CHA PTER A

COMMUNITY PHARMACY

LEARNINGOBJECTIVES
MANAGEMEN
Know the legal requirements to start acommunity pharmacy.
Understand the importance of site selection.
Appreciate various designs of the pharmacy and layout.
Know and maintain various registers in the pharmacy.

INTRODUCTION
In the last census, India had crossed one billion population with an exponential addition o
30million population every year. Due to overcrowded population, poor sanitation, limte!
medical facilities people are suffering from various diseases such as infectious diseases likc
Malaria, Filaria, Tuberculosis, Leprosy, Cholera and Gastroenteritis, Helminthic infestatut
Polio, AIDS and other Sexually Transmitted Diseases. Malnutrition disorders incs
anemia, and vitamin deficiency diseases are in high rise. Since Independence, althougn
governments are introducing many health care programs for improving the the public healt
problem
maternal and infant deaths are not under control. In urban and semi urban areas gutka
are different. Social habits such as cigarette smoking, chewing pan masala and chrouk
alcohol consumption are increasing and leading to many diseases like asthma,andliv
intestinal
obstructive puimonary disorders (cOPD), hypertension, diabetes, gastro theseso
diseases. Most of the people in the productive age group are becoming slaves for sick,the
habits and becoming burden to the society. In communities when people become o n°
symptoms
will first visit the nearby medical store for receiving the primary care. If
resolve, than patients willgo to the clinics for consulting the doctor. Medical
shop
th
In India, people often call community pharmacies as Medical stores, and areinwi
Medical and General Stores. Community pharmacists are suitably qualified patient
right position to help such people by providing the right medication for right
counseling
Pharmacy
suitable advice for medication usage, conducting awareness camps, group
Smoking cessation programs and other health care programs. The Community

66
 CHAPTER8 COMMUNITY PHARMACY MANAGEMENT 67

patient
defined as "a place where the medicines are stocked and dispensed to the patients or
oivers under the supervision of a qualified and registered pharmacist upon the
production of a prescription or when legally permitted without the prescription". Community
Pharmacy is not only a place for professional services but it is also a business establishment.
Success of a community pharmacy depends upon various important aspects such as location
of the pharmacy, design of the pharmacy, display of the goods, approach of the pharmacy
personnel, and proviSion of patient care services.
Site Selection
but predominantly it is a trade. So
Although community pharmacy practice is a professiontake suitable steps to improve the
anart from providing the services, it is essential to
should do a macro survey of the area
husiness. Before starting the pharmacy, the pharmacist
such as the population size, number of
where he or she is intending to start the business
existing around should be taken in to the
practicing doctors, number of medical stores important for a good business. A site
consideration. Suitable selection of the site is very
wronglychosen site may run the business in to
chosen correctly can boom thebusiness anda The prescription feed
losses since the pharmacy business depends upon the prescription feed.
doctor or nearby practicing doctor or nearby hospital, or floating
come from attached from all
to
the possible sources, it is essentialfor
prescriptions. To receive the prescriptions
by to prescription feed sources. The suitable sites
open the pharmacy which is close
opening a pharmacy are
(a) Attached to a clinic
(b) Close by to clinics
(c) Nearby toa hospital
(d) In a busy market
(e) Growing city extensions
station or bus station
() Close by to railway site for opening a pharmacy. The
This is the most suitable
(a) Atached to a clinic: good number of prescriptions based on your rapport
prescriber willsend youa very advantages of this kind of the
give to your clients. The
with himn and the service you substitution may be permitted when the prescribed
prescription feed, also consider the pharmacist
as
Setup is regular moment. Patients may
brand is not available at that
related information and
advice.
contact for health
first of
considered as a good choice to open a pharmacy close
(D) Close by to clinics: It is
also
market area. Advantages of opening the
colony or in a practitioners,
by to the clinics in a is good prescription feed from the generalgood customer
pharmacy in such areas when prescribed brand is not available,
permission for substitution 0TC sales. The pharmacist in co-operation and
rapport and opportunity for general provide pharmaceutical care services such as
doctor can These
taking the confidence of themanagement through health screening services. care
Counseling, drug therapy patient confidence about the pharmacist as health
services will improve the the success of the business.
professional and contribute for
68 COMMUNITY PHARMACY PRACTICE

