MODULE ONE

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 OUTLINES

• Pharmacy Appreciations

• Laws and Ethics Governing Pharmacy Practice

• Pharmacy as a Health service environment

• Pharmacy as a Business
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 INTRODUCTION
• This training is a certificate program spanning six months
• Offer a 3months tutorial and a 3 month hands-on experience with a
pharmacy of your choice

• This training is in accordance with the Health regulatory bodies Act 857,
which recognizes auxiliary staff who are to assist the pharmacist in
offering pharmaceutical care

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 Pharmacy appreciation
Introduction
• The whole idea or spirit behind this module is to make the
student appreciate what pharmacy is all about and what the
term pharmaceutical care means
Objectives

• The main objective is to get students to know the important

factors that contribute to pharmaceutical care

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 Definition of pharmacy
• Pharmacy is the art and science of

 Preparing medicine

 Dispensing medicine

 Providing any drug given related information to the public

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 Definition of pharmacy
• Pharmacy can also be define as the practice of preparing drugs,
making and filing up prescriptions and dispensing them.

• The term is additionally used to describe a place where these

activities are carried out

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• Here the pharmacist is responsible for the provision of
drug therapy for achieving a defined therapeutic
outcome that will improve a patients’ quality of life

• Pharmacists are educated and licensed to dispense

drugs and provide drug related information

• Pharmacists are the most accessible members of the

health care team and often the first source of
assistance and advice on common ailments and health
care matters
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 History of pharmacy (outside Ghana)
• The practice of pharmacy existed in a rudimentary fashion
before the word ‘pharmacy’ was introduced.

• The word ‘pharmacy’ was thought to have originated from the

Egyptian term ‘Ph-ar-maki’ which means Bestower of Security.

• The term ‘pharmacy’ is also generally ascribed to the Greek

term ‘Pharmakon’ which means Remedy

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• In the 19th century there were two types of healers.
Types of healers
 Empirical healers: these healers relied used plants,
animals for healing

 Magical healers: these healers relied on spells and magical

stones for healing more than plant materials.

• The sick always went back and forth between these healers
for cure.
• Some healers combined diagnosis with preparing
medicines as well
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• Formally, pharmacy practitioners who were trained and
worked with doctors or medical practitioners and mainly
prepared the written by doctors were called Apothecaries

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 History of pharmacy in Ghana
• Initially, a school was set by our colonial masters in Korle-Bu to
train dispensers.
• Students for the school, was selected from existing health workers
(nurses, lab techs etc.)
• Training was for a year
• Later on, in 1953, a pharmacy school was setup in KNUST to train
pharmacists for 3years
• The first batch was 12
• However, confusion arose due to the training of these 12 personnel

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• A policy was thus formulated to group them into one and to be
called pharmacists

• Henceforth KNUST was mandated to be the sole institution to

train pharmacist

• Korle bu began to train Dispensing Assistants.

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 CONT’D

• With the setup of the Kumasi Polytechnics,

Korle-bu stopped training and the mandate
was ceded to the polytechnics to train
Dispensing Technicians

• The training was 2years until it was upgraded

to 3 for the training of Dispensing
Technologists
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 CONT’D
• Period for training of pharmacists was increased from 3years to
4years and now to 6years as a Doctor of Pharmacy program

• Nearly 5decades the pharmacy program was run by KNUST solely

• In 2006, the Pharmacy council introduced the MCA program.

• The Pharmacy Council recognizes auxiliary staff who are to assist

the pharmacist which includes the Medicine Counter Assistant.
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 Modern concept of pharmacy
• Formally the pharmacy practice was concerned with compounding of
medicines for patients

• With manufacturing industries taking up formulation of drugs, modern

pharmacy has now become more patient oriented

• Now the pharmacist is primarily concerned with helping the patient to

take the drug in the right manner so as to maximize benefit

• This introduces the concept of pharmaceutical care

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 Pharmaceutical care
• The responsible provision of drug therapy to achieve definite outcomes,
which are intended to improve the quality of a patient’s life

• Therefore pharmaceutical care requires the pharmacist and other

pharmaceutical care providers to take interest in improving the heath of
patients with various interventions aimed at optimizing drug therapy

• Here the role of the pharmacist is remarkable

• The pharmacist provides drug therapy, i.e. drugs to be used in a particular way,
not just drug products.
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 CONT’D
• The aim of giving a drug is not only to get clinical outcome but also to go a
long way to improve patient’s quality of life.

• Pharmacists may assist patients with self-care using over the counter
medicines and with prescription drug therapy.

• Obviously, the pharmacist cannot do this alone and requires the co-operation
of the physician and patient.

• To do this well, the pharmacist must thus have a good relationship with all
caregivers
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 CONT’D

• This implies that pharmaceutical care in the pharmacy and any

healthcare institution would be done by a team and not only
the pharmacist

• This team of pharmaceutical caregivers includes the Medicine

counter assistants.

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21
 Basic components of P’ceutical care
• Adopting a patient focused practice (i.e. patient first)
• Structuring the practice setting to allow patient focused care. This is
done by:
Educating all staff of the pharmaceutical care team
Providing structure support to make the patient the center of all
pharmaceutical activity. Eg the pharmacy should have a counseling
room and an area for brief patient education and a follow up plan

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 Obstacles to P’ceutical care

• Poor quality of education and training for caregivers

• Lack of Practice skills

• Lack of Human resources and finance

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 The MCA a part of P’ceutical care
• From the discussion, it is obvious all members of the
pharmaceutical care team must work together to achieve a
common goal

• Thus to achieve this, all staff must be actively involved.

