Creating Value for All Healthcare Stakeholders
Vol:5 Issue: 10 September 1-15 2008
I believe .. patient power can heal a sick healthcare system
The Indian healthcare system has become sick. In the private
sector, doctors are no longer held in high regard; the doctor-patient
relationship has deteriorated; and patients believe that the medical
profession has become commercialized. The dismal state of the
government’s healthcare services for the poor and the middle-
class has also been extensively documented. The knee-jerk reflex
has been to train more doctors ; set up more hospitals; and force
corporate hospitals and doctors to provide subsidised medical
care.
This is simply a form of “band-aid medicine”. The only
effective solution will be to rely on the one resource which is almost
inexhaustible-the people themselves. The principle is simple -
educate them so they can manage their own health problems.
The reason that India is shining today is that we are in a
demographic ”sweet spot.” India’s major strength is its middle-
class, with its millions of educated young adults, and protecting
their health should be a high priority. Unfortunately, healthcare
remains a neglected area, because of which millions of working
years (and billions of rupees) are wasted on preventable illnesses.
Medical absenteeism exacts a huge toll, but because it is hidden
from public view, we have not addressed this problem effectively.
This is a daunting task, and the challenges are enormous.
However, the biggest mistake we make is to assume that people
are incapable of tackling their own medical problems; and that
we need to look to doctors for solutions. We need to change our
focus. Instead of trying to provide sophisticated healthcare
services (blindly imported from the West), which need expensive
technology, fancy machines and highly trained specialists, we
need to tap the people themselves. People are smart and
motivated, and are capable of remaining healthy, if we give them
the right tools and teach them how to use them.
Doctors are illness experts - and not healthcare experts.
Healthcare needs to learn from the revolution which has occurred
in microfinancing. When given money and the freedom to use it
as they see fit, even very poor people have come up with
remarkably innovative ideas which could never have been
planned, designed or anticipated by the traditional experts -
bankers!
Information Therapy - the right information at the right time
for the right person - can be powerful medicine ! Ideally, every
clinic, hospital, pharmacy and diagnostic center should have a
patient education resource center, where people can find
information on their health problem. The key is to develop patient-
friendly materials which people will want to watch and can learn
from. Most of us are visual learners, so this should be in graphic
format. Modern technology has made creating and sharing visuals
easy, so each community can build its own customised health
PhaRMeD Editor & Publisher
V. Bhava Narayana
TRADE NEWS Associate Editors
3-3-62/A New Gokhale Nagar, Ramanthapur, Dr. Aniruddha Malpani,
Hyderabad - 500 013 M.D
Tel Fax : 040-27030681, Mobile : 98495-51183
Dr. Mahesh Sharma,
M.D (Ayurveda)
E-Mail : pharmedtradenews@yahoo.com
Prof. G.P.Mohanta
www.pharmedtradenews.com
This Publication is Only for the use of Medical & Pharmacy Professionals
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Price Rs 20/-I believe .. patient
video libraries with ease ! A simple example would be to find an
articulate doctor with excellent communication skills, and to
record a doctor-patient consultation with her about the top ten
common clinical problems. A library of such videos could then
be published online as “open source content” ; and patients and
doctors could download and dub these in local languages. This
version can again be uploaded to the web and shared with other
patients from all over the country. Web 2.0 technology empowers
patients to form support groups and communities where expert
patients can help others. As the technology improves, it will soon
be possible to deliver this graphic educational content on the third
screen which is quickly becoming universal - the cellphone.
Patients will find these videos much easier to relate to, since the
videos are in their own language; deal with their immediate
personal concerns; use local characters they can identify with;
and provide local solutions which they are familiar with.
Information Therapy enhances patient autonomy by putting
patients first; promotes patient-centered healthcare; respects the
fact that the patient is the expert on himself; emphasizes personal
responsibility for health; reduces the risks of medical errors;
improves patient compliance with therapy; reduces the risk of
litigation, because the patient has realistic expectations of the
treatment; empowers patients to make their own decisions; and
allows the intelligent use of integrative medicine, (such as yoga,
homeopathy and ayurveda), so people can explore what works
best for them. It creates expert patients and allows patients and
doctors to form a healthy partnership, by improving doctor-
patient communication. Finally, it saves money on medical care,
both by promoting self-care (thus encouraging patients to do as
much for themselves as they can, and not become dependent on
doctors) ; and helping them with veto power, so they can refuse
medical care they don’t need, thus preventing overtesting and
unnecessary surgery.
