Bruce Scott and Frank Sheehy explore emerging trends in the marketplace, with attention to issues surrounding generics and biosimilars as well as specialty pharmacy. Copyright © 2020 Rx relief. The future of pharmacy has been an ongoing discussion for some years. Yet beyond tweaking the business model, there’s also a rare opportunity at hand. A majority of FPs (78%) believe price disclosures will be required in future direct-to-consumer advertising (Figure 5, item 4), but just over half of FPs believe that price controls will be enacted for some essential medications, such as insulin (Figure 5, item 5). William A. Zellmer, B.S.Pharm., M.P.H., President, Pharmacy Foresight Consulting, Bethesda, MD. Many educators and residency preceptors use the report as part of coursework, seminars, or journal club sessions to help engage pharmacy trainees in thinking about the future of the profession they are preparing to enter. Nominations were limited to individuals known to have expertise in health-system pharmacy, knowledge of trends and new developments in the field, and the ability to think analytically about the future. From top pharmaceutical companies to smaller biopharmaceutical companies focused on clinical trials for FDA … Competition in the retail pharmacy sector will continue to heat up, eroding profit margins. Currently, only 1 in every 10 drugs are successful through clinical trials. Health systems must work towards policies for the ethical use of this potentially very large volume of data.7 A majority of FPs agreed that development of such policies in health systems was likely (Figure 4, item 4). Also acknowledged for assistance with various aspects of the process are Eliza Asherian, Julia Beatty, James Blackmer, Kelly Brookbank, Stephanie Brown, David Chen, Lillian Clark, Dan Cobaugh, Rachael Freeman, Camryn Froerer, Brandi Gore, Laura Halsey, Clayton Hamilton, Chanese Hampton, Ryan Hays, Lynn Hoffman, Collin Jakubecz, Erica Krantz, Jennifer Lee, Jordan Long, Alexandrea Lux, Scott Mambourg, Maryam Mohassel, Derek Montgomery, Barbara Nussbaum, Shea O’Brien, Antoniette Parris, Jeff Schempp, Leticia Vargas, and Kjersti Vharen. Neben diesen gibt es noch weitere Trends, die die Pharma-Branche bewegen: Marktkonsolidierung in der Pharma-Branche schreitet voran; Der Marktanteil der Top 20 Pharma-Unternehmen beträgt inzwischen rund 81 % des globalen Pharma-Umsatzes. Our focus is on larger-scale trends, and our goal is to look beyond ethereal whims of politics and practice in an attempt to address deeper patterns that will impact us over months and years. The process of strategic planning should involve pharmacy staff at all levels: those in formal leadership positions, front-line staff (both pharmacists and pharmacy technicians), and others connected to departments of pharmacy, such as affiliated faculty members and key physician and nursing leaders involved in pharmacy activities. Consideration must be given to patients’ time investment in answering these questions. Pharma industry 2020: Key emerging trends to watch for in the new year. As an example, meeting new quality standards focused on sterile production and the handling of hazardous drugs by healthcare workers4 have required extensive investment in infrastructure and added labor expense despite limited evidence that systemic shortcomings in patient or worker outcomes exist. The Pharmacy Forecast is not intended to be a quantitatively or even qualitatively (directionally) accurate prediction of future events. Fifty-seven percent of FPs indicated they believe it is likely that colleges and schools of pharmacy will offer a joint doctor of pharmacy (Pharm.D.) Anemic reimbursements and industry consolidation are forcing retail pharmacy companies to look for new sources of revenue. Collaborate with public health officials to engage populations increasingly reluctant to accept vaccines, and deploy tactics that promote dialogue and education to optimize vaccination rates. Increasingly blurred lines between care settings. Integrated Pharmacy Research and Practice 2017:6 15–27 ... T2DM and the current and future roles of pharmacists in its management. © American Society of Health-System Pharmacists 2019. It is interesting that while FPs seemed optimistic that SPs owned by health systems will show benefit over national providers, they overwhelmingly feel that their patients will be forced by their insurers to seek infusion care outside their own health systems (Figure 6, item 4). Cloe Talamini serves as a pharmacy specialist and senior healthcare business analyst at BroadJump, an expense management company. Over the past 7 years, the Pharmacy Forecast has provided insight into emerging trends and phenomena that have impacted the practice of pharmacy and the health of patients in health