Pharmacy (shop)

In most countries, a retail outlet for prescription drugs is subject to legislation; with requirements for storage conditions, staff qualifications, equipment, record keeping (especially of controlled drugs) and other matters, all specified in legislation. It was once the case that pharmacists stayed within the premises compounding/dispensing medications, but there has been an increasing trend towards the use of trained pharmacy technicians, with the pharmacist spending more time communicating with patients. Pharmacy technicians are now more dependent upon automation to assist them in their new role dealing with patients' prescriptions and patient safety issues.

Pharmacies are typically required to have a qualified pharmacist on-duty at all times when they are open. It is also often a requirement for the owner of a pharmacy to be a registered pharmacist, but that is not the case in all jurisdictions: where permitted, many retailers (including supermarkets and mass merchandisers) now include a pharmacy as a department of their store.

Likewise, many pharmacies are now rather grocery store-like in their design. In addition to medicines and prescriptions, many now sell a diverse arrangement of additional items such as cosmetics, shampoo, office supplies, confections, snack foods, durable medical equipment, greeting cards, and provide photo processing services.

Community pharmacies offer a unique added value by building direct relationships with their customers. They are able to provide more personalized, dedicated care to local members of their community and even offer enhanced services such as Medication Therapy Management (MTM), Medication Synchronization, and compounding. With the aid of pharmacy management systems and different integrated technologies, these smaller pharmacies are able to keep up with their large-scale competition.

In parts of mainland Europe, the pharmacist is required to own the pharmacy of which she or he is the licensee. Under this arrangement, a pharmacist can be the operator of only a single outlet.[11] In the UK, 60% of all community pharmacies are owned by companies that own multiple pharmacies.[12]

In the United States, more than 25% of independent owners have ownership in two or more pharmacies.[13]

Most of New Zealand's community pharmacies are owner-operated.[14] In Australia, pharmacists recognise the need to integrate professional pharmacy services into the health system to meet the changing health care needs of the population.[15]

A survey conducted by PrescribeWellness found that almost half of Americans older than 40 years-old value pharmacies that offer preventative care services, and would be willing to transfer their prescriptions to pharmacies that offer those services.[16] Patients also value pharmacies where they can receive medical advice concerning their prescription medications, how those medications may interact with each other, and receive over-the-counter drug recommendations for the management of common ailments.[16] In a survey of over 1,000 U.S. adults older than 40 years-old conducted by Propeller Insights, 67% of patients responded that they would prefer that their pharmacist discuss new prescriptions with them, rather than their physician, because they viewed their pharmacist as "better at explaining side effects and has more time to spend with them."[16]

Canisters of pills from a mail order pharmacy.

Since about the year 2000, a growing number of Internet pharmacies have been established worldwide. Many of these pharmacies are similar to community pharmacies, and in fact, many of them are actually operated by brick-and-mortar community pharmacies that serve consumers online and those that walk in their door. The primary difference is the method by which the medications are requested and received. Some customers consider this to be more convenient and private method rather than traveling to a community drugstore where another customer might overhear about the drugs that they take. Internet pharmacies (also known as online pharmacies) are also recommended to some patients by their physicians if they are home-bound.

While most Internet pharmacies sell prescription drugs and require a valid prescription, some Internet pharmacies sell prescription drugs without requiring a prescription. Some customers order drugs from such pharmacies to avoid the "inconvenience" of visiting a doctor, or to obtain medications which their doctors were unwilling to prescribe. However, this practice has been criticized as potentially dangerous, especially by those who feel that only doctors can reliably assess contraindications, risk/benefit ratios, and an individual's overall suitability for use of medication. There also have been reports of such pharmacies dispensing substandard products.[17]

Of particular concern with Internet pharmacies is the ease with which people, youth in particular, can obtain controlled substances (e.g., Vicodin, generically known as hydrocodone) via the Internet without a prescription issued by a doctor/practitioner who has an established doctor-patient relationship. There are instances where a practitioner issues a prescription, brokered by an Internet server, for a controlled substance to a "patient" s/he has never met. In the United States, in order for a prescription for a controlled substance to be valid, it must be issued for a legitimate medical purpose by a licensed practitioner acting in the course of legitimate doctor-patient relationship. The filling pharmacy has a corresponding responsibility to ensure that the prescription is valid. Often, individual state laws outline what defines a valid patient-doctor relationship. The Food and Drug Administration (FDA) is also heavily involved in monitoring internet pharmacies and has issued warnings against several companies who have violated the U.S. Federal Food, Drug, and Cosmetic Act that protects individuals against rogue online pharmacies.

Canada is home to dozens of licensed Internet pharmacies, many of which sell their lower-cost prescription drugs to U.S. consumers (who must otherwise pay one of the world's highest drug prices).[18] In recent years, many consumers in the US (and in other countries with high drug costs), have turned to licensed Internet pharmacies in India, Israel, and the UK, which often have even lower prices than in Canada.

In the United States, there has been a push to legalize the importation of medications from Canada and other countries, in order to reduce consumer costs. While in most cases importation of prescription medications violates Food and Drug Administration (FDA) regulations and federal laws, enforcement is generally targeted at international drug suppliers, rather than consumers. There is no known case of any U.S. citizens buying Canadian drugs for personal use with a prescription, who has ever been charged by authorities.

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  Sign of the Town Hall Pharmacy in Tallinn, operating continuously from at least 1422, showing the Bowl of Hygieia
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  Convent pharmacy exhibited at the Museo nazionale della scienza e della tecnologia Leonardo da Vinci of Milan.
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  Contemporary pharmacy in an older building
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  19th-century Italian pharmacy
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  Classic symbols at the wall of a former German pharmacy
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  interior of an unidentified drugstore in Toledo, Ohio, United States, 1900s. A large cigar counter and a long bar with seating is featured. The photo was taken by Charles F. Mensing around 1900.
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  Typical American drug store with a soda fountain, about 1905
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  Drug store restoration ca. 1920 at Collingsworth County Museum and Art Center
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  Modern pharmacy in Norway
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  A chain store pharmacy in the United States
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  Outside an independent pharmacy in South Plainfield, New Jersey
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  A pharmacy at night in Nokia, Finland
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  A pharmacy in Norway that is part of a shopping mall
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  Interior of a pharmacy in Ethiopia
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  Richard Nixon at a drug store lunch counter in Houston, Texas, on March 20, 1974
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  A pharmacy in Nanning, Guangxi, China

• Dispensary – Office that dispenses medications

• International Pharmaceutical Federation (FIP)