Medicines will be out of reach of customers
Source: Época Magazine - SP - MAGAZINE - 21/08/2009
ON THE COUNTER
The gondolas of drugstores will not be able to display medicines. The medicines will be in places of restricted access to employees
Brazilians are used to running to the pharmacy at the first sign of nausea or headache - and taking home a stock of pills and syrups that they believe to be "shot and fall". Many do not even read the package insert, taking innocuous or exaggerated doses. For the Ministry of Health, this custom is endorsed by the way medicines are available in pharmacies. So the old habit will have to change. Last week, the National Health Surveillance Agency (Anvisa) issued a resolution that obliges pharmacies and drugstores to place any and all medications behind the counter.
Six months from now, when the resolution goes into effect, whoever has a simple headache will have to explain to the pharmacist why they want to buy that medicine and answer some questions about their health before completing the purchase. Anvisa also establishes a list of products that can be sold in pharmacies and drugstores. As a result, items such as slippers, insecticides, frozen foods, batteries and lamps are left out. Food for special needs, nutritional supplements and cosmetics can continue to be sold normally on the shelves.
"The pharmacy is a special trade, because it is dedicated to health," says Dirceu Raposo de Mello, CEO of Anvisa. He says that the objective of reorganizing pharmacy counters is to promote the rational use of medicines, since buying medicines without proper guidance puts health at risk, instead of preserving it. In Raposo's view, the current drugstore model is very similar to that of supermarkets. "What we see today is an incentive to consumption," he says.
Internet sales will also be controlled.
Virtual drugstores will not be able to sell medicines
Raposo intends to implement here the model he met on visits to Switzerland, Portugal and Denmark. For Anvisa, not only should the pharmacist have a more active role, but the consumer should understand the obligation to make a more cautious purchase. This includes consulting the package insert even for non-prescription medications. Pharmacies would have a “bulário” available for consultation, like the one that Anvisa keeps on the internet. It would be up to those who use a medication to report any adverse symptoms to the pharmacist. And make sure the origin of the products, especially in the case of purchase by phone or the internet. Internet sales will also change. The resolution published last week prohibits the sale of drugs through websites of companies outside the country. It will only be allowed to sell medicines on websites with a “.com.br” domain and that belong to drugstores with stores in the real world.
So much change has displeased those who sell medicine. "The adequacy of the drugstore concept is an ideological issue of Anvisa", says Sergio Menna Barreto, executive president of the Brazilian Association of Pharmacy and Drugstore Networks (Abrafarma). According to Menna Barreto, federal legislation gives states the power to decide what type of product a drugstore can sell, which would make Anvisa's resolution unconstitutional. "Anvisa has no power to make law."
While awaiting a possible legal battle, Anvisa is preparing an attack in another trench: that of pirated medicines. At the beginning of next year, a tracking system will work to prevent fraud, theft and forgery in the pharmaceutical industry. How it will work has not yet been defined. What is known is that each package of medicine will be identified with a unique code, such as those recorded on the chassis of the cars, and that this code will be registered by the laboratories in a central database together with data currently used, such as lot number and date expiry date. An awareness campaign that is being prepared by the government and anti-piracy agencies should encourage consumers to consult this database each time they buy a drug, either through an optical reader at the drugstore or at home, over the internet. The database will show the path the drug should take from the laboratory, including the brand, the location of the factory, the name of the distribution company, the city and the pharmacy chain in which that box should be being sold. If, for example, a product destined for Ceará is purchased in Rio de Janeiro, the consumer must report the incident to the laboratory or even the police.
Many consumers do not know the “scratch card”, a seal used
to guarantee the provenance of the remedies
The fight against counterfeiting and smuggling will also be done through an agreement between the Federal Police, Anvisa and the pharmaceutical industry. The objective is to increase enforcement to reduce the entry of illegal products across the border with Paraguay, sold in drugstores in different regions of the country. According to investigations in recent years, the smuggling of drugs across the Paraguayan border reflects a worldwide problem, since much of the raw material comes from China. The passage of “mules” and sacoleiros with pills and ampoules inside their clothes is daily through Foz do Iguaçu and Guaíra, in the region of Lago de Itaipu. In 2008, the IRS seized 1 million counterfeit pills in Foz do Iguaçu, mostly imitations of erectile dysfunction drugs, mainly Viagra and Cialis. "The estimated loss to the pharmaceutical industry because of these crimes is at least R $ 5 billion", says André Franco Montoro Filho, from the Brazilian Institute of Ethics in Competition (Etco). According to him, the value is equivalent to 27% of what the industry invoices in Brazil.
The alternative that laboratories have, for now, is to change their packaging from time to time, using expensive graphic resources, to make counterfeiting difficult. The “scratch card”, that white rectangle on the medicine box that, if rubbed with a metallic object, reveals the manufacturer's logo, is an expensive resource, mandatory in the packaging of all medicines in Brazil for some years. It was created precisely for this purpose. It works very well, since no one has so far managed to falsify it with quality. But most consumers do not know that it exists or do not insist on using it to verify the authenticity of the product.
Although the actions of the anti-piracy agreement involve border inspection, police training and an exchange of intelligence between the public and private sectors, consumer attention seems to be decisive. According to Colonel Paulo Roberto de Souza, president of the Union of Cargo Transport Companies of São Paulo, those who buy stolen cargo are the same participants in the legal chain of commerce. “The recipient is a trader in the legally established industry. He buys the stolen one because he pays for it at most 40% of the amount he pays for a legal product. It is greed for profit that moves this chain, ”he says. Checking each product on a digital tracking system may not be the most comfortable way to establish a relationship of trust between the consumer and the drugstore. But it can be a powerful incentive to educate citizens more interested in knowing what is really being done about their health.
PIRACY
A Federal Police depot with fake drugs seized in Foz do Iguaçu. The business generates R $ 5 billion per year What changes in pharmacies
Pharmacies have 180 days to comply with Anvisa's resolution that restricts access to medicines
AT THE POINT OF SALE
• Medicines must not be exposed to the reach of customers, and must remain in a restricted area for employees
• Anvisa is responsible for disclosing the list of items exempt from prescription that may remain for sale in the self-service sector of merchants
• It is mandatory to display the guidance: “Medicines can cause unwanted effects. Avoid self-medication. Check with the pharmacist ”
TO BUY THE DISTANCE
• Only pharmacies and drugstores open to the public and with a responsible pharmacist present throughout the opening hours can sell medicines by phone, fax and internet
• The websites of pharmacies and drugstores can only use the domain “.com.br” and must inform the name and registration number of the pharmacist in charge of the responsible pharmacist, the license or health license and the authorization to operate Anvisa