Healthcare networks will become more connected as interoperable technology develops. In 2018, ASHP established the Technician Forum to provide a home for these essential practitioners and serve as the collective voice for pharmacy technicians by supporting their advancement and professionalization. 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. Forecast Panelists’ responses to the question, “How likely is it that the following will occur by the year 2024 in the geographic region where you work?”, Nearly all states currently enable collaborative drug therapy management by pharmacists in some form or fashion along a continuum from most restrictive to least restrictive (including independent prescribing authority). Certification programs of the Board of Pharmacy Specialties (BPS) and the Pharmacy Technician Certification Board (PTCB) are now available for practitioner certification.1,2 The Joint Commission (TJC) has developed a Medication Compounding Certification program to assess compliance with standards for preparing sterile and nonsterile products.3 Michigan became the first state to require certification by TJC, with over 75 hospitals certified.3 This certification may become the best practice for compounding sterile i.v. They were asked to provide a top-of-mind response regarding the likelihood of those conditions being very likely, somewhat likely, somewhat unlikely, or very unlikely to occur. 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. All of these challenges are made more acute in the absence of a robust, deliberately developed and maintained strategic plan. ASHP Research and Education Foundation, Bethesda, Maryland, Jannet M. Carmichael, Pharm.D., BCPS, FCCP, FAPhA, American Society of Health-System Pharmacists, Bethesda, Maryland, University of Michigan, Ann Arbor, Michigan, University of Utah Health, Salt Lake City, Utah, James M. Hoffman, Pharm.D., M.S., BCPS, FASHP, St. Jude Children’s Research Hospital, Memphis, Tennessee, University of Virginia Health System, Charlottesville, Virginia, Cedars-Sinai Medical Center, Los Angeles, California, Pamela L. Stamm, Pharm.D., BCPS, BCACP, CDE, FASHP, Ross W. Thompson, B.S.Pharm., M.S., FASHP, Tufts Medical Center, Boston, Massachusetts, Robert Edward D’Eramo, Pharm.D. Most drug shortages are caused by quality and manufacturing problems at the factory, which presumably will continue to occur in production facilities employed by new supply chain entities. Copyright © 2020 Rx relief. While many FPs agreed that some employers will bypass traditional insurers and will contract directly with specific health systems, 36% felt it is unlikely (Figure 7, item 3). • In hospitals, 24% have completed residency, 17% are BPS certified2 Pharmacy technicians • 396,540 pharmacy technicians/pharmacy aides1 • 17% work in hospitals/health systems1 Cohen J. What’s holding back market uptake of biosimilars? Email this Post. The healthcare system is moving inexorably from fee-for-service to value-based reimbursement in which a health system accepts greater and greater financial risk tied to the quality of care it provides. The Pharmacy Forecast is a vital component of the Foundation’s efforts to advance pharmacy practice leadership, and the Foundation appreciates the many pharmacists and others who have contributed to the David A. Zilz Leaders for the Future fund, which provides the resources to develop the report. 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 … Among the challenges facing health-system pharmacy over the next 5 years are drivers of the cost of medications, the specialty pharmacy market, and delivering care supported by advances in technology. Address correspondence to Mr. Vermeulen (lee.vermeulen@uky.edu). In the United Kingdom, the National Institute for Health and Care Excellence provides guidance and utilization decisions based on clinical evidence. Also similar to the 2019 survey, FPs reported that their primary organizations offered very diverse services, including home health or infusion care (54% of FPs), specialty pharmacy (61% of FPs), ambulatory care (82% of FPs), pediatric care (61% of FPs), and hospice care (41% of FPs). Market share growth will be impeded by challenges in converting patients who are stable on originator products to biosimilars and by benefit designs that do not incent patients to use biosimilars. Despite increasing policymaker awareness, the outlook for the supply of prescription drugs is unlikely to improve over the next several years. When using the Pharmacy Forecast, it is recommended that planners review at least 1 or 2 past editions in addition to this new report; many of the observations and recommendations that are 1 or 2 years old remain important to consider. If you are an employer looking for pharmacists, Rx relief is ready to help you. While the independent pharmacy industry faces unprecedented challenges as a result of reforms and austerity measures, technology is currently in the process of transforming healthcare as a whole: from wearable tech and FDA-approved ingestible sensors to electronic health records – … Currents in Pharmacy Teaching and Learning is devoted to dissemination of high quality, peer-reviewed scholarship relevant to all areas of pharmacy education—promoting educational research excellence.The Journal maintains a particular focus in two major areas: pharmacy faculty development in the scholarship of teaching and learning and the scholarship of interprofessional pharmacy education. In these scenarios, if FPs believed that individuals or entities tend to be well equipped for responding to black swans, the charts would be skewed to the right (i.e., toward 100% resilience in dealing with an unpredicted disruptive event). Address correspondence to Dr. Fox (Erin.Fox@hsc.utah.edu). 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. Under fee-for-service, providers seek more reimbursement from payers, while capitated value-based systems seek opportunities to cut spending without compromising quality. 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. The advances in technology of all kinds, and their impact on the profession, are a serious concern. programs, such as the ability to develop and implement new clinical programs, may be of more value. Highlighting four “clear trends” that are driving the pharmacy of the future, Quilty says that the Guild is already preparing for the Seventh Community Pharmacy Agreement, which will cover the period 2020 to 2025. This result is a clear recognition that the composition of our health-system pharmacy staff—including technicians, pharmacists, and pharmacy leaders—will not become more diverse unless and until we focus on diversity in our training programs. Many pharmacy departments are organized by setting of care. 