Model pharmacies, but only on paper

The Directorate General of Drug Administration (DGDA) launched the Model Pharmacy initiative in 2016 to ensure exemplary pharmaceutical services to the public, but many pharmacies established under this initiative are now mired in irregularities.

The administration approved 15 model pharmacies and 50 medicine shops in Chattogram as part of the initiative in 2018, but a majority of such shops are not following the DGDA's guidelines for drug sales, and do not have registered pharmacists stationed at the premises.

The district administration's mobile courts – which conducted 20 drives at pharmacies and medicine shops across Chattogram this year – found many model pharmacies selling drugs to customers without prescriptions and padding the costs as well.

Such illegal practices are widespread amongst regular pharmacies and medicine shops, and the DGDA – under the health ministry – launched the Model Pharmacy initiative to protect the public specifically from these malpractices. 

Moreover, executive magistrates leading the mobile courts have unearthed enough evidence indicating that most model pharmacies are not complying with Model Pharmacy guidelines, according to sources from the district administration.

On condition of anonymity, an executive magistrate of the Chattogram district administration told The Business Standard, "When a model pharmacy or a medicine shop does not follow the rules for selling drugs, it cannot be considered as a 'model.'

"During our drives, we found a number of model pharmacies and medicine shops without any A, B or C grade pharmacists at the premises. These shops were also selling medicines without prescriptions and overcharging their customers, which also violate the rules."

The DGDA authorities said they lack the adequate manpower to properly monitor the model pharmacies, and these shops are taking advantage of the situation by violating the rules.

The authorities added that the Model Pharmacy initiative is a pilot project, so any pharmacy or medicine shop found to be engaged in irregularities currently only faces a warning and a small fine, but such measures have not been effective in improving the situation.
 
What are the guidelines?

A pharmacy or a medicine shop operating under the Model Pharmacy guideline must meet the criteria set by the DGDA. All pharmacists must complete their training and register with the Pharmacy Council of Bangladesh before selling medicines at any pharmacy.

A model pharmacy (Level I) service must be provided, managed, or supervised by an A grade pharmacist with an honours degree or above, who will have to be present on the premises to sell the prescribed drugs to the customers, and to provide them with necessary guidance and assistance. 

Several B or C grade pharmaceutical personnel may assist with the dispensing of drugs under the supervision of the A grade personnel.

Meanwhile, service at a model medicine shop (Level II) service must be carried out, at a minimum, by a person with a C grade qualification and at least a diploma. 

A model pharmacy should have a minimum 300 square feet space with at least 8 feet height. It should also have an adequate air conditioning system so that ambient temperature does not exceed 30 degree Celsius. 

The guidelines further recommend that the shop has a backup power supply, such as a generator. Pharmacists must also wear gloves when handing over medicines to the customers.

The guidelines further state that a model pharmacy must not sell any medicine without prescriptions, excluding the 39 medicines listed in the National Drug Policy. 

A model shop must have at least one refrigerator that is large enough to store temperature-sensitive medicines. Food items cannot be kept in the store, and personnel must keep track of all sales.

A shop cannot sell medicines distributed by the government free of charge, medicines without registration, and sample medicines handed out to physicians. A pharmacy or a medicine shop must meet these and other criteria to be approved as a model shop.
 
'Providing very little public benefit'

During a spot visit to Panchlaish, Chawk Bazar, Hazari Lane and Oxygen areas of the port city conducted on 23 December, The Business Standard found that several model pharmacies and medicine shops were engaging in blatant violations of the DGDA guideline. 

The pharmacist at the MCM Pharma in Chawk Bazar area was found selling medicines without prescriptions to three customers in front of this correspondent. In another incident, when another customer showed up with a prescription, the pharmacist only sold him the medicine, but did not explain the prescription.

The correspondent witnessed a similar situation at the Hafsa Hanif Model Pharmacy in the Oxygen area. Though the shop had a refrigerator for storage, it had no electricity connection. 

When asked, the shop's employee Ashraf Ullah said the refrigerator had been disconnected from the electricity connection because it had been facing issues recently. 

Ashraf also claimed to be a grade B pharmacist, but later admitted that he is not. However, he claimed to have six years of working experience in a medicine shop.

Responding to a query, Consumer Association of Bangladesh's (CAB) Vice President SM Nazer Hossain said, "The government launched the model pharmacy initiative with good intentions, intending to provide the public at large with medicines at an affordable price, and other facilities.

"However, the model pharmacies and medicine shops are providing very little public benefit. There are allegations that some model pharmacies are selling medicine at a higher cost than regular pharmacies."

He continued, "Many shops are not following the guideline that requires the presence of a pharmacist in the shop. These model shops are getting away with these irregularities due to DGDA's lack of proper monitoring."
 
Misuse of the 'Model Pharmacy' logo

DGDA sources said the approval process for new model pharmacies and medicine shops has been suspended for the last two years, but many dishonest shop owners are illegally using DGDA and Model Pharmacy initiative logos.

Such illegal practices are most common in medicine shops situated in front the Chattogram Medical College Hospital (CMCH). According to DGDA sources, though only 13 model pharmacies in the area have been approved by the administration, at least 25 shops are using the "Model Pharmacy" hallmark.

Many pharmacies in different parts of the port city have also been illegally using this logo.  

Employees of print shops in Chattogram's Andarkilla area told The Business Standard that many pharmacies have been ordering signs with the "Model Pharmacy" logo. The print shops added that they merely cater to customer needs.

Haque Pharmacy – located in the port city's Chowmuhani area – also uses the "Model Pharmacy" logo, but the name of the shop could not be found on DGDA's list of endorsed pharmacies.

When asked why Haque Pharmacy is using the DGDA's name and logo on its signage without approval, the owner Shariful Haque said, "Even though we are not approved by the DGDA as a model pharmacy, we are still trying to follow their guidelines.

We will apply for the approval shortly."

Commenting on the matter, assistant director of the DGDA in Chattogram Hossain Mohammad Imran said, "We are making a serious effort to restore discipline in the sector, and boost monitoring of the model pharmacies and medicine shops. 

"However, a lack of adequate manpower has made it difficult for us to conduct regular drives."

He continued, "As it is a pilot project, we are handing out firm warnings to model pharmacies upon finding evidence of irregularities. We will also hand out fines against such shops and cancel their licences in the coming days."

Another key objective of the DGDA's Model Pharmacy initiative is to protect the public from counterfeit and expired medicines.