BPS :: BANGLADESH PHARMACEUTICAL SOCIETY

Prospects of Pharmacy in Bangladesh
By Dr. Habibur Rahman

Introduction

Now-a-days internationally a well pronounced slogan is: BECOME A PHARMACIST, A PHARMACY CAREER MEANS A SALARY JOB OPPRTUNITY.

In fact, pharmacy career is more than a job. It is a rewarding profession in the health care industry. The importance of pharmacists in the health care system has been recognized all over the world. In appreciation of the valuable contribution of the pharmacists, Shaheed president Ziaur Rahman took the initiative to promulgate the pharmacy ordinance -1976 to recognize and promote pharmacy as a profession in Bangladesh.

The practice of pharmacy is the interpretation and evaluation of prescription orders; the compounding, dispensing, labeling of drugs and devices; the participation in drug selection and drug utilization reviews; the proper and safe storage of drugs and devices and maintenance of proper records; the responsibility of advising of therapeutic values, content, hazards and use of drugs and devices; and the offering or performing of those acts, services, operations or transactions necessary in the conduct, operation, management and control of pharmacy.

A pharmacist is the person of drugs or expert on drugs. In other words, a pharmacist is called “drug consultant”. He is the only expert on drugs, for expertise regarding drugs requires knowledge in depth in all the facets of pharmacy.

The physician, dentist and veterinarian may prescribe drugs and primarily be interested in those drugs on the patients, their therapeutic value and toxicology. The nurse may administer the drug and be concerned with dosage forms, routes of administrations and toxic manifestations, but the pharmacist is the only expert on drugs. It is his legally granted responsibility to handle drugs. It is his professional responsibility to know all about those drugs. No educational program other than that in pharmacy provides the background to understand completely about drugs. The pharmacist, and the pharmacist alone, is in that unique position of embracing complete drug expertise.

A health care team comprises of pharmacists and other health care providers like physicians, nurses, medical technologists, laboratory technicians etc. For better management of health care always requires significant contribution from each of these professional groups. As the drug and medicine play a very crucial role within the health care system , the pharmacist does play a very vital role in this regard.

Pharmacy is a highly specialized profession which requires graduate level qualifications and is concerned with research and development of drugs, their preparation, quality control, proper and safe storage, dispensing, and the eventual use and action on the human body. Pharmacy education includes the study of appropriate combination of (a) chemistry (analytical and organic) or biochemistry, (b) chemical engineering, (c) microbiology, (d) pharmaceutical sciences and technology, (e) pharmacology and toxicology, (f) physiology, or (g) other related sciences. Pharmacy curricula are tailor made to meet the highly specialized knowledge and expertise in the pharmaceutical field. The career and scopes of the pharmacists have been shown in Table 1.

Industrial Pharmacy Government Agencies Hospital Pharmacy Community Pharmacy Academics Others
Production Drug Administration Clinical Chain drug store Research Entrepreneurship
Product Development CMSD Administration Supermarket Teaching Merchandizing
Quality Control Public Health Service Drug Information Independent drug store Administration Indenting
Quality Assurance Armed Forces   Drug Information Publication  
Dispensing Government Hospitals        
Research & Development          
Marketing          

(Table - 1)

 
Industrial Pharmacy

In our country industrial pharmacy offers opportunities to qualified graduate pharmacists in an industrial environment. The greatest number of pharmacists are involved in production, marketing and administration. The section 13(1) of drug control ordinance (1982) categorically says that the overall supervision of drug production must be done by a qualified graduate pharmacist. Thereby, the production supervisory positions in industrial plant are always held by pharmacists with bachelor’s degrees. Apart from production, there are many other areas in which an industrial pharmacist can specialize. Pharmacists with master’s degree in business find opportunities in pharmaceutical industries in marketing, sales and legal departments. After 22 years of the promulgation of drug policy(1982), the drug business has jumped from 250 crore taka to almost 3000 crore taka. At the same time the import of drugs has dropped from 90% to 5%. This has been materialized by the efficient contribution of pharmacists. In marketing and product management, determining strategies, developing promotional materials and marketing research are the areas of interest for pharmacists. Quality control supervisory positions are also often held by pharmacists. Pharmacists sometimes develop their career as research and development personnel. Development of stable, aesthetic and cost-effective pharmaceutical products is a highly specialized area where an industrial pharmacist because of his pharmaceutical know-how and multidisciplinary background plays the most vital role. Because of high legal, ethical and moral responsibility, the industrial pharmacists ensures the full compliance with good manufacturing practice, good laboratory practice in an industrial set up.

Sometimes, manufacturers employ pharmacists as sales representatives who provide the link between the manufacturers on one hand and pharmacists and doctors on the other.