Teamwork is essential

• The team here includes the MCA. The MCA is to contribute by

performing various duties under supervision.
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 Duties of the MCA
Some duties of the MCA includes:
• Sale of OTC drugs

• Clerical tasks

• Offering Basic health education

• Assisting in purchases
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 CONT’D
• Assisting in dispensing of medicines
• Assisting in pre-packing of medicines
• Sorting drugs
• Tidying the pharmacy
• Assisting in inventory management

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LAW AND ETHICS GOVERNING
THE PRACTICE OF PHARMACY

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 Ethics in Pharmacy Practice
• Ethics concerns itself with distinguishing between right and
wrong based on knowledge and not feelings or opinions.
• Also concerned with what is morally good and bad
• Healthcare practice has been governed by ethical principles
and codes since health was first established in ancient Greece.
• The Hippocratic principles of “doing good and avoiding evil”
have combined to form the foundation of the basic ethical
principles governing medical practice.
• Over the years, several more principles have been added, and
these
• can be applied to the practice of pharmacy for both
pharmacists and support staff
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 Ethics in Pharmacy Practice
• From these ethical principles, codes of ethics have been
developed for each health care profession, including pharmacists
and pharmacy technicians.
• They are designed to direct pharmacy professionals in their daily
practice of pharmacy and publicly state the principles that guide
their duties.
• During their training, pharmacy professionals are taught the
codes of ethics that govern their professions, and it is important
to keep these codes in mind when working in the pharmacy.
• While they may not provide an answer to every ethical dilemma,
they should be applied in individual situations to help pharmacy
professionals determine the most appropriate solution. 29
 Principles of Ethics
• Autonomy: the right for patients to make decisions for
themselves.
• It allows patients to choose what medical treatments are best
for them and allows them to take ownership of their own
health care.
• After receiving all of the information necessary to make an
informed decision, health care choices must be made by
patients themselves without coercion
• While it can be difficult at times for health care professionals
to respect a patient’s decision, especially if they disagree
• it is ultimately the patient’s right to decide whether he or
she wants to take a medication or have a procedure done.
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 Principles of Ethics
• Beneficence describes the ethical principle of acting in the best
interest of the patient, or “doing good.”
• It encourages health care providers to help patients achieve the
best possible outcomes of their medical treatment, through
advocating for them and providing them with information to
make informed decisions.
• Providing patients with an opportunity to consult with a
pharmacist to ensure they are informed on the use of their new
medication is an example of beneficence.
• Pharmacy professionals play an important role in encouraging
positive outcomes for the patient, and should bear this principle
in mind on a daily basis.
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 Principles of Ethics
• Nonmaleficence describes the concept of “doing no harm.” it has been a
central idea of health care for decades, and continues to play an essential
role today.
• Professionals must constantly keep this in mind when providing care to
patients to ensure the actions they are taking to help the patient do not
end up causing harm.
• There are ways pharmacy professionals can apply this principle of when
assisting patients. Eg. preventing medication errors by checking for the
presence of drug interactions, adverse events, and duplicate therapies.
• MCA’s can also take an active role in preventing harm to patients by
focusing on medication safety and ensuring prescriptions are filled
correctly and accurately, as well as by learning from mistakes and
preventing their repetition.

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 Principles of Ethics
• The concept of justice can be applied to pharmacy practice, and
refers to the practice of allocating products and services to
patients fairly, regardless of race, gender, religion, or any other
external factors.
• All patients have the right to be treated fairly by their medical
providers, so in the pharmacy environment, medications should
be allocated in a first-come, first-served fashion, unless another
fair system has been developed.
• This will ensure all patients have the same ability to access
important medications.

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 Principles of Ethics
• Protecting the privacy of a patient’s medical condition and health
information is the definition of confidentiality.
• It is crucial to achieving the best outcomes for a patient, because patients
may be less likely to share personal information if they feel their
confidentiality will be violated, which could prevent the pharmacy team
from acting in the best interest of the patient.
• Daily duties must be conducted in a way that prevents health information
from reaching unauthorized sources, and the pharmacy’s policies and
procedures should reflect the importance of maintaining confidentiality.
• To maintain a patient’s trust, pharmacy personnel should respect the
wishes of the patient on who they want their patient information to be
disclosed

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 Code of ethics
They form a foundation for professional behaviors, attitudes, and
actions
It also
• Use their knowledge to ensure the patient’s safety and health.
• Endorse and support veracity and integrity.
• Assist pharmacists in distributing resources in a safe, effective, and
cost-efficient manner.
• Respect the ability of pharmacists and other health professionals.
• Continuously improve their pharmacy expertise and knowledge.
• Respect patient dignity, privacy, and individuality.
• Respect the privacy of patient medical records and disclose
information only when authorized.
• Refrain from promoting and distributing products of subpar quality
or that do not meet standards required by law.
• Refrain from taking part in activities that may disgrace the profession
of pharmacy.
• Take an active role in professional pharmacy organizations
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Code of ethics of p’ceutical society of Ghana
VISION
• We strive for the well-being of all through the provision
of excellent pharmaceutical services at all times.
MISSION
• To provide accessible, affordable, sustainable and
quality pharmaceutical services to all through
professionalism, continuous professional development,
leadership and collaboration with government, local
and international organizations and other relevant
stakeholders.
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• The appearance of the premises should reflect the
professional character of pharmacy
• The pharmacist is a good citizen and upholds and defends
the laws of the nation; he keeps himself informed on
pharmacy and laws of medicine. They co-operate with the
enforcement authorities. They shall not engage in any
activity that will bring the profession into disrepute and
shall expose, without fear or favour, illegal or unethical
conduct in the profession.
• The dispensing of medicines or professional services of a
pharmacist shall not be advertised directly or indirectly
• A pharmacist must only accept work where he has the
requisite skills and fitness for the tasks to be performed.

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• A pharmacist shall not allow others to use his name,
qualifications, address or photograph in connection with
the distribution of any medicinal product to the public
• A pharmacist shall render a reasonably comprehensive
pharmaceutical service and care to the public at all times
by ensuring that the client receives sufficient information
and advice to enable the safe and effective use of
medicines.
• A pharmacist shall not refuse a reasonable request to
supply pharmaceutical products or provide services in an
emergency.
• A pharmacist must ensure that all delegated tasks are
assigned to competent persons.
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• A pharmacist shall not supply to any member of the public
any substance, medicinal product or medical appliance,
which he knows or has reason to believe is intended to be
used in a manner which would be detrimental to health, or
whose quality he has reason to doubt.
• The pharmacist shall willingly make available his expert
knowledge of medicines to other health professions.
• The therapeutic efficacy of prescriptions shall not be
discussed with patients or others in such a manner as to
impair confidence in the prescriber.
• A pharmacist must respect the confidentiality of
information relating to a patient and the patient’s family.
Such information must not be disclosed to anyone without
the consent of the patient or appropriate guardian unless
the interest of the patient requires such disclosure.

