness is confirmed by further studies.”
A public consultation seeking feedback on this report is open until
3 February 2017. Following this, a final report will be prepared for
consideration by the HIQA Board, before being submitted to the Minister
for Health and the HSE. The report, along with details on how to take part
in the consultation, is available at www.hiqa.ie.
Architecture specifiction
IPUREVIEW FEBRUARY 2017 61

NEWS
National data collection
standards will contribute
to the delivery of safe
and reliable health and
social care
HIQA has published Information management standards
for national health and social care data collections, which,
when implemented, will improve the quality of
national health information and data, contributing to
the delivery of safe and reliable healthcare.
The 10 new standards focus on the information
governance practices and the management of national
health and social care data collections in Ireland. These
standards will apply to all health and social care data
collections established and maintained on a national
basis, providing a framework of best practice in the
collection of health and social care data.
Each national health and social care data collection
holds a rich source of data. These information sources
are used in many ways to inform decision-making,
monitor diseases, organise services and measure,
monitor and report on health and social care related
activities and outcomes. The HSE uses indicators
derived from these data collections through its service
plan to monitor its performance on the quality of
care. The Department of Health also collates these
indicators in an annual National Healthcare Quality
Reporting system report to provide a national overview
of the quality of healthcare in Ireland. These standards
will improve the quality of the data collected.
National health and social care data collections
are national repositories of routinely collected health
and social care data in Ireland. They play a crucial
role by providing a national overview of a particular
health or social care service. National data collections,
which play a role in providing a national overview
of particular health and social care services, include
the National Cancer Registry of Ireland (NCRI),
Immunisation Uptake Statistics and the Computerised
Infectious Disease Reporting (CIDR) System. They
enable the assessment of key indicators of the health
service, including influenza vaccine uptake, breast
cancer screening rates and information in relation to
hospital-acquired infections such as MRSA rates.
HIQA will develop a structured programme of
assessing compliance with the Information management
standards for national health and social care data collections
within its legislative remit. Recognising that these
standards are new, information sessions will be
held to support national health and social care data
collections to comply with these standards. HIQA plans
to initiate a review programme during 2017, which will
commence with the distribution of a ‘self-assessment
tool’ to national health and social care data collections
within its remit. This programme will be phased and
HIQA will continue to engage with national health
and social care data collections in advance of the
commencement of the process.
Huge rise in liver
cancer rates
shows need
to Get Cancer
through reducing
our risk
The startling increase in the number of people
diagnosed with liver cancer in Ireland highlights the
urgent need for us all to Get Cancer by reducing our
risk of contracting this devastating disease, the Irish
Cancer Society has said.
Latest figures from the National Cancer Registry
of Ireland (NCRI) show a 300% rise in liver cancer
diagnoses in Ireland in the past two decades. The
average number of new cases each year has gone from
60 in the mid-1990s to more than 270 in 2014. Of those
diagnosed, less than one in five (17%) survive their
disease for five years or more. In 2013, 306 people in
Ireland died from liver cancer, compared to an average
of just 40 people per year in the late 1990s.
The NCRI points to high alcohol consumption in
recent decades as one of the biggest reasons for this
four-fold increase.
Commenting on the figures, Irish Cancer Society
Head of Research Dr Robert O’Connor said,
“Alcohol is the cause of around 900 incidences
of cancer in Ireland each year, and 500 of these
patients will die of their disease. Overall, one in 10
of all cancers in men and one in 33 in women are
caused by alcohol. Liver cancer is one of seven cancer
types of which can be caused by alcohol. The high
incidence rates of the disease that Ireland is currently
experiencing is a result of decades of people in Ireland
simply drinking too much.
“One in five of all alcohol-related deaths are due to
cancer but our consumption of alcohol is increasing –
in 2010 it was 145% higher than the average amount
drank in 1960. Irish people drink more than the
European average, which stands at 11 litres of pure
alcohol per person per year.”
