14

Changes/decreases in pharmacy remuneration -

Governments and other

payers seeking to decrease

costs in healthcare, namely on

drugs; payers looking for

other ways to remunerate

pharmacies other than based

on margins, in order to

increase implementation of

services.

Changes in turnover composition for community

Pharmacies;

Focus can move towards more health care services or

towards higher volume per

pharmacy.

Pharmacy

Profession Factors

Adjustment of the pharmacy curriculum around the world;

Core competence and differential competence of

pharmacists based on

national needs.

Pharmacists will have more clinical skills and be able to

provide patient-centred care.

Pharmaceutical

industry and

innovation Factors

Consolidation within the pharmaceutical industry

Fewer Pharmaceutical Industry players results in

lesser companies to negotiate

with but also leads to less

competition and thus less

opportunities for price

negotiation.

Dry pipelines for new big blockbuster ambulatory

drugs;

Increase in biosimilars, generics.

Fewer new molecule discoveries; greater generic

usage;

Declining profit for pharmacies if remuneration

system is based on margin of

price.

More BioTech companies new inventions;

Personal medicines, gene technology.

New types of products may mean new

knowledge/specialisation

required;

Other/alternative distribution channels are being used which

poses a threat to community

pharmacy sustainability.