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• A pharmacist may recommend a medical practitioner or
medical practice to a member of the public seeking medical
services in the best interest of the patient.
• A pharmacist shall at all times be ready to help other
pharmacists in providing an efficient pharmaceutical service.
• The pharmacist keeps himself informed regarding professional
matters by reading current pharmaceutical, scientific and
medical literature, attending seminars and by other means.
• The pharmacist adheres to fair business practices, meets his
obligations promptly and fulfils his agreements and contracts.
• The pharmacist must boldly display in his establishment his
own name and the names of other pharmacists working with
him

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 Patient’s Charter
This Charter is made to protect the rights of the patient in the
Health Service. It addresses:
 the right of the individual to an easily accessible,
equitable and comprehensive health care of the highest
quality within the resources of the country;
 respect for the patient as an individual with a right of
choice in respect of health care plans;
 the right to protection from discrimination based on
culture, ethnicity, language, religion, gender, age and type
of illness or disability; and
 the responsibility of the patient or client for personal and
communal health through preventive, promotive and
simple curative strategies. 41
• THE PATIENT’S RIGHTS
• The patient has the right to quality basic health care
irrespective of the patient’s geographical location.
• The patient is entitled to full information on the patient’s
condition and management and the possible risks involved
except in emergency situations when the patient is unable
to make a decision and the need for treatment is urgent.
• The patient is entitled to know of the alternative
treatments and other health care providers within the
Service if these may contribute to improved outcomes.
• The patient has the right to know the identity of the
caregivers and any other persons who may handle the
patient including students, trainees and ancillary workers.
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THE PATIENT’S RIGHTS
• The patient has the right to consent or decide to participate
in a proposed research study involving the patient after a
full explanation has been given; and the patient may
withdraw at any stage of the research project.
• A patient who declines to participate in or withdraws from
a research project is entitled to the most effective care
available.
• The patient has the right to privacy during consultation,
examination and treatment and in cases where it is
necessary to use the notes of the patient’s case for
teaching and conferences, the consent of the patient must
be sought.
• The patient is entitled to confidentiality of information
obtained about the patient and that information shall not
be disclosed to third party without the consent of the
patient or the person entitled to act on the consent of the
patient or the person entitled to act on behalf of the
patient except where the information is required by law or
is in the public interest. 43
• THE PATIENT’S RIGHTS
• The patient is entitled to the relevant information regarding
policies and regulation of the health facilities that the patient
attends.
• Procedures for complaints, disputes and conflict resolution
shall be explained to patients or their accredited
representatives.
• Hospital charges, mode of payment and the forms of
anticipated expenditure shall be explained to the patient prior
to treatment
• Exemption facilities shall be made known to the patient.
• The patient is entitled to personal safety and reasonable
security of property within the confines of the institution.
• The patient has the right to a second medical opinion if the
patient so desires. 44
• THE PATIENT’S RESPONSIBILITIES
The patient should understand the responsibilities of the patient as
regard the patient’s own health and therefore co-operate fully with
the health care providers. The patient is responsible for,
• providing full and accurate medical history for diagnosis,
treatment, counseling and rehabilitation purposes;
• requesting additional information or clarification regarding the
patient’s health or treatment, which may not have been well
understood;
• complying with the prescribed treatment, reporting adverse
effects and adhering to follow up requests;
• informing the healthcare providers of any anticipated problems
in following prescribed treatment or advice;
• obtaining the necessary information, which has a bearing on the
management and treatment including the financial implications; 45
• THE PATIENT’S RESPONSIBILITIES
• acquiring knowledge on preventive, promotive and
simple curative practices and where necessary for
seeking early professional help;
• maintaining safe and hygienic environment in order to
promote good health;
• respecting the rights of other patients or clients and
Health Service personnel.
• protecting the property of the health facility.
NB: These rights and responsibilities shall be exercised by
accredited and recognized representatives on behalf of
minors and patients who are unable for whatever reason
to make informed decisions by themselves. 46
 Ethical Dilemma
• complex situations involving a conflict between morals.
• They have no right or wrong answer, and are often confusing,
frustrating situations that require careful consideration to
resolve.
• Many situations involve both ethical and legal considerations,
and can be difficult to resolve without guidance.
• Identifying the problem is the first step towards finding a
solution.
• The situation should then be assessed completely, and as much
information as possible should be gathered to help with the
decision-making process.
• Ethical principles can then be considered to help develop a final
decision. 47
 QUESTIONS
• ...................... is the ethical term used to describe
the right for patients to make decisions for
themselves.
a. Autonomy.
b. Beneficence.
c. Fidelity.
d. Confidentiality.

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• The principle of ................ describes the concept of “doing no
harm.”
a. Nonmaleficence.
b. Beneficence.
c. Autonomy.
d. Fidelity.
• ................. refers to the practice of allocating products and services
to patients fairly.
a. Autonomy.
b. Fidelity.
c. Justice.
d. Confidentiality 49
 Laws of Pharmacy practice
• System of rules which a particular country or
community recognizes as regulating the actions of
its members and which it may enforce by the
imposition of penalties.
• Laws may be
 Regulatory
 Civil
 Administrative
 Statutory

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 Laws governing pharmacy practice
• Ghana health service and teaching hospitals Act -
1996 (act 525)
• Public Health Act 851 (Food and Drugs Act, 1992)
• Health regulatory bodies Act 857 part iv
• National Health Insurance Act 852
• Constitution of PSGH
• Code of ethics of PSGH

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 Health regulatory bodies Act 857
• This law was established by an Act of parliament
for all the health regulatory bodies in Ghana
• It includes an Act for establishment of
 Pharmacy council
 Allied health profession council
 Nursing and Midwifery council
 Medical and dental Council
 Psychology council

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 Health regulatory bodies Act 857
• Establishment of the Council
 Establishment of the Pharmacy Council
 Object of the Council
 Functions of the Council
 Governing body of the Council
• Registration
 Registration of pharmacists and other pharmaceutical support staff
 Qualification for registration
 Registration of a foreign trained person
 Types of Registers
 Permanent Registration
 Temporary registration
 Annual list of practitioners
 Removal and restoration of names from register
 Suspension of registration
 Cancellation of registration
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 Appeal
 Health regulatory bodies Act 857
• Licensing
 Licensing of corporate bodies
 Licensing of over the counter medicine sellers
 License for wholesale supply of restricted medicines
 Action to be taken after supply of restricted medicines
 Restriction on sale and supply of restricted medicines
 Restricted Medicines Record Book
 Prescription and supply of medicines
 Restriction on preparation and supply of restricted
medicines
 Sale or supply of restricted medicines
 Possession of restricted medicines
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 Meaning of valid prescription
 HRB Act 857 Part 4
Establishment of the Pharmacy council
• There is established by this Act a body corporate with
perpetual succession to be known as the Pharmacy Council.
• Where there is hindrance to the acquisition of property, the
property may be
• acquired for the Council under the State Property and
Contracts Act, 1960 (CA. 6) or the
• State Lands Act, 1962 (Act 125) and the costs shall be borne
by the Council.