(c) Nearly to hospital: Opening a pharmacy nearby to agovernment general

any other secondary care or tertiary care hospital is a goodidea. The hos p ital or
preseription feed will be high. However the pharmacist requires
variety of product range with different brands. If appropriate
maintained, this is a good option for successful business. The
maiinopport
nventtainoiurinnigesty wiardee
for

rapport with the prescribing doctor and poor chances of brand disadvantages are less
maintaining morenumber of brands will influence the inventory costs.
(d) Ina busy mnarket: Busy markets are also considered as right choices for
substitution,
pharmacies due to increased movement of the public in these areas. Public
the market for purchasing different commodities. Along with purchase of o may
the
visit
opening
commodities, they will also tend topurchase the medicines for their health cate
pharmacies opened in busy markets will primarily depend on the Hlo
prescriptions. Success of such pharmacy depends upon layout and design of th
pharmacy with patient waiting area, water facilities, patient care services such
counseling, health screening services, and cash discount. On long run, customer
patronage will increase the business volume, which in turn increases the profit
margin. Shopping malls, close by cinema theaters are also other good options to
open the pharmacies.
(e) Growing city extensions: Growing city extensions are also good sites for opening
community pharmacies. People in such areas find difficulty in going to market fot
emergency requirement of medicines. If apharmacy is opened with facilities such as
patient waiting area, counseling and health screening services area willattract the
customers. Chronic patients like diabetes, asthma may require detailed counseling on
safe and effective use of insulin injections or inhalers. If such facilities are provided
patients will be pleased to patronize the pharmacies. The pharmacist can also make
the pharmacy popularize in the area by conducting health promotion programs and
health camps etc. This type of pharmacies will have good opportunities tor
pharmaceutical care services.
() Close by to railway station or bus station: Railway stations and bus stations are also
considered as good locations for opening the pharmacies. The commuters
require medicines to get an immediate relief for acute conditions such as diarhea.
common colds, or body aches. Availability of apharmacy in close by to these
Will help the patients to purchase the medicines. This type of pharmacies will recele
the tloating prescriptions and prescriptions for acute conditions. Along wu
prescription medicines, opportunity for generic sales will be also very nig
contributing to the business volume.
Apart from the above, other important criteria required to be considered bythe
pharmacists while opening a pharmacy are
(a) Parking space in front of the pharmacy
(b) Close by Traffic lights and traffic rules
(c) Visibility of the pharmacy
(d) Expansion opportunity for the existing space
 CHAPTER8 COMMUNITY PHARMACY MANAGEMENT 69

i Clear negotiations with the land lord regarding the rent or lease of the pharmacy
Facilities for temperature control for thermo labile medicines
(o) Separate storage spaces for poison and Schedule Xdrugs

SPACE LAYOUT AND DESIGN

ln the modern world the clients will always give importance for quality services in short
nossible time. Especially in service oriented establishments, preference also will be given for
interiors and ambience. To meet this demand it is essential to have a new work system and
facility design for the community pharmacies. The new work system should be developed to
ontimize the utilization of space, and sales personnel time and allow the pharmacist to
increase patient care services without adding the personnel. In the new design, pharmacists
should be able to review prescriptions, check technicians' work, and dispense prescriptions,
counseling patients as needed; technicians would enter prescriptions into the pharmacy
computer and fill them.
The objectives of a good pharmacy layout is to
Attract maximum number of customers

