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Pharmacists – Health VS Profit Margins

by Derek Del Simone on December 12, 2013
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I start this article acknowledging that this does not cover all pharmacists only a very select few. There are many pharmacists who are ethical and upstanding professionals. But as consumers we need transparency and discussion to ensure we are informed about decisions made in regards to our health.


Pharmacists who work in retail pharmacies have a serious conflict of interest. On the one hand, they are professionals, expected to be knowledgeable about drugs and to dispense them in a responsible and ethical manner. On the other hand, their income depends on the sale of products. We are all human; would you sell one product over the other if you had a better profit margin on it? Of course you would.


I have lost count the times I have gone into a pharmacy to fill a prescription and the pharmacist, I feel has deceitfully tried to push me to a generic product! Why? It’s more money for the pharmacy! Of course a pharmacy is a business and they have to make money, I don’t begrudge anyone trying to make money. But is pushing a generic cause they have a better revenue margin on it, the right thing to do? Where do we stand on this from an ethical and unethical practice? Is giving a patient a generic, which only has to contain a small portion of the active ingredient than what the brand product does, really the best thing for the patient?


I am all up for options and commend any pharmacist, like any profession who gives me an option to save money, but only if it is the right thing for me as a consumer. But when you have a pharmacist’s just hand over a generic without discussion or seeking approval to substitute the prescription or they say things like. “You should buy the generic its Australian made.” “We don’t have any stock left of that, but here is a substitute.” (Surprisingly it’s the generic). “That product is on back order globally.” Or my favourite “It’s a cheaper option for you.” I love this one the most, cause majority of the time the product is covered by the PBS system and costs you minimal or doesn’t impact on you in any way. How about some honesty from the pharmacist give the patient the facts including what your profit margin is for both the brand and the generic product?


I think it’s time that there is more transparency for the consumer when it comes to our health and our prescriptions. The PBS (Prescription benefit Scheme), is a body that acts on behalf of the government to buy prescription drugs, which then are dispensed to patients at a subsidised price. The co-payment is the amount you pay towards the cost of your PBS medicine. Many PBS medicines cost a lot more than you actually pay as a co-payment. From 1 January 2013, we can pay up to $36.10 for most PBS medicines, and the Australian Government pays the remaining cost.


Pharmacists are required to ask the patient if they would like the prescription substituted for a generic. How many times has a pharmacist not asked you? There are pharmacy chains out there; that is their policy just to give you the generic option without asking. It should be a decision made by the patient not the pharmacist, and if the patient is uncertain they should ask for advice from the pharmacist or their prescribing doctor.


This doesn’t stop just at Brand prescriptions VS Generics; if you look in a pharmacy you will see a lot of products from irrationally formulated dietary supplements, and dubious natural, herbal and homeopathic products. Where is all the scientific evidence backing up these products? Is it more about society market trends and demands and having products in stock that bring consumers in, rather than losing a sale to the competitor down the road?


Have pharmacists really given up their roles as health professionals, and become focussed solely on profit? Maybe they’re no longer in control of the pharmacy? Maybe they’re just behind the counter, and anything in front of that counter is to be sold. But it’s time for this profession to take responsibility for what it’s selling and giving patients the right information so they can make an informed decision.


It is unfair that there are a few unethical pharmacists, and revenue focus organisations who own pharmacy chains; that have put profit margins in first position over patient health. But when it comes down to our Health it shouldn’t be about profit margins.


Dispensing a pharmacy preferred brand of generic drug without consultation with the patient contravenes the Pharmaceutical Society of Australia’s Guidelines on Brand Substitution, guidelines which all pharmacists are expected to follow. It’s time for this to be regulated and enforced!

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