Is educating people about their health and medical issues too
expensive? In fact, it’s too expensive not to do it ! Human capital
is India’s most precious resource and we cannot afford to squander
it. Information Therapy is free ; has no side effects; and provides
a terrific return on investment. We should insist that doctors
dispense information therapy every time they do a consultation;
advise a lab test; or prescribe medicines. In fact, both the
government and insurance companies can make prescribing
information compulsory. Information Therapy can be Powerful
Medicine - let’s make the most of it !
Dr Aniruddha Malpani, MD, Medical Director HELP
info@drmalpani.com
EDITORIAL BOARD
Prof.B.Suresh, President Pharmacy council of India
Dr. Jawahar Bapna, Rtd Director, IIHMR
Dr. P.Hanumantha Rao, ASCI, Hyd
S.W. Deshpande, DG, AIDCOC

PhaR MeD News
KIMS
Healthcare services provider Kerela Institute of Medical
Sciences is looking to acquire two hospitals in South India
and has earmarked a budget of Rs 300 crore for the purpose.
The company is primarily interested in acquiring hospital
with a capacity of 100-150 beds in Bangalore and surrounding
areas in South India.
KIMS is the first venture of KIMS Healthcare Management
which was started by a group of doctors and entrepreneurs
and it currently it runs 450-bed multi-specialty hospital in
Thiruvananthapuram, Kerala.
FORTIS
Fortis Healthworld has acquired CRS Health, a Delhi-based
pharma and wellness retail chain. It is also planning to
rebrand itself and the pharma chains it acquires in future as
Religare Wellness.
CRS is the drug retailing arm of the diversified Delhi-based
SAK Industries. Though the size of the deal is not big, it is
Malvinder Singh and Shivinder Singh’s first acquisition since
they sold their pharma company Ranbaxy to Daiichi Sankyo.
Fortis will pay around Rs 15 crore to acquire 90% stake in
CRS Health. Ravi Rajan & Company was the advisor to the
deal.
CRS has 30 stores which will help Fortis expand in the South.
The promoters of CRS Health will hold 10% stake. Fortis has
around 40 stores and plans to expand its presence to over
100 cities in 18-24 months.
PIRAMAL GROUP
Aiming to provide affordable medicines in rural areas and
to combat chronic diseases in the country, pharma major
Piramal Group in collaboration with ASSOCHAM and
various NGOs has launched a project here on Saturday.
The programme ‘help-your-body’, inaugurated by former
President APJ Abdul Kalam, will emphasise on imparting
knowledge on healthy food for healthy body and target each
and every individual.
”Genetic causes, obesity, stress, inappropriate dietary habits
and lack of exercise play a major role in causing chronic
ailments,” Swati Piramal, Piramal Group’s Director said.
According to a WHO report, 38.8 crore people will die in the
next ten years due to chronic diseases and a significant
proportion would be from India.
”India is expected to be the chronic disease capital with over
70 mn diabetics, 213 mn hypertensive patients and 60 mn
with arthritis by 2025. We feel the government, the private
sector, the medical fraternity, NGOs should come together
against the onslaught of chronic diseases,” Piramal said.
Kalam suggested that the group should integrate various
systems of medicine such as allopathy, ayurveda,
homoeopathy, unani, siddha and yoga available in the
country to fight chronic ailments at an affordable cost.
PhaRMeD TRADE NEWS
TELE-MEDICINE
India’s second largest car manufacturer Hyundai Motor
India Ltd has initiated a satellite-linked mobile health clinic
with telemedicine facility covering 20 villages near its
Irrugattukottai plant near Chennai, a company statement
said Wednesday.
The company has also entered into an agreement with Sri
Ramachandra University to operate the mobile clinic
manned by a team consisting of a medical officer,
pharmacist, nurse and an attendant.
Hyundai Motor has availed the services of the university
which in turn engaged Indian Space Research Organisation
(ISRO) to have the telemedicine connectivity via antenna,
fixed on the mobile van, to enable interactive treatment
involving both doctor and patient with the main centre at
Sri Ramachandra Medical College.
The project cost, estimated to be around Rs.1 million, is
borne by Hyundai Motor as part of its corporate social
responsibility (CSR) activity, the statement said.
