Observed Therapy (DOT)

programmes in areas such as

the management of drug

addiction, HIV/AIDS,

tuberculosis and sexually

transmitted diseases.

Economic Factors Budgetary concerns due to introduction of new

medicines and higher

consumption lead

governments to push for

higher generic drugs

prescription and dispensing.

Increased dispensing of lower priced medicines not

financially sustainable for

pharmacy in the medium/long

term. Sustainability will come

from appropriate services

appropriately priced.

Prevalence of larger Pharmacy units due to

political/economic demand

for higher efficiency at


Concentration of Pharmacy Business in fewer and bigger

groups of employees. Fewer

pharmacy jobs, with fewer

manager/owners positions.



Health care reforms due to rising health care costs as a

percent of GDP. Concerns

about sustainability of

Healthcare System.

Possibility for pharmacy to be better integrated into the

health care system;

Possible need to adopt new remuneration schemes.

Regulatory Factors Liberalisation of economies - Free vs. constrained markets

as a philosophy;

Liberalisation of the pharmaceutical sector in

general open pharmacy

ownership, changes in

establishment rules, sale of

non-prescription medicines in

other outlets beside

pharmacies, - Free market

ideology; pressure from third

parties like supermarkets and

wholesalers to enter the

healthcare market

Possible ownership changes (multiple possible owners -

independent, chain,

wholesale, pharma industry);

Consequences may vary according to the type of

liberalization - the challenge

for pharmacists will be to

remain independent; the

challenge for pharmacies will

be to maintain economic