Embrace the scientific research that underpins the practice of pharmacy
The RPS’s latest report describes what pharmacists and pharmaceutical scientists can do to address some of the challenges of getting new medicines to patients
This week, the Royal Pharmaceutical Society launched its latest document “New medicines, better medicines, better use of medicines”. The guide is a landmark for pharmacy. For the first time in the recent history of the profession, it sets out the continuum of interdependent scientific research which underpins all pharmaceutical practice. It emphasises the value of science-based enquiry and illustrates how logical and systematic approaches can find solutions to problems and generate the evidence needed to ensure that patients — the ultimate consumers of our pharmaceutical endeavours — get the desired benefits from the medicines they take.
The document has been prepared by the RPS’s Expert Advisory Panel for Science (of which I was chairman) supported by RPS chief scientist Jayne Lawrence and chief assistant scientist Colin Cable.
However, it is not just their views that are reported. The document has been refined by an extensive consultation process which has been informed by feedback from a further 13 individuals and 20 organisations, including the Medical Research Council, BUPA and the Patients Association, as well as other pharmacy bodies.
Thus we can be confident that it reflects examples of the best of the pharmaceutical scientific research that has led to the effective and safe armamentarium of medicines that are available to today’s society.
Medicines are the most commonly used medical intervention. They are part of an amazing success story of curing diseases and improving and extending life. However, this document is not all about celebrating achievement. It does not shirk from highlighting the current challenges faced by today’s pharmaceutical scientists. These challenges exist at every stage of the journey of a drug, from its initial discovery through to its selection by the prescriber and its ultimate use by the patient.
So, for example, although there are many exciting new approaches to drug design and delivery, ranging from nanomedicines to biologics, it is estimated that many thousands of new drug molecules are required to be identified for one new medicine to be licensed for use. There is attrition at every step of the way, with the final lengthy regulatory process often being particularly expensive and burdensome.
For so-called orphan diseases, where the ultimate number of users of a medicine is small, the investment is often not seen to be warranted from a commercial perspective. Similarly, medicines used for short-term treatment of acute conditions may not be viewed as financially attractive. A highly damaging example of this, much in the public eye at the moment, is the small number of new antibiotics in the current development pipeline.
This links to the importance of the appropriate selection of the right drug to meet an individual patient’s needs. But the population must also be considered. Injudicious use of antibiotics to meet the short-term expectations of individual patients, but not the wider population, has led to the problem of antibiotic resistance we face today. The need for pharmacy practitioners to fight this major public health problem has never been greater.
Safety in the use of drugs is also highlighted by the report. Although medicines have, as stated above, been the proverbial lifesaver for many, they have also caused avoidable harm and even death. Improving the safety of prescribing is a another area of pharmacy practice that is underpinned by scientific evidence of benefit.
Ultimately, the long journey for the drug only ends when it is taken by the patient. There remains much to be understood about patients’ views on medicines and how these affect the way in which they take them. We have to address the unnecessary waste of medicines, due to over-prescribing and non-adherence, which comes at a huge cost to the NHS at a time when there is a struggle to afford life-saving new treatments.
The document is not all gloom and doom. It holds out the promise of personalised medicine, creating new roles for pharmacists and pharmaceutical scientists at all stages of the patient journey. It also highlights the key role pharmacists and pharmaceutical scientists must play in addressing some of the global issues associated with medicines — a pharmaceutical public health role on an international scale.
These and many more issues are described in detail in the document. There are also recommendations to address the challenges, many of which are relevant to the day-to-day practice of every pharmacist. If every pharmacist had a personal mission to try to contribute to one of the recommendations, as a profession we really would make a difference.
The above is not a synopsis of the report in any way. Please read the report, judge for yourselves and remember the importance of pharmaceutical science underpinning the practice of pharmacy.
Citation: The Pharmaceutical Journal DOI: 10.1211/PJ.2014.11138201
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