Pharmacists assist people in obtaining medication and ensuring that these are used in a safe and proper fashion. The role of the pharmacists has changed over the recent years. Although their main role is still to dispense medications in community pharmacies, pharmacists are increasingly providing direct care to patients (e.g. flu vaccinations in Ireland), both in community pharmacies and as part of integrated health care provider teams.

OECD countries generally have between 50 and 130 pharmacists per 100 000 population. Japan has by far the highest density of pharmacists, at twice the OECD average, while the density of pharmacists is low in Turkey, Chile and the Netherlands (Figure 10.6). Between 2000 and 2013, the number of pharmacists per capita has increased in nearly all OECD countries, with the exception of Switzerland. It increased most rapidly in Portugal, Ireland, Japan, Spain and Hungary.

In Japan, the strong increase in the number of pharmacists can be attributed to a large extent to government's efforts to separate more clearly drug prescribing from drug dispensing. Traditionally, the vast majority of prescription drugs in Japan were dispensed directly by doctors. Over the years, the Japanese government has taken steps to encourage the separation of drug prescribing from dispensing. The Medical Service Law was first amended in 1997 and then in 2006 to recognise community pharmacies as facilities providing health goods and services. Following these amendments, the percentage of prescriptions dispensed by pharmacists rose from less than 40% of all prescriptions in 2000 to 67% in 2013, while the number of community pharmacies increased from 48 252 to 57 071 (Japanese Pharmaceutical Association, 2015).

Most pharmacists work in community pharmacies, but some also work in hospital, industry, research and academia (FIP, 2015). For instance, in Canada in 2012, more than three-quarters of practising pharmacists worked in a community pharmacy while about 25% worked in hospitals and other health care facilities (CIHI, 2013). In Japan, around 55% of pharmacists worked in community pharmacies in 2012, while around 20% worked in hospitals or clinics and the other 25% worked in other settings (Japanese Pharmaceutical Association, 2015).

The number of community pharmacies varies widely across OECD countries (Figure 10.7). This big variation can be explained by the more or less active planning role of governments and agencies; by the remuneration model used in the country, as well as by different dispensing channels of medicines. In addition to community pharmacies, medicines can be dispensed through hospital pharmacies (serving both inpatients and outpatients) or can be provided directly by doctors in a few countries. For example, the relatively low number of community pharmacies in the Netherlands may be explained partly by the fact that patients can also purchase their prescription drugs directly from some doctors (Vogler et al., 2012). There are about 400 GPs who are selling medicines in the Netherlands, providing access to drugs especially in rural areas where the nearest pharmacy may be quite far away (RIVM, 2014). Denmark has few, but large, community pharmacies including branch pharmacies and supplementary pharmacy units attached to the main pharmacy (Vogler et al., 2012).

The range of products and services provided by the pharmacies varies across countries. In most European countries, for example, pharmacies can also sell cosmetics, food supplements, medical devices and homeopathic products and in a few countries pharmacies can also sell reading glasses and didactic toys (Martins et al., 2015). Depending on countries' legislation, pharmacies can provide services such as vaccination, medication use review, unit dose dispensing, generic substitution, point of care testing, medication administration, needle exchange programme, take back medicines (disposal of medicines), etc.

References

CIHI – Canadian Institute for Health Information (2013), Pharmacist Workforce, 2012 – Provincial/Territorial Highlights, Ottawa, Canada.

FIP – International Pharmaceutical Federation (2015), Global Trends Shaping Pharmacy – Regulatory Frameworks, Distribution of Medicines and Professional Services, The Hague.

Japan Pharmaceutical Association (2015), Annual Report of JPA 2014-2015, Tokyo.

Martins, S.F. et al. (2015), “The Organizational Framework of Community Pharmacies in Europe” , International Journal of Clinical Pharmacy, May 28.

RIVM – National Institute for Public Health and the Environment (2014), The Dutch National Atlas of Public Health, Bilthoven.

Vogler, S. et al. (2012), “Impact of Pharmacy Deregulation and Regulation in European Countries” , Vienna.

Note: Information on data for Israel: http://dx.doi.org/10.1787/888933280737