There may never be another medicine like it. That’s because of fundamental shifts in our understanding of biology, because of the demands made by patients, doctors, and society on new drugs, and because new drugs now have to compete with the super-cheap, generic versions of every medicine ever invented. Already, eight of ten prescriptions are for generics, and the drug industry is focusing on higher priced, specialty products for patients who are not helped by existing options. Good luck creating a new cholesterol drug as potent, safe for most people, and widely tested as Lipitor.

Thanks to aggressive marketing and pricing tactics by Pfizer, Lipitor will remain a big seller for years even as sales drop. Les Funtleyder, a fund manager at Miller, Tabak, says that the the stock, which his fund holds, could perform well partly because Lipitor sales may decline more slowly than investors expect, allowing Pfizer to beat earnings expectations. In fact, Pfizer probably has more to gain in the short term by controlling Lipitor’s descent than it does from any of several experimental drug programs, including a pill for rheumatoid arthritis and the use of its Prevnar 13 pneumonia vaccine in adults, that could show results in the next year. Because Lipitor is that big.

It’s hard to remember now, but Lipitor was introduced at a time before big drug safety scandals such as  Merck‘s Vioxx being linked to heart attacks or worries that antidepressants like Paxil and Zoloft might increase the risk of suicide in some patients. It was a time when Jay Leno routinely joked about Viagra – not a terribly big seller, but one of the biggest drug launches in history – and writer Elizabeth Wurtzel made the talk show rounds talking about her Prozac. It really did seem there would soon be a pill for everything and anything, and cholesterol drugs were the era’s biggest success.

A 1994 study with Merck’s cholesterol drug Zocor proved cholesterol-lowering meds could prevent death – to be specific, four deaths and seven non-fatal heart attacks were prevented for every 100 patients who took the medicine for six years. A study of Pravachol, from Bristol-Myers Squibb, showed similar benefits. When it was introduced in 1996, Lipitor didn’t have any such study proving its worth, but it was way more powerful than those drugs. It instantly grabbed market share, and then Pfizer followed up by running a series of giant clinical trials, some of the biggest ever, in order to get more patients on cholesterol drugs and prove that Lipitor was the best option. Pfizer also got a big boost from a backfiring Bristol study that showed high-dose Lipitor was better than Pravachol in some of the sickest heart patients.

Something like 20 million Americans take cholesterol-lowering drugs, and before Zocor went generic in 2006 more than half of them were on Lipitor. But all those huge, market-expanding clinical trials came with a cost. As heart patients got healthier because of better treatment, and Pfizer sought to expand the cholesterol market by testing patients who were healthier still, the absolute benefit that needed to be shown got smaller. For instance, in one big clinical trial, 100 patients had to be treated to prevent one heart attack. It’s not that the drugs stopped working, but that patients got healthier.

You can argue that it’s still worth taking Lipitor, especially at cheap generic prices, because heart attacks, the leading killer in the developed world, are a lifelong problem and clinical trials only last for a few years. But there’s no arguing that doctors are starting to rebel against the idea of treating everybody with the same pill for years in order to get a small benefit for the average patient. Why not, many say, insist that drug companies find the patients who do great on a medicine, so people who don’t benefit don’t have to take it?

One prominent voice in this changeover is Eric J. Topol of the Scripps Research Institute, who helped establish the one-pill-for-everyone ethos a decade ago by running some of the biggest clinical trials ever, including one of Plavix, a blood thinner that, like Lipitor, prevents heart attacks. It is the second-best-selling drug in the world, with sales of $9 billion, and its U.S. patent expires in 2012, posing Lipitor-like problems to makers Sanofi-Aventis and partner Bristol-Myers.

In a forthcoming book, The Creative Destruction of Medicine, Topol remembers being in the room in an extravagant Paris hotel when he first saw the results of a study comparing Plavix, a $4 a day drug, with aspirin. “The answer was, to my mind, quite disappointing,” he writes. Two patients out of every 100 benefited. That helped launch Plavix to success, but Topol has lately been pushing new work in genetics to help figure out which patients are helped most by a particular drug and electronic health records to track how well medicines are working in the real world. The current, one-size-for-all system just cannot hold, he says.