Provide an opportunity for the customers to purchase more

Create a pleasant ambiance in the pharmacy and provide basic amenities for the
clients with maximum space utilization
Provide customer convenience and the satisfaction
Minimize the salary expenses through layout efficiency and space utilization.
Based on the layout and design, the pharmacies can be classified as
(a) Prescription oriented traditional pharmacy design
(b) Super drug store pharmacy design
(c) Pharmacy with pharmaceutical care services design
PRESCRIPTION ORIENTED TRADITIONAL PHARMACY DESIGN
I hese are the traditional drug stores which are commonly seen in the market or street
side.
Major objective of such pharmacies is to serve the customers through filling maximum
volume. In such
umber of prescriptions and sale of other products to increase the business
pharmacies, the lay out will include a cash counter with facilities for billing and collection of
Lne cash. The product display will be in racks supported with the sales man service.
Customer chojce and selection will be very limited. Amenities for customers are also very
imited. Dimensions of such pharmacies willbe around 200 Sq.ft
70 COMMUNITY PHARMACY PRACTICE

Model layout of the Traditional Pharmacy Design

Patients Area
HEALTH CARE PRODUCTS
R Counter R
A A
C

Racks

SUPER DRUG STORE PHARMACY DESIGN

in the western world. Thee
Super drug store pharmacy designs are more common
pharmacies will provide opportunity for purchase of both giftprescription and other general
items. In such pharmacies.
health care items, cosImetics, baby care, eye care and other
supported health care items counter, gt
along with separate prescription counter, sales man
have a separate attached place to
items counter will be present. The pharmacy should also design ofte
displayed. The ambience and
collect the goods and storage before the goods aremore customers with increased purchasing
pharmacy are made in such a way to attract
Along with prescription items, sales for general items also will contribute for te
temptation.
business volume.

Model Lavout of Superdrug Store Pharmacy Designs

 CHAPTER 8 CoMMUNITYy PHARMACY MANAGEMENT 71

PHARMACY WITH PHARMACEUTICAL CARE SERVICES DESIGN

Pharmaceutical care is a responsible provision of drug therapy to achieve the desired
therapeutic goals. Pharmacies with pharmaceutical care services will have separate patient
care area for offering counseling and health screening services along with area for display of
medicines and other health care items supported with sales man service. The design should
inchde space for prescription counter, a separate counter for other health care items,
toiletries, and baby care items display and sales. The wrapping and billing counter should be
at the entrance.

Optimum Design Characteristics of a Pharmacy

The pharmacy should be painted with special light professional colors to give a serene
and pleasant feeling to the customers when they enter the pharmacy.
. The pharmacy should be well illuminated with proper ventilation or air conditioned
and with appealing room freshener.
Basic amenities such as customer waiting area with seating facility, availability of
health magazines for reading while the prescriptions are filled, with wash room
facility should be created. Water and espresso coffee facility may add value to the
customer care.

A separate counter should be made available for prescription medicines with

pharmacist services.
Aseparate pharmaceutical care service for patient care, special counseling cubicle
with health screening service equipment.
Display of health care items, toiletries and gifts should in a separate cormer with sales
person assisted services.
Adequate fixtures and furniture should be made in the design of pharmacy for
stocking all varieties of medicines.
Legal Requirements to Start a Community Pharmacy
order to sell drugs and pharmaceuticals, the pharmacy should comply with all the
provisions of the Drugs andCosmetics Act 1940. Any individual to open a pharmacy to sell
medicines in retail or wholesale or sale of drugs by retail without engaging service of a
qualified person (restricted licence), sale of drugs by wholesale from a Motor Vehicle, sale
Of homeopathic medicines by wholesale or retail should obtain the prescribed licence from
ae hcensing authority. For obtaining licence to sell drugs in above categories, following
application forms may be used.
72 COMMUNITY PHARMACY PRACTICE

