Why non-pharmacists should not own retail chain outlets – Pharm. Obideyi
Pharm. Olabanji Benedict Obideyi is the current vice-chairman, Association of Community Pharmacists of Nigeria (ACPN), Lagos State Chapter, and managing director, Newton Pharmacy, Lagos. In this interesting interview with Pharmanews, the one-time secretary of the Lagos ACPN expressed his views on the challenges facing community pharmacy practitioners in the country, as well as why he thinks the practice is not as lucrative as it should. He also reveals why he strongly believes that liberalisation of retail chain practice would do more harm than good to the entire pharmaceutical industry. Excerpts:
Briefly tell us about yourself
I was born in Ibadan, Oyo State, about five decades ago. I had my elementary education in Ibadan, after which I attended Ikorodu High School in Lagos State for my secondary education. I was at the Oyo State College of Arts and Science, Ile-Ife (now School of Science) between 1984 and 1986 for my A-levels. I gained admission into the University of Ibadan to study Pharmacy and graduated in 1992. I was at the University of Lagos between 1999 and 2001 for a master’s degree in Pharmacology.
I had my internship at the University of Ilorin Teaching Hospital, Kwara State and the mandatory national service at the NYSC Headquarters Clinic in Abuja, FCT. I worked briefly in some community pharmacies, both in Ibadan and Ife, before securing employment with the United Bank for Africa Plc. as a manager and head of pharmacy operations at the bank’s clinic. Due to policy change at the bank, the clinic transformed into a full-fledged company called Marina Medical Services Ltd (MMSL) and I was appointed as the pioneer chief pharmacist. After working at MMSL for about seven years, I resigned in 2010 to take up the full management of my community pharmacy. I have attended a lot of professional and management training programmes, both locally and overseas, including the FIP world congresses held in Cairo, Egypt, and Dublin, Ireland, in 2005 and 2013 respectively.
When did you establish your own pharmacy and how was it at the beginning?
I actually started my own pharmacy in 2006. It was initially managed by the superintendent pharmacist and one other director of the company. I was not fully involved in the day-to-day management of the pharmacy because of my busy schedule at MMSL. Most times before I got back from work, they would have closed at the pharmacy.
Yes, the beginning was very rough, considering that the finances were not readily available. I started with the little saving I was able to make from my job at MMSL, as well as some loans from family members and friends. Most of the wholesalers we contacted then were reluctant to give us stock on credit. We had to resolve to what I would call “selective-stocking”.
Other issues included not being able to implement some of the ideas I had on how things should run because I was more or less not available.
As a stakeholder, how would you assess community pharmacy practice in Lagos State?
Lagos, being the economic nerve centre, of the country is expected to have the highest number of community pharmacies in the country. This is exactly the case. As at the last count, we had about 800 community pharmacies in Lagos.
When you look at it from this angle, you might want to conclude that the practice is good. However I can authoritatively say that a sizable number of these pharmacies are not doing optimally well. This is due to:the huge number of unregistered pharmacies and chemists in the nooks and crannies of the state, engaging in sharp practices, thereby preventing the patronage of the officially registered premises.
There is also ineffectiveness on the PCN part of the Pharmacists Council of Nigeria in being able to carry out its regulatory functions. We now have a situation where NAPPMED (Nigerian Association of Patent and Proprietary Medicine Dealers)now usurps the authority of the PCN by issuing licences to their members to open patent medicine stores. These people operate far beyond what they are expected to do and nobody is reining them in.
Majority of the wholesalers also engage in retailing activities and undersell, thereby creating unnecessary competition with the retailers. We thank God that most of these issues are currently receiving attention of the present PCN management and we are hopeful that when the present situation is sanitised, then practice would improve and be of mutual benefit to both our members and their communities at large.
How lucrative is community pharmacy practice business in Lagos State?