Objectives of the Pharmacy council

• The object of the Council is to secure in the public interest the
highest standards in the practice of pharmacy in the country.
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 Pharmacy Council
Functions of the Council
To achieve the object, the Council shall
• educate and train pharmacists and any other p’ceutical
support staff for efficient pharmacy practice
• set standards for continuous professional development for
practitioners and p’ceutical support staff
• register practitioners
• ensure the equitable & accessible distribution of p’ceutical
premises
• monitor and inspect facilities where p’ceutical care is
provided;
• set and ensure standards for pharmacy practice and
professional conduct 56
 Functions of Pharmacy Council
• provide guidelines for the education, training, registration,
licensing and the practice of all pharmaceutical support staff;
• exercise disciplinary power over pharmacists and any other
pharmaceutical support staff;
• ensure accreditation for pharmacy programmes in
collaboration with appropriate State agencies;
• develop a management and administrative structure and
systems to provide an efficient mechanism to regulate
pharmacy practice;
• advise the Minister on pharmacy practice and related
matters; and 57
 Governing body of the Council
The governing body of the Council is a Board consisting of
• a chairperson who is a registered pharmacist of not less than
ten years standing as a pharmacist,
• one representative of the Ministry of Health not below the
rank of a Director,
• one representative of an accredited training institution that
provides tertiary training for pharmacists nominated by the
Minister,
• one registered pharmacist elected by registered pharmacists;
• three other persons who may not be health professionals one
of whom is a woman nominated by the Minister,
• one representative of the Attorney-General not below the
level of Principal State Attorney,
• the Registrar of the Council. 58
 Governing body of the Council
• The members of the Board shall be appointed by the
President of Ghana, in accordance with article 70 of the
Constitution.
• The Board shall ensure the proper and effective
performance of the functions of the Council

59
 Registration of pharmacists and other
pharmaceutical support staff
• A person shall not practice as a pharmacist or a pharmaceutical
support staff unless that person is registered as a practitioner
in accordance with this Part.
• A person seeking registration shall apply to the Registrar in the
manner determined by the Board.
• The registration is valid for the period determined by the
Board.

60
 Qualification for registration
A person shall not be registered to practice as a pharmacist
unless that person
holds a degree in pharmacy, or
holds a qualification recognised by the Board that entitles
that person to be registered as a pharmacist, and
provides evidence of completion of an internship
programme undertaken in an accredited pharmacy
institution after academic training in the country,
has passed the professional qualifying examination, and
satisfies any other requirements of this Part.

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 Qualification for registration
• A person shall not be registered to practice as a
pharmaceutical support staff unless that person fulfils the
requirements determined by the Board.
• A person registered by the Board shall pay the prescribed
fee.
• A person who has obtained an additional qualification is
entitled to have the additional qualification inserted in the
register in addition to the qualification previously registered.

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 Registration of a foreign trained person
• A foreign trained person may be registered as a practitioner
where that person
has satisfied the requirements in section 83,
has a good working knowledge of the English language, and
has proof of qualification and registration to practice in that
person's country of origin or where that person was trained.

Types of register
• permanent register for practitioners who intend to practice
permanently
• temporary register for practitioners who intend to practice for a period
of not more than three months
• provisional register for newly qualified and foreign trained practitioners
• The Registrar shall publish the list of registered practitioners yearly in
the Gazette by the 31st of January 63
 Suspension of registration
• The Board may suspend the registration of a pharmacist or
pharmaceutical support staff where
 an offence or allegation of misconduct in relation to the
pharmacist or pharmaceutical support staff is being
investigated
 a false declaration has been made in an application for
registration by the pharmacist or pharmaceutical support
staff; or
 the pharmacist or pharmaceutical support staff has
contravened a provision of this Part.
• Registration shall not be suspended unless the Board has given
the pharmacist or pharmaceutical support staff at least thirty
days’ notice of its intention to suspend the registration and has
provided the pharmacist or the pharmaceutical support staff an
opportunity to make a representation to the Board.
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 Licensing of corporate bodies
• The Board may grant a license to a body corporate
or a government institution if satisfied that
 the applicant is fit to carry on the business of
mixing, compounding, preparing or supplying
restricted medicines by retail, and
the business of the applicant is carried on under
the super-vision of a superintendent pharmacist.
• The Board may revoke the license granted under
subsection (I) where a condition specified in the
license has not been complied with.
65
 Licensing of corporate bodies
• Licensing of over the counter medicine sellers
• The Board may grant a license to an over the counter medicine seller
if satisfied that
 the applicant is fit to carry on the business of the retail supply of
restricted medicines other than prescription only medicines or
pharmacy only medicines, or
 the area where the applicant proposes to carry on the business is
deprived of a pharmaceutical service.
• The Board may revoke the license granted to an over the counter
medicine seller if the over the counter medicine seller is in default of
a provision of this Part or if a condition specified in the license has
ceased to exist.
• The Board may impose a penalty not exceeding two hundred and
fifty penalty units instead of revoking a license where an over the
counter medicine seller contravenes this section. 66
 Classification of medicines
• The Minister shall on the advice of the Food and Drugs
Authority and the Pharmacy Council by executive
instrument classify medicines and conditions for the supply
and dispensing of medicines for the purpose of this Part.

Prescription
• Prescription is a written note by a prescriber to the
pharmacist for the supply of medicine

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 Action to be taken after supply of restricted
medicines
• Where a restricted medicine is supplied under a
valid prescription, the supplier of the medicine shall
 enter on the valid prescription in indelible writing,
the date on which the medicine is supplied and
the name and address of the supplier, and
 if the medicine is fully dispensed, retain the valid
prescription for two years on the premises at
which the medicine is dispensed so that the
prescription is readily available for inspection.

