Developments in Sweden Tommy Westerlund, PhD Finally, I want to thank you for your attention and welcome Lena-Karin Lütz to the stage, another Helsingborg colleague! Queen's Centenary Special Pharmacy Symposium Belfast Northern Ireland October 28th 2008

Apoteket Exclusive right to operate the country's pharmacies since 1971 Nearly 1 000 pharmacies today > 90% community 35% of community pharmacies in health care centres One pharmacy per 9,000 inhabitants

Apoteket responsible for ensuring a nationwide system of drug distribution promoting rational drug use determining extent and location of pharmacies and other sales outlets for drugs having uniform prices of both prescription and OTC drugs sold to the general public throughout Sweden offering health care producer-independent information and statistics on drug consumption

Distribution services 1000 pharmacy representatives in remote areas Postal mail deliveries Individually packed drugs Electronic prescriptions

Gross profit margin Percentage of sales of prescription drugs

Substitution of drugs in order to reduce the costs to society When a drug included in the drug benefit scheme is prescribed and one or more comparable alternatives exist, the pharmacy must replace it with the cheapest alternative available locally

Personnel categories 900 pharmacists 5,100 prescriptionists 2,200 pharmacy technicians Pharmacist education 5-year-programme Prescriptionist 3-year-programme Techs high school/ in company training

Pharmacist assignments Educational activities Project work Drug & Therapeutics Committees Medicine reviews R&D Hospital wards

Self selection departments

Self care customer services A national standard for self care counselling - an important quality assurance tool Favourable impact on customers' ailments Appropriate referrals Health points Additional counselling services

Swedish community pharmacy classification of drug-related problems Westerlund System 7. Interaction 8. Contraindication 9. Inappropriate time for drug intake/ wrong dosage interval 10. Practical problems 11. Other drug-related problem 1. Uncertainty about aim of drug 2. Therapy failure 3. Underuse of drug 4. Overuse of drug 5. Drug duplication 6. Adverse effect DRPs were identified and classified according to the IT-based classification used in all Swedish community pharmacies since 2001, known as the Westerlund System. It contains 13 DRP categories.