 
Government Agencies

Government services offer opportunities to pharmacists in various capacities. In our country, although, this particular sector is not that much healthy as compared to that of advanced countries, there are many places where pharmacists are working with dignity and prestige. At present more than 20 pharmacists are working in Directorate of Drugs Administration in different levels. But this number is quite insufficient to monitor or control the overall drug situation in Bangladesh.

A significant number of pharmacists can be employed in CMSD. Currently, seven pharmacists are engaged in CMSD in our country. However, there are ample opportunities still remaining in this field. After decentralization of government CMSD in 1989, local purchase is conducted by civil surgeon instead of the Director, CMSD. Government can take advantage of saving huge amount of money by taking proper decision in preparing the Medical and Surgical Requisite (MSR) list. The involvement of experienced Pharmacist in MSR selection committee of each district can only ensure the rational preparation of the MSR list. Such decision will indeed reduce the chance of over-expenditure and misuse of drug products and increase the efficiency and transparency of purchasing.

Pharmacy Council of Bangladesh (PCB) is another semi-government agency that can provide scope for the graduate pharmacists. The council can be considered as the controlling authority of pharmacy education and practice. Recently, 8 pharmacists are working in PCB with advanced level of performance. The pharmacists working in this field ensure the highest standard of quality required for pharmacy training and practice in different academia.

Like other developed countries, pharmacists can also be employed by the government in defense like Army, navy and the air force where the health and ambulatory system will be coupled with proper guidance and supervision regarding drug products.

 
Community Pharmacy

The plethora of manufactured drug products and the abundance of physicians coupled with the propensity to prescribe multiple products for various concurrent ailments present an opportunity for pharmacists in community practice. The community pharmacy can broadly be considered as community-based pharmacy. The main responsibilities of a community pharmacy include compounding, counseling and dispensing of drugs on prescription to the patients with care, accuracy and legality. Appropriate procurement, storage, dispensing and documentation of medicines are within the purview of its professional responsibilities. It is an important branch of the pharmacy profession and involves a qualified and pertinent pharmacist. Being closely in contact with general people, the community pharmacists should have the required education, skills and competence to deliver the professional service to the community.
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Pharmacists in community pharmacy practice, whether independent or chain settings, are slowly shifting their focus from the drug product to patient service. Yet the shift of attention from drug product to patient does not find its genesis solely for the satisfaction of pharmacist needs, aspiration or even in altruism. This change is an exigency for their professional survival. Without a change in focus from drug product to patient service, pharmacists, themselves will be in danger of displacement. Refocusing from drug product to patient has caused the pharmacy profession to develop newer skills and explore the diversified dimension of community pharmacy which need insight both into drug effects ( eg. understanding drug action, kinetics and interactions) and patient dynamics (i.e. learning how to communicate with and educate patients regarding drug, disease and dosage regimen).

Though auspicious enough, the scenario of community pharmacy is quite different in our country. As we know Mr. Nasser Shahrear Zahedee President of Bangladesh Pharmaceutical Society (BPS), delineated a clear status of community pharmacy in Bangladesh in his presentation in National Conference on Community and Hospital Pharmacy in 2002. At present, there is not a single pharmacy graduate working in any pharmacy in the country. There are more than 60,000, which Mr. Zahedee termed “ Pharmacy outlets” in our country but not a single “Community Pharmacy”. Steps are continually being taken by BPS, both individually and collectively with the government, to convert and develop these “Pharmacy outlets” to professionally operated community pharmacies. This development will open an immense opportunity of occupational engagement for the graduate pharmacists in near future.

 
Hospital Pharmacy
Hospital and clinical pharmacy can also provide the graduate pharmacists with ample prospect of professional accommodation. This sector, though not in a completely flourished state in Bangladesh, is critically important for the benefits of the patients as well as for the reduction of hospital budgets. Introduction of hospital and clinical pharmacy in practice will certainly exert its manifold impact on total health policy of a country. With the advent of the concept of hospital pharmacy, the government will be benefited in terms of cost by seemly utilization of finance and appropriate handling of stock while the patients will be benefited in terms of prescription standards and counseling. Additionally, the hospital pharmacists can monitor indoor patient medication chart, provide updated drug information, exchange technical view-point of drug related clinical activities with other health professionals and provide with statistical compilations of consumed drugs and expenditure reports. Pharmacists can also be engaged in the administrative positions of a hospital where significant contributions can be made. Drug information centre in a hospital is another unique area where pharmacists can build up their career.
 