List of Application Forms, Licenses Categories of Drugs to Be Sold

Appl.
S Category of Drugs to
Presence of
Form Number in
licence is issuedwhich
No. Form qualified person
be sold
Number required for
1 19 Wholesale/Retail of Yes 20-
categories of drugs
drugs other than
For retail sale
specified in Schedule Category A
drugs
20 8
Adrugs Wholesale of category
21 - Sale of
drugs category B
21 B wholesale
of
drugs
21 C
category
renewal
A&Band 21 A
of
licenses 20
&B
2 19 A
Restricted Licence No 20 A- retail
sales of
Adrugs and 21 A- category
retail
19 AA of category Bdrugs. sale
Sale of drugs from Yes 20 BB
Motor Vehicle
A
drugs wholesale of category
21 BB
4 19 B B drugs
wholesale of category
Wholesale/Retail
of
sale
Yes 20 C- Sale by retail
medicines
Homeopathic 20 D- Sale by wholesale
20 E -Renewal of License
5 19 C 20 Ci20D
Wholesale/Retail sale Yes 20 F sale by retail
of drugs specified in
Schedule X 20G sale by wholesale
20 C Renewal of above
Procedure to Obtain the Licence
An applicant to sell the drugs
should apply to the Drugs of A category, B Category and Schedule X drugsin etal
prescribed fee. Along with theControl Department in a suitable application fom withthe
atached. application form, the following documents are requiredtok
(a) The layout of the
area required to startpremises,
a retail
where pharmacy is going to be started (The minimut
(b) The rent
agreement pharmacy is 120 Sqft.)
(c) Invoice proof of between landlord and the applicant
the
(d) The purchase of the refrigerator for C&Cdg
in-charge person should be a stocking the Schedule pharmacist.
qualified person who is a registered
 CHAPTER 8 COMMUNITY PHARMACY
MANAGEMENT 73
the licence, the
For granting licensing authority will inspect the premises and
satistaction will issue the license to start the upon
pharmacy.
Staff
is not only
Pharmacybusiness trade but also a profession. As per
the medicines should be dispensed under the the Drugs and Cosmetics
Act, all person passed 2 year supervision of a qualified person. In
Indian context., aof Diploma in Pharmacy (D. Pharm) and undergone
practical training
s00 hours in a hospital
pharmacy or community pharmacy or a B. Pharm
graduate with 150 hours of practical training is also eligible to register in State Pharmacy
CouncilIas a pharmacist. Only such registered pharmacists are called as
assistthe qualified persons in pharmacy operations, individuals with other
qualified
persons. To
qualifications
such as 10+2 qualification or degree may be appointed as pharmacy assistants. The patient
focused pharmacy program Pharm D was started in 2008 by Pharmacy Council of India.
Pharm Dgraduates are trainedto take the responsibility in managing the overall activities of
pharmacy including patient focused services such as patient counseling, health
ser ices and drug therapy monitoring. Pharm D graduates will really add valuescreeningto the
pharmacy through patient care services.
Materials-Coding, Stocking
When medicines are received from the supplier i.e., wholesaler, the stocks should be
nronerly arranged in the racks for easy location and removal of the drug from its carton box
at the time of dispensing. Various methods are adopted by the pharmacists as per their choice
and convenience. Such as company wise, product wise or pharmacological category wise
etc. the methods used for coding the stocks are classified in to:
(a) Mnemonic method
(b) Scientific method
(c) Random method
(a) Mnemonic method: Mnemonic means "memory". In order to remember easily the
location of particular category of medicines, a suitable code may be used such as
"Gr for all the categories of drugs that are used to treat Gastro Intestinal disorders.
On the top of the medicine cabinet, a label can be fixed stating "GI".
D) Sientific method: In the scientific method, all medicines may be divided into
various categories such as therapeutic classification. This may be further subdivided
into dosage forms. A simple example of this is major therapeutic class is
Cardiovascular Drugs"The drugs under this class may be further sub divided in to
HIN, which mean the drugs used totreat hypertension. Further allthe drugs used to
reat hypertension such as Diuretics, Beta Blockers, Calcium Channel Blockers,
Angiotensin Convertase Enzyme Inhibitors (ACEI) or Angiotensin Receptor
Blockers (ARB) may be further coded as DU, BB, CCB, ACEland ARB. Based on
e ype of dosage form, the medicines may also be coded.
(c)
Randommethod: It is more like an arbitrary method. Medicines may be stored in
alphabetical order or in numeral order or dosage form order.
74 COMMUNITY PHARMACY PRACTICE

