Pharmacy profession: challenges ahead

Dr Nitul Sarmah

(The writer is Deputy Director of Medical Education, Assam. He can be reached at drnitulsarma@gmail.com)

L ooking back over the past century, it is clear that medical science has made breathtaking advances in combating life threatening diseases. This is shown, for instance, by the fact that life expectancy has risen enormously to around 80 years, compared with 55 in the late nineteenth/early twentieth century. Pharma industry in India is playing a vital role in the healthcare area of the nation. The Indian pharmaceutical industry currently tops the chart amongst India's science-based industries with wide ranging capabilities in the complex field of drug manufacture. Almost every type of medicine is now made in the Indian pharmaceutical industry. More so, the Indian pharmaceutical industry is a success story providing employment opportunities to millions and putting their act together to tap the generic drugs markets in the regulated high margin markets of the developed countries. India is today the world's fourth largest producer of drug formulations and thirteenth in terms of total turnover of medicines. The generic drug market is growing at the rate of 12 per cent per annum. However, despite the enormous progress that has been made by Pharmaceutical Industry, developing a new drug is still a major challenge in our country. It is a fact that, the pharmaceutical industry is a knowledge driven industry and is heavily dependent on research and development (R&D) for new products and growth. Basic research (discovering new drug molecules) being a time consuming and expensive process and is thus, dominated by large global multinationals.

During the last few decades, since Drugs and Cosmetics Act 1940 and Pharmacy Act 1948 were enacted, pharmacy profession of India has been subjected to many reforms and developments. Pharmacy profession is responsible for the appropriate use of medication, devices and services to achieve optimal therapeutic outcomes to combat these complexities. Pharmacists are those who are educated and licensed to dispense drugs, to provide drug information and are experts in handling of medication.

There was a time when pharmacist had to make various preparations like mixtures, ointments, pills, tinctures, syrups, elixirs, powders, etc. in their pharmacy, based on prescriptions given by physicians. They packed them suitably, labeled and dispensed them along with appropriate advice. But the situation now has changed; the compounding has been largely replaced by the ready to use products prepared by commercial manufacturers. The pharmacist's role now has changed globally from that of compounder and dispenser to one of "drug therapy manager". The pharmacy profession now has exciting opportunities, as well as challenges. Pharmacists with their knowledge and expertise can help in production, distribution, storage and dispensing of quality medicines. In the coming years, there will be an increasing demand for qualified pharmacists in all sectors, namely research (Research and development (R&D), quality control (QC), quality assurance(QA), regulatory affairs, manufacturing, marketing, clinical, community, academics, etc. both in our country as well as across the world.

Pharmacy education which was introduced in India in 1937 by Prof MM Malaviya and Prof ML Schroff in BHU has undergone dramatic changes over the past few decades. But it has not yet attained the desired level in terms of standards, innovation/ production of drugs at affordable price to the common people. Pharmacy education in India is largely industry oriented and hence Indian pharmaceutical industry with its tremendous growth capacity has several job opportunities. The primary purpose of pharmacy education is to develop technical human resources, novel approach and vision with respect to teaching, research and development (R&D) and training future health care professionals in the field of drugs and pharmaceuticals. The role of pharmacist is highly significant in the sustainable growth in pharma industry as well as health care system. The country should see that future pharmacists are given appropriate education and relevant training to make them fit to meet the challenges.

Although, considering the increasing responsibilities of pharmacy profession, the minimum qualification needed for a practicing pharmacist was upgraded from that of a certificate course (compounder) to a diploma in pharmacy by Pharmacy Council of India (PCI), Indian pharmacists are yet to assert themselves due to lack of up-to-date knowledge and compelled to realize that diploma as the minimum qualification with minimal or no training are negative factors for their image. The students are required to be trained in practical skills to confidently face the challenges of clinical and hospital pharmacy on one hand and industrial pharmacy/ pharmaceutical technology on the other. It is felt that lack of focus on quality of service is causing much harm for the professional growth of Indian pharmacist and health care professional. It is a fact that, when appropriate skills and knowledge are not present, delivery cannot be effective in any field. It is a demand of time that the practice of earning a diploma in pharmacy as the minimum requirement to be a registered pharmacist should be discontinued and all the students should be compulsorily made to earn a four-year B Pharm degree course. Such a move can bring in the dignity and equity to pharmacy profession at par with others.

Considering the rapid expansion of medication use and change of portfolios in pharmacy profession, time has come for pharmacy education and it's professionals in India to redefine its future goals. Of late, the Government of India has taken keen interest to grow Pharma education and Research by establishing a number of higher Institutions of national importance namely National Institute of Pharmaceutical Education & Research (NIPER) across the country, that also includes Assam. These institutions have an important role to play in creation of a disciplined cadre of professional pharmacists in the country and will be the epicenters of knowledge creation, knowledge storage and knowledge dissemination in pharmaceutical sciences.

It is a matter of concern that, despite a lion share of generic medicine manufactured by Indian Pharmaceutical industries, a majority of our population does not have regular access to essential medicines at affordable price, Further, developing new drug molecules is still a major challenge for the Indian pharma sector. Rising cost of healthcare, increasing disease burden (both communicable and now non communicable) and advent of new diseases, irrational use of medicines, floating of spurious and substandard medicines in the market as well as in Government hospitals, non-availability of health care providers in sufficient number especially in rural areas are all challenges that have to be overcome. As we are moving towards globalization, there is a need for strategic planning to meet the challenges posed by the modern era. Further, the number and complexity of prescription filled each year increases, the cost associated with medication misuse also increases. Thus, there is a strong need of the health care providers, particularly Pharma professionals, to take care of these complexities.