Vol 16 - Nov 2010

Phuture IPSF Education Supplement

r e:
f u tu
t h e i on
in t o o fe s s
look t he pr
r d s’’
A re i
s
t ow a
he
’’ W oving
m
International Pharmaceutical
Students’ Federation
 Message From IPSF Contact us:
www.ipsf.org

IPSF Secretariat
Dear IPSFers, PO Box 84200, 2508 AE
Den Haag, The Netherlands

It is my pleasure to present to you Phuture 2010

with the theme “A look into the Future - Where is
the profession moving towards?’’. Through Phu-
ture we are trying to fulfill the IPSF objective: ‘’To
encourage full dissemination of scientific and pro-
fessional knowledge.’’

This year we focus on the direction our profes-

sion is heading and what it holds for various
areas of pharmacy. We focus on the areas of
Hospital Pharmacy, Pharmaceutical Sciences,
Community Pharmacy and Pharmacy
Education. Through this we hope to give you a
glimpse of the future.

I would like to thank the authors for their invalua-

ble contributions, Pharmacy Education Sub Com-
Table of Contents
mittee, Shirley Yeung, Lena Kojukarov and
A look into the Future - What is the Future In
Bastien Venot for their contributions.
Pharmaceutical Sciences?
Dr. Tathagata Dutta
4
Viva la pharmacie,
A look into the Future – Where is Hospital
Satyanarayana Murthy Chittoory
Pharmacy heading?
IPSF Chairperson of Pharmacy Education
Lea Knez
2009 - 10
8

A look into the Future – Where is Community

Pharmacy moving? What should we do?
Raj Vidya
10

A look into the Future - Where is Pharmacy

Education heading globally?
Andreia Bruno
13

Phuture - Issue 16 - Nov 2010 3

 A look into the Future: What is the Future in Pharmaceutical
Sciences?
Dr. Tathagata Dutta, Aizant Drug Research Solutions Pvt. Ltd.,
Dr. Tathagata Dutta graduated with a PhD in
Pharmaceutical Sciences from Dr. Hari Singh
Gour University, Sagar and Postdoctoral studies
from School of Pharmacy, University of
Queensland, Brisbane, Australia. Currently, he
is the Deputy Director- Formulation Develop-
ment and Research of Aizant Drug Research
Solutions Pvt. Ltd., a premier drug discovery
and formulation research organization. He is an
expert in Nanotechnology and Dendrimer based
drug and gene delivery. He has published more
than 33 international papers in reputed journals,
authored several book chapters and serves on
the editorial board member of several internatio-
nal journals on drug delivery research.
ting crowded with more and more companies
each day and the number of molecules getting off
patent decreasing, generic companies are focu-
sing more on biosimilar/follow on biologics formu-
lation development. Development of novel drug
delivery system (NDDS) and nanotechnology
based formulations is also gaining tremendous
importance.
Biosimilar or Follow on Biologics
Formulations:
B iosimilars, or fol-
low-on biologics,
are new versions of existing

L ooking back into the past century, it is biopharmaceuticals whose pa-

clear that medical science has made tents have expired1-3. They are
ground-breaking advances and pharmaceutical produced using the same core genetic
companies have made tremendous progress in material and are approved on the basis that they
treatment of many illnesses like cancer and are equal to the reference product in terms of
AIDS. This is shown, for instance, by the fact that both safety and efficacy. Biosimilars are large,
life expectancy has risen to about eighty years, complex molecules produced by living orga-
compared fifty-five years in early twentieth cen- nisms, which are sensitive to manufacturing
tury. However, remaining at the cutting edge of changes; generics are small molecules, produ-
technology in the face of such rapid advance- ced by chemical synthesis, which are usually
ment is becoming increasingly expensive. Des- very stable. Biosimilars is the official term used
pite the enormous progress that has been made, by the European medical authorities; the US ter-
developing a new drug is still a bit like looking for minology is follow-on protein products (FOPPs).
a needle in a haystack, only one in 10,000 subs- Biosimilars are formulations of highly uns-
tances screened eventually becomes a fully fled- table proteins produced in living organisms often
ged product that can be used to treat patients. provided with an application device, therapeutics
And as I have said, it takes ten to fifteen years to equivalence with the innovator product establi-
achieve that. That costs an average of about one shed by extensive clinical studies. Biopharma-
billion USD for each drug brought onto the mar- ceutical drugs have outperformed the
ket, including opportunity costs and the cost of pharmaceutical market as a whole largely due to
failures. Over the past twenty years, the cost of two factors: they address areas of clinical need
developing new drugs has increased by a factor that are unmanageable with conventional thera-
of eight. Therefore, pharmaceutical companies peutics, including many cancers and genetic di-
are focusing less on discovering new chemical seases, and they are able to command a
entities and more on newer technologies to make premium price. Usually, the imminent expiry of a
novel formulations of existing drugs for better sa- drug’s patent leads to companies developing
fety and efficacy. With the generics market get- cheaper, bioequivalent versions of the original