As I mentioned before, the practice would have been lucrative if the present situation were sanitised and people played the game by the rules. With the level of practices as currently obtainable, I don’t think the practice is as lucrative as it ought to be. Government has not really provided the enabling environment for business to thrive. How would the practice be lucrative when you don’t have access to finance? Most banks are becoming tight-fisted when it comes to giving loans, and when they do so, the interest rates and other requirements are discouraging. This problem has prevented majority of practices to expand. Added to this, you would still need to generate electricity to power your refrigerator, air conditioners, computers and others. So, in the long run, you incur huge running expenses, leaving you with little or nothing as profit.
However, amidst all these negative and discouraging situations, we still have some of our members that have achieved uncommon feats. We have the likes of Pharm Bukky George of HealthPlus, with over 20 branches nationwide; Pharm Joke Bakare of Medplus; Pharm Ike Onyechi of Alpha Pharmacy and a few others. I am very sure that even these ones who seem to be doing relatively well would have their stories to tell if you ask them to share their experiences.So it is my prayer that the much needed change that the incoming federal government has been talking about addresses these issues of finance, infrastructure and regulations. Then and then would we have the practice becoming lucrative and then we would be able to employ people, pay good salaries, expand into many viable branches and enjoy the luxury of being successful business owners.
Can you tell us some of the achievements and challenges within the ACPN Lagos that you have observed as a former secretary and now vice-chairman of the association?
The association, under the able leadership of Pharm. Abdusalam Aminu, during the last administration, recorded tremendous achievements in several areas. These can be categorised under the following: protection of interest of members, publicity, training, members’ empowerment, and productive endorsement. Permit me, for emphasis sake, to mention just few of these achievements.
Early in the life of last administration, ACPN Lagos prevented the incursion of the state government into regulating members’ activities that are purely under the exclusive list. The then acting registrar of the PCN had written a letter to the Lagos State Commissioner of Health transferring regulatory powers over the association to the ministry. The association mobilised the members to a protest that led to the termination of the directive in the said letter. I am certain that if this had been allowed to sail through, our members would have been impoverished as all sorts of levies would have been imposed on them by the state.
We also celebrated World Pharmacists Day for the first time and this helped a great deal in creating awareness about the association- who we are and what we are doing for our communities. It also created an avenue for us to educate the public and encourage positive attitudinal change from improper use of medicine to responsible medicine use.
The yearly continuing education conference has been reorganised and packaged to be more informative and educative. PCN has just endorsed the conference as a point-earning module of MCPD.
The association also ensured that PIC activities were sustained by always putting the state and the PCN staff on their toes to for its sustenance. More effort is however still required in this regard.
Another zone, AMEN Zone, was formed and launched during the last administration, bringing the total number of zones to 21. Morever, towards the end of the tenure of the last administration, the association partnered with Afrab-Chem Ltd, and this alliance led to the company empowering us with an 18-seater bus. Members were also empowered by the company through direct sales credit scheme, where interested members are encouraged to buy their products and are allowed up to four weeks before making payment. There are other modest achievements which, for lack of time, I will not be able to mention.
What can you say about the state of the nation’s health care sector?
The health sector, in recent times, has been plagued with strikes here and there. As doctors are resuming from their strike, JOHESU is starting its. Without sounding sentimental, I believe that this problem started in 1985 during Olikoye’s time as the minister of health when he approved jumbo pay for doctors to the detriment of other health professionals.
Health care business is a team work and the roles of the members are complementary. As we have it currently, government makes it look as if doctors are the only important professionals in health care provision. Or how do you explain a situation where house officers are earning more than chief pharmacists, chief physiotherapist and other top ranking officers of other professions, who possibly would have spent a minimum of 25 years before attaining that post? The bold move by government to redress all these anomalies led to the last strike embarked upon by the medics, while Ebola ravaged the country.
To resolve this imbroglio, there has to be a roundtable meeting of sort, where all these issues would be discussed. A “peace accord”, similar to that of the recent presidential election, may have to be signed by all the professional health groups, pledging to agree to whatever the outcome of such a meeting might be.
