Building GPP pharmacies- obstacles still exist

In order to enhance competitiveness in the process of international integration, the Vietnamese pharmaceutical industry has determined to develop and maintain GPP (Good Pharmacy Practice) drugstores. The presence of GPP pharmacies not only helps patients take medicine correctly, safely and effectively, but also helps doctors treat diseases with peace of mind. However, unfortunately, the current number of GPP drugstores is very modest in relation to total pharmacies in the country.

GPP model

A GPP drugstore must be able to help customers understand the medicine prescription and use medicines safely and economically. This high-grade pharmacy model aims at getting rid of the current complex drug trading and distribution system to bring practical benefits to patients. The GPP principle of selling prescription drugs also helps people relinquish the habit of buying pharmaceuticals in an imprudent manner, leading to drug resistance and accidental drug overdose. GPP drugstores must meet following conditions: The owner must have a medicine practising certificate and the displaying area must be at least 10 square metres. Drug preservation requirements must satisfy specifications written in instruction leaflets; storage chamber temperature must be kept at 30 degrees Celsius or lower and humidity must not exceed 75 percent. Drugs supplied to patients must have clear origin and must not be expired.

The presence of a GPP-standardised pharmacy system helps the sick adapt to a modern pharmaceutical retail model as in developed countries and helps doctors feel more secure in treating patients. Additionally, with GPP, drugstores also benefit. According to owners of GPP drugstores Ho Chi Minh City, since the standard is adopted, service is getting better. Compared with substandard drugstores, GPP-standardised stores are not confined to buying and selling activities, but meet GPP requirements. Starting from the source, a pharmacy must buy from drug makers authorised and certified by the Ministry of Health and they must have commercial invoices. During the process of selling drugs, pharmacies regularly check their drugs. When a patient comes to check diseases and buy medicines, the GPP pharmacy will consult him on dosage and store his personal information (name, age, address and telephone number) to inform him immediately if there is any irregularity. In case the Ministry of Health or other health authorities discover disqualified medicines and recall them, the pharmacy can quickly inform patients. These benefits help the pharmacy build up the trust of patients.

According to Doctor Nguyen Phi Tien, Director of Dak Lak Province Department of Health, pharmacies must adapt to this trend if they do not want to be wiped out. Manufacturers and importers also unite to support the GPP policy – the fundamental measure to ensure drug quality, brand and prestige.

Barriers exist

According to the GPP construction plan initiated by the Ministry of Health, by the end of 2008, all hospital pharmacies must meet GPP standards and all pharmacies in the country must satisfy the standard by January 1, 2011. But, after two years, the number of GPP pharmacies in the country is very small. Particularly, Ho Chi Minh City, the largest economic hub in Vietnam, now has only 467 GPP drugstores out of 3,577 operating pharmacies, or 13 percent certified by the Department of Health. In Dak Lak province, there are only three GPP pharmacies, a modest number compared to 21 hospitals and more than 500 drugstores. Hanoi, the second largest city, has 249 GPP-certified drugstores out of 1,500 registered pharmacies, accounting for less than 20 percent, according to the Department of Health.

One of main obstacles to the process of building a GPP pharmacy system is the higher investment required of drugstores, as they must hire certified pharmacists to run the front counter. This raises costs, as it is very difficult to recruit certified pharmacists. It is difficult to build GPP pharmacies managed pharmaceutical companies, but it is even harder to apply this standard to small pharmacies. Moreover, building a GPP pharmacy requires significant investment for infrastructure and equipment, possibly out of reach for many small units. Because of the necessary investment, many GPP pharmacies suffer losses when starting operation. For instance, Phano Pharmacy 2 – the first drugstore in Ho Chi Minh City to be certified as Good Pharmacy Practice – had to turn down 40 percent of customers in its first week because they lacked proper drug prescriptions.

In addition, the psychology of consumers is also an obstacle to building GPP drugstores. They have long been familiar with buying drugs without prescription, especially patent medicines (even specific drugs are banned from circulation). Many are unwilling to accept the strict regulations applied by GPP pharmacies, which are ready to reject their orders; thus, they choose non-GPP pharmacies where they can buy medicines easily and quickly. Thus, many pioneering GPP pharmacies have to accept business loss when they start to apply the new norm as they have to turn away customers without proper prescriptions. In addition to non-GPP drugstores, they have to compete with private clinics which diagnose diseases and sell drugs.

Combined with high investment costs and consumer preference, human resources shortage is another difficulty for building GPP drugstores. Pharmacist Pham Khanh Phong Lan, Deputy Director of Ho Chi Minh City Department of Health, said the core of GPP is to ensure that customers use medications correctly, safely and economically and the role of pharmacists is decisive. Currently, GPP pharmacies are meeting many difficulties as they lack pharmacists. According to the Department of Health, HCM City now has about 3,856 pharmacists, about 4.5 pharmacists per 1,000 residents. This rate is three times higher than the national average, but still lower than the world rate. Hence, the pharmaceutical industry is currently encountering difficulties in recruiting pharmacists for GPP pharmacies.

The GPP pharmacy model adopted by the Ministry of Health aims to strengthen the role of drugstores in the medical community, bring about practical benefits for patients like purchasing qualified drugs at reasonable prices, and offer advice for effective and safe drug usage. Although the GPP pharmacy development system in Vietnam still faces many hindrances, it is a necessity to ensure good health and improve the quality of the pharmaceutical industry amid growing competition with foreign distributors.

Therefore, to encourage the construction of the GPP pharmacy system, the Ministry of Health has completed policies to support drug distributors. Accordingly, all companies with GPP pharmacies will be licensed to directly import, or import under authorisation, special medicines Vietnam has not had yet. In addition, the business scope of GPP pharmacies will be broader than non-GPP drugstores. Along with preferential tax policies, the Ministry of Health has given a handsome amount to help GPP pharmacies increase their popularity. However, in addition to support from the State and interventions from authorities, the most important thing is that pharmacies recognize the operating purposes, industry requirements and responsibilities in medicine business and adopt GPP standards. – VCCI

Tags: GPP pharmacies, Vietnam phamarceuticals