To see how big this change is for drug companies, you only have to look at the reception to a new drug that was just found to be better when added to Plavix than Plavix alone. The medicine, Xarelto, is expected to become a multi-billion dollar seller for Bayer and marketing partner Johnson & Johnson. It’s one of a class of new blood thinners, called Factor X inhibitors, that are expected to replace the old blood thinner warfarin for many patients with heart valve problems.

But Xarelto is the only one of these drugs that succeeded in a clinical trial to best Plavix in heart patients, and you’d be forgiven for thinking that would mean it would be a Plavix-like success. The drug actually managed to save lives in its large trial, reducing the risk of death by an impressive 30%, despite increasing the risk of major bleeding. One of several Harvard-based physicians who ran the study, C. Michael Gibson, compared the findings for Xarelto to the findings with aspirin. Another, Eugene Braunwald, compared it to Lipitor beating out Bristol’s Pravachol, a study which his research group had also run.

A more revealing statement, though, came from Jessica Mega, another Harvard Medical School-based researcher who helped run the trial. She too argued that the mortality benefit was “hard to ignore,” but also said that part of the reason Xarelto is important is because it provides a new option as we start to better understand how the blood-clotting process goes wrong to cause heart attacks.

“Patients probably have heart attacks for a lot of different reasons,” Mega says. “The more we understand about the biology, the more we’re going to be able to give the patient options.” This is actually the flip side of the main argument against Xarelto, as made by Paul Gurbel of the Sinai Center for Thrombosis Research: that the bleeding rate is too high, and that doctors need a way to test which patients need their blood thinned more and which don’t. Whoever you side with, one-size-fits-all is on its way out.

Analyst Larry Biegelsen of Wells Fargo Securities estimates that there if every patient who could got Xarelto, it would be worth $2.1 billion a year to Bayer and J&J, essentially doubling the drug’s market opportunity. But he thinks that only 10% to 20% of those patients will get the drug – about $300 million of extra sales. Not a Lipitor. Not a Plavix.

That’s why the drugs with the biggest sales forecasts – medicines like Abbott’s Humira for rheumatoid arthritis or Roche’s Rituxan for cancer – are expensive, targeted at less common diseases. Without more Lipitors, the best hope for more progress against common diseases is that new technologies for understanding biology and genetics also make it easier, faster, and cheaper to develop new medicines.

Given the stakes, it should be no surprise that Pfizer is doing everything it can to slow Lipitor’s decline. The efforts started a year ago with a new coupon card that brings the patient’s share of Lipitor costs down to $4, less than a generic. (See: How Bargain Lipitor Could Raise Health Costs) Pfizer has also cut deals with the jobs.pharmacy-bg.com/”title=”pharmacy” >pharmacy-benefit managers to decrease cost to health plans, and even set up its own retail outfits. A web site called LipitorForYou will help patients stay on the brand. Pfizer says its research says a third of people don’t want to switch to generics, even though generics have an excellent track record for safety and efficacy thanks to the FDA’s regulation.

These steps work because only two companies – India’s Ranbaxy and Watson Pharmaceuticals – can make generics for the first six months after the patent expires. Ranbaxy challenged Pfizer’s patent and reached a deal with the drug giant, and Watson has a license from Pfizer. Ranbaxy does not yet have FDA approval for its copy. Watson will pay a 70% royalty to Pfizer, according to Sanford C. Bernstein. This three-way competition will drop Lipitor’s price 20% to 30%. After that, dozens of generic companies will make copies in the U.S., and competition could push Lipitor’s $5-per-pill price well below $1.

Even after cheap generics abound in the U.S., Lipitor will persist, selling more than $1 billion a year in countries where there is not an arbiter like the FDA to make sure generics are safe enough to substitute for brand names. For instance, in South Korea, the price of Lipitor dropped 20% when generics were introduced, but sales are already recovering because more Lipitor is being sold there. So Lipitor will hang around a bit, even though the economic and scientific environment that created it is gone – perhaps forever.

Forbes

Lipitor – Why There Will Never Be Another Drug Like Lipitor is a post from: Pharmacy in jobs, news, schools

Good news! You learn that today, November 30, 2011, a generic version of Lipitor® is going on sale for the first time. You have been using Lipitor® as an adjunct to your diet to reduce your cholesterol, So you run down to the pharmacy and ask to have the generic atorvastatin, at a fraction of the price you have been paying for Lipitor®, the world’s top selling drug made by Pfizer.