4 Phuture - Issue 16 - Nov 2010

brand, generics, followed by intense price com-
petition. This approach to the biopharmaceuticals
market can yield significant reward: according to
Frost & Sullivan, the biosimilars markets in Eu-
rope and the USA has the potential to generate
sales of $16.4 billion by 2011 at an average an-
nual growth rate of 69.8%. However, the com-
mercial and scientific hurdles facing
biopharmaceuticals hinder the entry of generic
biopharmaceuticals, so called biosimilars and,
less accurately, biogenerics, and mean that com-
panies that want to develop biosimilars will need
to rethink some fundamental assumptions about
the generics market and work according to new
business models. Companies that are likely to
succeed in the biosimilar market need to have an
appropriate marketing structure as well as the fi-
nancial resources to develop the products and to
accept higher upfront risks in development, com-
mercialisation and capital investment, a major
shirt in skills for most generic players. This skills
shift means that biosimilars players will need to
evaluate their strategic options and to adopt dif-
ferent business models and skill sets to conven-
tional generics companies. This is new territory
for most generic players and the likely commer-
cial rewards of entering most biosimilars markets,
in the short-term at least will probably be small.
duced side effects. In addition, intravenously in-
jected nanovehicles travel along the bloodstream
without blocking vessels. Floating nanoparticles
are accumulated at the inflamed site having leaky
blood vessels by the enhanced permeability and
retention (EPR) effect. The presence of targeting
molecules at the surface of nanocarriers in-
creases the targeting ability, resulting in higher
accumulation at the target site.
Predicting the future of nanotechnology in
drug delivery systems is not simple because the
technology is moving forward fast and dynami-
cally changing, and we are in the middle of such
changes. One could, however, find possible clues
from the efforts to overcome the problems facing
the research community today. One of the first
things that can be predicted is the minimalistic
design of drug delivery systems. Multifunctional
drug delivery systems have been reported, but
only few of them were used successfully in small
animal models. The future of nanotechnology in
drug delivery is very bright, as
combined efforts of scientists in different disci-
plines are bound to make nanotechnology prac-
tical.
Liposomes

Nanotechnology in Drug Delivery L

iposomes are spherical vesicles that
are prepared using one or more am-
and Novel Drug Delivery Formula- phiphilic phospholipids (such as phosphatidylcho-
tions line) and cholesterol that self-associate into
bilayers that have aqueous interior. Li-
posomes may be formulated into
N anotechnology deals with the design,
production, characterization and ap-
plication of sub-micron-sized particles. The popu-
small structures (80–100 nm) that
encapsulate either hydrophilic
larity and effectiveness of small-sized particles drug in the aqueous interior or li-
can be extended to broad areas in pharmaceuti- pophilic within the lipid bilayers.
cal, medical, chemical and engineering applica- Drug release, in vivo stability and
tions mainly due to their unique properties. The biodistribution are determined by
main goal of developing a nanotechnology based the size, surface charge, surface hydrophobicity
NDDS formulation of a drug is either to alter is and membrane fluidity.
pharmacokinetics, or to reduce its toxicity by tar- Some of the highly successful commer-
geting to specific cellular targets thereby impro- cially available liposomal formulations are AmBio-
ving its safety and efficacy. Nanocarriers can some® (Gilead sciences/ Fujisawa Healthcare),
carry poorly soluble, unstable, or systemically containing membrane-intercalated amphotericin
toxic drugs with extended blood half-lives and re- B; DaunoXome® (Gilead Sciences), containing

Phuture - Issue 16 - Nov 2010 5

 encapsulated daunorubicin; Myocet® (Elan),
containing encapsulated doxorubicin; and Doxil®
(J&J Alza), containing doxorubicin encapsulated
in PEGylated liposomes. A critical evaluation of
pharmacokinetic parameters of Myocet® and
Doxil® clearly shows that PEGylation of lipo-
somes has increased the area under the curve
(AUC) of doxorubicin by 100 folds while decrea-
sing its clearance by 80 folds4-6.
Nanoparticles
Dendrimers
D endrimers have generated a great
deal of interest as controlled and tar-
geted drug/gene delivery systems due to their ex-
ceptional structural properties such as
monodispersity (≈1.0), high density of peripheral
functional group, and well-defined globular shape
and multivalency. Dendrimers are globular, nano
scaled macromolecules with a particular architec-
ture constituted of three distinct domains: (i) a
central core that is either a single atom or a group

