Sarah H.
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I did post some of the following earlier at the end of the “Should I do Pharmacy” discussion. I have added a little more and in light of very recent and important developments concerning Community Pharmacy I think, on reflection, it perhaps worthy of a new discussion. Some of these developments have been recently mentioned by valuable SR contributers (@0895 et al). I hope this is OK and not against SR etiquette.

A very quick recap for prospective Pharmacy students……

A little over a decade ago it was decided that Community Pharmacy would begin a transition away from the traditional medicine supply role (dispensing prescriptions) into a provider of “clinical services”. These services were never properly defined and this resulted in a somewhat chaotic mix of often temporary local and national services. Funding for these services was limited and erratic.

For the reasons outlined (and others) this brave new clinical service future never took off. CP struggled to reposition itself. The most well-known service was the MUR (Medicine Use Review) which is now being phased out. Abuse of the MUR service by elements in CP was a factor (Google for more information). Clinical services have never come close to producing the income stream of medicine provision and never will. Influential advocates within CP would now admit that this services-based future is dead in the water (several articles in the Chemist & Druggist archive). When the medicine supply function goes then it is more or less game over for CP.

Now to Amazon. By chance I was discussing this with other pharmacists a couple of days ago so the following is not entirely my own thoughts.

Pharmacy2U (the leader in UK online prescription medicine supply) is currently reporting enormous financial losses. I suspect that the losses are largely the product of the fact that P2U has to engage in extensive and expensive advertising and is reliant on the regular postal services. Posting refrigerated medicines (e.g. insulin) and heavy/bulky items have to be major loss makers. They may well be absorbing the losses intentionally whilst building up to a size where they become an attractive takeover target.

Amazon is now clearly making preparations to enter the market by their recent trading name registrations. When or how we don’t know. They do have a very impressive track record of being innovative disruptors of established markets.

Should they buy out P2U they would bring their established, highly efficient logistics and distribution systems into play. They already have a connection with millions of UK citizens so promotion will be cheap and easy. This is highly significant and will likely result in a very profitable online medicine supply role that would rapidly take business away from bricks and mortar CP. They are already in position to supply some medicines and traditionally CP products (toiletries, cosmetics etc). There will be a very advantageous symbiotic relation for Amazon between prescription supply and their huge range of other products and services.

The Covid19 situation I think will be a powerful catalyst for this move. Overnight it has effectively killed off paper prescriptions in favour of electronic prescriptions that can be transmitted to and dispensed anywhere. Isolating patients now are having their prescriptions delivered. Patients are learning to order online as the GP surgeries lock their doors.

The result is that the traditional physical link or bond between patient and CP is being rapidly eroded with patients becoming accustomed to the fact that there is no need to visit a CP to obtain their monthly medication.

Patients now used to their medicines being delivered will expect this to continue to when this lockdown situation is over. It should be noted that CP, already struggling with funding cuts, is now having to cover the considerable costs of delivery. I know for a fact that some CPs that were profitable a couple of years ago are now unsustainably trading at a loss. I have seen audited accounts. Enter Amazon?

The patients future reduced need of bricks and mortar CPs could be then met by very much reduced CP presence. The situation for Pharmacists working in CP is far from great in this scenario.

Apologies for length of this post but I do hope it will give prospective Pharmacy students something to mull over. Please discuss and contribute……..
Last edited by Sarah H.; 3 months ago
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0895
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(Original post by Sarah H.)
I did post some of the following earlier at the end of the “Should I do Pharmacy” discussion. I have added a little more and in light of very recent and important developments concerning Community Pharmacy I think, on reflection, it perhaps worthy of a new discussion. Some of these developments have been recently mentioned by valuable SR contributers (@0895 et al). I hope this is OK and not against SR etiquette.

A very quick recap for prospective Pharmacy students……

A little over a decade ago it was decided that Community Pharmacy would begin a transition away from the traditional medicine supply role (dispensing prescriptions) into a provider of “clinical services”. These services were never properly defined and this resulted in a somewhat chaotic mix of often temporary local and national services. Funding for these services was limited and erratic.

For the reasons outlined (and others) this brave new clinical service future never took off. CP struggled to reposition itself. The most well-known service was the MUR (Medicine Use Review) which is now being phased out. Abuse of the MUR service by elements in CP was a factor (Google for more information). Clinical services have never come close to producing the income stream of medicine provision and never will. Influential advocates within CP would now admit that this services-based future is dead in the water (several articles in the Chemist & Druggist archive). When the medicine supply function goes then it is more or less game over for CP.

Now to Amazon. By chance I was discussing this with other pharmacists a couple of days ago so the following is not entirely my own thoughts.

Pharmacy2U (the leader in UK online prescription medicine supply) is currently reporting enormous financial losses. I suspect that the losses are largely the product of the fact that P2U has to engage in extensive and expensive advertising and is reliant on the regular postal services. Posting refrigerated medicines (e.g. insulin) and heavy/bulky items have to be major loss makers. They may well be absorbing the losses intentionally whilst building up to a size where they become an attractive takeover target.

Amazon is now clearly making preparations to enter the market by their recent trading name registrations. When or how we don’t know. They do have a very impressive track record of being innovative disruptors of established markets.

Should they buy out P2U they would bring their established, highly efficient logistics and distribution systems into play. They already have a connection with millions of UK citizens so promotion will be cheap and easy. This is highly significant and will likely result in a very profitable online medicine supply role that would rapidly take business away from bricks and mortar CP. They are already in position to supply some medicines and traditionally CP products (toiletries, cosmetics etc). There will be a very advantageous symbiotic relation for Amazon between prescription supply and their huge range of other products and services.

