I agree with the contents of Charles Micallef's letter Dispensing Of Medicines (September 19) though there are some points upon which I wish to expand.

First, the relation between doctors and medical representatives needs further investigation. The fact that Pierre Mallia, the former president of the Malta College of Family Doctors (September 15) is not aware of any case of a doctor being influenced by drug companies does not mean that all is well. It is ridiculous to believe that doctors take any money to push one brand of medicine instead of another. But would a constant supply of samples have the same effect as an enticing offer? I leave that to the ethics people and consumers to discuss.

I am in full agreement with Mr Micallef in defending the point that providing an alternative instead of the one prescribed does not mean a change of prescription. When an alternative or a generic is provided, in reality the pharmacist is supplying the same medicine prescribed. When someone implies that the pharmacist is changing the prescription, in fact one is suggesting either that the pharmacist is not doing his job well or that the information provided on the medicine is not correct or, in the case of generics, that the standards are not being adhered to. This applies also to when the pharmacist is providing a generic medicine instead of a branded one. The accusation that pharmacists may be tempted to sell a more expensive medicine does not make sense for two reasons. First, I believe that our pharmacists are well-trained professionally and ethically to perform their duties in a correct and effective manner. Secondly, the reason given by Mr Micallef - that most pharmacists are not the owners of the pharmacy - is one based on the reality. In fact, that is why our association pushed for liberalisation of pharmacists - to give a chance to all pharmacists to own their own pharmacy and provide the consumer with more choice and thus more competition.

However, if one would not like to give pharmacists the option of providing an alternative, then we can give the consumer the choice of deciding once he has been advised by the pharmacist. In that way, we would still respect the doctor's professional advice while opening the door to more competition and, hopefully, lower prices while guaranteeing professional and ethical standards.

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