Belgians are among the top five consumers of medicines in Europe, with more than 55% of the population over the age of 15 consuming at least one prescription medication for a period of two weeks in 2019.
To try to reverse the trend, as of April 1, pharmacists will be able to establish free medication plans for their clients who routinely take more than five prescription medications. The objective of this measure, introduced by Federal Minister of Health Frank Vandenbroucke, is to reduce the consumption of pharmaceutical products.
In concrete terms, a patient taking more than five prescription medications who has questions about the number of different capsules, their use or their combination, can ask their pharmacist for an opinion. This will make it possible to take stock of their consumption, perhaps to identify harmful mixtures, or even to replace some drugs with other more effective formulas or even to eliminate some unnecessary tablets.
Any action plan put in place by a pharmacist will be done so in close collaboration with a patient's doctor. In other words, the pharmacist cannot prescribe a drug or change a prescription but must consult the client’s attending physician as soon as a question is asked.
Welcomed by pharmacists
"The advantage of the pharmacist is that they know the drugs and have an overview that maybe the doctor does not really have," Vandenbroucke told RTBF. "This could be because a person has maybe had prescriptions from different doctors or maybe the situation has changed or there are possible alternatives."
"Drugs are necessary but consuming too much, or making mixtures, can affect their effectiveness and sometimes even pose a risk to health," the minister continued. "Some people need to be hospitalised because of misuse. You have to take the right dose and combine them correctly with other medications."
Pharmacists have welcomed the decision, and many say that the new measure is a sign of trust and appreciation for the profession. Rather than being just salespersons, the new measure highlights the knowledge and training the pharmacists need when dealing with medications and the needs of clients.
Pushback from doctors
Doctors, on the whole, are also supportive. But Luc Herry, Vice-President of Absym, the Belgian Association of Medical Unions, has raised some questions: "What about the patient's right? He is free to see several doctors and does not always agree that his personal data circulates," Dr Herry told RTBF. "The pharmacist must inform his client that, as a referee, he has access to all his data. If the patient agrees, no problem."
Another grey area, according to Absym is how the sharing of information will be implemented between pharmacists and doctors when apparently there is an incompatibility between the systems they use. "This will not work," said Dr Herry. "Using mail or the telephone as the only means of communication could make the new action plan incredibly tedious."
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"It's going to take time too,” he added. “And time is money. The pharmacist will be paid for the work done but there is nothing for the doctors. We will have to work on a voluntary basis. This is a fundamental oversight of this measure for both general practitioners and specialists."
The measure has been allocated nearly €3 million to be paid out to pharmacists for their extra work, approximately €95 (VAT included) per patient.