N anoparticles made of biocompatible having at least two identical chemical functiona-

and biodegradable polymers are gai- lities; (ii) branches emanating from the core, com-
ning importance, especially in pharmaceutical posed of repeat units having at least one junction
areas, and have proved to be good candidates of branching, whose repetition is organized in a
as novel drug delivery devices. Nanoparticles are geometric progression that results in a series of
solid colloidal particles, ranging in size from 1 to radially concentric layers called generations (G);
1000 nm, consisting of various macromolecules, and (iii) many identical terminal functional groups,
in which the therapeutic drugs can be adsorbed, generally located in the exterior of the macromo-
entrapped or covalently attached. Solid nanopar- lecule, which play a key role in their gene-com-
ticles offer distinct advantages in drug develop- plexing or drug-entrapping ability. Because of
ment, which can be ascribed to their physical their molecular architecture, dendrimers show
stability and the possibility of modifying the for- some unique physical and chemical properties,
mulating materials in order to achieve controlled which make them particularly interesting for drug
release characteristics. The ability to formulate and gene delivery applications. Dendrimers are
nanoparticles to achieve sustained release offers widely explored in the field of controlled and tar-
an opportunity for product life cycle management geted drug delivery, gene delivery and genetic
by developing formulations with decreased do- immunization, transdermal and topical drug deli-
sing frequency for drugs that are going off patent. very, peptide and vaccine delivery, and delivery
There has been a variety of materials used to en- of diagnostic agents. Starpharma’s lead product
gineer solid nanoparticles both with and without VivaGel®, is a dendrimer based vaginal microbi-
surface functionality. Perhaps the most widely cide gel, which is effective in preventing sexually
used are the aliphatic polyesters such as transmitted disease including HIV is currently un-
poly(lactic acid) (PLA), the more hydrophilic dergoing clinical trials13-15.
poly(glycolic acid) (PGA), and their copolymers
poly(lactide-coglycolide) (PLGA). The degrada- Conclusion
tion rate of these polymers and often the corres-
ponding drug release rate can vary from days, for Nanopharmaceuticals are
PGA, to months, for PLA. The effectiveness of emerging complex drug
nanoparticles in drug delivery can be attributed delivery systems that are
to many factors, such as physical and biological being shown to be bene-
stability, good tolerability of the components, sim- ficial for therapeutic use
plicity of the manufacturing process, possibility of with their targetability and
facile scale-up of the manufacturing process, improved bioavailability. However, they might pre-
amenability to freeze drying and sterilization7-12. sent new and unusual risks, and there is very little
information from sponsors about how the risks

6 Phuture - Issue 16 - Nov 2010

can be identified, assessed, and controlled. Safe nanopharmaceuticals will not become a reality un-
less proper risk management and mitigation tools are utilized.

