Jeroen van de Pol

179 6 General discussion should oblige healthcare insurance companies to reimburse CPS instead of limiting reimbursement to dispensing. Moreover, the Dutch Healthcare Authority should start assessing whether reimbursement within the community pharmacy profession is sufficient to enable community pharmacists to adhere to newly developed guidelines and intervene if they do not. For the third point, CPS provided by community pharmacists to patients should preferably not be paid (partly) out of pocket by patients. Medicines, however, can be part of a capped out-of-pocket scheme to reduce national spending. Including CPS within out-of-pocket payments will seriously hamper patients desire to actively seek CPS provided by community pharmacists, especially considering that services provided by GPs are fully reimbursed with no out-of-pocket expenses for patients. Keeping medicine reimbursement part of a capped out-of-pocket cost will stimulate patients to seed deprescribing or to look for cheaper alternatives. General conclusion Community pharmacists hold great potential both on a societal level, by improving the effectiveness and safety of pharmacotherapy and containing healthcare costs, and on the individual level in improving the outcomes of pharmacotherapy and subsequently quality of life for individual patients. Currently, community pharmacists are not utilized to their full potential. This thesis has identified both barriers and facilitators for community pharmacists to redirect their main focus toward CPS provision. Now, the professional bodies, regulators, policymakers, and payers must fully facilitate and enable community pharmacists to focus on CPS provision. This thesis can also be considered a call to community pharmacists to fully demonstrate their potential and to seize the challenge to help the profession into the next phase.