‘Post Office unfit to distribute chronic meds’

Pharmacists say postal service’s ‘poor track record’ is a red flag

Pharmacists are seething over the health department’s decision to entrust the South African Post Office with the distribution of chronic medication for state patients, saying its “poor track record” is a red flag.

About 300 post offices in SA, with the exception of the Western Cape, have been vetted to be part of the department’s Central Chronic Medicine Dispensing and Distribution programme, which allows chronic patients to collect their medicines from external pickup points closer to their homes or places of work.

The programme was rolled out during the 2014/15 financial year and included Clicks, Dis-Chem and MediRite, doctors’ rooms and some community pharmacies.

The Post Office announced in June that its branches had become medicine collection points.

Post Office spokesperson Johan Kruger said the service is being rolled out at various branches, mainly in townships and suburbs in Gauteng, Limpopo, North West, Free State and KwaZulu-Natal.

“In terms of the contract with the health department, the Post Office was appointed as a collection point for pre-packaged medication. The Post Office does not dispense medication in the way pharmacists do.”

Kruger referred queries to the health department.

Health department spokesperson Foster Mohale said strict criteria, including geographical and physical accessibility, security of patients and medicines, reliable cold chain equipment or fridges and a good reporting system had to be in place for these pickup points.

“Out of all the post office branches in the country, only 300 met the criteria mentioned and we haven’t received any complaints since the rollout of the programme.

“The role of the pickup points is merely to issue what has been dispensed and packaged by qualified pharmacists in line with pharmacy regulations, with the details of the patients. To date we have enrolled more than 5-million patients who collect their life-saving medication from 2,800 external pickup points in eight provinces. Western Cape has a similar system, so there was no need to reinvent the wheel,” said Mohale.

Vincent Tlala, head of the South African Pharmacy Council, said the body was not consulted about the inclusion of the Post Office.

“The council is aware of the growing concerns from pharmacy professionals regarding the Post Office being used for the delivery of medicines to chronic patients.

“We are still establishing the details regarding the arrangement between the Post

Office and the department of health. Once we have established these details, especially whether unqualified people will be handling the medicines and whether the Post Office has proper storage facilities, we will be able to express ourselves on the matter.

“However, we wish to emphasise that medicines should always be dispensed and stored by or under the direct supervision of a pharmacist or other registered health-care professional holding the relevant permit, in line with regulation 21 of the regulations relating to the practice of pharmacy.

“The requirements of good pharmacy practice in relation to the storage, handling and dispensing of medicines should be adhered to at all times,” said Tlala.

The Independent Community Pharmacy Association (ICPA), a non-profit organisation that represents 1,200 independently owned pharmacies and 3,500 pharmacists, said it was concerned about the Post Office’s “extremely poor track record when dealing with normal items of post”.

“The Post Office is not trusted with our letters, how can we trust them with our life-saving medicines? It is not unreasonable for a patient to want to collect chronic medicine from a facility that is regulated in terms of good pharmacy practice (GPP) and from a registered health-care professional who can counsel and advise them on the medicines they are collecting,” said ICPA CEO Jackie Maimin.

She said inappropriately stored medicines can quickly degrade, and certain medicines can become toxic or corrosive when they expire.

“It is a known fact that 5%-25% of all chronic medicines dispensed through chronic management programmes are actually collected. Currently, there is no mechanism for collection of uncollected medicines, and we are very concerned as to what will happen to these as they start to accumulate at the Post Office.”

Maimin said ICPA is worried that uncollected medicines may find their way into the illegal medicine market.

She said it would be in the interest of public health to use the pharmacy infrastructure already in place and “rather have the Post Office concentrate on improving their parcel distribution, which they are trained to do”.

Mohale said the department did not dispute challenges facing the Post Office but the ones selected have met requirements and are being monitored regularly just like other pickup points.

“Once the medicines in packs arrive at the point of collection, the patients receive SMSes to collect within 14 days. All uncollected medicines are returned to the pharmacy depot by the contracted courier companies.”

He said the programme is aimed at reducing pressure at health facilities, long queues and to offset travelling costs for patients.