To speak to a cancer nurse on any aspect of cancer,
contact the Cancer Nurseline on Freephone 1800 200
700, email cancernurseline@irishcancer.ie or drop
into a Daffodil Centre in hospitals nationwide.
Visit www.cancer.ie for cancer information and
support services.
62
IPUREVIEW FEBRUARY 2017

NEWS
Eileen Byrne appointed
Managing Director of
Clanwilliam Health
Clanwilliam Group has appointed Eileen Byrne as Managing
Director of its Clanwilliam Health division.
Howard Beggs, CEO of Clanwilliam Group, said Eileen was
well-placed to chart the future direction of Clanwilliam Health.
“Eileen has a vision for the difference technology can make
to healthcare delivery in Ireland. As Managing Director of
Clanwilliam Health, she leads a team of over 150 personnel
in Ireland and the UK that are committed to innovation
and constantly enhancing our offering to pharmacy and GP
customers. I am delighted that she has agreed to take on this
position and look forward to continuing to work with her as
we harness the benefits
of digital advances to
support our customers,”
said Mr Beggs.
Eileen was previously
Director of Customer
Services at Clanwilliam
Group and has been
involved with the
business for the past two
decades, having held
senior roles in training
and implementation
previously.
New CEO takes the
helm at Muscular
Dystrophy Ireland
Muscular Dystrophy Ireland (MDI), the national charity
supporting people with muscular dystrophy and their families
across Ireland, is delighted to announce the appointment of its
new Chief Executive Officer, Mr Richard Lodge.
Mr Lodge was most recently the Network Manager at St Luke’s
Oncology Radiation Network, which operates from St Luke’s
Hospital and St Luke’s Radiation Oncology Units in St James’s
and Beaumont Hospitals in Dublin. Mr Lodge has spent the past
10 years with that organisation, having previously been the CEO
of St Luke’s Hospital.
Mr Lodge holds an MBA from Middlesex University and a
Master’s degree in Transfusion Medicine from Westminster
University. He is a Fellow of the Institute of Biomedical Science.
Intas Pharmaceuticals completes deal to acquire
Actavis UK & Ireland generics businesses from Teva
Intas Pharmaceuticals Ltd. (“Intas”), through
its wholly owned subsidiary Accord Healthcare
Ltd. (“Accord”), has completed the deal to
acquire Actavis UK Ltd. & Actavis Ireland
Ltd. (“Actavis UK & Ireland”) from Teva
Pharmaceutical Industries Ltd. (“Teva”), for
an enterprise value of £603 million payable
in cash. The transaction is part of the European Commission’s
anti-trust divestiture requirements arising from Teva’s
acquisition of Allergan’s generics business.
Following the completion of the acquisition, Accord
strengthens its footprint in the UK and Ireland retail market to
become a leading player in the industry at European level, while
Intas becomes a top 20 generic player globally. The combination
with Actavis UK Ltd. and Actavis Ireland gives Accord an
exciting opportunity to build on its already
strong position in the market, providing the
company with increased access to UK and Irish
retail and hospital markets. The combination of
these two, high-performing businesses expands
Accord’s UK manufacturing presence, and the
addition of the GMP Barnstaple site that was
included in the acquisition, further demonstrates Accord’s
commitment to UK manufacturing and adds to the recent
significant investment to reinstate a facility in Newcastle. The
Barnstaple plant will become one of Accord’s four UK sites,
ensuring the company has one of the most extensive local
supply chains, providing service to wholesalers, hospitals and
pharmacies across the UK and Ireland, as well as into Europe.
IPUREVIEW FEBRUARY 2017 63

NEWS
© Government of Ireland 2016.
HEALTH IN IRELAND
Key Trends 2016
Department of
Health publishes
Health in Ireland:
Key Trends 2016
The Department of Health published Health in Ireland: Key Trends
2016 at the end of December. This report provides insights
into trends in demographics, population health, hospital and
primary care and health service employment and expenditure.
The presentation of trend data over the last decade in the
2016 report highlights the many significant achievements
that Ireland has made in terms of key outcomes relating
to the health and wellbeing of the population. However,
it also highlights the challenges that persist in terms of
the accessibility of timely healthcare and in the context of
increasing demand.