What happens? There’s a good chance you’ll be told by the pharmacist that generic atorvastatin is “not available” but brand-name Lipitor® is.

Why?

As Paul Bisaro, President and Chief Executive Officer of Watson Pharmaceuticals [WPI], the maker of generic atorvastatin, explained on CNBC’s Squawkbox this morning:  “What’s happening now is that Pfizer is blocking the ability of the pharmacists to dispense the generic. They can only dispense the Pfizer product. When the pharmacist takes the script and punches in the code and your health insurance number, it says that he can only dispense this brand drug.”

Restraint of trade?

Larry Bossidy, who happened to be on the CNBC set also and who has served on the board of Merck asked, “Isn’t that restraint of trade?”

Declining to answer that particular question, Bisaro said:”The pharmacy benefit managers (PBMs) are an area where [the brand manufacturer] can easily attack the situation, because  they can control the script.

“The thing that bothers me is confusion in the marketplace. We have told people that generics lower the cost of health care. That’s the way people should move. 80 percent of scripts today are filled with generics. That’s good for America. We saved a trillion dollars over the last ten years using generics. Unfortunately what’s happening now is that people are being told that they can’t even get the generic even though they know it is available, because the brand is being sold a lower price than the generic. We don’t need that confusion in the marketplace.“

A concerted effort to block generics

For those who follow developments in big pharma, the blocking of the generic Lipitor® doesn’t exactly come as a surprise. Earlier this month, the top pharmacy benefit managers (PBMs) announced plans to deny reimbursements for the less expensive generic. The move reflects Merck’s success in using rebates to PBMs to continue offering exclusively the more expensive brand drug.

Under the guise of “continued access to affordable prescription drug benefits,” PBMs like Medco Health Solutions [MHS], CatalystRx and Medimpact say they will–at least for now–lower Lipitor co-payments to the price of a generic and reject claims for Atorvastatin, Lipitor’s new generic equivalent.

While on the surface the move looks like a price match, leaders from the PBM watchdog organization Pharmacists United for Truth and Transparency (PUTT) say PBMs have merely disguised their true intent. “While the Lipitor® co-pay will drop on November 30th, plan sponsors will stay the same.”

“Plan sponsors are employers, Medicare Part D patients and taxpayers. PBMs are multi-billion dollar corporations pulling money out of the economy when Main Street needs it most,” said Dr. Kenneth Fields, CEO of ApproRx.

“That means plan sponsors will be forced to pay more for brand Lipitor even though a low cost generic is available,” said Dave Marley, a pharmacist and spokesman for PUTT, who estimates plan sponsors will pay $35 more per prescription for Lipitor® than they would for generic Atorvastatin. “Roughly 70 million Lipitor prescriptions were filled last year. Plan sponsors need to evaluate their contracts to see how much, if any, of the Lipitor rebate money they receive. It is unlikely they will receive any of it.”

A widespread practice

“The Lipitor® case is not rare,” said Fields. “Imagine how many jobs employers could create if they weren’t being fleeced by the PBMs.”

In one instance, an insurance company (Blue Cross/Blue Shield of Texas) is said to have refused to recognize the generic equivalent of Concerta (Methylphenidate ER) as a generic.  Watson Pharmaceutical released the generic form on May 2, 2011. Therefore, the patient is paying $60 for the brand name Concerta rather than $10 for the generic.  The decision is being appealed.

In another instance, customers cannot receive generic Adderall XR. The plan requires use of the brand name drug. The customers believe that there is rebating to the PBM, leaving them with higher copays for the brand name.

In yet another instance, a patient used the brand name eyedrop drug Xalatan for several years.  There was no generic, and she paid a premium price for the drug.  A year or so ago a generic for this drug became available – Latanoprost. She was thrilled, since the cost for the generic was much lower. She recently received the 2012 formulary for our Medicare Advantage plan with Anthem Blue Cross, and were surprised to see that Latanoprost will be a “brand name” drug in 2012 and she will again be required to pay a premium price. When she called Anthem she was told that only a small number of manufacturers are producing this drug (perhaps two), and that the manufacturers are therefore able to set the price.