systems. Many of the FPs hold the title of chief pharmacy officer or director of pharmacy (13% and 16% of FPs, respectively). (Evidence-based Pharmacy Practice). This transformation has been from dispensing products to taking a broader responsibility for patient care. Employers may offer financial incentives to employees who voluntarily choose preferred providers they have under direct contract, but based on experience with high-deductible insurance plans, financial incentives are not terribly effective in driving employees to more efficient care options. Involving an institutional patient and family advisory council to guide this process can help mitigate this risk. In doing this, large pharma companies can think and act more like their nimble small pharma counterparts. The complexity of this new therapy also required immense effort to get organized for its use. The University of Utah Drug Information Service (UUDIS) has a contract to provide Vizient (a group purchasing organization) with drug shortage information. Forecasting future events is an important exercise that can help leaders create well-informed strategic plans. Current Trends in Biotechnology and Pharmacy. Subject Area and Category: Biochemistry, Genetics and Molecular Biology Biotechnology Pharmacology, Toxicology and Pharmaceutics Drug Discovery Pharmaceutical Science: Publisher: Association of Biotechnology and Pharmacy: Publication type: Journals: ISSN: 22307303, 09738916 : Coverage: 2009-2020: Scope: The … Invest in the collection of PRO data using validated questionnaires, and make the information readily retrievable in the EHR for frontline staff. Diane B. Ginsburg, B.S.Pharm., M.S., Ph.D., FASHP, Clinical Professor and Associate Dean for Healthcare Partnerships, Pharmacy Practice Division, The University of Texas at Austin College of Pharmacy, Austin, TX. These future trends pose both challenges and opportunities for community pharmacies. The forces impacting society and the healthcare industry will also affect trends in pharmacy. The methods used to develop the 2020 Pharmacy Forecast were similar to those used in the previous editions, drawing on concepts described in James Surowiecki’s book The Wisdom of Crowds.1 According to Surowiecki, the collective opinions of “wise crowds”—groups of diverse individuals in which each participant’s input is provided independently, drawing from his or her own locally informed points of view—can be more informative than the opinion of any individual participant. The advances in technology of all kinds, and their impact on the profession, are a serious concern. or Pharm.D./M.H.A. Whether or not a fully realized single-payer system is achieved, broadening access to efficient care—particularly outside the acute care setting—is essential. Pharmacists with P.A. Address correspondence to Dr. Nesbit (email@example.com). However, pharmacy leaders who accept responsibility for other departments must also see and exploit the strengths of their other departments and drive collaboration across all areas they lead. 1. aBased on 2010 U.S. Census population data (estimated). Two out of three FPs indicated they do not believe health systems will assign pharmacists to provide education and support to parents who are uncertain about vaccinating their children (Figure 1, item 6). The Pharmacy Forecast could not be created without the contributions of the report editor, founding editor, members of the Advisory Committee, Forecast Panelists who responded to the forecast survey, and chapter authors. Medicare for All? In one, a majority (76%) of FPs agreed that new performance metrics will be based on evidence of improved patient outcomes (Figure 4, item 2), and a similar majority (76%) agreed that mandates related to handling of hazardous products will be based on evidence of lower risk to patients and healthcare workers (Figure 4, item 3). Our Mission: consistently provide client experiences focused on what they value most. Pharmacy departments should take advantage of institutional resources aimed at managing that risk but should also focus on prevention of events that are unique to their physical space and their staff workflows. The stability of the supply chain is of critical importance, and recommendations for focused strategic planning are provided. Boeing bypasses traditional health insurance model in contract with MemorialCare health system: a sign of things to come? An important pharmacy-specific example of a black swan relates to Hurricane Maria in September 2017, which decimated pharmaceutical manufacturing capacity in Puerto Rico, thereby creating a crisis for U.S. hospitals. Does the department’s planning process engage all team members in strategic thinking?5, Do pharmacy leaders periodically facilitate “what if” discussions