Electrical stimulation may ease vaginal pain
Transcutaneous electrical nerve stimulation or TENS is a
safe and effective treatment for a type of vaginal pain called
vestibulodynia.Vestibulodynia is the burning pain that
occurs in the vulva, one of the most sensitive parts of the
body, located at the opening of the vagina. Intercourse,
tampon insertion, and wearing tight clothing may cause the
pain. Although many women experience vestibulodynia,
the cause is not fully understood. TENS has been used to
treat a number of chronic pains and involves nerve
stimulation through the skin with mild levels of electricity.
To test whether or not TENS can cure vestibulodynia, Italian
researchers randomly assigned 40 women with
vestibulodynia to undergo real or sham TENS treatments
delivered with a vaginal probe twice weekly for a total of
20 sessions. Pain levels were assessed before and
immediately after treatment and at 3 months. The
researchers used standard pain scales and questionnaires
and found that the TENS group experienced significant
improvements in pain, whereas the sham group did not.
Pain during intercourse and sexual function also improved
with TENS.The above findings show that TENS is a simple,
effective and safe short-term treatment for the management
of vestibulodynia. However, it is probably not a one-time
cure for vestibulodynia and the effect of TENS may decline
with time. BJOG: An International Journal of Obstetrics
& GynaecologyAugust 2008
ILLOGICAL FDCs
Partial, cumulative list of dubious fixed-dose combinations
(FDCs) being marketed in India but not approved in any
developed country. Most of these combinations are not
approved by the Drugs Controller General, India and hence
illegal.
ALPRAZOLAM + SERTRALINE
ALPRAZOLAM + IMIPRAMINE
ALPRAZOLAM + FLUOEXETINE
ALPRAZOLAM + MELATONIN
IMIPRAMINE + DIAZEPAM
RISPERIDONE + TRIHEXYPHENIDYL
NORFLOXACIN + TINIDAZOLE
SEPTEMBER, 1-15, 2008 Page 2
NORFLOXACIN + TINIDAZOLE + DICYCLOMINE MNC REDUCE MED REPS
NORFLOXACIN + TINIDAZOLE + LOPERAMIDE
Multinational pharmaceutical companies are trimming their
NORFLOXACIN + METRONIDAZOLE
medical representatives or sales force in India. While some
NORFLOXACIN + ORNIDAZOLE
have introduced voluntary retirement schemes to their sales
CIPROFLOXACIN + TINIDAZOLE
CIPROFLOXACIN + METRONIDAZOLE force, others have stopped recruitments. Most companies
OFLOXACIN + TINIDAZOLE have started offering ‘executive’ designations to their sales
OFLOXACIN + METRONIDAZOLE force so that they do not form part of employee unions.
OFLOXACIN + ORNIDAZOLE
FLUCONAZOLE + TINIDAZOLE Federation of Medical Representatives Association of India
DOXYCYCLINE + TINIDAZOLE (FMRAI) general secretary DP Duvey confirmed the
TETRACYCLINE + METRONIDAZOLE development. He said: “About 10 MNCs are cutting 100-200
MEFENAMIC ACID + DROTAVERINE people each in India.” In addition, he added, they are not
NIMESULIDE + PARACETAMOL recruiting fresh field agents but people in different
NIMESULIDE + DICLOFENAC designations that does not come under the purview of
NIMESULIDE + DICYCLOMINE employee unions. A source from Sanofi-Aventis also admitted
NIMESULIDE + CHLORZOXAZONE that the company was changing the designations of people
NIMESULIDE + METHOCARBAMOL so that they do not have the union’s protection.
NIMESULIDE + CAMYLOFIN
NIMESULIDE + SERRATIOPEPTIDASE Mr Duvey said the list of the companies reducing field
NIMESULIDE + TIZANIDINE workforce includes Merck, Sanofi, Novartis, Pfizer,
NIMESULIDE + PARACETAMOL + CHLORZOXAZONE GlaxoSmithKline (GSK) and Wyeth. Incidentally, they are
NIMESULIDE + TIZANIDINE + PARACETAMOL cutting down almost 1,000 sales staff globally. Spokespersons
ROFECOXIB + TIZANIDINE for Sanofi-Aventis and GSK denied the reduction in field staff
IBUPROFEN + TIZANIDINE in India or abroad. Email queries sent to Merck, Wyeth and
DICLOFENAC + TIZANIDINE Pfizer nearly two weeks ago did not elicit response.
