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THE PURDUE
PHARMACIST
PURDUE UNIVERSITY SCHOOL OF PHARMACY AND PHARMACAL SCIENCES
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Vol. 62
SPRING 1985
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No. 2
The Dean's
Column
Pharmacy in Germany
Varro E. Tyler
Having recently returned from a six-
month's sabbatical leave spent as a visiting professor at the University of Got-
tingen in Germany, I would like to share
some of my observations about the
practice of pharmacy in that nation.
Germany is, of course, a highly developed, technologically and scientifically
advanced country that is, in many ways,
extremely similar to the United States.
In pharmacy, however, the similarity is
only partial.
After World War II, the formerly re-
♦rictive system of allocating the number
\    pharmacies on the basis of popula-
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tion was abolished. Now any pharmacist can establish a business at any location, and since chain operations are
essentially unknown there, the number
of individually owned pharmacies has
proliferated to the place where competition is often extremely keen. This, coupled with the generally depressed German economy, has caused severe financial problems for many owners. Of
course, the cost of most medication is
borne by the state, and this tends to
protect the pharmacies'economic positions, at least partially.
Pharmacy education is basically old
fashioned by American standards. Students devote many hours to class and
laboratory work in galenical preparations, analytical techniques, crude drug
analysis, and similar areas that are of
little consequence in actual practice.
Clinical pharmacy is essentially unknown. Practice is also very different
from what is now considered quality
pharmaceutical care in this country. All
drugs are unit-dose packaged in prescription-sized containers. On receipt of
a prescription, the pharmacist selects a
package from a drawer, hands it to the
patient together with accompanying
package insert, stamps the prescription
with a date stamp, and returns it to the
patient as well. No repackaging, no
relabeling, no oral instructions for use,
no records, nothing but a request for
payment accompany the medication.
Since the unit-dose packages often contain units of ten doses, one can even
purchase portions of a prescription.
This can lead to inappropriate usage of
drugs such as antibiotics. The patient
should take 30 tablets over a ten day
period, but feel better after the first ten
doses, never even obtains the remainder
of the  prescription.  The absence  of
■^prAopriAlelco^s^ijrig on the proper
use of medications is simply deplorable.
And the absence of permanent records
also precludes the pharmacist from detecting drug-drug incompatibilities and
the like. I never saw a computer in any
of the scores of German pharmacies that
I visited, nor, for that matter, in any of
the pharmacy laboratories in the educational institutes.
German pharmacy does have an additional unknown in the United States
that is of particular interest to me as a
pharmacognosist. The use of natural
medicinal products is extremely popular there, as is the case in most countries
other than our own. To give you some
idea of the number involved, the standard reference in the field, a book very
similar to the PDR, requires 1614 pages
to list and describe them in its 1984 edition. Great emphasis is now being placed
on such drugs as echinacea, thuja, and
even ginseng that are believed to stimulate the body's immune system and thereby increase resistance to disease and
other forms of stress.
So, like most things, the German system
of pharmacy and pharmacy practice has
some things about it that are quite good
and some that are not so good in comparison to our own. I think it does provide us with a challenge to seek out and
attempt to understand the differences,
and after evaluating them, to accept
those that would improve our American
system. Also, there is some possibility
that my own lectures to German audiences describing our way of doing things
will be helpful to them. This process of
observing different ways of doing things
and then adapting the good features of
them to an individual's own needs is just
one of the things that makes sabbatical
leaves worthwhile.
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Address all correspondence to The Purdue Pharmacist, School of Pharmacy and Pharmacal Sciences, Purdue University, West Lafayette, IN
47907. Editor: Mary Lea Gora.
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