Bangladesh is an over populated country. Almost 180 million people live in this country. So there is a huge number of pharmacy or medicine shop in this country. Previously we don't have enough graduate pharmacist. That's why our government train some people as "C grade" pharmacist to maintain the medicine shop. But now-a-days we have many graduate pharmacist from both public and private universities. Now our government try to implement the ideal properties of a pharmacy. The model pharmacy initiative is this type of project.
Definition of Model Pharmacy
Model pharmacy is a community-based pharmacy, where pharmacists are responsible for checking and dispering of prescribed and non-prescribed drugs, providing advise on drug selection, counseling patients, giving extraordinary care to the patients.
Model Pharmacy Related Organization
There is an organization called Management Sciences for Health (MSH). It is a nongovernment, nonprofit international health organization. It works shoulder-to-shoulder with countries and communities to save lives and improve the health of the world’s poorest and most vulnerable people by building strong, resilient, sustainable health systems. They provide the concept of model pharmacy to Bangladesh government. In 2016, Directorate General of Drug Administration (DGDA), Pharmacy Council of Bangladesh (PCB) and Ministry of Health and family Walfare started work to establish model pharmacy. This project is named as "The Bangladesh Pharmacy Model Initiative."Number of Model Pharmacy in Bangladesh:
22 December, 2016 → 30
7 March, 2018 → 193
2021 → 450
April, 2022 → 672
Problem in our existing pharmacy
1. Unnecessary use of antibiotics.
2. Problem in storage of medicine
3. Selling drugs without Prescription
4. Selling counterfere counterfeit drugs
5. No patient counselling.
Importance of model pharmacy
The problem in our existing pharmacy is the importance of model pharmacy. Some of them are mentioned here:
1. Stop selling drug without prescription.
2. Proper storage of medicine.
3. Reduce unnecessary use of antibiotics.
4. Reduce to sell fake drug.
5. Misuse of drugs can be reduced.
6. Ensurce affordable medicine.
7. Provide information about drugs.
8. Counceling by "A greade" pharmacist.
9. Increasing job opportunity for pharmacist.
Category of Model Pharmacy
There are two category in Bangladesh Pharmacy Model Initiative. They are:
Model Pharmacy (Level 1): This level of service will be provided, managed or supervised by an "A grade" pharmacist, who is present on the premises. B or C grade pharmacist may assist with despenning.
Model Medicine Shop (Level 2): This level of service will be carried out, at a minimum, by a person with "C grade" qualification.
Guidelines for Model Pharmacy
1. A model pharmacy should have a minimum 300 square feet space with at least 8 feet height.
2. All pharmacist must complete their training and register with the Pharmacy Council of Bangladesh before selling medicine.
3. A model pharmacy service (Level 1) must be managed or supervised by an "A grade" pharmacist, who will have to be present on the premises to sell the prescribed drug. Several B and C grade pharmacist may assist.
4. Model medicine shop (Level 2) service must be carried out at a minimum "C grade" pharmacist.
5. They can not sell medicines distributed by the government free of charge.
6. Medicines without registration and sample medicines handed out to physicians cannot be sell.
7. A model pharmacy should have a minimum 300 square feet space with at least 8 feet height.
8. It should also have an adequate air conditioning system so that ambient temperature does not exceed 30° C.
9. A model pharmacy must have at least one refrigerator that is large enough to store temperature-sensitive medicines.
10. A model pharmacy must not sell any medicine without prescription, excluding the 39 medicines listed in the National Drug Policy.
11. Food items can not be kept in the store.
12. The guidelines also recommend that the shop has a backup power supply, such as generator.
13. Maintain record of all medicines dispensed in a registrare.
14. No damaged, counterfeit, substandard or expired medicines are dispensed.
15. Must maintain DGDA recommended maximum retail price (MRP).
Allowable Products in Model Pharmacy
The allowable products in model pharmacy are: Prescription-only Medicines, Non-prescription/ OTC Medicines, Alternative Medicines, Medical Supplies and Devices, Non-pharmaceutical Products. They are briefly discussed below:
Prescription-only Medicines: Model pharmacies are allowed to stock and sell all prescription-only medicines registered by DGDA.
Non-prescription/ OTC Medicines: Model pharmacies will be allowed to stock and sell all non-prescription/OTC medicines registered by DGDA.
Alternative Medicines: DGDA approved traditional/alternative medicines such as Ayurvedic, Unani medicine may be stored and sold. But they must be stocked seperately from therapeutic products with distinct signage such as "Treaditional/Alternative Medicines."
Medical Supplies and Devices: Model pharmacies allowed to stock and sell medical supplies and devices, if they meet DGDA established quality standards. All medical supplies and devices will be stocked separately from therapeutic products with distinct signage such as "Medical Supplies and Devices."