In the last decade alone, there has been an increase of almost
two and a half years in life expectancy. These gains are driven
largely by reductions in mortality rates from principal causes
of deaths such as those from heart disease and cancer.
Another striking feature is the growth in the number of
people aged over 65. Each year this cohort increases by almost
20,000 people. This trend is set to continue into the future and
will have implications for future planning and health service
delivery. The largest proportional increases in the population in
Ireland will be in the category of those aged 85 years and older.
Ageing of the population in conjunction with lifestylerelated
health threats continue to present major challenges
now and into the future in sustaining and further improving
health and health services in Ireland. Although difficult to
quantify, the contribution of modern health services to these
improvements in health outcomes and in life expectancy have
been significant.
Ireland’s fertility rates still continue to be among the highest
in Europe. However, in Ireland the birth rate has now fallen to
its lowest rate for the last decade.
While there are fewer inpatient hospital beds than a decade
ago, there has been a 43% increase in day beds and a shorter
length of stay. This shows Ireland is using its capacity more
efficiently.
This year, the numbers employed in the public health service
have increased across most grade categories.
The full report is available online at http://health.gov.ie/
publications-research/publications/.
Joe Schmidt
launches 2017
National Saddle Up
for Epilepsy cycle
Ireland Rugby Head Coach Joe Schmidt launched the
2017 National Saddle Up for Epilepsy and Epilepsy
Ireland’s Strategic Plan (2017-2021), in the Royal College
of Physicians of Ireland, Dublin.
The National Saddle Up for Epilepsy cycle takes place
on 25 February in Breaffy Sports Arena, Castlebar, Co
Mayo. Now in its third year, the growing event aims to
help raise funds for Epilepsy Ireland’s support services
and increase public awareness of the condition.
Speaking at the launch, Joe Schmidt said, “The
effort of all the organisers and volunteers is inspiring
and this event proves the positive impact sports
can have in supporting a charity. I would encourage
everyone with an interest in epilepsy to register for
The National Saddle Up for Epilepsy cycle – an effort
which I’m sure will continue to increase in popularity
well into the future.”
Epilepsy Ireland is the national organisation
supporting and representing people with epilepsy,
their families and carers. Established in 1966, the
charity today provides a wide range of support
and information services from their head office in
Dublin and from nine locations around the country.
The charity also provides training programmes
for both health professionals and for young adults
with epilepsy; actively works to improve public
understanding of epilepsy and funds high quality Irish
research into the condition.
To download a copy of the Epilepsy Ireland Strategic
Plan 2017-2021, visit https://goo.gl/0M4qaQ or to
register for the 2017 National Saddle Up For Epilepsy,
log onto www.saddleupforepilepsy.com.
64
IPUREVIEW FEBRUARY 2017

NEWS
New Year – New Lungs
with We Love Quitters
Quitting smoking is year-on-year in the top five New Year’s
Resolutions in Ireland, alongside spending more time with
family, getting fit, eating healthier and enjoying life more. We
Love Quitters is here to help.
We Love Quitters is all about assisting smokers who want to
quit the habit with support, hints, tips and motivation. All you
have to do is pledge to become a Quitter.
For smokers, this is an amazing opportunity and fantastic
motivation to quit. Every day without a cigarette is good news
for your health, your family and friends and your pocket. We
Love Quitters will be online to help smokers who want to break
their unhealthy habit forever by providing motivation, moral
support, guidance and helpful advice to ease them on their
journey towards a smoke-free future.
Once smokers sign up to become a Quitter through the
innovative social media campaign, supported by Nicochew,
the welovequitters pages on Twitter (@welovequitters) and
Facebook (facebook.com/welovequittersireland) promise to
support quitters on their journey to becoming cigarette free
with Quit Smoking Tips/Motivation to help them stay on track.
There will be ongoing helpful hints and tips and a way for you
to announce to family and friends that you wish to be a quitter
to ensure you receive support from them also.