References

1. EMEA guideline on similar biological medicinal products

2. EMEA guideline on similar biological medicinal products containing biotechnology-derived proteins
as active substance: quality issues
3. EMEA guideline on similar biological medicinal products containing biotechnology-derived proteins
as active substance: non-clinical and clinical issues.
4. Weissig, V., Boddapati, V.S., Cheng, M.S., D’Souza, G.M.G. (2006) Liposome and liposome like
vesicles for drug and DNA delivery to mitochondria. J. Liposome Res.16, 249-264.
5. Nagayasu, A., Uchiyama, K., Kiwada, H. (1999)The size of liposomes: a factor which affects their
targeting efficiency to tumors and therapeutic activity of liposomal antitumor drugs. Adv. Drug Del.
Rev. 40, 75-87.
6. Zuidam, N.J., Lee, S.S.L., Crommelin, D.J.A. (1992) Sterilization of liposomes by
heat treatment. Pharm. Res. 10, 1591–1596.
7. Kayser, O., Lemke, A., Hernandez-Trejo, N. (2005) The impact of nanobiotechnology
on the development of new drug delivery systems. Curr. Pharm. Biotech. 6, 3–5
8. Jung, T., Kamm, W., Bretenbach, A., Kaiserling, E., Xiao, J.X., Kissel, T. (2000)
Biodegradable nanoparticles for oral delivery of peptides: is there a role for
polymers to affect mucosal uptake? Eur. J. Pharma. Biopharm. 50, 147–160
9. Hu, J., Johnston, K.P., Williams, R.O. (2004) Nanoparticle engineering process for
enhancing the dissolution rates of poorly water soluble drugs. Drug Dev Ind. Pharm. 30, 233–245
10. Alle`nmann, E.,Gurny,R.,Doelker, E. (1993) Drug-loaded nanoparticles-preparation
methods and drug targeting issues. Eur. J. Biopharm. 39, 173–191.
11. Kipp, J.E. (2004) The role of solid nanoparticle technology in the parenteral
delivery of poorly water-soluble drugs. Int. J. Pharm. 284, 109–122.
12. Lockman, P.R., Mumper, R.J., Khan, M.A., Allen, D.D. (2002) Nanoparticle technology for drug
delivery across the blood-brain barrier. Drug Dev. Ind. Pharm. 28-32.
13. Dutta, T and Jain, N.K. (2007) Targeting potential and anti HIV activity of mannosylated fifth ge-
neration poly(propyleneimine) dendrimers. Biochim. Biophys. Acta. 1770, 681-686.
14. Dutta, T., Garg, M., and Jain, N.K. (2008) Targeting of efavirenz loaded tuftsin conjugated
poly(propyleneimine) dendrimers to HIV infected macrophages in vitro. Eur. J. Pharm. Sci. 34 (2-3),
181-189.
15. Dutta, T., Garg, M., and Jain, N.K. (2008) Poly(propyleneimine) dendrimer and dendrosome
based genetic immunization against Hepatitis B. Vaccine. 26 (27-28), 3389-3394.

Phuture - Issue 16 - Nov 2010 7

 A look into the Future – Where is Hospital Pharmacy heading?
Lea Knez, University Clinic Golnik, Slovenia

Lea Knez is a young pharmacist embracing the
path of clinical pharmacy in Slovenia.
She graduated in 2006 from the Faculty of
Pharmacy, University of Ljubljana. Lea conti-
nued practicing in the field of clinical pharmacy
at the same institution and started her PhD at
the Faculty of Medicine, University of Ljubljana
and is studying the impact of pharmacogeno-
mics of multidrug resistance on chemotherapy
outcomes. Lea tries to implement the principles
of evidence-based practice, contributing evi-
dence also through her own research which
was presented in the form of papers and pre-
sentations on national and international confe-
rences as ESOP and FIP congress.
vices provided by hospital pharmacists, the diver-
sity in the availability of human and other re-
sources, and the level of recognition of the role
of hospital pharmacists; all contribute to the he-
terogeneity in the level of practice of hospital
pharmacy among and within different countries.
And as each of us is struggling to improve patient
care in our own hospital setting, can we be sure
that we are taking the profession to the next
level? To do so, each small step needs to be
streamlined toward a common goal to achieve
global impact.
The need for a consensus on future direc-
tions for hospital pharmacy practice was recogni-
sed and served as a drive for the organisation of

T hrough the undergraduate pharmacy the Global Conference on the Future of Hospital
curriculum, the first idea of hospital Pharmacy. The conference was organised by FIP
pharmacy is created, an idea that is later eluci- Hospital Pharmacy Section just preceding the
dated and refined through clinical practice and, 68th FIP congress in Basel, Switzerland in Au-
finally, coloured when experiences are shared gust 2008. The conference produced a shared vi-
and mixed with pharmacy colleagues worldwide. sion among hospital pharmacy leaders around
The final picture is indeed very bright and colour- the world about the preferred future on hospital
ful; and this is the image I have of hospital phar- pharmacy practice. The Basel Statements offer
macy at the very time of writing. Although it is guidance on the cornerstone elements in hospital
hard to imagine a common future for such diver- pharmacy and further evaluates in detail six to-
sity and describing this in 1000 words seems pics: medicine procurement, prescribing, prepa-
nearly impossible, I am convinced that the idea ration and distribution, administration and
on where hospital pharmacy is heading was monitoring, and human resources and training in
never as clear as it is today. Why? Keep rea- hospital pharmacy. Since the Basel Statements
ding... are freely available on FIP website and the pro-
ceedings of the conference were published as a
supplement in the March 1, 2009, issue of the
American Journal of Health-System Pharmacy,
only few overarching statements of strong
consensus, as selected by the editors of the abo-
vementioned conference proceedings, are high-
lighted herein.