about how the department could respond to a seemingly improbable event?e. A majority of state governments (33 as of June 2019) have legalized marijuana in some form.9 Use of medical cannabis has expanded across a range of acute and chronic conditions, with varying levels of associated evidence. Future Trends Affecting Pharmacy Practice. Based upon the Society's Future Models of Care Commission, the report was intended to create a coherent narrative for pharmacy reform. Most of the FPs (81%) had been in practice for greater than 10 years, and 46% had been in practice for greater than 20 years (down from 58% of FPs in 2019). However, the increasing cost of medications is an ongoing issue affecting patients and payers, and government action is required to capitalize on saving opportunities presented by lower-cost agents. Those organizations involved in education or training should consider the use of the Pharmacy Forecast as a teaching tool. Todd W. Nesbit, Pharm.D., M.B.A., FASHP, Director – Pharmacy Patient Care Services, The Johns Hopkins Health System, Baltimore, MD. Today’s strategies for providing care in rural areas include alignments with regional systems, creation of referral networks, and mergers or acquisitions. Another possible solution discussed at various stakeholder meetings is the establishment of an essential drug list (such as the list maintained by the World Health Organization7), with targeted incentives to ensure availability of key products. Sixty-five percent of FPs were optimistic about the vacancy rate for pharmacy positions that require specific expertise in sterile compounding and drug distribution (Figure 2, item 1). The pharmacy of the future is not a monolith, but a convener of plug-and-play partners—traditional and new entrants—serving consumers as their “health hub." For full access to this pdf, sign in to an existing account, or purchase an annual subscription. While it is possible that new supply chain entities will assist with some shortages, it is doubtful that they will have the capacity to address the hundreds of shortages that exist today. What pharmacy innovations would make future pharmacies solution centers for the sick? Recognize the incentives and motivations that are encouraging disruptive developments in healthcare, particularly those driving entities not traditionally directly involved in delivering care. Country: India - 11. Given the complexity, uncertainty, and pace of change in healthcare today, strategic planning must be a continuous process. Specialty pharmacy continues to grow. They were asked to base their response on their firsthand knowledge of current conditions in their region, not based on their understanding of national circumstances. The ASHP Research and Education Foundation (“the Foundation”) is pleased to present the eighth edition of the annual Pharmacy Forecast. For the purposes of the review, papers were FPs indicated that Haven will reduce healthcare spending for the companies’ employees (Figure 7, item 2), but it is unclear if those savings will be realized more widely. While staff with certain conditions (e.g., pregnancy) may request adjustments to their job responsibilities to avoid exposure, health systems should have policies and procedures that protect all staff from exposure to hazardous drugs. Employers, in an effort to reduce costs and improve outcomes, will continue contracting directly with providers. Read on for my seven trends for specialty pharmacy's future, plus a bonus photo of me with two notable conference attendees. However, price controls for a few specific products will not have a meaningful impact on the overall challenge of the extraordinarily high cost of medications. fluids such as normal saline became unavailable. Conrad Emmerich, M.B.A., Senior Vice President of Operations, Wake Forest Baptist Health, Winston-Salem, NC. With advances in artificial intelligence and ‘fuzzy’ logic (an approach to computing based on ‘degrees of truth’), and in logistics and supply (e.g. Concerns regarding workplace violence are discussed, as is the potential for the development of a “center of excellence” model for health-system pharmacy following the example of Magnet certification in nursing. Health-system SPs will be challenged to demonstrate that their ability to coordinate patient care results in superior outcomes. Develop and implement policies and procedures that protect all staff involved in the handling of hazardous medications, including appropriate education, training, and certification of personnel, regardless of the health status of the individual employee. Chaired by Dr Judith Smith, director of policy at the Nuffield Trust, the Commission brought together expertise from across pharmacy, the wider healthcare sector and patients. The author has