Various health care items are sold in the pharmacy such as

OTC medicines and other health care and surgical items. prescription
dimef idciucilntes,
It is
very
remember the location of the items before they are sold. Thus in order
their location, location coding also may adopted keeping the type of to
Wise o cOmpany wise. item,remsupphe
ember
All medicines received from the stockiest should be taken in to the
From there the stocks may be taken in to the pharmacy in small central stote.
they may be dispensed. This act will help the retailer in assessing quantities where
\Maintenance of Various Registers in the Pharmacy
inventory needs.
For the successful operation of the pharmacy activities, following registers shoula ,
maintained.
Inventory registers
b) Cash register
Ledger
USE OF COMPUTERS: BUSINESS AND HEALTH CARE SOFT WARES
In recent times, computers have become a very important tool in
all areas of science and
technology. With the proliferation of the internet and the developments in computer
technology. number of computer applications is increased. In the field of pharmacy.
computers are used starting from drug designing &
hardware and software have been developed to meet development to patient care. Various
the needs of pharmaceutical industry
and hospital & community pharmacy. Further development is still in
make pharmacist's job easier. Following are the progress which will
pharmacy . applications computers in community
of
1. Communication
2. Prescription Processing
3. Checking the pharmaceutical care
4. Inventory control
5. Accountancy
1. Communication:
From email to otherComputers are usedmessaging
within pharmacies communication
internet-based to facilitate
systems, online communication allows
pharmacists and other pharmacy staff to keep in contact both within their ow
organization and also within the chain

have their own intranetprofessional community. Some pharmacy

companies systems for communications
Overthe
Internet. internal
2. Prescription processing: Prescription processing is invariably one of the mait
usel
activities going on within a pharmacy on a day computers
are
to make this process
mnore -to-day basis, and
reliable and efficient. Both the service us'
Sideof

pharmacy operation and the dispensing aspects are today customer through
the

carried out
 CHAPTER 8 COMMUNITY PHARMACY 75
MANAGEMENT
of computing systems. Pharmacy computers also handle customer service activities
such as sales and cash handling within the retail operation.
1, Error prevention: Pharmacy computer systems can help to prevent errors in
prescriptions. potentially saving lives and generally preserving the health of patients.
As well as checking medicines and combinations of medicines, these systems can in
Some cases check on patient information. Availability of such systems varies across
the different geographical arcas, but in some cases pharmacy computers are able to
check on preseribed medicines with specific reference to a patient and their overall
health-care picture.
Irventor control: Pharmacy software is so designed to give the accurate stock
nosition at any point of time and also togive reorder levels.
S 4ccountancy: Community pharmacy is a retail business where all transactions are of
financial nature. Thus it is very essential to record, classify and summarize all the
financial transactions in order to know the profit and loss in the business. Thus
accounting system is mandatory in any business. Accounting is defined "as the
process of identifying. measuring and communicating economic information in a
business".
Accounting is a guide post for investors for investing into the business, for creditors to
adyance money to the fim and to the government to know its functioning and to consumers
for price changes.