Academic

Even before a decade or two, Department of Pharmacy, University of Dhaka was the only academic institution that served to develop the professional skill and competence of young graduate pharmacists. With the passage of time, more academia came forward with the facilities of pharmacy education. At present there are 4 public universities and at least 10 private universities where pharmacy is being taught (Table 2).

Sl. Name Location Estd.
1. University of Science and Technology, Chittagong Chittagong 1994
2. The University of Asia Pacific Dhaka 1996
3. University of Development Alternative Dhaka 2002
4. East-West University Dhaka 2003
5. Manarat University Dhaka 2003
6. State University of Bangladesh Dhaka 2003
7. Northern University Dhaka 2003
8. Primeasia University Dhaka 2003
9. Gono Biswabiddyalay Savar 1998
10. Stamford University Dhaka 2003
11. Southeast University Dhaka 2003

(Table 2)

Every year, about 300 students earn their graduation in this subject and accordingly get involved in professional outlets in home and abroad. Although, the trend of enrollment of students with better intellectual performance in this subject was always higher than the others, in the nineties, students showed greater propensity to get themselves admitted into the subjects related to IT and computer science in University of Dhaka. However, the trend has been changed in the recent years as the students topping the merit list are taking admission in Pharmacy and the pattern is almost the same for all other national universities where pharmacy is being taught. Greater job availability, job security, satisfactory remuneration package and higher professional variability and diversification are the underlying causes for such proclivity of the students toward pharmacy education.

Research and development in the field of newer drug molecules, novel drug delivery systems or improved health care concepts is another prospective arena of pharmacy education. In Bangladesh a good number of pharmacy graduates are involved in research in different institutions. This area of pharmacy profession is certainly carries better prospect both in home and abroad.

 
Others

Since the very beginning, a good number of pharmacy graduates involved themselves in trade and business and this trend still persists. The pharmacist, being trained on different aspects of pharmacy practice, manufacturing and marketing, can get involved in manufacturing and merchandizing of drug product, raw material, intermediate chemicals and pharmaceutical equipment with skill and efficiency. In the context of Bangladesh, this is indeed a challenging career that can be undertaken by pharmacy graduates.

A pharmacist is a person with specialized skill and knowledge. As a result, he has a broader avenue to work in the specialized field of drugs in home and abroad. From the very beginning of pharmacy profession, a significant number of pharmacy graduates migrated to western countries where they ensued their career successfully. In abroad, pharmacists get the scope to build his career mainly in retail pharmacy, hospital pharmacy, and industrial pharmacy. As a fraction of skilled population, the rate of migration of pharmacists to foreign countries is increasing almost linearly with time as can be observed from Figure 1.

The figure illustrates that, the migration of unskilled personnel soared up to a maxima during the year of ’94—’95 after which their rate started to decline. On the other hand, the emigration of skilled personnel, though less in number than those of unskilled people, is increasing steadily. The rate of migration of the pharmacists, as skilled personnel shows almost the same pattern. Pharmacists graduated from Bangladesh are mainly going to the USA, Canada, Middle East, Japan and also some other European countries. The rate of going abroad of pharmacist can be clearly manifested from Table 3 and the country wise distribution of these emigrant pharmacists are illustrated in Fig. 2. Table 3 shows that, a total number of pharmacy graduates those have been registered by PCB is about 2300 among which only 1000 is working in Bangladesh and the rest of them have gone abroad. Figure. 2 also illustrates that, most of pharmacists graduated from Bangladesh are migrating to the USA, and Canada since these two countries offer better scope for career development.

 
Country wise distribution of pharmacists graduated from Bangladesh:
Country / Region Number
Total number of A-grade pharmacists graduated 2381
Total number of pharmacists working in the country 1050
Total number of pharmacists working abroad 1331
Woking in the USA 830
Working in Canada 150
Working in the Middle-east 120
Working elsewhere 231

Source: Pharmacy Council of Bangladesh

 
Conclusion
Pharmacists and the profession of pharmacy are at the crossroads of healthcare. Opportunities for the creation of new forms in the profession abound. In the advanced countries like the USA, pharmacy profession is the third largest health profession. It is a trusted profession because of the care and service it provides. It is a career with a blend of science, healthcare, patient care, computer technology and business. The demand of the profession is extremely high. Opportunities are also tremendous. With the new drugs coming out the employment future is very good. Thus a pharmacist gets job security, recession proof employment, well paid job and above all financial security. In our country with the creation of new opportunities, the demand of this pharmacy profession is hoped to be increased in geometric fashion in near future. Now the fastest growing and demanding subject both in private and public universities is pharmacy. Health is a cardinal sector which is to be restored in every aspect- whether at individual level or at the national level. And to restore of this either individual health or national health, there is no other alternative to pharmacy profession.