declared no potential conflicts of interest. degree holder than a pharmacist without the ability to diagnose and prescribe. This year, we again surveyed a large group of individuals and obtained at least 1 response from every state with the exception of 9 (Alaska, Arkansas, Delaware, Hawaii, Idaho, Nebraska, Oklahoma, Rhode Island, and West Virginia); in comparison, 7 states were not represented in the previous survey. Dimos: One would be point-of-care testing. For example, Kentucky recently joined California and a few other states in expanding the pharmacist scope of practice, granting independent prescribing authority (to be exercised in collaboration with physicians) under approved protocols for a wide range of conditions, including acute infections, tobacco cessation, and opioid use disorder.1. Health-system pharmacists must continue to plan for manufacturing quality deficits resulting in recalls and shortages, as well as higher drug prices. Overall, the results stimulate important reflections on the nature of strategic planning in health-system pharmacy. This is inconsistent with national trends and attention to the preparation of these medications. Here's what they have to say: 1. Preferred cost-sharing networks in Medicare Part D contain just about all prescription drug plans, which limit the number of retail pharmacies that can take part. As value-based reimbursement becomes more common, it is also possible that initiatives emphasizing continuity of care may make health-system SPs attractive to insurers contracting for the total care of select patients. While the responses indicate a concern regarding the impact that such burden could have, patients may be willing to embrace complex self-care management.6,7 The responses may also reflect confidence that individual- and health system–level factors can mitigate potential burdens. As another election cycle begins, many stakeholders are discussing ways to reduce drug prices. About 30 years ago, a transformation in the pharmacist’s role began. While tactical plans can and should reflect phenomenon that change daily, the focus of strategic planning should be on longer-range forecasts. Another event that could have a big ripple effect throughout the industry is the merger of CVS and Aetna. FPs were split on the question of whether pharmacy technicians will have education and training comparable to that of staff in other fields or be compensated similarly (Figure 2, item 2). This is largely due to an unacceptable level of adverse effects reported by trial participants. According to U.S. News & World Report, physician assistants made a median salary of $104,860 in 2017; the top quartile made $124,200 that year, while the lowest quartile made $87,980.4. The Pharmacy Forecast was supported by a grant from Omnicell, Inc., to the ASHP Foundation's David A. Zilz Leaders for the Future Fund. Their novelty lies in entering into contracts with health systems that guarantee access to drug supplies over longer periods than are offered in typical group purchasing organization contracts. The continuing trend toward value-based reimbursement models—paying for performance rather than for volume of care delivered—places pharmacy departments in a particularly vulnerable position. University-based colleges and schools of pharmacy may offer training through their continuing education departments, but unless training is provided through degree-granting programs, their involvement will be limited. Identify and implement procedures that ensure that diversity is included as a component of the recruitment process for all pharmacy staff, including students, residents, technicians, pharmacists, and pharmacy leaders. Both examples represent troubling milestones in resetting the definition of “expensive drug.”. A total of 325 FPs were recruited to complete the forecast survey. FPs clearly acknowledged the role cost will play in patient decision-making, with 70% believing that some patients may decline therapy after considering the costs, benefits, and risks of treatment (Figure 1, item 4), a decline from 82% for a similar question in the 2016 Pharmacy Forecast.9 This change may reflect the increase in patient assistance programs that may now blunt the impact of rising patient out-of-pocket costs despite continued drug price increases.10 Out-of-pocket medication costs should be a part of shared decision-making discussions with patients, especially when multiple treatment options exist, with close attention paid to the impact of forgoing treatment. : Erin R. Fox, Pharm.D., BCPS, FASHP, Senior Director, Drug Information and Support Services, University of Utah Health, and Adjunct Associate Professor, University of Utah College of Pharmacy, Salt Lake City, UT. 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