SYSTEMS OFAccoUNTING
Followingare the main systems available torecord all the business transactions.
(a) Cash system
(b) Mercantile system
(c) Mixed system
(2) Cash system: In cash system actual receipts and payments of cash transactions are
recorded. This system does not help in knowing the exact financial position of the
business at a particular day.
(b) Mercantile system: Under this system all transactions relating to a period is recorded
system
in the books of accounts including the income receivable and payable. Thisdiscloses
and
gives a complete picture of financial transactions of the business business on a
Correct profit or loss and exhibits true financial position of the
particular day.
used.
(C) Miced system: Under this systenm both cash system and mercantile systems are
mercantile
Some transactions are kept under cash system and others are under
system.
 76 COMMUNITY PHARMACY PRACTICE

Accounting Cycle
An accounting cycle includes the following steps:
(a) Recording all business transactions in to a primary book called as
subsidiary books. journal or in its
(b) Posting of transactions in to the ledger.
(c) Preparation of final accounts.
At the end of the financial year final accounts may be prepared following the
cycle and this continues for whole life of the business. accounting
Objectives of Accountancy
Accountancy helps us to
1. Know the profit and loss of business during a particular period.
2. Understand the financial position of the business such as assets and liabilities.
3. Know the progress of the business.
4. Comply with the legal requirements.
HUMAN RELATIONS AND COMMUNICATIONS
Concept of pharmacy practice has changed from product focus to patient focused in recent
years. The pharmacy profession has undergone an extensive self analysis and reevaluation of
its duties and objectives. The result of reexamination has focused more emphasis on
incorporation of clinical pharmacy in patient care. It is now universally recognized that
pharmacist is far more than a mere dispenser of the drugs but is pharmaceutical care
provider. The pharmacist has the following important duties:
(a) It is important to analyze the medication's safety from patients past medication and
medical history.
(b) To identify any known allergies, drug interactions or other contraindications in a given
prescription.
(c) To ensure that patients uses their medicines appropriately as indicated.
Pharmacy operations are not just mere billing the medications and distributing to n
patients. An element of personal care by the pharmacist improves the customer satistaction
and increases the patronage of the client to the pharmacy.
Attitude and Appearance
Attitude is the overall emotional stance of an individual towards his/her job responsibilite
clients, employers, and other colleagues. Appearance is the overall look of an employA
should
during his job including the dress and grooming. It is expected that thepharmacist the
look like a professional by wearing aformal dress with an apron and a name tag, greeting
customers with smile and make the eye contact while talking to them. Respond politey
commoD
customer with their queries, and at the same time respect their privacy. Use of
 CHAPTER 8 COMMUNITY PHARMACY MANAGEMENT 77

courteous words in every interaction such as "Good Morming","Have anice day". "Please",
dThank You" should become a part of their regular vocabulary. Pharmacist should be
sensitive to cultural and language differences. If the pharmacist cannot understand a
stomer because of the language difference, it is better to apologize for the language
deficiency and take the help of other employee or other store employee to translate the
conversation. Cultural differences also should be taken in to account. If the pharmacy is
located in an area. where people of particular community reside, try to understand their diet,
bealth habits or beliefs and courtesies. Knowing more about the culture will help us to
understand them and provide services in better way and this will satisfy the clients.

KEY PoINTS
Community pharmacy is a first point of contact for public to get the treatment for
minor ailments and to receive the prescription medicines.
To have good customer patronage, it is essential to open the pharmacy where public
movement or patients' movement is high.
Good location and attractive ambience with patient care facilities increases the
customer patronage.
Pharmacists should know the legal requirements to open the pharmacy and
accordingly all licenses should be obtained from the regulatory authorities.
Pharmacists with professional attire and with good communication skills make a
positive impact on patients.

SUGGESTED READINGS
management. CBS Publishers and
1. Mohammed Ali and Jyoti Gupta. Drug Store and Business
Distributors, New Delhi.
Management. Vikas & Co. Jalandar.
2. Mohan Singhal and Jai Dev. Drug Store and Business
management. B.S.Shah Prakashan,
3. SHMerchant, J.S. Quadry. A text book of retail pharmacy
Ahmedabad.