DICLOFENAC + FAMOTIDINE Atul Walavalkar, a medical representative with Johnson &
DICLOFENAC + PARACETAMOL + TIZANIDINE Johnson (India), said: “The job description has not been
DICLOFENAC + SERRATIOPEPTIDASE changed but the designation has been. Companies are doing
DICLOFENAC + PARACETAMOL + SERRATIOPEPTIDASE this to try and reduce the bargaining power that the medical
IBUPROFEN + PARACETAMOL + MAGNESIUM representatives have. They are sugar-coating the issue.”
TRISILICATE Instead of the usual medical representative designation,
RANITIDINE + DICYCLOMINE companies are assigning new designations like professional
SUCRALFATE + OXETHAZINE service representative and medical service representative, he
CISAPRIDE + SIMETHICONE added.
CISAPRIDE + OMEPRAZOLE Another medical representative with Wyeth, who did not
MOSAPRIDE + METHYLPOLYSILOXANE wish to be quoted, told ET that the company started a
MAGALDRATE + SIMETHICONE + OXETHAZINE + voluntary retirement scheme in 2004 to encourage people to
DICYCLOMINE leave the company. It has also not recruited any new talent
DIAZEPAM + DRIED ALUM. HYDROX. GEL + ALUM. for the past four years and has preferred to go in for
GLYCINATE + OXYPHENONIUM franchisees for marketing purposes. Pfizer has managed to
DIAZEPAM + DRIED ALUM. HYDROX. GEL + MAG. keep the unions out completely by assigning designations
TRISILICATE + DIMETHYLPOLYSILOXANE such as “professional service officer”, said a Pfizer employee.
DIAZEPAM + MAGALDRATE + OXYPHENONIUM According to Ajay Piramal, chairman of Piramal Healthcare,
DIAZEPAM + PROPANTHELINE + DIHYDROXY. ALUM. “MNCs look at numbers on a global level. Their productivity
AMOXYCILLIN + SERRATIOPEPTIDASE in India is low because the price is low here. Also, they don’t
PIPENZOLATE + PHENOBARBITONE have a large product basket so the medical representatives
AMOXYCILLIN + PROBENECID + TINIDAZOLE are working with a lot less.” Ironically, Indian pharma
CEFUROXIME + SERRATIOPEPTIDASE companies are going the opposite way and hiring as many
ROXITHROMYCIN + AMBROXOL people as possible. “The Indian market is growing at 14 per
CIPROFLOXACIN + AMBROXOL cent per annum and Indian companies are not looking at
CEFOPERAZONE + SULBACTUM cutting back on their sales force. At Sun Pharma, we are
RAMIPRIL + LOSARTAN looking at gradually expanding the number of medical
AMLODIPINE + LISINOPRIL representatives we have,” the company spokesperson said.
AMLODIPINE + ENALAPRIL
AMLODIPINE + RAMIPRIL Mahendra Bangar, Wockhardt’s HR vice-president, said: “We
AMLODIPINE + LOSARTAN have ambitious plans for expanding out sales force and want
ATENOLOL + ALPRAZOLAM to retain out market position and rank. Many Indian
PROPRANOLOL + ALPRAZOLAM companies are looking at expanding in rural areas and rural
PROPRANOLOL + DIAZEPAM markets and we are looking at that as well.” Elder Pharma,
CINNARIZINE + DOMPERIDONE which makes 80 per cent of its turnover from the Indian
DOMPERIDONE + RANITIDINE
market, is also expanding its field force. “Disease profiles are
DOMPERIDONE + OMEPRAZOLE
growing in India. We have a field force of 1,800 all over India,
DOMPERIDONE + FAMOTIDINE
but are looking at expanding in rural areas. MNCs, on the
MEBENDAZOLE + PYRANTEL
other hand, are using franchising models and asking Indian
MEBENDAZOLE + LEVAMISOLE pharma companies, who have a strong field force, to market
SIMVASTATIN + NICOTINIC ACID their products.”
CETIRIZINE + PARACETAMOL +
PHENYLPROPANOLAMINE Swati Piramal, vice-chairperson of Piramal Life Sciences, said:
“We are hiring strongly and in one of our major divisions
Source: MIMS - India

PhaRMeD TRADE NEWS SEPTEMBER, 1-15, 2008 Page 3

(Tru Care) we are doubling sales force from 600 to 1200. We
are customer-driven and align our products to what customers
need in both urban and rural areas.” The sales force, she adds,
is the pillar of the company and play a vital part in growing
sales. Sales force cuts are the easiest to make but if marketing-
related costs and decisions are judiciously made then costs
can be controlled, said Mr Bangar.