The overreaching goal of hospital pharma-

cists is to optimise patient outcomes through the
judicious, safe, efficacious, appropriate, and cost-
effective use of medicines.
All prescriptions should be reviewed, interpreted,

T he ultimate goal of hospital pharmacy and validated by hospital pharmacist before me-
is unequivocally clear: to provide the dicine is dispensed and administered.
best patient care in a hospital setting. However, The “five right” (right patient, right medicine, right
unequivocal is also the diversity found in the ser- dose, right route, right time) should be fulfilled in

8 Phuture - Issue 16 - Nov 2010

all medicine-related activities in the hospital.
Thus, the Basel Statements definitely answer the
question posed in the title: where is hospital
pharmacy heading. The primary message of the
Global Conference on the Future of Hospital
Pharmacy is for hospital pharmacists to orientate
their efforts towards an improvement in patient
care, minimising the risks associated with medi-
cines use in hospitals and accepting the respon-
sibilities for all medicines, everywhere in the
hospitals, and at all times. Moreover, the Basel
Statements do not only provide guidance on what
shall we aim to, but in doing so, it is not restricting
its applicability due to the different levels of prac-
tices by defining the way of how to do it.
And, as the Basel Statements indicates
the way forward, hospital pharmacists from all
over the world have to take leadership in impro-
ving hospital pharmacy practice in their country.
They need to transform the vision into clinical ser-
vices to improve the health of patient treated with
medicines. In these initiatives, while evaluating
current practices and implementing new services,
research should be integrated at all times to pro-
vide evidence on the need and importance of
hospital pharmacy contribution to patient care.
genetics of enzymes involved in drug metabo-
lism, and the choice between different treatment
modalities will be based on the presence of diffe-
rent molecular biomarkers. These principles are
already being implemented in the treatment with
specific medicines in the field of oncology. As
these ideas are finding their way into clinical prac-
tice, all healthcare professionals are required to
acquire extensive knowledge and understanding
of pharmacogenetics. In a hospital setting, phar-
macists have the best position to assist the trans-
lation of new discoveries from laboratory benches
to patients’ bedside with the appropriate clinical
interpretation as no other healthcare professional
has a more comprehensive understanding of
both, basic research and its clinical applicability.
Personalised medicine is, indeed, an area of new
challenges for hospital pharmacists.

O verwhelmed by the hectic rhythm of

everyday practice, research is often
neglected as being something “on top” of other
activities, while it should be recognised as an es-
sential tool for convincing hospital boards and
healthcare policymakers about the need for
changes and bringing these changes to life.
Thus, well-designed and well-conducted re-
search of clinical practice that focuses on impor-
tant clinical outcomes, ultimately, quality of life
and survival, is of outmost importance. Moreover,
while advocating for hospital pharmacy, the gai-
ned evidence should be reported and published
in order to reach a broad pharmacy audience,
other healthcare professionals, healthcare poli-
cymakers and the general public.
T hus, where is hospital pharmacy hea-
ding? Towards the realisation of the
Basel Statements and beyond. For sure, the fu-
ture of hospital pharmacy was never before so fo-
cused and goal oriented as it is today, and
hospital pharmacists were never so passionate
and motivated to improve their profession as they
are today. And while constant improvement is im-
perative in providing best patient care, hospital
pharmacists are fulfilling their role as they could
never have before.

Being more futuristic in looking at what

awaits the profession, new challenges for hospi-
tal pharmacists will emerge as patient-centred
care is entering the era of personalised medi-
cines, where the “one fits all” principle will be
substituted by an individual approach. For exam-
ple, dose selection will not be based solely on pa-
tient’s health condition but will consider also the

Phuture - Issue 16 - Nov 2010 9

 A look into the Future - Where is Community Pharmacy mo-
ving? What should we do?
Raj Vidya, Indian Pharmaceutical Association
Mr. Raj Vaidya is a Master of Pharmacy. As a
community pharmacist he has been actively in-
volved in the activities of IPA at the state and
O ther health care professionals, doc-
tors and nurses, have well accepted
the roles of pharmacists, as equal partners in de-
national level for a decade and a half. He is the cision making for patient care, with the onus of
team leader and active resource person of GPP making choices for medicines and medicine ma-
Project of IPA and has been the major contribu- nagement slowly shifting towards the pharma-
tor in framing the GPP guidelines. He is also cists. That the pharmacists have attained
part of the FIP GPP working group. He is also knowledgeable and professional levels are
the Vice Predident of IPA and Chair of the Com- grounded in the practice oriented curriculum and
munity Pharmacy Division of IPA. Mr. Vaidya is thorough training and exposure to practice orien-
Co-ordinator of Peripheral Adverse Drug Repor- ted learning, compulsory internships in practice
ting Centre, Goa. settings, and the need to pass a pre-registration
exam. In short, one needs to be thorough, well