Government should also ensure equitable distribution of key posts in the health ministry. If you appoint a doctor as minister of health, then the minister of state for health should be from another professional group or vice versa. The permanent secretary should also be from another professional group. When things are done this way, it would be difficult for the system to be skewed in favour of one professional group.
Nobody should feel belittled because I have undergone an approved training to become a consultant in my field or lose sleep because I am going to be appointed a director. This issue of doctors’ dominance has affected virtually all facets of the health care industry. For example, universal health insurance coverage, as presently being organised, would be a total failure because doctors seem to be the only recognised healthcare providers, providing medical consultation, carrying out medical laboratory investigations, dispensing medicines and doing other duties, without employing the services of trained professionals.
I think we should borrow cues from the developed countries we are trying to imitate and see how they are doing things right.
What grey areas in the pharmacy profession do you think the national chairman of ACPN and other stakeholders need to address at this year’s national conference?
Community pharmacy empowerment is a key issue that should be given serious consideration. Many colleagues’ practices are folding up on daily basis not because they lack professional knowledge to make it work, but majorly because they lack adequate finances to run their practices. ACPN national has done something in this regard by getting Fidelity Bank and Stanbic IBTC Bank to give non-collateralised loans to members to stock up their pharmacies. They can do more by negotiating favourable terms so that members who take these facilities can pay with ease.
For example, one of the elders in the profession once shared the German experience with us. He said that Germany has a bank that funds pharmaceutical industries and that as soon you graduate and are ready to go into community pharmacy practice, the government gives you a huge amount of money to set up properly. The interest being charged is so little and you pay back the loan within a 20-year-period. ACPN national can discuss along this line with the government, especially with SME funds being disbursed currently, so that our members can benefit.
The conference should also feature various management training programmes on how to run good and thriving businesses.
What are your thoughts on retail chain pharmacy?
The issue of retail chain pharmacy is another burning issue. Generally, ACPN Lagos is not opposed to retail chain pharmacy. What we frown at and oppose vehemently is the idea of changing the existing law that makes establishment of retail pharmacy to be the exclusive preserve of a pharmacist or group of pharmacists.
It was not like this initially, but over time, some issues that border on patient’s safety came up and the authority decided to restrict establishment of retail pharmacy outlets to pharmacists alone to address these issues. The retail chain pharmacy investors want this law changed so that every Tom, Dick and Harry could open a retail outlet once a pharmacist is employed. I think we should be careful here because this move could create both economic and health problems for the citizenry. First, capital flight would occur as most of the companies trying to come in would use whatever money they make here to better the lots of their countries. The second issue is that professionalism would be thrown to the wind, as the major preoccupation of these companies would be to make money.
Also, amending the existing law would lead to proliferation of sub-standard community pharmacies that would be superintended by non-pharmacists or owned by Register-and-Go pharmacists. The problem would be so enormous that the PCN, combined with NAFDAC, would not be able to tame it. We all know the problem with regulation and enforcement even now that the retail pharmacy practice has not been liberalised. I think we should tread with caution.
One of the reasons adduced by the proponents of this idea is that pharmacies are not enough and that people do not really have access to where they can get genuine medicines. But can companies like Walmart and Boots go to remote areas like Igbesa, Alasia, Magbon and a host of other villages? I am sure the answer would be capital no. What should be done is for government to encourage our members to go into these remote areas by giving them incentives like tax holidays, funding, office equipment like computers, software and so on.
Our indigenous pharmaceutical companies would equally not be spared because the bulk of the medicines that would be marketed would be imported and you can be sure that our fellow countrymen will easily shift to these medicines because of their love for imported things, medicine included. The attendant consequence of this would be mass closure of companies and loss of jobs. I am sure no government would want this to happen. Every country is trying to protect the interest of her citizens and indigenous companies, no matter who is coming to invest; and I think Nigeria should not be an exception.
Investment in the pharmaceutical manufacturing sector or the much publicised mega drug distribution centres is a key opportunity that these foreign investors could tap into, without modification of any pharmacy laws. I foresee a situation where massive investments in these two sectors would drive down the cost of medicines to the end user at the retail end.