Kuensel has found that some pharmacies are vaccinating patients for fees

Health: In view of a few pharmacies in the country giving tetanus toxoid (TT) injections to patients, the Bhutan Medical and Health Council (BMHC) has clarified that such practices are not allowed.

A few private pharmacies in the country, especially those located in the outskirts are allegedly providing TT injections while some are also checking the blood pressure of patients charging a minimal fee for the services. It is alleged that the pharmacies charge around Nu 50 each for a TT injection.

Although the practice is not rampant currently, observers said that it could lead to issues if not addressed from the start, as private medical practices are not allowed in the country. Others also questioned the competency of the pharmacists administering such vaccines.

BMHC officials said that such practices at the private pharmacies although run by competent persons are not allowed, as it is a form of a private practice that is not permitted in the country currently.

The Council’s registrar Sonam Dorji said that they have heard of such practices but haven’t received any formal complaint yet without which they can’t take any action. “Only upon receiving a formal complaint can we investigate and then take action,” he said. “If the pharmacies are providing such services but without any charges then we can’t say it’s a private practice.”

Sonam Dorji also said that although trained and certified persons run the pharmacies, they can only  deal with medicines in line with the Drug Regulatory Authority (DRA) regulations.

However, DRA officials said that it is not clear in the regulations whether pharmacists can administer any vaccines.

Officials said that the pharmacists are retired health assistants and assistant clinical officers who are experienced. “But there is nothing mentioned in the regulations when it comes to administering injections,” an official said. “This is under the purview of the BMHC.”

Officials said that the retail pharmacies are allowed to sell vaccines that are registered with DRA but that BHMC should look into whether they are allowed to provide vaccinations.

“It’s not within the mandates of DRA to check if they are allowed to give vaccinations or not,” the official said. “This is not mentioned in the Bhutan medicines rules and regulations.

The Bhutan medicines rules and regulations on the duties of pharmacists states that they should dispense certain drugs only upon the production of a prescription, maintain stock ledgers, set up a temperature monitoring system for medicines in the storages and maintain reports and proper segregation of medicines, among others.

The private pharmacists also register with BHMC besides DRA.

On whether it is appropriate for pharmacies to engage in such practices, health ministry’s department of medical services director Dr Pandup Tshering said he feels that the pharmacies should go by the approval given by DRA which is to only to sell medicines.

When asked about the probability of reducing the workload at hospitals if TT injections are allowed in private pharmacies, Dr Pandup Tshering said as of now private pharmacies are allowed to sell medicines only and there is no plan to allow them to give TT injections. “If any plan to allow private pharmacies to give injection comes up then we should have proper rules and regulations in place to ensure safety of patients,” he said.

Dr Pandup Tshering said that as the pharmacies are not allowed to give TT injections, people should not go to these private pharmacies to take TT injections.

Karma, a private employee, said he got the TT injection from a pharmacies after a cut on his leg to avoid the long queue at the hospital. “I don’t mind availing the service from a private pharmacy at a minimal fee,” he said.

Kinga Dema