The Covid19 situation I think will be a powerful catalyst for this move. Overnight it has effectively killed off paper prescriptions in favour of electronic prescriptions that can be transmitted to and dispensed anywhere. Isolating patients now are having their prescriptions delivered. Patients are learning to order online as the GP surgeries lock their doors.

The result is that the traditional physical link or bond between patient and CP is being rapidly eroded with patients becoming accustomed to the fact that there is no need to visit a CP to obtain their monthly medication.

Patients now used to their medicines being delivered will expect this to continue to when this lockdown situation is over. It should be noted that CP, already struggling with funding cuts, is now having to cover the considerable costs of delivery. I know for a fact that some CPs that were profitable a couple of years ago are now unsustainably trading at a loss. I have seen audited accounts. Enter Amazon?

The patients future reduced need of bricks and mortar CPs could be then met by very much reduced CP presence. The situation for Pharmacists working in CP is far from great in this scenario.

Apologies for length of this post but I do hope it will give prospective Pharmacy students something to mull over. Please discuss and contribute……..
I agree with you over Amazon. Claremont was talking about profit in the other thread. They don't need to make a profit to start with, just disrupt the sector, watch it implode, then swoop in and pick up whatever bits they fancy! I too fear that should they gain a foothold, they will destroy community pharmacy.
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quasa
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(Original post by Sarah H.)
I did post some of the following earlier at the end of the “Should I do Pharmacy” discussion. I have added a little more and in light of very recent and important developments concerning Community Pharmacy I think, on reflection, it perhaps worthy of a new discussion. Some of these developments have been recently mentioned by valuable SR contributers (@0895 et al). I hope this is OK and not against SR etiquette.

A very quick recap for prospective Pharmacy students……

A little over a decade ago it was decided that Community Pharmacy would begin a transition away from the traditional medicine supply role (dispensing prescriptions) into a provider of “clinical services”. These services were never properly defined and this resulted in a somewhat chaotic mix of often temporary local and national services. Funding for these services was limited and erratic.

For the reasons outlined (and others) this brave new clinical service future never took off. CP struggled to reposition itself. The most well-known service was the MUR (Medicine Use Review) which is now being phased out. Abuse of the MUR service by elements in CP was a factor (Google for more information). Clinical services have never come close to producing the income stream of medicine provision and never will. Influential advocates within CP would now admit that this services-based future is dead in the water (several articles in the Chemist & Druggist archive). When the medicine supply function goes then it is more or less game over for CP.

Now to Amazon. By chance I was discussing this with other pharmacists a couple of days ago so the following is not entirely my own thoughts.

Pharmacy2U (the leader in UK online prescription medicine supply) is currently reporting enormous financial losses. I suspect that the losses are largely the product of the fact that P2U has to engage in extensive and expensive advertising and is reliant on the regular postal services. Posting refrigerated medicines (e.g. insulin) and heavy/bulky items have to be major loss makers. They may well be absorbing the losses intentionally whilst building up to a size where they become an attractive takeover target.

Amazon is now clearly making preparations to enter the market by their recent trading name registrations. When or how we don’t know. They do have a very impressive track record of being innovative disruptors of established markets.

Should they buy out P2U they would bring their established, highly efficient logistics and distribution systems into play. They already have a connection with millions of UK citizens so promotion will be cheap and easy. This is highly significant and will likely result in a very profitable online medicine supply role that would rapidly take business away from bricks and mortar CP. They are already in position to supply some medicines and traditionally CP products (toiletries, cosmetics etc). There will be a very advantageous symbiotic relation for Amazon between prescription supply and their huge range of other products and services.

The Covid19 situation I think will be a powerful catalyst for this move. Overnight it has effectively killed off paper prescriptions in favour of electronic prescriptions that can be transmitted to and dispensed anywhere. Isolating patients now are having their prescriptions delivered. Patients are learning to order online as the GP surgeries lock their doors.

The result is that the traditional physical link or bond between patient and CP is being rapidly eroded with patients becoming accustomed to the fact that there is no need to visit a CP to obtain their monthly medication.

Patients now used to their medicines being delivered will expect this to continue to when this lockdown situation is over. It should be noted that CP, already struggling with funding cuts, is now having to cover the considerable costs of delivery. I know for a fact that some CPs that were profitable a couple of years ago are now unsustainably trading at a loss. I have seen audited accounts. Enter Amazon?

The patients future reduced need of bricks and mortar CPs could be then met by very much reduced CP presence. The situation for Pharmacists working in CP is far from great in this scenario.

Apologies for length of this post but I do hope it will give prospective Pharmacy students something to mull over. Please discuss and contribute……..
(Original post by 0895)
I agree with you over Amazon. Claremont was talking about profit in the other thread. They don't need to make a profit to start with, just disrupt the sector, watch it implode, then swoop in and pick up whatever bits they fancy! I too fear that should they gain a foothold, they will destroy community pharmacy.
tbh, in my county, UPS is doing an amazon / p2u style service whereby pharmacists and technicians work in warehouse and have 0 patient interaction whatsoever.

also re: pharmacy2u, fun fact is that a majority of the people who run it used to work for gambling companies, so im not at all surprised to see them reporting loses (in addition to the well documented budget cuts which have happened since 2012 and more recently 2017-present). the worst part si that rishi sunak still wont increase spending on pharmacy but is doing it with all other health sectors .

also re: electronic prescriptions. prettymuch everywhere minus OOH and hospitals are using EPS (and even hospitals are transitioning to electronic prescribing), but also wouldnt be surprised to see OOH doctors implement EPS (assuming they can be authorised to issue EPS2 tokens and transmit them electronically to a pharmacy).
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