Ending drug companies’ pay-for-delay deals

On October 24, 2011, the Washington Post said that an upcoming report by the Federal Trade Commission will show that brand-name pharmaceutical makers continue to cut questionable deals with generic manufacturers that delay the introduction of cheaper drugs onto the market.

“Such pay-for-delay arrangements hurt consumers and increase costs for federal programs such as Medicare and Medicaid, according to the report, a copy of which was obtained by the editorial board,”  writes the Post. “These deals are not illegal, but they should be.”

These deals should also give pause to those who believe, like David Brooks who wrote in the New York Times that handing over Medicare to the private sector will “unleash a wave of innovation”. Unfortunately the “wave of innovation” that will be unleashed is rather more likely to benefit the insurance companies and big pharma than it is to benefit patients.

Fixing the big pharma

Fixing these special deals between big pharma and the PBMs by making them illegal is relatively simple.

Fixing big pharma is something else. The fact is that these deals are merely a symptom of a wider problem in which the focus of big pharma is on making short-term profits, rather delivering real value to their customers.

Just as at Apple [AAPL] before Steve Jobs’s return in 1997, big pharma is being driven by the sales and marketing men. As at Apple, that is not a particularly profitable game over the long haul. Intelligent investors should take a look at the ten-year share price of Pfizer, as well as its competitors, Merck [MRK] and GSK [GSK].

This is not to say that big pharma cannot, like Apple, emerge from its death spiral by shifting its focus from short-term profits to delighting the customer. It’s not rocket science. It’s called radical management.

Pfizer’s Lipitor: How Big Pharma Blocks Reimbursement Of Generics is a post from: Pharmacy in jobs, news, schools

Ranbaxy Laboratories Ltd. (RBXY)’s copy of the $10.7 billion Lipitor cholesterol pill was released in the U.S., sending its share up the most in six months and threatening sales for Pfizer Inc. (PFE)

Ranbaxy, India’s biggest drugmaker, won approval to sell generic versions of the world’s top-selling medicine by the Food and Drug Administration yesterday. The company, based near New Delhi, will share profit on the first six months’ sales with Israel’s Teva Pharmaceutical Industries Ltd. (TEVA), Ranbaxy said today, adding that terms of the agreement won’t be disclosed.

Ranbaxy sought to persuade the FDA that its copies are equivalent to the original and that approval shouldn’t be thwarted by an ongoing dispute about plant violations in India. The FDA approval was for products made at a plant in New Jersey which may have been contingent on a deal with Teva, said Bino Pathiparampil, a health-care analyst at IIFL Ltd. in Mumbai.

“It could well be that the Lipitor ingredients could come from Teva,” Pathiparampil said in an interview. In that scenario, “Ranbaxy will assemble the drug at their factory in New Jersey.”

Spokesmen at Ranbaxy and Teva declined to elaborate on today’s statement.

The Indian drugmaker, 64 percent-owned by Daiichi Sankyo Co., surged as much as 11 percent in Mumbai trading. The shares traded 4.7 percent higher at 454.85 rupees, the most since May 30, at 11:22 a.m. local time, while the BSE India Sensitive Index gained 2.8 percent.

Daiichi Sankyo (4568) increased 2.1 percent to 1,402 yen in Tokyo trading at 2:53 p.m. local time. A spokesman for the Tokyo-based company declined to comment on the agreement between Teva and Rabaxy, as well as on the impact on earnings of sales of generic Lipitor sales.

‘Simply Relieved’

“The market is simply relieved to hear that the drug is approved,” said Yasuhiro Nakazawa, a health-care analyst at SMBC Nikko Securities Inc. in Tokyo.

Copycat Lipitor may generate as much as $650 million for Ranbaxy in its first 180 days of sale, according to the median estimate of five Mumbai-based analysts surveyed by Bloomberg.

“This medication is widely used by people who must manage their high cholesterol over time, so it is important to have affordable treatment options,” Janet Woodcock, director of the FDA’s Center for Drug Evaluation and Research, said in a statement released late yesterday in Washington.

Ranbaxy may have sought a marketing deal with Petach Tikva, Israel-based Teva in case it didn’t win timely approval, said Priti Arora, an analyst at Kotak Institutional Securities in Mumbai.