68
 Restriction on sale and supply of restricted
medicines
• A person shall not sell or supply prescription
medicine unless
 under a valid prescription,
 the medicine is in a container of the prescribed
description, and
 the container bears a label indicating the
prescribed particulars of its contents

69
 Restricted Medicines Record Book
• A person who supplies restricted medicines shall keep on the
premises from where medicines are supplied a Restricted
Medicines Record Book of the prescribed description.
• Before a person supplies a restricted medicine, that person
shall record in the Restricted Medicines Record Book
 the name and quantity of the medicine to be supplied,
 the name, the address and signature or thumbprint of the
person to whom it is supplied,
 the name and signature of the person who supplied the
medicines, and
 the date of supply.
• This section shall not apply to transactions which are recorded
electronically. 70
 Prescription and supply of medicines
• A pharmacist or licensed company shall not sell or supply prescription only medicine
except under a valid prescription issued by a medical practitioner, a dentist or a
veterinary practitioner or any person authorised or approved by the Minister.
• Restriction on the preparation and supply of restricted medicines.
• A person shall not mix, compound, prepare or supply a restricted medicine unless that
person is a pharmacist or is a licensed pharmaceutical company.
• Subsection (1) does not apply to
the supply of medicines by
a medical practitioner, dentist or veterinary practitioner to a patient in urgent need
of treatment, and
other health practitioners who may supply a limited range of
medicines determined by the Board,
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 Prescription and supply of medicines
 the administration by a nurse or midwife of a medicine in accordance with
directions given by a medical practitioner to an out-patient attending a
medical treatment centre or to an in-patient,
 the supply of a medicine other than a prescription only medicine or
pharmacy restricted medicine by a licensed over the counter medicine seller,
 the mixing, supplying, compounding or preparing of a medicine by a
pharmacy technician or student under the supervision of a pharmacist or by
a student or a trainee undergoing instructions at an institution approved by
the Board; Or
 programmes of the Council aimed at enhancing access to pharmaceutical
services.
• A pharmacist or licensed pharmaceutical company may sell or supply
prescription only medicine to a person without a valid prescription if the
supplier of the medicine reasonably believes that the person to whom the
72
medicine is to be supplied is the proper person.
 Meaning of valid prescription
• For purposes of sections 96, 97, 99 and 101 a prescription is valid
only if it is for the sale or supply of medicine and;
 is in indelible writing signed and dated by a medical practitioner,
dentist or veterinary surgeon, or approved prescriber
 states the name, qualification and address of the person signing it,
 states the name and address of the person for whom the
treatment is given or the name of the person to whom the
medicine is to be delivered if for veterinary purposes,
 indicates the total amount of the medicine to be supplied and the
dose of the medicine to be taken except in the case of an
ointment, and
 has not previously been fully dispensed
• A valid prescription signed by
 a dentist shall bear the words "for dental treatment only", or
 a veterinary surgeon shall bear the words "for animal treatment
73
only".
 Power of closure
• An inspector may close premises that sell or supply
restricted medicines where there are grounds to
believe that a health hazard may exist on the
premises or where the premises are unlicensed.
• The order in respect of the health hazard may have
conditions attached as determined by the Board.

74
 Professional misconduct & offences
A person who
• makes a false declaration in an application for registration as a
pharmacist or pharmaceutical support staff,
• willfully and falsely uses a name, title or addition implying a
qualification to practice as a pharmacist,
• operates or permits any other person to open premises to the
public under the description of pharmacy dispensary, chemist,
drug store or any other similar description with-nut a registered
pharmacist on the premises to supervise the dispensing of
medicine or medication unless otherwise authorized by the
Board:
• without being registered under this Part,
 practices or professes to practice as a pharmacist, or
 falsely claims to be qualified to practice as a pharmacist or as a
practitioner under this Part 75
 Professional misconduct & offences
• willfully destroys or damages a register kept under this Part
• supplies restricted medicines from a promotional or marketing
office without the supervision of a registered pharmacist,
• obstructs a person authorized by the Board from exercising
lawful authority
• is found to be in possession of restricted drugs without lawful
authority,
• peddles restricted medicines as an itinerant medicine supplier,
or
• supplies or sells restricted medicines from unauthorized
premises commits an offence and is liable on summary
conviction to a fine 76
 Importance of Laws and Ethics in Pharmacy practice

• without these laws and ethics, P’ceutical malpractice would go

unpunished, and more importantly, lives would be lost
• It defines the jurisdiction of professionals and specifies the manner
in which they may exercise their authority
• an obligation both toward government, which controls it, and toward
the public that it serves
• It improves accountability

77
PHARMACY AS A HEALTH SERVICE
ENVIRONMENT

78
 Scope of health service environment
• The scope of health service environment extends
from health education, preventive healthcare to
hospital practice, clinics, pharmacies, chemical
shops.
• The government of Ghana has the responsibility
of providing the health care needs of its citizens.
• It is the right of every citizen to enjoy quality
health care.
• The Government of Ghana does this through the
ministry of Health
79
 Ministry of Health
• The ministry of health is responsible for
 Policy formulation
 Planning
 Coordination
 Resource mobilization and distribution
• These responsibilities of the ministry is carried out by the
Ghana Health Service
• Thus, the GHS is the implementing body of all policies
formulated by the Ministry of Health

80
 The Ghana Health Service
• The Ghana Health Service was established by an act of Parliament
(Act 525, 1996) with the objective to:
• Implement approved national policies for health delivery in the
country
• Prudently manage resources available for provision of health services
• Increase access to improved health services
• The GHS performs these functions by
• Ensuring access to health services at all levels of the country
• Develop mechanisms of equitable distribution of health facilities in
the rural and urban areas
• Promote health, mode of healthy living and good health habits
• Plan, organize and administer comprehensive health services with
special emphasis on primary health care
81
 Health sector
• The health sector in Ghana is made up of two main
sectors
 Formal
 Informal sector
• The FORMAL SECTOR comprises
 Public sector
 Private sector
• The INFORMAL SECTOR comprises
 Traditional medical practitioners
 Faith healers
82
 Public sector
• The public sector refers to
• The sector offers its service through a network of
hospitals, clinics, health centers and maternity homes
that are organized at five levels
• These levels of organization are:
• Community
• Sub district
• District
• Regional
• National
83
 Health Providing Institutions
• Some health service providing institutions in the
country includes
 Hospitals
 Clinics
 Health centers
 Pharmacies
 Chemical shops
 Alternative medical centers