C ommunity pharmacy is making giant versed and knowledgeable with pharmacy prac-
strides in the developed countries of tice before being allowed a license to practice!
the world. It is moving from strength to strength The developing and the underdeveloped
and pharmacists have professionalized and are countries unfortunately remain far behind in all
also innovating towards improving their services these areas. Unfortunately, most people see
towards patient benefit. Pharmacy is seen as a pharmacy as a business with no need of profes-
profession with a business outcome. Community sionalism! In many of these countries, there are
pharmacists are one of the highest paid pharma- severe shortages of healthcare manpower, and
cists in these countries. It is a rewarding as well that includes pharmacists also. Large number of
as a professionally satisfying career. Majority of pharmacies can function without a pharmacist
pharmacists in these countries go into community most of the times. Even if a pharmacist is pre-
pharmacy, followed by hospital pharmacy, but sent, the professional backing and touch is often
very small percentage of pharmacists go into in- missing. Access to health care and essential me-
dustry, research, academics, etc. dicines also remains a problem. In many of these
The professional practice has been countries, there is no pre-registration exam, and
backed by the small beginning in the late 1960’s, thus not much can be judged of the quality of
where the focus first slowly but steadily started pharmacists being churned out.
shifting from product to patient. Today, the pro-
duct aspects are being looked into more by the
trained technicians, whilst the pharmacists look T oday, in most places in India, and so
also in large areas of south –east asia,
more into the patient aspects. Providing informa- community pharmacies largely operate as trade
tion about their medicines through verbal and – merely doing buying and selling. Most prescrip-
written instructions, and backed by patient coun- tion medicines are available without a prescrip-
selling. tion. The regulatory authorities have failed
miserably in implementing the important provi-
sions, presence of a pharmacist in the pharmacy,
and sale of prescription medicines only against
an authorized doctor’s prescription. The main
crux of the issue lies in these two very important
aspects. The third issue is of trained pharmacists
executing a professional task in the pharmacy.
Other problems are include, too many pharmacy
licenses concentrated in some areas too close to
one another, cut throat competition with large dis-
counts, expiry problems, pharmacies reluctant to

10 Phuture - Issue 16 - Nov 2010

hire or pay pharmacists well, etc. Public are not
much aware of the role of the pharmacist, they
are unidentifiable, nor do pharmacists have confi-
dence in discussing medicines management eye
to eye with doctors. Another vital ingredient in this
unprofessional cocktail is the ignorance of the au-
thorities and politburo who have even made
strong recommendations that a pharmacist is not
necessary to run pharmacies! And the icing on
the cake has been the pharmacists’ lack of awa-
reness of their true potential in community phar-
macy and a strong resistance to change!

T he scenario is of course changing and

optimists feel that they can see a shim-
mer of light at the end of the long winding tunnel
we have to traverse. The consistent work done
by professional pharmacy associations, educa-
tional institutions, pharmacy stalwarts and profes-
sionals across the world in the past fifteen to
twenty years has slowly generated the impor-
tance of community pharmacy and slowly awa-
kened the pharmacists in community that they
need to do something.
The FIP with its international presence and its va-
rious Forums in the six regions of the world have
been able to go strong on policies and document
the role of the pharmacist, education material for
pharmacists, need for inter-professional interac-
tion and working together, and promoting good
pharmacy practice (GPP) across continents. Ex-
periments of Accreditation of pharmacies in Uru-
guay and Thailand have certainly helped to lay
down the platform for further spread of this
concept, and improve community pharmacy prac-
tice.
I n India, the Indian Pharmaceutical Asso-
ciation (IPA) and the All India Organiza-
tion of Chemists & Druggists (AIOCD ) are
involved in training of pharmacists, promoting
GPP. Pharmacists are trained through patient
counselling courses (PCC), opening their inner
windows, which explores their own potential for
professionalism, playing a crucial role in society
and ultimately professional satisfaction. Currently,
the PCCs are conducted in Maharashtra, for
“owner-pharmacists”, and very shortly, pharma-
cists in other parts of the country will come under
the training radar. The challenge for countries like
India is huge considering it has more than half a
million pharmacies
S ome steps which need to be taken in
underdeveloped and developing
countries to gear up community pharmacy in their
countries are:
1. Sensitization and awareness of authorities and
politburo about the role of the pharmacist and im-
portance of professionalizing pharmacies across
the country.
2. Proper implementation of drug laws uniformly
across the country.
3. Upgrading the curriculum and making it more
practice oriented along with better exposure at
undergraduate level.
4. Orientation & training of pharmacy teachers to-
wards practice, and introducing the concept of
teacher practitioners.
5. Continuous training of pharmacists in the coun-
try, helping them to professionalize
6. Sensitization of pharmacy owners (especially
non-pharmacists) to professionalize their phar-
macies, importance of pharmacist, and need to
implement GPP in their pharmacy.
Students role: Community pharmacy is in the
need of heroes. In the public eye, the credentials
and professionalism of a pharmacist are reflected
from the community pharmacies. If pharmacists
are not present in them, or if they are present but
not noticeable, if they do not function other than
plain ‘selling’ of drugs, it in no way will convey
what role of pharmacist in health care can be!