‘Backup Measure’

“There is something more in this deal than meets the eye,” Arora said in a telephone interview. “My feeling is that they allied with Teva as a backup measure in case approval was held back due to its manufacturing issues.”

Teva said on Nov. 2 that if it manages to introduce an “important undisclosed product” in the fourth quarter, it would meet the upper range of its forecast of earnings excluding some costs of $4.92 to $5.02 a share this year. Sanford C. Bernstein & Co. analysts speculated in a report last month that the new product “is ostensibly Lipitor.”

Pfizer’s medicine lost patent protection in the U.S. yesterday. Watson Pharmaceuticals Inc. (WPI) began selling a copy of Lipitor in the U.S. yesterday under an agreement with New York- based Pfizer, the world’s largest drugmaker. Watson’s version didn’t require FDA clearance because Pfizer is providing the drug to sell without the brand label in return for a share of the revenue.

Limited Competition

As the first generic to challenge Pfizer’s patent, Ranbaxy is allowed six months before other generic versions can come on the market under a 1984 law.

Mylan Inc. of Canonsburg, Pennsylvania; Teva; and Dr. Reddy’s Laboratories Ltd. of Hyderabad, India, are among generic-drug makers seeking FDA approval to sell Lipitor copies after Ranbaxy’s six-month exclusivity expires, according to U.S. court filings.

The U.S. enforcement actions against Ranbaxy, India’s biggest drugmaker, began in 2008 when the FDA cited manufacturing defects at two of the company’s plants in India and subsequently barred the company from importing about 30 different drugs. The following year, the agency said one of those plants, in Paonta Sahib, India, falsified data used in drug applications.

No Settlement

U.S. prosecutors had been negotiating a dispute settlement that may cost Ranbaxy more than $1 billion, Fortune Magazine reported in May, without saying where it go the information. There was no mention of a settlement in the FDA’s statement yesterday.

Making generic Lipitor in the U.S. instead of India will reduce the amount of profit Ranbaxy makes on each dollar of sales, Kotak’s Arora said.

“Margins for manufacturing in the India are around 60 percent compared to about 40 percent from the U.S.,” she said. The brokerage had estimated Ranbaxy would generate $560 million in generic-Lipitor sales during the six months of exclusivity.

“We will have to revise our estimates because of this and the Teva deal,” Arora said.

Pfizer Deals

Pfizer has struck deals with companies including Catalyst Health Solutions Inc. (CHSI) and Coventry Health Care Inc. (CVH) to prevent generic Lipitor from reaching some patients until the end of May 2012, according to documents obtained by Bloomberg.

Such deals may help Pfizer retain as much as 40 percent of the Lipitor market during the six-month period in which Ranbaxy and Watson will be the only providers of generic versions, Paul Bisaro, Watson’s chief executive officer, said Nov. 9 in a speech at a Credit Suisse health-care conference.

Pfizer also has reached agreements with health insurers to keep as much of the market as possible. UnitedHealth Group Inc. (UNH), the biggest U.S. health insurer by sales, said Nov. 19 it will charge a lower co-pay for Pfizer’s pill than it does for generics for the next six months, taking advantage of a price reduction from the drugmaker.

That will limit the benefit of Ranbaxy’s exclusivity, said SMBC Nikko’s Nakazawa. Ranbaxy’s copy may generate $300 million for the Indian drugmaker next year, adding 10 billion yen ($129 million) to Daiichi Sankyo’s operating profit for the year ending March 2013, he said.

Ranbaxy’s Lipitor Generic Approved by U.S. FDA, Threatening Pfizer Sales is a post from: Pharmacy in jobs, news, schools

Medicines that require counseling and, therefore, may be sold only in pharmacies, subject to the pharmacies. This medication safety should be granted. A prescription is not necessary as long as the drug is prescription.

The simple requirement is governed by Pharmacy Drugs Act § 43. Pharmacy-only medicines are medicines in simple terms, which may be sold only by pharmacy staff. It is part of the pharmacy staff counseling requirement (unless the customer expressly rejects a consultancy).

Such open issues should be submitted to the levy in order to clarify the need for advice. Internet mail-order pharmacies are obliged to carry out this advice in another appropriate manner, for example by e-mail or telephone. This form of consultation may be undertaken by pharmacy staff. Detrimental to the advice in the mail order is that advice is usually only after the express request of the customer uses. Often, the customer, but not at first recognize that a document is needed, as when he demands a remedy that did not fit with his symptoms. For the same reason exists for a self-ban on pharmacy medicines.