84
 Health Care Team
• Health service is not provided by one person or
profession
• It requires collective effort
• Therefore there is a mixing of different roles
played by different players in the health sector all
aimed at achieving the ultimate goal; seeking the
welfare of the patient

85
 Members in the health service
• Some of the players within the health service are
 Medical practitioners
 Pharmacist
 Nurses
 Radiologist
 Physiotherapist
 Laboratory technician
 Dispensing technician
 Medicine counter assistants
 Paramedics
 Drivers
• The health service is made up of two major health care
teams. These are
 The medical healthcare team
 Pharmaceutical healthcare team
 Auxiliary healthcare team 86
 Members of the medical care team
• Medical Doctors
• Nurses and midwives
• Ward Assistants/ ward mate
• Laboratory technician

Roles by members of the healthcare Team

• The medical health team receives, diagnose, with consultation
from the pharmaceutical care team prescribe appropriate
medicines to patient
• They also aid the administration of drugs to patients
• They provide emergency health services

87
 Medical doctors
• They are responsible for diagnosing and treating of diseases
as well as their prevention
• They also prescribe appropriate medication for the
treatment of illnesses.
• They are also trained to do surgical operations as a means of
treating some diseases
• There are also specialists doctors who specialize in a section.
eg. Paediatrician, Gynaecologist, Ophthalmologist
• The medical superintendent/ Director is the head of this
team
• There are physician assistants who are to assist the medical
doctors in diagnosing and prescribing medicines for the
treatment of diseases. 88
 Nurses
• Receive and attend to patients
• Aid in the administration of medications
• Takes the patient’s vital records
• Offers other psychological aids to patients
• Monitoring of hospitalized patients
• Assists medical officers where and whenever
needed

89
 Pharmaceutical care team
• The pharmaceutical care is defined as the responsible
provision of drug therapy for the purpose of achieving
specific outcomes that improve a patient’s quality of life

• This definition implies that the well being of the patients

depends on the pharmaceutical caregiver

• Thus the pharmaceutical caregiver through the use of

therapy is responsible for the patient’s health

90
 Pharmacist
• A core duty of the pharmacist is to check the
appropriateness of choice of drug and dose for each patient
• Supply of drugs
• Counselling patients on potential side effects and benefits
• Look out for patients reactions to medications
• Look out for potential interactions with prescribed or
unprescribed medications
• Ensure accurate dispensing and labelling of drugs
• Assess patient’s understanding of dispensed drugs and
relevant information
• Carry out proper inventory checks
• Ensure all pharmaceutical staff are well trained and
91
professional in carrying out duties
 ‘auxiliary’ healthcare team
• Paramedics – they don’t fall in medical or
pharmaceutical team.
• Radiologists – they are trained to perform X-ray,
scan, MRI, on humans to aid in diagnoses of
diseases.
• Laboratory technologists – they are trained to
perform medical tests such as Liver function test,
Kidney function test, Hematocrit count, etc.

92
 Regulators
• Within the healthcare team, there are bodies that
are established by an Act of Parliament to control
the various members of the team
HEALTH PROFESSION REGULATOR

Medical doctors and dentist Medical and Dental Council

Nurses and Midwives Nursing and Midwifery Council

Pharmacist and Pharmaceutical Pharmacy Council

Supporting Staff

Radiologist, Laboratory Technician, Allied Health Professionals council

Biomedical engineer etc

Clinical Psychologist Psychology Council

93
 Professional associations
• Aside these regulators, there exist professionals
associations who are fraternities of professionals

• Their main objective is to push for policies in the

interest of the profession so as to facilitate and
improve service delivery

• Though they are associations, they may exert some

regulatory functions on their members
94
 PSGH
• It is a family of pharmacists who work together to
ensure the highest standard of pharmaceutical
practice in the country( Ghana)

• The body has a constitution and code of ethics to

govern its members

• To ensure that professionals in this fraternity are

abreast of new trends of pharmaceutical care, they
may engage other stakeholders to offer continuous
professional development programs
95
• Ghana Medical Association (GMA) : is an
association of medical doctors with its aim as
fostering unity and maintaining high ethical
standards among practitioners

• Ghana Registered Nurses Association (GRNA):

servers as a mother union for all nurses and
negotiates on behalf of all nurses in matters of
mutual concern. They promote ethical standards
in the practice of nursing in the country

96
 Pharmacy in the healthcare system
• Healthcare is the prevention, treatment and
management of illness as well as the preservation of
mental and physical well being through the services by
the medical, pharmacy, nursing and allied health
profession
• The pharmacy is the first point of call in most
communities when people are ill. The pharmaceutical
care team therefore plays vital role in the healthcare
delivery.

97
 Pharmacy in the healthcare system

The pharmacy plays a major role in the health service

by:
• Keeping charge of all medications and ensures their
proper use
• Providing the best and most appropriate alternatives
to prescribers
• The last and most important point in service delivery
by dispensing the right medicine for patients
• Offering counselling and education for patients

98
 Pharmacy in the healthcare system

• The pharmacy is the first point of call, the pharmacist is

therefore trained to handle emergencies such as fire burns,
accidents and other minor illnesses
• By the HRB Act 857 part IV, pharmacists are allowed to give
treatments for simple diseases of common occurrences such
as diarrhoea, headache, malaria, ulcer, constipation etc.
• The pharmacist must refer serious medical conditions to the
appropriate health facility
• The pharmacist also serves prescriptions from medical
officers, dentists, veterinary doctors etc.