Source: The Economic Times
BULK DRUGS PRICES
now offloading them since prices would fall once Chinese
supplies resume,” SME Pharma Industry Confederation’s
general secretary Jagdeep Singh said.
Industry sources said the price of ofloxacin has come down
to Rs 2,700 per kg in the past few weeks as compared to Rs
3,200 per kg earlier. Similarly, price of a broad spectrum
antibiotic tetracycline (used to treat bacterial infections) has
fallen from Rs 1,300 per kg to Rs 950 per kg. The price of
oxytetracycline, which used to cost Rs 700 per kg till some
time ago, has declined to Rs 570 per kg.

The government would take measures to revive bulk drug
units that have either closed down or suspended
manufacturing due to short supply of raw material from
China.
Bulk drugs are active pharmaceutical ingredients (APIs) used
in the manufacturing and processing of a medicines or
formulations. Due to shortage of raw material and their rising
prices, close to 50 bulk drug manufacturing units have closed
while others have cut down manufacturing of loss-making
drugs. According to industry sources, China is the largest
supplier of raw material for bulk drugs to India and controls
over 70% of the Rs 15,000-crore annual market for imported
bulk drugs.
”China has also been dumping a large number of cheaper
APIs into the Indian market for almost last 10 years. Despite
the government imposing anti-dumping duty on several APIs
and intermediates, the import of cheaper drugs has
continued,” an industry expert said.
As the Chinese government had shut many manufacturing
units to cut pollution during the ongoing Olympics, prices of
such drugs have gone up. In order to help the industry manage
the situation, the government has started inspecting bulk drug
clusters such as Hyderabad, Ahmedabad and Vadodara.
However, industry observers feel prices of certain bulk drugs
are declining. “Traders who were hoarding these items are
However, prices continue to be high in the case of items such
as paracetamol, said Mr Singh. The price of paracetemol has
risen from Rs 165 per kg to Rs 325 per kg.
PPI Cost-Effective as Co-Therapy with Aspirin for
Cardiovascular Prophylaxsis
— In patients taking aspirin for cardiovascular prophylaxis,
over-the-counter proton pump inhibitors significantly reduce
bleeding and are cost-effective in average-risk patients,
investigators here concluded.
Action Points
◆ Explain to patients that co-treatment with a proton
pump inhibitor may reduce the risk of gastrointestinal
bleeding associated with long-term aspirin therapy.
◆ Note that the findings were based on a statistical
model, not a randomized, controlled clinical trial.
Statistical modeling suggested only a third of the risk of upper
gastrointestinal bleeding and associated deaths in average-
risk patients who began concomitant PPI therapy at age 65,
Sameer Saini, M.D., of the University of Michigan, and
colleagues reported in the August issue of Archives of Internal
Medicine.

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PhaRMeD TRADE NEWS SEPTEMBER, 1-15, 2008 Page 4

 Added Value of Pharmacists in the Public Health
Dr. Nirmal K. Gurbani
Public Health Training Institute, Jaipur

Pharmacists Availability: India ▲ Self care (Diabetes, HT, OA, etc.)

▲ Nearly 500,000 trained pharmacists
▲ Almost 75% engaged in CP and HP
▲ Elsewhere Pharmacists - considered as experts in
medicine management and health care
▲ Large pool of HRH remained unutilized as service
provider by the government, society or allied health
professionals
▲ Working in isolation rather than as a member of the health
care team
Changing Paradigm of Pharmacy Practice
▲ Traditional role of pharmacists to manufacture and
supply medicines has undergone a sea change
▲ Community pharmacy practice evolved in the post
Second World War period
▲ Forced the evolution of the pharmacist’s role into a more
patient centred approach
Pharmacy in a New Age (PIANA)
The New Horizon has identified 4 major Area
1. Managing Prescribed Medicines
2. Managing Chronic Conditions
3. Managing Common Ailments in giving patients
(reassurance and advise with or without use of Non-Rx
Med)
4. Public Health - promoting & supporting Healthy Lifestyles
(helping people to protect their own health)
Major Breakthrough
WMA and the FIP joint statement on working relationship
between physicians and pharmacists aims to demonstrate
that each have
▲ complimentary and supportive roles and
▲ responsibilities
