This September 25th is celebrated World Pharmacist Daycreated in 2009 by the International Pharmaceutical Federation (FIP) during a Council held in Istanbul (Turkey), with the aim of promoting and supporting the role of these professionals in disease prevention, health promotion and treatment monitoring in the world #DMF2024.
To “celebrate”, OKSALUD speaks with the president of Professional Federation of Spanish Pharmacists (FEFE), Luis de Palacio, who, in addition to toasting this date, gives us information about the upcoming elections within the organization.
QUESTION: This September 25th marks World Pharmacists Day. Make a wish…
ANSWER.- That all outpatients can collect all their medications from their community pharmacy.
Q.- Is the pharmacist a valued health professional in Spanish society? Why?
A.- The pharmacy plays a special role in the genesis and maintenance of all cities in this country. 95% of cities with more than 500 inhabitants have a pharmacy.
For this reason, the pharmacist is the health professional closest and most available to the Spanish population, and access to medicines through him is the first and greatest social achievement in centuries.
Q.- What is the biggest obstacle for pharmacists practicing in Spain?
A.- A jealous restriction on the development and deployment of the pharmaceutical profession.
It is very difficult for us to offer services beyond the strict supply of pharmaceutical products, simply because when they are marketed, they tend to be persecuted. Starting with advertising them.
Q.- How does this affect the professional? Excessive regulation in Spain?
A.- Well, in accordance with the above, this limits the possibilities of development of the pharmacist as well as the benefit that society can derive from this development.
Spain is, paradoxically, a country where pharmacies are easily accessible, but where vaccines are not administered; Simple diagnostic tests are not usually performed; There are few developed pharmaceutical services, as there is only a professional scope in the provision of pharmaceuticals; Pharmacists cannot responsibly substitute the form of medications or dispense medications for minor symptoms that decongest primary care according to medical guidelines, etc. etc.
Q.- Do you think that in Spain there is a disorderly liberalization of pharmacy?
A.- The Spanish model strictly regulates the organization of the physical establishment of pharmacies in the territory, as well as the ownership of these establishments. I sincerely believe that we are at the opposite end of the spectrum from disorderly liberalization.
Q.- How do you manage public hospitals and primary care centers that “capitalize” part of what could be managed from the pharmacy?
A.- These activities mentioned obey a way of making a specific health policy. In my opinion, the pharmacy will always manage the storage, rotation and dispensing of medicines more efficiently than the public health system. I think it will cost less money, more families will be supported throughout Spain and the population will benefit from a better service. Today, people have to go to the hospital for one type of medicine and to the pharmacy or even the health center for the rest of their medicines. The solution of the policies is to take them directly to the home, leaving aside the local pharmacies. This is very good, but it is much less efficient, and when it continues to lower prices and margins, it prevents us from serving nursing homes and distributing the entire vademecum to mobile patients. In reality, what remains is an intention: to move to the pharmacy.
Q.- Can we speak of an “intrusion” into the pharmaceutical profession by pharmaceutical laboratories in their relationship with patients? Because?
A.- I think not in general. Because the laboratory understands that the figure of the pharmacist implies a responsibility towards the patient, which is also not the purpose of the laboratory. For them, their current activity is simple and sufficiently responsible. Issues such as checking for counterfeit products are incompatible with the fact that laboratories deliver drugs directly.
Now, there have been cases that I consider ugly, or unethical, such as the exclusion of the pharmacy from access to flash glucometers, which are delivered to health centers if they are funded, or directly from the laboratory to the patient online if they are delivered. it is private. In addition, with the subsequent patient record, their parameters, the name of their doctor, etc.
A similar thing happens to us with some nutritional supplements that have a status of “quasi-drug”, and for this reason, they do not apply the same standards of commercial behavior as the pharmaceutical industry, that is, refraining from addressing the patient directly.
Q.- There will soon be elections at the FEFE…
A.- The current term ends in the summer of 2025, and as this is the second, there must necessarily be a replacement, because the FEFE has clear limits in this sense.
Our responsibility is to work until the last day and leave things the same or better than how we received them. Of course, I always encourage everyone to participate in the evolution of the company, and failing that, I ask you to join and support the institution.
Q.- What are the milestones of the FEFE with you at the helm? Among its objectives were the collection of mandatory guards; health and digital pharmacy, the abolition of the sealed coupon, the abolition of royal decrees and the return of the Hospital Diagnosis in pharmacy.
A.- All this is true, they were and remain objectives to be conquered. On a material level, some progress has been made, especially after the pandemic. However, this progress has been insufficient. Furthermore, I must say that these are objectives that do not even depend entirely on us as interlocutors or main executors. They depend on the national and regional governments and legislators. They also depend a lot on the fact that they are objectives shared with the professional associations that have the autonomous coordination that the regional governments confer on them. I believe that in terms of opinion in the sector, we have done a great job of influence and we have been an intellectual reference in very specific areas such as those mentioned, for which we have not lost face, which I consider an important step in itself. In fact, the Valencian Community will eliminate the seal coupon this year, starting now with Castellón. My deepest gratitude to the presidents of the associations touched by their determination, especially to Rosa Arnau, president of the College of Pharmacists of Castellón.
Furthermore, in what concerns us, that is, our role as social agent, in the collective agreement and in the social dialogue through the CEOE, I think that the performance has been very good. We have legal security and validity in the collective agreement. We have limited to the maximum the increases in wages and other working conditions, reaching difficult agreements for the unions and for us. Knowing that the cost of personnel of companies is the main item of expenditure in our economy and that taxes on labor are reaching historical highs with 42% of salaries, the result of the unlimited collection effort of current governments, the management that we do of this agreement is an activity of great responsibility for all pharmacists.
At CEOE, we are part of the Executive Committee and we have the vice-presidency of the Health Commission, where we participate in many working groups. Therefore, we will set the bar high from which others can continue to benefit.
Q.- What questions are blocked or pending?
A.- Examining our conscience, we have tried with determination and commitment all the elements that we proposed. In addition to the problems mentioned and that remain to be resolved, there are a few others that I regret not having completed. Both related to each other and referring to the FEFE organization. One is the application for FEFE members, which is functional and useful to the pharmacist, and which allows the organization to be efficient in its structure and management of members. And the other is a statutory reform that also encourages the growth of the entire company, which streamlines the management of FEFE, and which could link the work that the FEFE management does with the final objective, which is to grow in associates.
I personally regret that this did not happen, but I recognize that there was a lack of conviction in the rest of the FEFE, and that a possible imposition of these changes could generate an internal division that constitutes the greatest evil known to the FEFE in its history.
Q.- How should pharmacy adapt in this 21st century?
A.- This innocent question is what we want to develop every year during our FEFE ONE DAY congress, which will take place this year on October 15 in Madrid.
The main themes are the digitalization of society; the use of mobile phones for absolutely all aspects of commercial, administrative and social life; advances in digital prescription; communication in these times in a multichannel and multiplatform way and the legal and fiscal keys that remain to come in our sector.
Q.- Make a prediction about the FEFE elections.
A.- One wish is that whoever comes is good for FEFE, which will be good for the pharmacies. But I think it is very convenient that the president, or his secretary, or both, have a lot of availability to be in Madrid every day, either in the FEFE offices or in the institutional life that this position implies.
Q.- Make another wish…
A.- Health for all, and take care of it from the pharmacy.