Phuture - Issue 16 - Nov 2010 11

 W ho are the pharmacists in the phar-
macies? They are non-other than
‘students’ of Pharmacy Colleges once upon a
time. Had they been well captured, and well trai-
ned, and well oriented towards community phar-
macy and the concepts of ‘taking the health of the
public’ in their hands, we could have had better
pharmacist interfacing with the public. The seeds
of professionalism have to be planted in the phar-

macy colleges!” The ‘Good Pharmacy Students’

of today will be ‘Good Pharmacist’ of tomorrow.

T he future of pharmacy thus lies in the

...act!
HANDS of our pharmacy students. It
is the student who can make or break the profes-
sion of pharmacy. It is time now to take the tre-
mendous task of development of the true
pharmacy profession, into your hands! The time
to act as now, for tomorrow will always be too
late!
The pharmacy profession cannot grow
and gain recognition unless we, pharmacists,
give back something. The profession will benefit
the most when we, the pharmacists, venture out
into the community pharmacies and enlightened
the patient – pharmacy interface. Only when
more and more interested, dedicated and know-
ledgeable pharmacists venture into this field of
pharmacy, will the possibility arise of influencing
and impressing the community...

To gain something we have to sacrifice a

lot! Do we have young pharmacist willing to do
that? It’s time to inspect, and...

12 Phuture - Issue 16 - Nov 2010

A look into the Future - Where is Pharmacy Education heading
globally?
Andreia Bruno, FIP Collaborating Centre | School of Pharmacy, University of London
Andreia Bruno graduated from the Instituto Su-
perior de Ciencias de Saude Egas Moniz in
Portugal. At this time she is doing her PhD in
the FIP Collaborative Centre | School of Phar-
macy, University of London in the Competency
domain of the Pharmacy Education Taskforce,
developing a Global Competency Framework
for pharmacy workforce. She was involved in
IPSF for three years, 2003 to 2006, as a
Contact Person and part of the Public Health
Sub-committee while a student; and now she is
still involved as a coordinator in the Moving On
II project. She has attended many international
events and congresses (FIP Congresses,
ISPW, and several IPSF congresses).
P harmacy education relates to what is
mentioned above, but confusion is
often present when we try to think globally. One
can argue that there is a need to have pharma-
cists that are competent and fit-for-purpose when
leaving universities, but how do we assess it?
What is the appropriate path to follow in educa-
tion? Is there only one path? This article will try
to provide a global perspective on what is in prac-
tice nowadays and also to extrapolate what will
happen in the future.
T he challenges facing the profession re-
late to the shortage of qualified phar-
macists to provide pharmaceutical care and
patient-focused practice to meet the demands of

A ccording to Wikipedia (a tool use by our society. Unfortunately, this happens not only
many as an online encyclopaedia), in low human development countries, such as
the pharmacy profession links the health Malawi, as possibly expected, but also in the me-
sciences with the chemical sciences and is char- dium human development ones, such as
ged with ensuring the safe and effective use of China1,2. New opportunities within the profes-
medicines. It further explains that the scope of sion have shaped our professionals to become
pharmacy practice focus has shifted from a tra- more involved with patients; this is a tendency
ditional role (compounding and dispensing medi- that we can observe worldwide. As technology
cation) to a more modern role which includes and medicines become more complex pharma-
clinical services, reviewing medication for safety cists need to keep up-to-date with the latest
and efficacy and providing medicines information. trends and arm themselves with new and/or im-
It also states that pharmacists, therefore, are the proved skills to face new challenges - here is
experts in medicines therapy and are the primary where education can step in. This is valid for both
health professionals who optimise medications undergraduate education and continuing profes-
use to provide patients with positive health out- sional development as education underpins our
comes. pursuit of continually expanding our knowledge
and professional performance.

