From 9 February 2019 the EU Falsified Medicines Directive will change the process of dispensing medicines in Europe. What do we know about it?

1 Bad meds travel fast?

The EU Falsified Medicines Directive (FMD) has been introduced to reduce the risk of counterfeit medicines in the supply chain. The World Health Organization estimates that up to 15 per cent of all medicines are counterfeit, varying from 30 per cent in some areas of Africa and the Far East to about one per cent in the EU. 

2 What does FMD mean for pharmacies?

In order to comply with the requirements of the FMD, as part of the dispensing process pharmacy contractors will be required to: 

1. Check the anti-tampering device to ensure it is intact before dispensing.

2. Change the status of the pack on the UK’s National Medicines Verification System (NMVS) from “active” to “inactive – supplied”. This involves scanning the 2D barcode on each pack and communicating with the NMVS.

3 Work still to be done 

The UK Community Pharmacy FMD Working Group (FMDWG) comprises representatives from PSNC, NPA, AIM, CCA, CPW, CPS and CPNI, and is working with the DHSS and the MHRA to ease FMD implementation in the UK. The group says there is still work to do to ensure community pharmacy is ready, including updating IT systems and associated hardware, connecting pharmacies to the NMVS, training staff and providing patient information. Guidance includes The Way Forward For FMD In Community Pharmacy.

4 FMD pros and cons 

The FMDWG says pharmacy workflow and SOPs will need to be updated, to ensure all relevant prescription medicines are authenticated and decommissioned during the dispensing process, before handover to patients. Processes will also be needed to deal with any unexpected results and with reverse decommissioning. On the plus side, manufacturers will have better control of their products through the supply chain, protecting their brand integrity and increasing patient safety. 

5 Hello to 2D barcodes

Under FMD, all prescription medicines will have a unique code placed on the packaging in the form of a 2D barcode (data matrix), which will be held on a national database. Over time all older linear barcodes will disappear from prescription medicines.

6 Special dispensation 

Specials and other one-off products are outside the scope of the FMD. However, any licensed products used in their production will need to be authenticated before they are used.

7 Funding FMD

The costs of establishing the UK’s NMVS will be borne by manufacturers of branded and generic medicines and parallel distributors, which have been urged to register promptly with SecurMed UK, the UK medicines verification organisation. UK-based marketing authorisation or parallel import licence holders must register and pay set-up fees of £35,000.

8 Cost to contractors

Pharmacy is responsible for its own costs for connecting to the NMVS, which will include initial IT software and hardware set-up, plus ongoing operational costs that could total thousands of pounds. However, it is hoped that contractors’ FMD-related costs may be recognised in future NHS funding settlements.

9 Patient safety implications

Although patient safety is the main driver behind the FMD, the Community Pharmacy Patient Safety Group has warned that changes to established operating procedures can “increase risks to patients and will place a significant burden on pharmacy teams, at least in the short term”, and any risk will need to be managed.

10 Pharmacy data

The FMDWG says there are two forms of FMD data that pharmacy owners can make use of. The hard data printed on each pack and encoded in the unique identifier (UI) 2D data matrix can prove useful for stock control, re-ordering, accuracy checking and expiry-date checking. There is also data on the UI held within the verification system that will give updates when products are scanned if they are subject to a withdrawal or recall, but this requires a live link.