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ng the mission of pharmaceutical care. Huttin (Huttin 1996) in 1995 has examined various system of remuneration for pharmacist, and she classified on two major criteria : product versus patient oriented and single versus multiple range of services. Product oriented such as mark-ups and graduated mark-ups system are focusing on the dispensing services. This system calculates number of prescription (and medicine) that has been dispensed by pharmacist. On the other hands, patient oriented system focus to value other forms of pharmaceutical services. This system rewards a full range of services, more than dispensing prescription. The example are capitation and fee for service.

Percentage mark up is a type of remuneration system that is used in competitive retailing system such as in USA and European Markets. The principle is fix percentage mark-up to all medicines. It represents system that focus on single services, dispensing. In this system, pharmacists have incentive to sell the medicine on high prices unless he gets discount as the result of selling higher volumes of product.

Graduated mark-ups firstly introduced in German to reduce cost and to fix different mark-up levels according to different manufacturers. This system encourages pharmacist to sell lower priced, for example generic products, than branded name which is more expensive. The system is suitable for pharmacists because they have authority to substitute drug product. The margin rate is based on the negotiation between pharmacist and the government, therefore strong bargaining power is needed to maintain fair level remuneration for pharmacists. However, this system is not applicable on the country which has already applied generic prescribing for treating patient, such as in United Kingdom.

Under capitation system, pharmacist revenue relied on the number of patient that has been treated, and not of the prescriptions dispensed. The concept implies that pharmacy will dispense all of the prescriptions from the patient and provides other pharmaceutical services that is required by patients. Pharmacist will receive fix amount of money for each enrolled patient, for example five dollars per month per enrolled patient. Capitation system is applied in Canada, particularly for nursing home, and by applying this system we can minimize the behavior of profit maximization. Unfortunately, capitation has several drawbacks. Capitation will increase risk selection for providers, this means that the providers will choose to treat patient with low risk, less symptoms or easy case in order to treat as many patients as possible in a month. As the consequence is under provision of care because the professional worker will be less aware to patient's problem and tend to ignore the quality of care.

The concept of fee for service system is paying pharmacist in a fix fee for every pharmaceutical services that he has delivered. This system is effective to improve the professional role of pharmacist because it weights more on services and not merely on dispensing amount. The major interest of this system is to provide larger scope to differentiate fees for various pharmaceutical services. The major weakness of this system, contrary to the capitation, is over provision of care and preferably s本论文由英语论文网提供整理，提供论文代写，英语论文代写，代写论文，代写英语论文，代写留学生论文，代写英文论文，留学生论文代写相关核心关键词搜索。