Professor Luke Clancy, Director General, Tobacco Free
Research Institute Ireland, said, “Tobacco use is the most
preventable cause of death, chronic disability and a major
cause of health inequality in Ireland today. 70% of smokers
want to quit and many make several attempts without success.
Effective treatments exist and every smoker should be offered
help to quit. Although smoking is decreasing, it still remains
high and if we want to achieve the government’s goal of
becoming SmokeFree by 2025, it is imperative that we improve
the treatment of tobacco dependence for smokers and offer
them the support they need to help them quit.”
The Office of Tobacco Free Research Institute Ireland recently
stated that the overall prevalence of cigarette smoking in 2014
was 19.5%. This compares to 21.5% for 2013. This equates to
over 70,000 fewer smokers in 2014 compared to 2013. Smoking
rates were highest among young adults (18-34 years), reaching
27.3% in the 25-34 year old age group. Prevalence was lowest
among the 15-17 age group at 7.9%.
Every cigarette smoked reduces a smoker’s life by five and a
half minutes. Every 6.5 seconds someone in the world dies from
tobacco use. This adds up to a shocking 1.5 million people dying
needlessly each year, so now is the time to become a Quitter.
The Pharmacists
Blood Pressure
Monitor
Blood pressure monitors come in all shapes and sizes
nowadays but pharmacists need a model that is reliable,
robust, fits all arm sizes and is durable.
The Medicare Lifesense A4 from Fleming Medical
provides all that and more with its fully automatic
upper arm measurement and two cuff sizes to
ensure all patients are easily assessed. Other features
include irregular heartbeat detection, super-size LCD
display, a visual risk category indicator and a WHO BP
classification.
To coincide with Fleming Medical’s Happy Heart Month,
Fleming Medical are offering a special discounted price of
€35 for the A4. Contact Fleming Medical on 1800 307 777
for more details.
CLASSIFIEDS
PHARMACY FOR SALE. Long established family pharmacy
located in large provincial town in the Midlands.
For full details, reply to Box No. 117.
ALL BOX NUMBER REPLIES SHOULD BE POSTED 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:
Aoibheann Ní Shúilleabháin, IPU, Butterfield House,
Butterfield Avenue, Rathfarnham, Dublin 14.
Tel: (01) 493 6401. Fax: (01) 493 6626.
Email: ipureview@ipu.ie
STACK’S FAMILY PHARMACY,
MONASTEREVIN
Require a support pharmacist (3 days per week) to
cover Maternity leave from 29 March
Contact: tomstackpharmacy@gmail.com
or 086 811 0025
IPUREVIEW FEBRUARY 2017 65

NEWS
PRODUCT INFORMATION
Warm Up & Cool
Down the Right Way
Medicare has recently launched a Sports Warm Up
Kit with all the key equipment to ensure that pre
and post workout exercises are correctly and
effectively performed.
Kits contents include:
n A Foam Trigger Roller – Perfect for relaxing
and stretching muscles;
n Slider Pads – Designed to improve balance
and co-ordination;
n Power Band – Great for warming up and
cooling down;
n Stretching Strap – Ideal for Sports &
Yoga warm up stretches;
Imatinib Krka*
100mg and 400mg
Launched
Krka Pharmaceuticals would like to announce the
launch of Imatinib Krka* 100mg and 400mg. We would
like to draw your attention to the fact that, although
Imatinib as an active ingredient is no longer protected
by patent, Novartis does hold a patent in certain
European countries (patent EP 1 332 137), which
protects the use of imatinib for the treatment of gastro
intestinal tumours (GIST); this patent is valid in Ireland
until October 2021.
* Imatinib Krka is not approved for the indications treatment of GIST,
which is protected by the patent.
n Myofascial Ball – Perfect for pressure on smaller
muscle groups that rollers can’t reach; and
n Mini Band – Great for increase strength & stability.
The durable bag includes pockets ideal for earphones
and a water bottle. It also includes a detailed instruction
leaflet outlining how to use each of the kits contents.
