“In the square to defend the clinics” –

The Uap, the Union of Outpatient Clinics, Polyclinics, Authorized Private Institutions and Private Contracted Hospitals, “expresses its full support at a national level to the President of the Fnomceo Anelli in protecting the professionalism of doctors and announces a massive demonstration for September 30, which will see all the major professional associations, united at a national level, to support the quality and professionalism of medical activity, avoiding the crime of abuse of the profession and protecting those who provide health services in compliance with national regulations and Legislative Decree no. 502/1992”. This was announced by the Uap itself in a note.

“Unfortunately – says Dr. Giorlandino, President of Uap – we are living in a period of total lack of protection of the national procedures provided by the Italian health system, just like in the Far West. It is unacceptable that the health of Italians is managed by those who do not have a degree, by those who do not have the requirements (such as pharmacies) and by those who do not want to comply with the law”. “The Uap – continues Giorlandino – representing 95,000 private health facilities, announces this demonstration at a national level to protect the health of citizens to block the advance of the Lobbies, which take away funds from those who have been practicing the health profession with professionalism and adequacy for over 50 years, which are provided to pharmacies with reimbursements much higher than the NHS, which also perform tests without the requirements and without civil and criminal liability in the event of a diagnostic error, with increased costs for Italian citizens”. “We therefore ask ourselves whether the Government is in favor of healthcare or of the Lobby and whether it is appropriate for both the Government and the Ministry of Health to be composed of several pharmacists, who approve ad hoc laws in conflict with our own Constitution, or whether it would be more appropriate to have the country governed by individuals who are not bearers of their own category interests but who act with the sole purpose of protecting the health of Italians. The true medicine of the territory is made up of clinics, polyclinics, private and accredited hospitals, authorized private clinics and accredited private clinics, with their 350,000 employees who operate in full compliance with the law and procedures. The Uap awaits clear answers from the Government and the Ministry of Health to the questions posed”, concludes the president.

The representatives of the pharmacies respond to the reasons of the clinics, who, in a press release, point out that “contrary to what is attempted to be accredited, pharmacies are allowed a limited and circumscribed possibility of carrying out some diagnostic tests, which is also carefully regulated to guarantee the quality and safety of the services. The regulatory references are: Legislative Decree 3 October 2009, n. 153, which introduces the concept of “pharmacy of services” and allows them to provide health services, including some simple diagnostic tests (first instance) and prevention services; Law 8 November 2012, n. 189 (Balduzzi Law), which provides further provisions for service pharmacies, allowing them to carry out some diagnostic and prevention tests, such as measuring blood pressure, checking blood sugar and other self-diagnosis tests; Decree of the Ministry of Health 16 December 2010, which regulates the conditions and limits within which pharmacies can carry out diagnostic tests. Pharmacies can perform first-instance diagnostic tests, such as those for checking blood sugar, cholesterol, triglycerides, and other self-diagnosis tests, provided they are performed with tools that do not require the intervention of medical personnel; Budget Law 2021, which introduces additional measures that allow pharmacies to offer telemedicine services and perform rapid swabs for the diagnosis of COVID-19, expanding the role of pharmacies as access points to diagnostic and prevention services”.

Permitted diagnostic tests are therefore generally limited to those that can be considered self-diagnosis or first-instance and that do not require immediate medical interpretation. In conclusion, pharmacies can perform limited diagnostic tests in derogation of the general regulation, provided that they comply with the specific provisions set forth in the laws and implementing decrees. The fact remains that outpatient specialist services can only be performed in compliance with the general rules set forth in Legislative Decrees 509/92, 517/93 and 299/99. With a further notation: it is undeniable that there might be a potential conflict of interest for pharmacies between the sale of medicines and the provision of diagnostic services. This conflict might manifest itself in various ways: incentive to prescribe drugs: pharmacies that offer diagnostic services might have an economic incentive to promote the sale of drugs following the results of diagnostic tests performed on site. This might lead to overprescribing of drugs; independence in advice: pharmacists may be perceived as less independent in their advice on medicines, as they may have a direct financial interest in sales. This may undermine patients’ trust in the recommendations they provide; appropriateness of healthcare services: there may be a risk that diagnostic services are used as a tool to increase sales of medicines rather than to provide a real health benefit to patients.”