99
 Members of P’ceutical care team
The pharmacy has the pharmacist as the head of the
team. Other members in the team who are to
dispense under the supervision of the pharmacist
are;
 Dispensing Technologists
 Dispensing Technicians
 Dispensing Assistants
 Licensed Chemical sellers (MCA)

100
 Chain of command
• Amongst the pharmaceutical care team, there exist a chain of
command that must be respected by all.
• This order helps with administrative functions.
• At the government sector there is the Chief Pharmacist, Deputy
Chief Pharmacist, Principal Pharmacist, Senior Pharmacist and
Pharmacist is followed for administrative procedures in the
addressing of issues in the pharmaceutical health care team
setting.
• At the community pharmacy, the Superintendent Pharmacist is
the head then the Locum pharmacist
• As MCA, all issues beyond your domain are to be reported to
the dispensing technician who then reports to the pharmacist
101
PHARMACY AS A BUSINESS

102
 Pharmacy:
Is the practice of preparing drugs, making and filling up
prescription and dispensing them.

 Business:
Referred to as the act of engaging in the purchase and sale of
commodities, implying financial transaction involving goods and
services.

Every business venture comes into existence with a goal or

vision in mind. Before business can come into being one needs
to put together material, financial and human resources.
103
 CONT’D
For a business to achieve its goal and objective should be:

• Planning

• Organizing

• Directing

•
Controlling. NB
:
No business can be successful without the effective
implementation of these activities.
104
 CONT’
• Planning: Is the process of thinking about the activities required to
achieve a desired goal. Or deciding on the appropriate actions and steps
to be taken in order to achieve set goal.

• Organizing: The process of putting together people (m. c. a) in an

organization in a coordinated manner to accomplish goal.

• Directing: Is the function of guiding, overseeing and instructing people

towards the accomplishment of organization goal.

105
• Some key element of directing.

 Supervision

 Communication

 Motivation

 Leadership

These are important element of directing.

• Controlling: Are measures put in place to ensure human behaviors and

response to work lead to expected outcomes.

106
 THE 4 Ps OF PHARMACY BUSINESS

The four major factor that affect the business aspect of the
pharmacy are the product, personnel, place (location) and the
price referred to as the four Ps or the sitting of the pharmacy,
the quality of the medicine, the personnel that serve in the
pharmacy and the right pricing of the products are all very
important factors that affect the growth of the pharmacy
business.

107
 PRODUCTS
 In the pharmacy there are two categories of products:
• Pharmaceuticals (medicine/drugs)
• Non pharmaceutical (cosmetics and sundries)
Pharmaceutical products have various classification:
• Brand – Original product and Generic
Example: Original name (Flagyl) Generic name (Metronidazole)
• Pharmacological: Anti-malaria, Anti-hypertensive

108
 PERSON (PERSONNEL)

A business starts with a person that is you. Sell yourself: improve

upon your attitude by considering the following:

 Always present a professional appearance.

 Maintain a sense of dignity in your work.
 Treat client or customer with courtesy.
 Maintain good health habits.
 Have a good inter- personal relationship.
 Be an excellent listener and a good communicator.
109
 PLACE

• Location is very important in the pharmacy business. Most

pharmacy shops are sited at market places, by streets, in town
and cities, near hospitals and villages.
 Beside the location, the premises must be attractive with
surroundings tidy at all time.
 Neatness of the premises must be maintain at all time.

110
 PRICE
 Make every effort to be consistent in the pricing of products.
 Know what to say if a customer complains that your prices
are too high (expensive products).
Providing good service in the pharmacy:
In the pharmacy business, the service that one offers forms an
integral part and must be attended to with all seriousness.
The basic instruction below may be of help:
 Know the class of people.
 Know how to listen attentively.
 Know how to ask sensible questions.
 Know how to welcome customers.
 Know how to thank customers at the end of the service. 111
• NB: Every business, like a seed when planted is
expected to grow. Through growth, more human
resource can be employed. Thus, for a business to
grow, one is expected to put more resource into the
business to allow growth. If a business makes losses
the business would surely die or fold up with time.

• Here you form a human resource and must follow

direction of the manager and help support the
growth of the business by doing one’s work as
directed to ensure profitability.
112
 PROFIT

• Definition: Profit, also called net income, is the amount of

earnings that exceed expenses for the period.

• In other words, it’s the amount of income left over after all the
necessary and matched expenses are subtracted for the
period or is the making of gain in business activity for the
benefit of the owners of the business. The word comes from
the Latin meaning to make progress and is defined in two
different ways, one for economics and accounting purpose.
113
 CONT’D
 Economic profit: Is the difference between the total
revenue received by a business and the total explicit and
implicit costs of a firm.

• Explicit costs are the everyday costs that you pay for to
run a business, such as wage, rent , utilities and raw
materials.

• Implicit costs are also known as imputed cost is the

opportunity cost equal to what a firm must give up in
order to use a factor of production for which it already
114
owns and thus does not pay rent.
 CONT’D
 Accounting profit: Is also called bookkeeping profit,
is the net income that remains after subtracting the
explicit costs from a firm’s total revenue.

• In calculation of profit explicit cost assists in

calculating both accounting profit as well as
economic profit and implicit costs help in
calculating only economic profit.

115
 METHODS OF IMPROVING PROFITABILITY

• Service methods: Better services can increase sale

thereby increasing profits.

• Stock methods: Increase in stock and range of

products can increase sales and profit.

• Price methods: Increase or decrease of prices can

yield high sales leading to increase in profitability.

116
 CONT’D
• Waste methods: Monitoring the production and
expiry dates of all drugs/medicine and preventing
them from expiring, also lead to profitability.

• Seasonal method: Every business there are seasons

of high yield and seasons of low output. Example: in
raining seasons the rate of malaria increase and on
easter festivities food poisoning cases increase,
therefore stocking of drugs well in their seasons and
preventing shortage increase profit.
117
PRODUCTS PRICING AND
PROFITS

118
 Pricing products
• The price you set for a product directly affects your business
profitability and customer demand.
• Prices need to be low enough to appeal to customers but high
enough for you to cover your overhead expenses and make a
profit.
• Pricing is the most important factor affecting profits.+
Profits = Sales − Costs
Sales = Items sold × Price
• When pricing a product, consider these questions:
 What are the customers willing to pay?
 What is the break-even point?
 Are all of your costs covered?
 Do you want to price the same or below your competitors?
 What’s the supplier’s suggested retail price?
 Customer-focused strategies
• Opportunistic pricing — Setting a premium price on an item
in short supply.
• Psychological pricing — Making a price sound right to
customers.
• Price skimming — Setting a high price on a high-demand
product.
• Loss leader pricing — Selling a few products at a loss in order
to bring customers into your store.