A s humans we are a complex species

and do not always share the same
opinion when it comes to education. In different
countries, different pharmacy programmes are
taught with the same common goal ‘producing
quality pharmacists’, and even within one country
different degrees are awarded2,3. This makes it
difficult to unify a profession that at the starting
point is already divided, but not all is lost and I do
believe that we will reach a consensus in the fu-
ture.

Phuture - Issue 16 - Nov 2010 13

 D espite many differences, Europe de-
veloped the Bologna Process, with
the purpose of creating the European Higher
Education Area (EHEA). EHEA makes academic
degree standards and quality assurance stan-
dards more comparable and compatible throu-
ghout Europe. In a press release from the
European Commission, the students also had a
voice in what is happening at the moment:
“A new Europe-wide survey among students
shows that they want wider access to higher edu-
cation and that universities should open up co-
operation with the world of work and to lifelong
learning. A large majority agree that it is important
for higher education institutions to foster innova-
tion and an entrepreneurial mindset among stu-
dents and staff, and that there should be the
possibility to undertake work placements in pri-
vate enterprises as part of a study programme.
More students want to study abroad and a majo-
rity want more information about the quality of hi-
gher education institutions in order to inform their
study choices.” 4
I t is a growing trend for students and
practitioners to seek other countries dif-
ferent from their own to pursue further studies,
expand their knowledge and skills, and bring
what they have learned back home.
P harmacists wish to reinforce their role
as medicines experts and education
programmes need to ensure that they are com-
petent to undertake these new responsibilities.
Competency-based programmes are already
being used in some countries such as Australia
5, and are possibly the future for pharmacy edu-
cation. The term ‘competency’ is a challenging
one, since there is no universally accepted com-
petency framework or performance standard at
the point of graduation or post-registration for
pharmacists in the same way there is for doc-
14 Phuture - Issue 16 - Nov 2010
tors6, who have a method to ensure uniformity of
competency-based skills. Why not develop an
agreement on the core competencies and beha-
viours for the pharmacy profession in a global
sense that would be adapted according to the
specificities of the country?
A n emergent role for pharmacists that
we are currently witnessing in the Uni-
ted Kingdom8 is the introduction of supplemen-
tary and independent prescribing. Such new roles
have to be supported by appropriate training and
continuing professional development.
T o think about the future of pharmacy
education, one has to think about the
future of the profession as these cannot be dis-
sociated one from the other. To support a unified
pharmacy profession worldwide focused on the
interests of patients and their health outcomes, I
foresee developments in education that will ex-
pand among other things the use of problem
based learning, objective structured clinical exa-
mination and competency-based outcomes. I
also foresee strengthened mobility of students,
researchers, staff and pharmacists that will en-
able a shared vision of the pharmacy profession.
References
1. Wuliji T. 2009 FIP Global Pharmacy work-
force report. 2009
2.  Ryan M, Shao H, Yang L, Nic XY, Zhai SD,
Shi LW, Lubawy W. Clinical Pharmacy Edu-
cation in China. American Journal of Pharma-
ceutical Education. 2008; 72(6): 129.
3. Kheir N, Zaidan M, Younes H, Hajj M, Wil-
bour K, Jewesson P. Pharmacy Education
and Practice in 13 Middle Eastern Countries.
American Journal of Pharmaceutical Educa-
tion. 2008; 72(6): 133.
4. Last assess 13th of July 2010 - http://eu-
ropa.eu/rapid/pressReleasesAction.do?refe-
rence=IP/09/618&format=HTML&aged=0&la
nguage=EN&guiLanguage=fr
5. Marriott J, Nation R, Roller L, Costelloe M,
Galbraith K, Stewart P, Charman W. Phar-
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Practice. American Journal of Pharmaceutical
Education. 2008; 72(6): 131.
6. World Federation of Medical Education.
WFME Global Standards for Quality Improve-
ment in Medical Education: 2003.
7. Sosabowski M, Gard P. Pharmacy Educa-
tion in the United Kingdom. American Journal
of Pharmaceutical Education. 2008; 72(6):
130.