WHO Recognition Pharmacist
WHO and FIP have also jointly identified seven-core
expectations from the pharmacists as:
• Communicator
• Care Giver & Quality Drug Supplier
• Trainer & Supervisor
• Care Giver & Quality Drug Supplier
• Trainer & Supervisor
• Collaborator
• Health Promoter
• Leader & Manager
• Life-long learner
Good Pharmacy Practices
Activities to be addressed:
▲ Promotion of good health (prophylaxis & care)
▲ Managing supply of medicines and other items
▲ Rational Use of Medicines (influencing prescribing &
medicine use)
Access to Primary Health Care
▲ PHC : first contact that a patient has with a health care
professional to diagnose or/& treat his/ her complaints,
including prevention (Health Education)
▲ Pharmacist is usually first contact with majority of
Population in times of sickness and quest for health
Untapped Manpower in NHP
An ANM/HW with bare 10+18m training
▲ A crucial partner of Healthcare team (NHP) - direct
contact, communication, IEC
▲ Managing SC with about 5000 population
▲ Advising, educating & prescribing 20-30 products to the
community
Pharmacists have better educational background in
Health Education, National Programmes and RCH, but
are not exploited under NHP
Current Public Health Concerns in India
Some of the public health challenges we face today are
▲ Communicable, Non-Communicable, Vector-born
Diseases (NVBDCP), All NPs
▲ Malnutrition (Vit A & D Def., Anaemia)
▲ RCH
▲ Sedentary Lifestyle/Improper diet
▲ Sexual Behavior/STD’s, HIV-AIDS
▲ Substance Abuse: Alcohol,Tobacco,Drugs
▲ Family Violence
Evidence base for Pharmacist in Public Health
A practical guide for Community Pharmacists- Jointly
prepared by Pharmaceutical Services Negotiating
Committee, National Pharmaceutical Association,
Royal Pharmaceutical Society of Great Britain; www:
PharmacyHealthLinl
▲ Smoking cessation
▲ Coronary heart disease
▲ Skin cancer prevention
▲ Drug misuse
▲ Sexual health (including emergency hormonal
contraception)
▲ Immunisation
▲ Head lice management
▲ Oral health
▲ Mental health
▲ Obesity
▲ Accidental injury prevention

PhaRMeD TRADE NEWS SEPTEMBER, 1-15, 2008 Page 5

▲ Folic acid and pregnancy Pharmacists : Patient Information
▲ Asthma Use of Patient Information Leaflets (PILs) in Mumbai (2004-
▲ Diabetes 2006)
▲ Nutrition and physical activity ¨ Leaflets : KM Kundnani Pharmacy Polytechnic
▲ Multi-topic health promotion campaigns in collaboration with Delhi Pharmaceutical Trust
Desired Qualities of Public Health Professionals ¨ Distributed to 3500 patients in Mumbai and Thane area
▲ Excellent Communication Skills through 50 retail pharmacists
▲ Trustworthy ¨ PILs were for Atenolol, Cefadroxil, Atorvastatin,
▲ People Oriented Diclofenac and Glibenclanmide
▲ Easily Accessible ¨ In the present study respondent’s medication taking
▲ Experts in providing health care information behaviour (compliance) was improved in 91% cases
▲ Good rapport with other healthcare providers compared to the 36% prior to the intervention
Pharmacists Qualifies All Desired Qualities Pharmacists Fight against TB
Some Areas Suited to Pharmacist Volunteerism in ▲ TB Patients buy medicines from pharmacists
Public Health ▲ Importance of Compliance - not been fully emphasised
T▲ Smoking Cessation – IPA NPW : Pharmacists for Tobacco by prescribers, leading to MDR and XDR
Free Society ▲ Pharmacists as valuable resource was hardly tapped
▲ Youth Counseling – Drug Abuse, STD’s under the TB Control Programme
▲ A TB Fact Card project was launched by IPA in 2005 in
▲ HIV-AIDS : SEARPharm Forum Guiding Principles for
Mumbai as collaborative project with CPA, IPSF,
Fight Against HIV-AIDS
Maharashtra State Chemist & Druggists Association &
▲ Elder Outreach – Nursing Home Activities
Mumbai District TB Control Society
▲ Active Lifestyle/Diet Modification Activities
▲ Students of 6 Pharmacy Colleges, 5000 patients
LACK OF PATIENT’S KNOWLEDGE & NON
▲ Compliance established
ADHERANCE TO TREATMENT REASONS
▲ Another major breakthrough - participation of some
▲ Inappropriate attitudes and poor communication skills
Pharmacists as DOTS providers-an excellent example of
of providers
PPP
▲ Patient’s fear of asking questions, esp doctors
▲ Inadequate consulting time Spanish Study : Provision of directly observed treatment
▲ Lack of access to printed information about drugs (leaflets short course (DOTS) through community pharmacies in
or labels) Spain resulted in improved treatment completion and
cure rates when compared to self-administered treatment