Pharmacies obligation wiki Germany medicines is a post from: Pharmacy in jobs, news, schools

Today is subjected to the pharmacy, both as an institution and companies more than ever, numerous statutory provisions such as the Medicines Act, the Pharmacy factory regulations and with the Social Security (Germany). This pushes them into a tight corset that leaves little flexibility for modern business management in terms of price, communication and product policy. Pharmacies should be the main focus of the self of the independent pharmacist counseling of patients, respectively customers. Often, however, advised the politically by continuing legislative changes induced by forced sales and the desire, the best for the customer to do, coexist. The call for open competition among pharmacies with a legitimate product by cheapening the one hand, many see pharmacists associated with the risk of the worse advice and harmful additional consumption of medicines for patients, with the continued existence of the other economic risks.

In order to deal with conflict of interest, was formerly the relative price (ie the percentage markup on the purchase price) of prescription medicines on 1 January 2004 (ie on a Festaufschlag to the purchase price will be added a fixed amount, regardless of the purchase price) converted. Thus the pharmacy in high-cost funds earned as much as to make this cheap and has no economic interest, preferably more expensive drugs. On the other hand, the legislature dropped with the aim of intensifying competition, the shipping ban and the price-fixing and non-prescription, pharmacy medicines (so-called “OTC drug) and loosened the so-called multiple ownership. Since then it has pharmacists allowed to possess up to three branch pharmacies and send in appropriate conditions medicines too. Moreover, many shipping and Internet pharmacies in Germany and in neighboring countries caused, for example in the Netherlands, Switzerland or the Czech Republic.

To protect the health of the population only one authorized pharmacist may own a pharmacy (Fremdbesitzverbot). However, corporations must operate a pharmacy. Otherwise, corporations could in fact force them employed pharmacists to sell certain drugs, even if it was not medically necessary. In recent years, has often been assumed that the German third party and multiple European law is inadmissible. On 19 May 2009 the European Court, however, that not associated with the Fremdbesitzverbot restrictions on freedom are disproportionate and would be consistent with European law. Thus, the minority interest in Germany will be maintained. The judges accepted the argument that countries should adopt appropriate rules, if they deem it necessary for the protection of health.

Legal regulations pharmacy germany wiki is a post from: Pharmacy in jobs, news, schools

Indicator of Pharmacy Germany is a post from: Pharmacy in jobs, news, schools

Modern depiction of a medieval apothecary, Archeon
Pharmacy (presentation of 1508)
The Moors Pharmacy in Bayreuth

The forerunner of the pharmacies were in the 8th and 9 Century spice trader based in the Middle East.

The first “Pharmacies” in Germany were of merchants who drove with herbs and spices trade, as a kind of run grocery store.

Around 1241 was adopted by the Hohenstaufen Emperor Frederick II, the “Edict of Salerno” (also called “Constitutions” or Medizinalordnung): the first legally fixed separation of the professions of doctor and pharmacist. Doctors could not own pharmacy or be involved. Drug prices have been enshrined in law in order to prevent price gouging. The Edict of Salerno was modeled on pharmacy laws in Europe.

Following the enactment of the developed urban pharmacies Medizinalordnung orders, which set that pharmacies may not be based solely on the sale of drugs.

During the 14th Century are changing the pharmacists from street vendors to wealthy patrician, who not only sells herbs, spices and drugs, but also produces own medicines in the dispensary (Latin officina). From this period dates the oldest still-existing pharmacy in Europe: 1241 in Trier, was opened a pharmacy, which still exists today. Later shifted to the production of drugs from the dispensary in the recipe, but still (to be professionals in the showroom), the workrooms of a pharmacy or (deprecated) even called the pharmacy dispensary.

Pharmacies X Germany X Pharmacy X History

Since the economic viability of pharmacies that time also depends on diseases and epidemics, was in some places there were supply problems, if no such long period of time occurred. To prevent this, were in the 15th Century, for example built in Lower Austria by the so-called Country Estates Landscape pharmacies.

