ABSTRACT
Introduction: Interprofessional education projects with pharmacy and medical students (PS and MS) are rare in Germany (Institut fuer Medizinische und Pharmazeutische Pruefungsfragen, 2019). However, for a future trustful collaboration personal contacts and mutual understanding are vital (Weisenborn et al., 2019). Care by an interprofessional team is beneficial for patients. According to the fifth Action Plan 2021 - 2024 to improve medication safety of the Federal Ministry of Health (2021), interprofessional collaboration is an important key element. Objective(s): The authors developed and implemented an interprofessional education project for PS and MS. The pilot study was conducted to understand the students' perceptions and to evaluate whether students were satisfied with their learning progress and would recommend this project. Method(s): The project, developed by an interprofessional team, consisted of three parts: (1) an interprofessional online seminar, (2) practical training at the Medication Management Center (MMC) and (3) a one-day internship in a general practitioner's (GP's) office. In all three parts, PS and MS performed patient-oriented casework and medication reviews together. The project was evaluated using anonymous pre- and post-questionnaires, containing the German version of the Student Perceptions of Physician-Pharmacist Interprofessional Clinical Education instrument (SPICE-2D) and open-ended questions to further evaluate the students' perceptions (Pudritz et al., 2020). The post-questionnaire asked for feedback as well as a recommendation of this project for other students, using a five-point Likert scale. Furthermore, the students' satisfaction with their learning progress was assessed. Result(s): Due to the SARS-CoV-2 pandemic, only the seminar (part 1) was performed in each term. The other parts of the project were implemented progressively. The third execution in the winter term 2021/22 was eventually able to contain all three parts. Through all executions, 105 students (46 PS, 59 MS) attended the interprofessional seminar, 64 (29 PS, 35 MS) the practical training at the MMC and nine joined the internship in a GP's office. For the seminar, 41 of 53 participants were satisfied with their learning progress and 64 of 67 students would recommend it to others. Regarding the practical training at the MMC, 37 of 46 students were satisfied with their learning progress and 45 of 47 would recommend it to others. Finally, the internship in a GP's office was mostly rated positive. Conclusion(s): Despite the pandemic, the interprofessional education project was successfully implemented. The insights gained from the evaluation will be used to adapt the project and its evaluation, eventually. Moreover, the development of further interprofessional education projects will benefit from the gained understanding. The focus of the evaluation of the main study will shift to the students' perceptions towards patient-oriented casework and medication reviews. In addition to the questionnaires, guided individual interviews will be used.
ABSTRACT
Background Recently, among others due to the COVID-19 pandemic and the war in Ukraine, European countries have been experiencing rising inflation. Value-added taxes (VAT) on essential goods have gained public attention, and abolishing VAT for these goods has been discussed as a measure to prevent poverty and inequities. The study aims to investigate the relevance of value-added tax on medicines in European countries. Methods We collated information on medicines-specific and standard VAT rates in 41 countries of the WHO European Region (all 27 European Union Member States, Albania, Armenia, Iceland, Israel, Kazakhstan, Kyrgyzstan, Kosovo, Moldova, North Macedonia, Norway, Serbia, Switzerland, Turkey and United Kingdom). Data were reviewed from literature and were validated by national public authorities. Results In three countries (Albania, Kazakhstan and Malta), all medicines are exempt from VAT. 28 of the 38 countries with VAT on medicines impose a single VAT rate on all medicines, and in most of these countries (21 countries) the medicines-related VAT is lower than the standard VAT rate. Ten countries have differentiated VAT rates: In Ireland, Kyrgyzstan, Sweden and the UK defined medicines (e.g. oral medicines, prescription-only medicines) are exempt from VAT, whereas for the other medicines the standard VAT rate applies;six further countries have a lower VAT rate for some medicines (e.g. heparins, blood products, contraceptives or reimbursed medicines in general) compared to the remaining medicines, whose VAT rate equal the standard rate or is lower. Conclusions Some European countries apply specific mechanisms (exemptions, reduced rates) regarding the VAT for defined or all medicines. This may act as a protective measure for patients in case of non-reimbursed medicines and help public payers to ensure financial sustainability to funded medicines. Further medicines-specific research is needed to understand the impact of inflation. Key messages • Value-added tax is a relevant component of medicine prices. • Lowering or abolishing the VAT on medicines can be an important policy espeically when patients pay out-of-pocket.