▲ Inability to pay for prescribed medicines
(Reference: Juan G, Lloret T, Perez C, et al. Directly
▲ Complexity and duration of treatment particularly in
observed treatment for tuberculosis in pharmacies
chronic diseases
compared with self-administered therapy in Spain. Int J
IMPACT OF PROVIDING DRUG INFORMATION TO THE Tuberc Lung Dis 2006;10:215–221)
PATIENTS ON PATIENTS KNOWLEDGE
Delhi Study (DSPRUD) ▲ Collaboration between community pharmacists and local
TB units of the RNTCP could provide a continuum of
Knowledge of the patient (Mean + SD)
Parameters Control group (n=114) Study group (n=118) care for patients navigating their way from diagnosis to
treatment
Pre Post Pre Post
Primary Indicators ▲ Strategies that involve greater public and private sector
Purpose 1.07 (1.53) *1.45 (1.69) 1.32 (1.70) **3.42 (2.04)
Dose 3.49 (1.97) *3.78 (1.75) 2.88 (2.02) **4.22 (1.97) collaboration could lead to significant improvements in
Frequency 3.54 (1.94) *3.75 (1.75) 2.95 (2.09) **4.27 (2.00) TB control.
Duration of treatment 3.14 (2.66) 3.21 (2.60) 2.21 (12.42) **3.83 (2.22)

Sum of primary indicators 11.25 (5.86) *12.21 (5.44) 9.36 (6.39) **15.66 (7.33)
Pharmacists in Malnutrition
score ▲ In Satara (Maharashtra) – PPP; Pharmacists, their
Supplementary Indicators association, IMA, Government & other associations/
Next appointment 3.40 (2.75) 3.42 (2.80) 3.14 (2.10) **4.15 (2.18)
Adverse effects 0.04 (0.39) 0.01 (0.09) 0.05 (0.41) **2.47 (1.87)
individuals
Precautions 0.09 (0.45) 0.11 (0.36) 0.08 (0.46) **2.89 (2.07) ▲ Each year Health camp for children but no follow up
Sum of supplementary 3.52 (2.78) 3.52 (2.76) 3.27 (2.67) **9.52 (5.21) ▲ Pharmacists played important role in finding cases of
indicators score
malnourished children with the help of Aanganvadi
Missed doses (Mean +SD) 1.6 (0.7) 1.9 (.4)
workers
Regular 12 3
Occasional 19 7 ▲ 84 children in age 6 months to 6 year Malnutrition
Not missed 83 108
category 3 & 4 identified and enrolled in the programme

PhaRMeD TRADE NEWS SEPTEMBER, 1-15, 2008 Page 6


▲ In a year, on each first day of the month -medical and
HE posters
▲ Implement and Regulate GPP Guidelines with same
fervor as GMPs under Schedule M
Pharmacists Action Needed
▲ Commitment of Pharmacists, Pharmaceutical
Associations & Organizations on consensus
▲ Collaboration - PCI, IPA, IPGA, APTI, IHPA, AICDO,
IPO, etc and Social Clubs & Org. Lion, Rotary, etc.
▲ Transforming trading mentality to professional services
mindset
▲ Focus from product to patient
▲ PCI initiating a NEED BASED Curriculum Designing for
appropriate empowerment
Government’s Role
▲ Considering prevailing unmet need of trained HRS in
achieving the targets under NHPs - Redefine National
Health Policy and augment the workforce by including
Pharmacist as HRH
▲ Draw appropriate training manuals for empowerment
of pharmacists in all NHPs like Training Manuals for
doctors, nurses, HWs, Aanganwadis, etc
▲ Treat CP outlets as distribution & display point for HE
literature for public and HE posters
▲ Implement and Regulate GPP Guidelines with same
fervor as GMPs under Schedule M
Roles of Pharma Organizations
▲ Awareness of Community pharmacy and Role of a
Pharmacist
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One Million Indians die this year
due to Smoking
PhaRMeD TRADE NEWS
▲ Encourage Ph for display of HE posters and distribution
of HE literature in their outlets
▲ Collaboration and Partnerships with other health
professionals; eg WMA / FIP
IPA / IMA/ PCI / MCI
▲ Working together for various national and international
days, events and compaigns, instead of only working in
isolation for a week in NPWs
▲ PCI:Open up - encorage DHOs as faculty in HE &
doctors in medically oriented subjects
▲ Advocacy and Networking
CONCLUSIONS
Pharmacist is circumcenter of a triangle with physicians,
patients and nurses at the corners
▲ He has direct contact with patients and Community
▲ Patient finds much more in comfort with Pharmacist
than a physicians
▲ Pharmacist is under utilized in PH and NHPs
▲ Steps should be taken by the Government and the
pharmacist together to play a significant role in NHPs
▲ Pharmacy Associations need to work in collaboration
and Partnerships, A & N
▲ check up by IMA doctors and pharmacists distributed
free medicines Many other individuals & associations
(grocers, food merchants) joined
▲ Now most of the children have shown significant
progress & weight gain of 5 to 7 kgs.
