Dace Ķikute, Chairwoman of the Pharmacists’ Society of Latvia
The Pharmacist’s Society of Latvia (LFB) was founded in 1994 and is celebrating its 30th anniversary this year. LFB represents the professional, economic, and legal interests of pharmacists and pharmacist assistants, with over 1000 members. We collaborate with state institutions and other public organizations in the pharmaceutical sector.
Several LFB sections are actively working. This year, the membership of the Industrial Pharmacists section has increased, supported by colleagues employed in pharmaceutical manufacturing and representation. Taking advantage of membership benefits, they enhance their professional knowledge, particularly in pharmacovigilance. There is significant interest in webinars from the European Industrial Pharmacists Group (EIPG).
Pharmacists employed in closed-type pharmacies and healthcare institutions have joined the Hospital, Oncological, and Clinical Pharmacists section. The role of hospital pharmacies has increased since pharmacists working there perform the dilution and preparation of cytostatic medications for specific patients, are involved in developing the drug dispensing process, digitization, and acquiring technical support. Currently, it is important to address the issue of hospital pharmacists' remuneration and the introduction of clinical pharmacy services in hospitals. Pharmacists are not and will not be healthcare providers, but they are a separate profession directly involved in the therapeutic process as providers of drug therapy. The best therapeutic outcome for the patient is achieved through cooperation between the patient, doctor, and pharmacist.
Ensuring Professional Qualification and Continuing Education
One of LFB's main daily processes is ensuring the professional qualification and continuing education of pharmacists and pharmacist assistants. We are proud to successfully implement the LFB Concept for the Continuing Education of Pharmacists and Pharmacist Assistants, which is one of the cornerstones of quality pharmaceutical care in pharmacies and patient safety. The system for the continuing education of pharmaceutical specialists ensures continuous supplementation of qualitative and current knowledge, as well as periodic submission of reports—this process is overseen by LFB. The continuing education system is binding for over 3000 pharmacy specialists working in pharmacies. Annually, we organize an average of 10 conferences where we educate ourselves on legislation, ethics, and pharmaceutical care issues important for pharmacists' work.
Advocating for Pharmacists' Interests at the National Level
One of LFB's most important tasks is to "keep a finger on the pulse" and lobby for pharmacists' interests when changes are introduced in pharmaceutical care processes due to regulatory changes. Since 2018, we can mention several examples – the functioning of e-prescriptions within E-health, the start of drug verification, the introduction of the International Non-proprietary Name (INN) in drug prescription, overcoming the challenges posed by the Covid-19 pandemic in serving the population in pharmacies, disruptions in drug availability due to various international processes, and the general need to strengthen national security due to the war in Ukraine. Although commercial entities – the owners of pharmacies – respect and implement all necessary technical changes, it is important for LFB to ensure that pharmaceutical specialists in all pharmacies can provide equally quality pharmaceutical care. Each introduced change reaches the specific patient through the pharmacist, who is the most accessible healthcare specialist for the population. We still must regularly explain to pharmacy visitors how to obtain medicines prescribed on an e-prescription for a relative, child, or neighbour. The state has imposed disproportionately many requirements for the dispensing of reimbursable medicines. In many cases, a pharmacist could provide broader pharmaceutical care in the patient's interest (e.g., substitute medicines, find solutions when a specific medication is unavailable, etc.), devote more time to verbal information for the patient, and monitor the use of medicines. In other European Union countries, pharmacists' knowledge is used more broadly, and the range of permissible pharmacist services is more diverse. Latvian pharmacists are still prohibited from seeing the medication history prescribed to a patient in the e-prescription for at least the last 3 months, although colleagues in Estonia and Lithuania have access to and use this information to ensure rational use of medicines.
After a two-year long coordination period, amendments to the Medical Treatment Law came into force this year, strengthening the role and functions of pharmacists and clinical pharmacists within the therapeutic process. We hope this will promote the development of pharmaceutical care and pharmacy services. Unfortunately, the pharmacy is classified as a specialized retail store according to the international classification of economic activities (NACE), so pharmaceutical care must be constantly defended and promoted as a part of healthcare at all levels.
Current Issue: Upcoming Drug Pricing Regulation
Currently, we are actively evaluating and discussing the drug pricing reform proposed by the current Minister of Health, Hosams Abu Meri. We are concerned about the impact of the proposed pricing model on pharmacy competition, which may weaken the positions of individual pharmacies. Pharmacists working in individual pharmacies in the regions provide daily pharmacy services and advice close to residents' homes. It is also important to ensure competitive remuneration for pharmacists, but the new drug pricing model is inflexible and not tied to the indexation of other services or goods prices or tax changes—this is one of the risks of the new drug pricing model identified by LFB.
We also cannot agree that such a significant reform will be implemented simultaneously with the reorganization of the National Health Service, planned by the Ministry of Health for this year.
In all cases, we evaluate changes from the perspective of pharmaceutical specialists as representatives of regulated professions—we assess how the planned changes will affect pharmacists' ability to make professional decisions in the clients' best interests. All the mentioned changes in dispensing prescription medicines have increased the number and volume of technical activities required, which takes additional time for pharmacists and, in some cases, reduces the time for patient consultations. We assess whether the changes fit organically and conveniently into the drug dispensing process and whether they do not create additional administrative burdens. We recall the good practice example of cooperation with the Latvian Medicines Verification Organization when introducing drug verification in pharmacies. Various questions from pharmacists and pharmacy owners were heard, joint solutions to difficulties were found, risk assessments were made, and involved parties were regularly informed.
Currently, public-political processes require actively strengthening national security at various levels, and only the cooperation and information exchange of all involved parties will yield an acceptable result for all, ensuring quality and safe healthcare for residents, including pharmaceutical care.