The trade price for the kits is €49. Medicare is
including a free Medicare Sport water bottle worth
€9.95 with all kits sold during February.
The kits are available from Fleming Medical on
1800 307 777 or info@flemingmedical.ie.
Actavis Launch Imatinib
Actavis Group 400mg
Actavis has launched Imatinib Actavis Group 400mg in a pack
size of 30 film-coated tablets. Imatinib Actavis Group is a
prescription-only medicine indicated for the treatment of the
following cancers:
n Chronic myeloid leukaemia;
n Philadelphia chromosome positive acute
lymphoblastic leukaemia;
n Myelodysplastic/myeloproliferative diseases;
n Hypereosinophilic syndrome (HES) and/or chronic
eosinophilic leukaemia; and
n Dermatofibrosarcoma protuberans.
Imatinib Actavis Group is now available from Uniphar and
United Drug. For further information, please contact your
Actavis representative, call Actavis in Cork on 021 461 9040 or
visit www.actavis.ie.
66
IPUREVIEW FEBRUARY 2017

SEMINAR
CLASSIFIEDS
NEW Insurance Scheme
for PHARMACISTS
PROFESSIONAL INDEMNITY,
LEGAL EXPENSES including
FITNESS TO PRACTICE and RETAIL.
O’CALLAGHAN
INSURANCES
For Best in Class.
Contact the professionals
Dundalk Office: 042-935 9004
Navan Office: 046-902 1855
Monaghan Office: 047-64998
O’Callaghan Insurances t/a O’Callaghan Insurances is regulated by the Central Bank of Ireland
PHARMACY
GROWTH
SEMINAR
To register your interest email
seminar@fitzgeraldpower.ie or
call 051 870152
Get ready to grow your
pharmacy business
#PharmacyGrowth
Wednesday
8 th
March 2017
Citywest Hotel,
Dublin
McS-Appoint-171116.qxp_Layout 1 19/01/2017 10:18 Page 1
PERMANENT
PHARMACIST
REQUIRED
Stradbally Pharmacy requires a Permanent
Pharmacist in Stradbally, Co Laois (10 minutes
from Portlaoise) to work every Saturday from
9am-2pm, with immediate start.
No contact details???
PHARMACISTS REQUIRED
– TRALEE AREA
3 Days per week, One Sunday per Month
No Nursing Home
Excellent Salary plus bonuses for suitable candidate.
Contact: traleepharmacy1@gmail.com
RYAN’S PHARMACY
THURLES, CO. TIPPERARY
Requires full time pharmacist (hours negotiable).
One Saturday in four. No late nights.
Contact 087 245 4988
or ryanpharm@eircom.net
Group Support Pharmacist
• For our Athlone Stores
• Member of the Pharmaceutical Society of Ireland
• Ability to work on own initiative and as part
of our pharmacy team.
Please forward C.V’s to
karenk@mcsharryspharmacy.com
Closing date 17th February
PHARMACIST
WANTED
Costigan’s Pharmacy is looking for a
full-time pharmacist to join our team in
Tipperary Town from March 2017.
No late nights, working 1 Saturday in 3,
excellent experienced support staff.
Send your CV to costiganspharmacy@eircom.net
or phone Siobhan at 086 880 4924
To advertise here,
contact Aoibheann at
ipureview@ipu.ie
IPUREVIEW FEBRUARY 2017 67

PHARMACY
GROWTH
SEMINAR
Wednesday
8 th
March
2017
Citywest Hotel,
Dublin
Get ready to grow your
pharmacy business
Speakers
Stuart Fitzgerald
Director,
Fitzgerald Power
Michael Hussey
Davy Corporate Finance
Barbara Kenny
Partner,
William Fry
Mark Stafford
CEO, Stafford Group
David Fitzsimons
CEO, Retail Excellence
Ireland
Daragh Connolly
President, Irish
Pharmacy Union
#PharmacyGrowth
Ramona Nicholas
MD, Cara Pharmacy
Group
To register your interest email seminar@fitzgeraldpower.ie
or call 051 870152