In the 17th and 18 Century, German chemists developed from the place of manufacture of medicines due to the knowledge of chemistry and a place of drug discovery. Especially in Berlin, Thuringia and Saxony focused pharmaceutical and chemical research and teaching in Germany.
Pharmacy sales in 1900

Through the achievements of the pharmaceutical industry at the end of the 19 starts and early 20 Century, a shift of the German pharmacy. Rather than produce medicines themselves increasingly engaged in the pharmacy, to consider the quality and identity of drugs and advice about drugs.

In 1958, following a decision by the Federal Constitutional Court (see Case pharmacies) the freedom introduced since then so may open each pharmacist a pharmacy on site of their choice, regardless of need. Because of drug price regulation which set uniform prices of drugs so far for all of Germany’s competition took place not on price but also partly by the granting of so-called gifts, but especially on the expertise of the pharmaceutical consulting, delivery, service, friendliness, special or additional services (drug-delivery service for customers who can not themselves come to the pharmacy, increased range of expertise in specific areas, etc.). Recently, the pharmaceutical price regulation is more flexible, it is feared that this increased competition will take place over the price and charged to the pharmaceutical quality, as competent advice is time consuming and labor-intensive and are also making only with highly qualified personnel is, in turn, to higher operating results as a mere sale.
Mobile dispensary in the town of Pomßen, 1988

In the Soviet occupied zone, the German Economic Commission (DWK) had on 22 June 1949, the expropriation of the pharmacies and thus all rights to have been declared extinct. Owners who themselves were pharmacists, but given the right to operate as a “privately owned pharmacies to continue” may, if the service charges were paid. By the owners or heirs leased pharmacies “state pharmacies, the owners have received compensation as a share of the proceeds of the” holding charges “. Only in 1954 precise amounts of compensation was determined and accounted for 30 to 50% of the average annual turnover, net of possible exposure amounts to pharmacies. The payment was made centrally planned economy after five years. Newly established pharmacies in the German Democratic Republic (GDR) were basically “country pharmacies” that have been leased or managed as a hospital pharmacy. The number of “Private pharmacies” in 1956 amounted to around 298 by 1533 pharmacies (= 19.4%) and the number decreased steadily until it just “state pharmacies or pharmacy gave clinics. Due to the poor economic opportunities, many fully trained pharmacists emigrated in 1951 to the West, so that the state leadership was forced to adopt the Soviet model called pharmaceutical engineers as the mean medical personnel with training in vocational schools, for example, the then Pharmacy school Leipzig.
Modernized Pharmacy in Berlin-Lichtenberg, 1991

In the 21 Century, the pharmacy in many transformed into a modern and profitable company. In Germany, approximately 21,500 pharmacies to provide uninterrupted, 365 days a year, the population with drugs. In customer satisfaction surveys, the German pharmacies situated in typically top positions.

Pharmacies X Germany X Pharmacy X History

Pharmacy History Germany is a post from: Pharmacy in jobs, news, schools

OMB No. 0920-0666

NHSN           Antimicrobial Use and Resistance (AUR)         *                            *

PhariTiaCy Data – Monthly Report Form Assi PUT Publ and this CDC Facility ID:                                 *Location Code:                     *Month:                       *Year:                        *Patient Days: Parenteral Antibiotics Antibiotic “Quantity Used^f Antibiotic “Quantity Used^f amikacin

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Oral Antibiotics Antibiotic “Quantity Used^f Antibiotic “Quantity Used^f amoxicillin

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ranee of Confidentiality: The infonnation obtained in this surveillance system that would permit identification of any individual or institution is collected with a guarantee that it will be held in strict confidence, will be used only for the jses stated, and will not otheni/ise be disclosed or released without the consent of the individual, or the institution in accordance with Sections 304, 306 and 308(d) of the Public Health Service Act (42 USC 242b, 242k, and 242m(d». K reporting burden of this collection of infonnation is estimated to average 2 hours per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing eviewing the collection of information. An agency may not conduct or sponsor, and a person is not required to respond to a collection of information unless it displays a currently valid OMB control number. Send comments regarding urden estimate or any other aspect of this collection of infonnation, including suggestions for reducing this burden to CDC, Reports Clearance Officer, 1 600 Clifton Rd., MS D-74, Atlanta, GA 30333, ATTN: PRA (0920-0666). 57.124 Rev. 1

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