Drug union gears up for review

Any Limerick hurling fan would have witnessed their heroes on the field of play engage in hard-fought and close-run battles over the years.

And fervent fan Ms Marie Hogan is no exception. But other tough battles may lie ahead for the president of the Irish Pharmaceutical Union (IPU). The union is gearing up for crucial negotiations in coming months as regulations governing the pharmacy sector, worked out between the IPU and the Department of Health in 1996, come under review.

A brief look at Ms Hogan's background shows she has more than enough experience and knowledge to champion her industry in the coming negotiations.

She is serving the first of two years as president of the IPU, the first woman president in the organisation's 26-year history. She has been active in the IPU for many years, serving on various committees before the election as president. In addition, she was also appointed to the Irish Medicines Board in January 1996 for a five-year term.

In that time, Ms Hogan has seen the industry change. But it could change much more radically if the regulations governing pharmacies are relaxed.

But Ms Hogan says she welcomes the review of the current regulations. However, she says the IPU's aim will be to ensure that the review will be driven by the same outcomes envisaged under the 1996 regulations.

But that may not be what bodies such as the Competition Authority, which claimed the legislation operated purely as a protection to existing pharmacies, including inefficient pharmacies, and the Consumers' Association of Ireland, which has condemned the rules as effectively setting up a cartel, want to hear.

"In approaching pharmacy, groups such as the Consumers' Association and the Competition Authority are looking at it from a purely financial viewpoint and I think they have to consider more the quality of the pharmaceutical service that is being provided," she says.

"The aim of the regulation was to promote a rational spread of pharmacies around the country. As a result, something like 25 pharmacies have opened in rural areas. That wouldn't have happened if these regulations hadn't come into place."

If the sector is deregulated, subsidies for pharmacies in small towns may be needed, she says. She also argues that the debate goes far beyond just that of pharmacies but to society in general.

"If ever the Boston-Berlin contrast that has been used about Ireland in recent times comes into play, it's in the context of pharmacy. In the US model, where a pure competition dogma and where pure market forces arguments have been allowed to reign, the quality of the service has suffered enormously to the extent where insurance companies and pharmaceutical companies dominate. The State has no control over prices. The consumer has little say. Mail order is very common, whereas in the European model, any company coming in with a new product has to negotiate with the State or with some agent of the State on the subject of prices. Prices tend to be cheaper, the service is distributed and there is a high emphasis on the quality of service."

She says the IPU does not want a cartel but argues that it is seeking to strike a balance.

"Nobody wants non-competitive, closed-shop cartel arrangements. That isn't what we set out to achieve. We want a situation where a quality service is allowed to develop and to strike a balance between that and, at the same time, making sure you don't create unnecessary barriers."

She adds: "I would very much hope that the State, in terms of looking at its health services, will realise the value of the service it is getting from primary care and will look at ways of developing that rather than just pursuing a short-term economic theory and a form of economic dogma that, in the long-term, may harm the quality of the service that is being provided."

Nevertheless, the argument has been made that regulations have led to the prices of pharmacies rising dramatically to the benefit of existing pharmacy owners and has also led to the emergence of chains of pharmacies able to afford these high prices.

"I don't accept the argument that the regulations facilitated the growth of multiples. If you're looking at the price of pharmacies, I think you have to look at the price of anything else. In the past five years the price of property has boomed and that's going to have knock-on implications. The value of any retail unit has boomed and that has further knock-on effects. Those have had an impact on the value of pharmacies as well and there's a danger that the impact of the regulations will be overstated."

Ms Hogan said the IPU, through its Independent Pharmacy Ownership Scheme has helped 15 independent pharmacists buy their own pharmacies.

In fact, further reform is required, according to Ms Hogan.

"While people talk about pharmacies being highly regulated, the professional legislation governing practice in the profession, fitness to practice and professional standards dates from the 1960s. We have been waiting for a pharmacy bill which would set standards of practice and fitness to practice criteria. We have been actively seeking that change for years."

In terms of regulation and fitness to practice, the increasing popularity of the internet has become a source of concern for organisations like the IPU.

"There have been concerns throughout the world about the quality of medicines that are provided over the internet and how to regulate the internet," she says.

Along with the Pharmaceutical Group of the European Union, the IPU has published a position paper warning the public on the dangers of buying medicines over the internet.

"There always needs to be some form of regulation to prevent exploitation," said Ms Hogan. "That's as true in ordinary terrestrial practices as it is on the internet."

Ms Hogan's background as a pharmacist is no less impressive than that of her IPU input. She is a second-generation pharmacist and now works with her sister Elenora in the family pharmacy at Upper William Street, Limerick. It was established by their late father, Pat, in September 1940.

"From a young age, I'd wanted to be a pharmacist. I was always going that way," she says.

Ms Hogan was in the first class to graduate from the new School of Pharmacy in Trinity College in 1981. She qualified in 1982, having completed her pre-registration year in the National Children's Hospital in Harcourt Street. She worked in Noyek's Pharmacy, Pearse Street; St Luke's Hospital, Rathgar; and B Braun (Medical) Ltd before returning to Limerick on her father's retirement in 1989.

Apart from hurling, her other interests include gardening and reading. She is also a member of Limerick Golf Club and the Sacred Heart Choir.

Despite her heavy workload as president of the IPU, which involves regular trips from Limerick to the organisation's headquarters in Dublin, Ms Hogan still manages to find time to follow her beloved Limerick hurling team. Despite losing to Tipperary in the Munster final, the county team is still in the championship through the GAA's "back-door" system.

"I'm following the Limerick team with great interest at the moment. They're giving us a great summer, even though their last outing against Tipperary was a disappointment. But friends come in through the back door, so I have no problems with the back-door system."