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SEPTEMBER, 1-15, 2008 Page 7
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Hospital Directory
dabad Eye Care Hospital Ramnagar, SabarmatiAhmedabad
Polytecnic Road - 380015 Ahmedabad 079-26446133, 26430503 Paraplegia Hospital
Bansali Trust Hospital & Diagnosis Civil Hospital CampusAhmedabad 079 22680471079
Opposite Dinabhai Tower, Sahyog Building, 22680471paraplegia@icenet.net
MirzapurAhmedabad 25350722 Sharadaben General Hospital
Chatrabhuj Lajpatrai Hospital SaraspurAhmedabad 361072
Shahibaug RoadAhmedabad 22866311 Thakersay Charitable Trust Hospital
Chest Disease (ESI) Hospital Near Umiya Vijay Bus stand, Near Satellite RoadAhmedabad
Kamdar Rajya Vima Yojna, Gujarat StateAhmedabad 6744244
Dr. Arvind Shah General Hospital Victoria Jubilee Hospital
Near Chhotalal Chawl, Odhav Main RoadAhmedabad Kalpur Railway Station, Railwaypura Ahmedabad 2141080
2 871054, 2871382 No.71, 11th Main, Malleswaram, Opposite Malleswaram
ESIS General Hospital Railway StationBangalore
BapunagarAhmedabad 2745770, 2743935 Bangalore Hospital
Gujarat Cancer & Research Institute 202 RV Road,Bangalore south Bangalore 91-80-26632753/3494
Civil Hospital Compound, AsarwaAhmedabad (079) 22681451, Bangalore Institute of Oncology
22681433(079) 2268 5490 Cancer Detection Centre, 44-45/2ND CRS RM Roy
Gulab Bai General Hospital ExtensionBangalore 40206400
Opposite Kalupur Police Station, Dhana Suthar ni Pole Bangalore Kidney Foundation
NakaAhmedabad 339055, 384468 6, 11th Cross, 15th Main, PadmanabhanagarBangalore(80)
Gulabdevi S Chowdhary Kidney Hospital 26392700
Shahibaug RoadAhmedabad 2866313 Bhagawan Mahaveer Jain Heart Centre
Infectious Disease Hospital General Miller Road, Vasantha NagarBangalore 22207640 /
Near Calico Mill, Pirana Road, BehrampuraAhmedabad 22207649
25323646 Bhagawan Mahaveer Jain Hospital
Leprosy Hospital Millers Road, Vasantha NagarBangalore 2207641-49, 2260944,
NarolAhmedabad 25712309 2261153
M.P. Shah Cancer Hospital Bowring & Lady Curzon
Gujarat Cancer & Research Institute, New Civil Hospital Lady Curzon Road, Shivaji nagarBangalore 25591325, 25591362
Campus, Asarwa Ahmedabad (079) 2268 1451, 2268 1433(079) Cauvery Medical Center
2268 5490 3-B, HBS Apartments No.1, Edward RoadBangalore
Nagri Eye Hospital CDR Medical Center
Near Gujarat College, Ellis BridgeAhmedabad 26466724 / 531, 11 Main, 4 V Block, JayanagarBangalore 26655055
26460176 Church of South India Hospital
Navdeep Clinic 2, Hazarat Kambal Posh RoadBangalore 2861103, 2861104
Opposite Aakashwani, Ashram Road Ahmedabad 6584009 City Corporation Hospital
P.P. General Hospital 5 Kempegowda CLE 9, VijaynagarBangalore 23300977

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