Pharmacy chains issue orders to pharmacists. Supervisory authority: this must be reported
"Any information regarding pharmacists' actions that are inconsistent with the Code of Ethics should be reported to the appropriate Professional Liability Advocates operating at the District Pharmaceutical Chambers," we hear from employees of the Chief Pharmaceutical Inspectorate . They add that cases concerning violations of the Act on the independence of pharmacists are the domain of provincial inspectors.
Officials responded to questions about the matter revealed by Rynek Zdrowia. On Monday (July 21), we reported that pharmacy staff working in some pharmacy chains are receiving letters suggesting they are obligated to sell specific products. While such letters are not legally binding, the requirement to sign or acknowledge the order may result in consequences for failing to comply with the businesses' wishes.
A letter signed by Dr. Max's management states that, in line with profitability indicators and the care taken to ensure the effectiveness of treatment for patients visiting pharmacies, "actively working with Dr. Max products allows us to maintain optimal economic indicators for the pharmacy and effectively helps with patient ailments." Management claims that private-label products are of high quality and attractive price, and their wide range allows them to "perfectly integrate into the treatment process."
With this in mind, Dr. Max's management "encourages active work with its own brand" and "utilizing its full potential for the benefit of patients." The letter ends with the following clause: "I have read the above statement and undertake to implement its recommendations in my daily work – signatures of pharmacy staff."
We have no reason to believe the letter in question is false, even though we obtained it from only one source. When asked to confirm or deny its authenticity, Dr. Max has remained silent.
Another document we have obtained concerns pharmacies operating under the CEFaRM 36.6 brand. In the letter, a representative of the Farmacol Capital Group (which includes the aforementioned pharmacy brand) informs pharmacy managers that each of them will receive an individual list of approximately 30 products that are listed in the pharmacy's inventory program as having been in storage for more than six months. If the product is physically in storage, "it should be displayed and sold as a priority." If the product is not in storage, "it is requested to be sold anyway."
Dr. Max did not respond to our questions regarding this article. Mariusz Kwaśniak , CEO of Cefarm 36.6 Pharmacy and Marketing Director of the Farmacol Capital Group, indicated that the chain operates in accordance with applicable laws and professional ethics, including in sales practices. He emphasized that the company conducts "educational activities aimed at minimizing inventory losses."
The President of the Supreme Pharmaceutical Council, Marek Tomków, told us that it would be good if the pharmaceutical inspection investigated whether the described practice did not violate legal provisions regarding the interference with the independence of the pharmacist's profession.
- As a chamber, we ask pharmacists to report to us all attempts to interfere with their independence - added the representative of the pharmacists' self-government.
After publishing the text, we received the position of the Chief Pharmaceutical Inspectorate.
It states that, pursuant to Article 35, Section 1 of the Pharmacist Profession Act (hereinafter referred to as the Pharmacist Profession Act), a person practicing this profession makes independent decisions regarding the provision of pharmaceutical care, the provision of pharmaceutical services, and the performance of professional duties, guided solely by the patient's best interests. In this respect, they are not bound by official orders.
Article 35, paragraph 2 of the Pharmaceutical Act imposes on the entity operating a pharmacy, pharmacy outlet, or hospital pharmacy department the obligation to provide pharmacists with the conditions to make independent decisions in these areas, to the extent they are related to the entity's business activities. Violation of this provision by the entrepreneur may result in the issuance of a decision to withdraw the pharmacy license by the provincial pharmaceutical inspector.
At the same time, a pharmacist is obliged to practice his profession with due diligence, respect for the patient's rights, care for his safety, in accordance with the current pharmaceutical and medical knowledge, methods available to him and in accordance with the principles of professional ethics and deontology ( Article 27 of the Pharmaceutical Act ).
In addition, the pharmacist must perform activities based on available knowledge and information obtained from the patient, full and accessible information as part of the pharmaceutical care and pharmaceutical service provided, and in particular provide information on medicinal products and medical devices traded in pharmacies and pharmaceutical wholesalers and on their effects, use, precautions and possible interactions ( Article 28 of the Pharmaceutical Act ).
The issue of independence is also regulated by the Polish Code of Ethics for Pharmacists . It prohibits, among other things, any conduct, including factual or legal actions, that may result in a restriction of the professional freedom or independence of a pharmacist, in particular in the provision of pharmaceutical care, the provision of pharmaceutical services, or the performance of professional tasks of a pharmacist.
According to the Code, a pharmacist should refuse to carry out an order restricting professional freedom or independence and is not bound by an official order in this respect, unless the obligation to carry out the order results from other applicable provisions.
The Code also states that when recommending products to a patient, a pharmacist is obligated to rely on current knowledge, effectiveness, and safety of the recommended product. The choice or recommendation must be based solely on the patient's well-being.
The Chief Pharmaceutical Inspectorate (GIF) officials emphasize that the application of the Pharmaceutical Profession Act falls within the purview of the Chief Pharmaceutical Inspectorate, not the provincial pharmaceutical inspectors. They also emphasize that the Pharmaceutical Profession Act regulates the practice of this profession only for pharmacists, not pharmacy technicians employed in pharmacies.
According to the most recent data obtained by the Chief Pharmaceutical Inspectorate from the Provincial Pharmaceutical Inspectorates, in the period from January 2022 to September 2023, the Provincial Pharmaceutical Inspectorates did not receive any information or complaints from pharmacists regarding violations of the provisions of the Act on the Pharmacist Profession by entrepreneurs running pharmacies, in terms of violating independence.
Officials add that any information regarding the actions of pharmacists that are inconsistent with the provisions of the Pharmacists' Code of Ethics should be reported to the relevant Professional Liability Advocates operating at the District Pharmaceutical Chambers.
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