Non-pharmaceutical Products: Model pharmacies allowed to store and sell cosmetics and other hygiene and health promoting products. They are stocked seperately from therapeutic products with distinct signage such as "Non-pharmaceutical Products."
Health Services Center
Model pharmacy is not a place where we can buy medicines. It is a complete health service centre. From model pharmacy we can take this services:
→ Blood pressure monitoring
→ Sugar level test
→ Body temperature
→ Body weight
→ Nebulization
→ Rapid diagnostic test for malaria
→ Test for pregnancy
Requirement for accredited model pharmacy
Owner
a. Have a Bangladeshi NID
b. Have a TIN
c. Have a trade license
d. Pharmacy Council approved business training course and pass the post course examination.
Technical Personnel
All A, B or C grade pharmaceutical personnel working in the model pharmacy must undergo a PCB approved 30 houre orientation (A and B grade) or 80 houre dispensing training course (C grade).
Supervision of Model Pharmacy
→ A grade pharmacist registered by PCB.
→ Have one week pharmacy council approved orientation training.
Contract between Model Pharmacy Owner and pharmacist
Every model pharmacy owner and pharmacist-in-charge must sign a legally binding contract.
Premises
1. Permanent structure
2. Leakage free root and ceiling
3. Customer waiting space
4. Minimum 300 square feet space with at least 8 feet height
5. Electricity and backup powere supply
6. A "No Smoking" sign
7. A sign indicating operating hour
8. Pharmacy grade refrigerator
9. Adequate air conditioner (AC) so that ambient temperature does not exceed 30°C.
10. Thermometer to monitor room temperature
11. Electronic alarm system or CCTV security camera
12. A purchase record book must be maintained.
13. Labeling of dispensed medicine in local language must be done.
14. Storage will be a separate place within the professional service area with no public access.
15. Regular general cleaning schedule must maintained
16. Record of all medicines dispensed shall be maintained in a registrar approved by DGDA.
17. Damaged or expired medicine shall be recorded, sealed, quarantined and labeled with the statement in red ink "Expired/damaged medicines - Not for sale."
Design of a model pharmacy
Dispensing area, counseling area, prescription drop off and collection point, OTC and preserption only medicine storage area.
Model Pharmacy in University
In April, 2018; North South University take the initiative to establish a model pharmacy in there university campus. It is the first among public & private universities. It was that time when our government try to advertise and encourage people about model pharmacy. So the family and health welfare minister Md. Nasim, DGDA Major General Md. Mustafizur Rahman and many other higher official of Bangladesh government was present in that opening ceremony.
In December, 2022; Rajshahi University announce to open a model pharmacy in there university campus. It is the first public university which take initiative to open a model pharmacy. This pharmacy will be supervised by the department of pharmacy. It will give 24 hour service. Rajshahi University pharmacy department is one of the renowned department in Bangladesh. There students can gain practical experience of model pharmacy from this.
Target Audience of Model Pharmacy
1. Primary Audience: Consumers of medicines and potential consumers (mass people).
2. Secondary Audience: Medicine sellers and medicine shop owners both from rural and urban.
3. Tertiary Audience: Stakeholders at 3 levels such as: Central, District and Upzillas.
Responsibilities of a pharmacist in model pharmacy
Review prescriptions: Pharmacists review prescriptions before dispensing medications to patients. This ensure patients get the right drugs for their health condition.
Ensure health and safety: These profesional make sure they are dispensing the correct medications by reviewing each patient's medication history. They also ensure that the prescription are up-to-date by making sure the patient has visited a doctor recently. This is essential to the health and safety of patients.
Communicate with prescribers: Pharmacists communicate with the prescribers if there is any problem in the prescription. They discuss with doctors about alternative medicines, change in dosage, drug-drug interaction etc. This helps to ensure that the prescribed drugs do not cause adverse reactions.
Counseling patients: Pharmacists advise patients on when and how to take their medications, potentially harmful reactions between drugs and food or all alchol, recommend taking non prescription drugs, potential side effects of the drugs etc.
Perform administrative tasks: Pharmacists also perform a wide range of administrative tasks, such as maintaining patient records, stocking medicine, ensure quality, security and proper disposal of pharmaceuticals by packaging and labelling procedures in compliance with health care policies and regulation.
Current Seenario of Model Pharmacy
→ selling medicine at higher cost
→ selling antibiotic without full course
→ selling drugs without prescription
→ no pharmacy grade refrigerator or refrigerator with no electrocity connection
→ no "A grade" pharmacist available
→ no counseling /explanation service
→ selling other food products
→ misuse of "model pharmacy" logo
Future prospects of model pharmacy
In future, it will provide:
Patient care
Drug information
Safety and quality
Profesionalism and ethics
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