Paying for Pharmaceutical Care

This chapter aims to provide a summary of different approaches to the payment of pharmaceutical care that have been adopted in selected countries. Each of them is described in brief, with the ultimate goal of highlighting the pros and cons of each approach. The second part of the chapter elaborates on a possible solution to make pharmaceutical care not only a clinical activity which is essential to ensure the patient receives optimal therapy to attain better outcomes, but also to transform this practice into a profitable service. We believe this option is essential for pharmaceutical care to flourish worldwide

Provision of pharmaceutical care by community pharmacists: a comparison across Europe.

To investigate the provision of pharmaceutical care by community pharmacists across Europe and to examine the various factors that could affect its implementation.; A questionnaire-based survey of community pharmacies was conducted within 13 European countries. The questionnaire consisted of two sections. The first section focussed on demographic data and services provided in the pharmacy. The second section was a slightly adapted version of the Behavioral Pharmaceutical Care Scale (BPCS) which consists of three main dimensions (direct patient care activities, referral and consultation activities and instrumental activities).; Response rates ranged from 10-71% between countries. The mean total score achieved by community pharmacists, expressed as a percentage of the total score achievable, ranged from 31.6 (Denmark) to 52.2% (Ireland). Even though different aspects of pharmaceutical care were implemented to different extents across Europe, it was noted that the lowest scores were consistently achieved in the direct patient care dimension (particularly those related to documentation, patient assessment and implementation of therapeutic objectives and monitoring plans) followed by performance evaluation and evaluation of patient satisfaction. Pharmacists who dispensed higher daily numbers of prescriptions in Ireland, Germany and Switzerland had significantly higher total BPCS scores. In addition, pharmacists in England and Ireland who were supported in their place of work by other pharmacists scored significantly higher on referral and consultation and had a higher overall provision of pharmaceutical care. The present findings suggest that the provision of pharmaceutical care in community pharmacy is still limited within Europe. Pharmacists were routinely engaged in general activities such as patient record screening but were infrequently involved in patient centred professional activities such as the implementation of therapeutic objectives and monitoring pla or in self-evaluation of performance