Competition-focused strategies
• Defensive pricing — Temporarily lowering prices to
discourage new competitors.
• Responsive pricing — Monitoring competitors’ prices and
adjusting yours to be competitive but still make a profit.
 Markup
• One way to set the sales price of an item is to use a markup
percentage.
• To determine the markup percentage, you need to know the
wholesale cost of an item and the amount above that cost
that you want to charge for the item.
• The mark up is the profit set on an item
Markup = Selling price − Wholesale cost
Markup percentage = Markup ÷ Wholesale cost
• For example, if you buy four strips for ₵2 each wholesale
and want to sell them for ₵ 3 each:
• Your markup: ₵ 3 - ₵ 2 = ₵ 1.
• The markup percentage: ₵1 ÷ ₵2 = 0.5 or 50%
 Markup
• Most suppliers provide a suggested retail price (SRP) on their
invoices.
• The markup percentage of those suggested prices can be between 20
and 50 percent depending on the product.
• The suggested retail price may be the retail sales price, but should be
calculated using the SRP as a point of reference.
• One could calculate the new selling price based on the markup
percentage.
Wholesale cost × (1 + Markup) = Selling price
• Your overall markup should be enough to cover your operations and
carrying costs.
• Consider how you will factor in the cost of freight, whether as part of
your overhead or included in the wholesale cost.
• If you would prefer not to increase your selling price, you can try to
find a cheaper wholesale supplier to lower your cost.
 Discounts
• In general, business owners tend to mark down prices to reduce
inventory.

• A trade discount is a reduction of catalogue price (or list price).

• Cash discount is offered by businesses to prompt payment.

• Markdown is basically the reduction in the regular selling price

• Reasons for wanting to reduce inventory can include

 The cost to store items
 Spoilage
 Space is needed for new merchandise
 Items aren’t selling as anticipated
 Profit determination
• Using the markup formula, it is easy to calculate the profit of
a business.
• And the markup is almost equal to the profit including other
business expenses
• If the multiplier of a product is 1.40, then the markup is 40%
• Likewise if the multiplier is 1.35, then the markup is 35%.
• Assuming a product is sold at ₵50 after multiplying by 1.65,
then 65% of ₵50 is the markup. The remaining 35% was the
cost price.
• Therefore the cost price: 0.35 X ₵50 = ₵17.5
• Subtract the cost price (₵17.5) from ₵50 would obtain the
markup which is = ₵32.5
• ₵32.5 is exactly 65% of ₵50
 Profit determination
• Assuming the total sales a month of a pharmacy is ₵10000
and all products are sold at a markup multiplier of 1.40
• 40% of the sales is the profits of the business
• Therefore for Pharmacy A, the monthly profit is ₵4000.
• However there are expenses such as utility, loss to expiry,
salaries of employee and other bills which would be
subtracted from the profit.
• The overall profit would therefore be less than the 40% or
₵4000
 Examples
• Amoksiclav 625mg contain 14 tablets in the
pack . A carton contains 24 packs at ₵18.67 per
pack at the wholesale and mark up is 20%.
• Calculate the following
a) The retail price per pack
b) Retail price per the carton
c) Retail price per tablet
d) The profit per pack
e) Profit per carton
f) Profit per tablet.
TYPES OF BUSINESS OPERATION IN PHARMACY PRACTICE

• A pharmacy may operate as a sole proprietor, a

partnership, or limited liability company. Each has
advantages and disadvantages.

 Sole proprietor: This is the simplest form of

business organization. It is often refers to as one
man business. Thus, a single person owns and
control the entire business. The strength of this type
of firm is in the direct personnel interest of the
proprietor in efficiency of this enterprise.
127
 Features of a sole proprietor

• A single person provide the capital, pays the decision and

assume the risks. He alone is sole responsible for the
success or failure and as therefore the sole right to such
profit as may be made or such loss as he may incur.

• It is managed and control by the proprietor alone, at a

time with the help of one or two people who can be family
members or friends. It therefore has no board of directors.

• In this form of business, the proprietor alone enjoys all the

profit made. Thus profit sharing. 128
 Source of finances
 Proprietor personal savings.
 Obtaining credit from facilities example: Obtaining goods
from wholesalers on credit bases.
 Winning from lottery.
Advantages
 A small capital is usually needed to start hence not difficult
to operate.
 Since the entrepreneur is the sole decision maker and has
no need to consult any body when any changes in policy
are required, decision taking is fast.
 Sole proprietor can withdraw cash and good for any
purpose without the permission of any body.
129
In spite of the advantage stated above, sole proprietorship also
has the following disadvantages.
 Risks bearing: Sole proprietor is the sole risks bearer. He
alone bears the consequences of any bad decision.
 As the sole proprietor is in most cases responsible for the
operation of every aspect of business he or she may lack
professional competence in one aspect of the entire business
operation. Example A sole proprietor with no knowledge in
accounting beyond handling cash, transactions may lack the
competence to balance the cash book.
 Death/Illness: In most cases the death of the sole proprietor
spells the death of the business where there is no outside
assistance, in addition the absence from the business
through sickness brings the business down. 130
 PARTNERSHIP
• A partnership is a form of business ownership which is formed by
people with a view of making profit. It is usually formed by two and
not more than twenty people who contribute capital towards a
common purpose.
• It can also be defined as a joint association of two or more individuals
carrying on business jointly for the purpose of making profit.
It is obviously large in size than a sole proprietorship. The following
are some of the condition that give legal backing to a business to be
operated under the name partnership.
 It must be registered under incorporated private partnership (Act
152) 1962.
 It must be established with the motive of earning profit.
 It must be formed by two people but not more than twenty.
 There must be a bank account through which all financial transaction
131
should pass.
 TYPES OF PARTNERSHIP
• There are two main type of partnership which are
ordinary/general and limited partnership.
 Ordinary/General Partnership
Ordinary partnership has it own members ranges between 2
and 20. Members in this type of partnership do not enjoy limited
liability, that is they may lose their capital contribute in addition
to their assets if the business happens to go bankrupt.
All partners have the same right, duties and responsibilities
without limitation for the debts of the firm.
 Limited Partnership
Members of limited partnership are limited liabilities. This
implies that debts payment is limited to assets they have
contribute to the partnership business. Debt payment cannot
cover their private payment as in case with the ordinary 132