Browsing by Subject "pharmacy"

The Finnish medicine reimbursement system is complex and several different conditions required by the Health Insurance Act (1224/2004) and the Social Insurance Institution of Finland (Kela) must be met in order to receive medicine reimbursement. The understanding of medicine reimbursement criteria from the perspective of medicine users has not been studied in Finland before, and little research has been done on the subject internationally. Medicine user-oriented research on the medicine reimbursement system, both in Finland and internationally, has largely focused on the financial opportunities of medicine users to purchase medicines and their opinions on the fairness of medicine reimbursements. The aim of this study was to obtain information on the understanding of medicine reimbursement criteria and the background factors affecting it, the implementation of price, generic substitution and medicine reimbursement counselling in pharmacies, seeking advice on medicine reimbursement, and the financial difficulties of buying prescription medicines. The material used in this study was from the population survey (n=1650), which examined the activation of price competition for pharmaceutical products and customers' expectations of pharmacy operations. The understanding of medicine reimbursement criteria, the price counselling provided in a pharmacy, the effect of financial challenges on the non-buying of medicines and the use of sources of advice related to the medicine reimbursement were described as frequency distributions. The effect of background factors on the understanding of medicine reimbursement criteria was compared using the chi-square test and logistic regression analysis. About a third (31%) of respondents told that they do not understand the basis on which medicine reimbursement is usually received for prescription medicines, and 13% had unclear why they had not been reimbursed for their prescription medicine in the past year. Especially younger age, low income, low medication use, depression and other mental health problems, lack of long-term illness, and insufficient medicine reimbursement counselling in a pharmacy were found to be associated with poorer understanding of medicine reimbursement. 72% of the participants in the study felt that they usually receive sufficient information about the prices of medicines and 61% about the reimbursement of medicines when buying prescription medicines from a pharmacy. Less than half (47%) of respondents felt that they have usually received sufficient information about how the amount of reimbursement for medicines is determined. Slightly over 70% of respondents said that they are usually told about the cheapest medicine available when buying a prescription medicine and/or are suggested to switch to a cheaper one. About 60% were usually told about the difference between the two interchangeable medicines. 88% of respondents would seek information about medicine reimbursement primarily from a pharmacy or pharmacy´s online services. About 3% of all respondents in the study had not bought a medicine prescribed by a doctor for financial reasons in the last six months. Based on the study, about a third of medicine users have remained unclear regarding medicine reimbursements, and not everyone feels that they have received sufficient counselling and information about medicine prices and medicine reimbursements when buying prescription medicines from a pharmacy. Counselling from a pharmacy was found to be related to understanding of medicine reimbursement criteria. Advise on the pricing, medicine reimbursement and generic substitution should continue to be actively provided to medicine users, so that the counselling meets the requirements of the law and the knowledge of the reimbursement system of medicine users can be improved. Based on the results of this study, counselling should be targeted in particular at younger, low-income and from mental health problems suffering medicine users, as well as those who are less familiar with reimbursement issues, for example due to low morbidity or medicine use.

Individually tailored smoking cessation, SC, service provided by community pharmacies is a chargeable special service for customers motivated to quit smoking. The service is based on the PAS service model developed in Great Britain and it has been provided by Finnish community pharmacies since 2006. It includes 4-6 meetings with a specially trained pharmacist, who provides counselling, support, SC plan and follow-up. In this pilot study, the service was investigated from customers' viewpoint, assessing their SC outcomes and experiences. The pilot study was a cooperation project of Division of Social Pharmacy and Association of Finnish Pharmacies. It was a part of a larger SC project co-ordinated by Pulmonary Association Heli and financed by Ministry of Social Affairs and Health. This pilot study assessed the feasibility of the service from customer's viewpoint. It assessed weather the service could increase customers' ability to stay abstinent in different phases of the service. Customers' experiences in relation to SC service and SC itself were also assessed. 14 voluntary pharmacies in different geographical locations in Finland participated in this intervention study and they recruited altogether 36 customers. Before customer recruitment pharmacies received education and introduction of the SC service provided by the Association of Finnish Pharmacies. As part of study protocol, the pharmacies informed local healthcare professionals about the pilot study and asked them to send suitable customers to the service. Pharmacies were paid an expert reward for each customer and they were able to provide SC service to the customers either free or with a low charge. Customers' smoking status and experiences about SC service were assessed with two enquiry forms, which they had filled at the beginning of the service and after three months they had started the service. Their background information was collected with specific background forms during the first meeting and their progress in SC service was investigated by service progress forms. 20 of the 28 customers who returned the first enquiry form and 13 of the 17 customers who returned the second enquiry form were abstinent (55,6 % and 36,1 % of all customers, respectively). All the quitters used some pharmaceutical treatment. Customers who quitted assessed their ability to stay abstinent higher than those who were unable to quit, at the outset and during the service. The customers considered service useful and support of the pharmacist was found important. The customers also considered it significant for pharmacies to provide the SC service. Approximately 32 % of the customers who returned the first enquiry form and 41 % who returned the second enquiry form would pay for the service. They would pay 45 € on average (10-100 €). Multidisciplinary service model was not working as expected, since only a small number of customers were recruited by other healthcare professionals. As a result some of the pharmacies recruited customers also from the pharmacy counter without any contact to other healthcare. 36 % of the 36 customers were abstinent at three months. The control group, planned for the pilot study, failed in recruitment and thus we can only compare our findings to other international studies of the SC service, which have provided similar results. Individually tailored SC service provided by pharmacies is suitable SC support for motivated customers. Customers considered service important and useful, but poor willingness to pay creates challenges for pharmacies to provide this kind of service.