Community Pharmacy and Cancer

I know that I bang on a bit about the value of generalists in a specialised setting, but I'm not about to stop. I've devoted at least half of my career to it, it's the basis of my PhD and I see opportunities related to it all the time. Many of those opportunities relate to cancer care, and one in particular relates to cancer screening programs.

I must be honest and say that I never realised how expensive many cancer screening programs are. Nor did I appreciate the costs (both financial and to the individual patient) of over diagnosis and treatment. This means that even though there are effective screening methods for some cancer, they are not suitable to roll out across the entire population.

One of those relates to lung cancer. There is a screening method available but it would cost more than $100k for each QALY gained, which is simply not affordable. But it could be affordable if the program targeted those at higher risk, such as smokers.

Targeting these people can be easier said than done though. They might not go to their GP. Public advertising campaigns are expensive and not very effective these days with so much competing for your attention. So my question is, why aren't community pharmacists pushing to be involved in this? Why aren't community pharmacists jumping at the opportunity to be involved in this important public health measure of cancer screening? Why wasn't there a PSA representative at COSA flying the flag for pharmacists in the community setting?

I think there are two main reasons. The cynical reason is that it's not a service that is transactional (I.e. revenue raising). The other reason is that I think community pharmacy avoids cancer. They consider it to be within the domain of specialists and don't recognise how they can add value.

Community pharmacists, any pharmacists, can add value to cancer care and I think it's time we started recognising that. It's a leading cause of death and affects the lives of many people and their families. They need primary care and generalist medication management services as much as anyone else with a chronic condition does.


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