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. As value-based reimbursement evolves, health systems should consider value-based pharmacy designs, which may not only improve clinical outcomes but also reduce total costs of care. A total of 325 FPs were recruited to complete the forecast survey. Pub. SEVEN TRENDS YOU CAN BET ON 1) The specialty pharmacy gold rush is on. The report further reveals that though the e-pharmacy segment is at its nascent stage in India, it has the potential to grow to a very large industry segment in the near future. The stability of the supply chain is of critical importance, and recommendations for focused strategic planning are provided. Top Five Pharmacy Trends In 2019. While these clinics may serve an important role in some communities as a “consumerist” delivery model that frames healthcare as transactional rather than relationship based, they often conflict with principles of patient-centered care.11. Smaller pharmacies are feeling the squeeze as larger insurers and chain pharmacies collaborate more closely. 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. Thus, Armada’s attendance has exploded, along with the competition for dispensing specialty drugs. We are one of the nation’s leading pharmacy placement firms. Actively participate in discussions around increasing the transparency of medication and healthcare costs to the public, and contribute to the development of mechanisms of helping patients make more informed healthcare decisions. The aging of the Boomer generation, the increase in chronic disease, and the development of new medications will contribute greatly to the changing pharmacy landscape, as will the growing demand for specialists and the plateau of generic medications. 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. Healthcare has been remarkably resistant to reform. Edney A. America’s love affair with cheap drugs has a hidden cost (January 29. National pharmacy organizations will expand their membership to include technicians. The authors of each Pharmacy Forecast section took the “crowd wisdom” and created impactful messages and recommendations. They foresee an increase in the number of health-system bankruptcies over the next five years. Both examples represent troubling milestones in resetting the definition of “expensive drug.”. About 30 years ago, a transformation in the pharmacist’s role began. Pharmacy departments have significant costs but limited ability to create billable revenue under the traditional fee-for-service structure. Hospital pharmacy departments were forced to divert attention from previous priorities to compounding sterile i.v. Various legislators and policy analysts have proposed the introduction of a single-payer system as a comprehensive reform plan to reduce administrative costs endemic in multipayer systems, better align investment in healthcare interventions with returns, ensure access, and improve quality. While the cost of healthcare, and specifically the out-of-pocket financial responsibility borne by patients, is a critical issue in this section, several key areas surrounding patient decision-making, including an exploration of where patients choose to seek care in the future and concerns regarding vaccine choices, are addressed as well. Pharmacy Technicians are currently in very high demand and this demand is expected to continue through at least 2025. The research report speak about … 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 American Nurses Association has been successful with its Magnet Recognition Program. What pharmacy innovations would make future pharmacies solution centers for the sick? This arrangement has been reviewed and approved by Johns Hopkins University in accordance with its conflict of interest policies. Integration across these service lines should entail the development of new expertise and the development of strong partnerships with existing subject matter experts (e.g., cell therapy laboratories). Two topics that are often included in the Pharmacy Forecast—the healthcare marketplace and healthcare reform—also appear in this year’s edition. Dr. Fox is also a member of the AJHP editorial board. G. Caleb Alexander, M.D., M.S., Professor of Epidemiology and Medicine, Division of General Internal Medicine, Department of Medicine, Johns Hopkins Medicine, Baltimore, MD. As the complexity of healthcare delivery continues to increase, the challenges facing pharmacy leaders will escalate—as will the opportunities for growth in innovation and influence. degree holder than a pharmacist without the ability to diagnose and prescribe. Are You on Track for Your Yearly Career Goals? To compile these results, we surveyed all levels of specialty pharmacy professionals to uncover trends, opinions, and predictions for the future of the industry. A bit of a “dog’s breakfast” of topics, this section includes a discussion of emerging advanced computing technologies, genomics, and future concerns regarding medical cannabis and provides important guidance on those issues. Pharmacists and technicians who complete additional training and/or certification may qualify for higher salaries, but this would be based on additional credentials, not necessarily the compounding of hazardous medications. (Evidence-based Pharmacy Practice). Routine communication and collaboration on quality improvement projects will yield efficiencies, helping to financially justify the added time needed for this work. Pharmacists’ acknowledged ability to drive efficiency will allow them to contribute substantially to their organizations. The demand for postgraduate training programs continues to increase each year, with demand outpacing supply; however, 64% of FPs felt it was unlikely that health systems would offer nontraditional residency programs (Figure 2, item 4). 15 pharma trends for 2020. For the survey items in this domain, Forecast Panelists (FPs) were asked to review a definition of black swans and then estimate on a sliding scale the percentage of individuals or entities in their region that embody a certain characteristic. All rights reserved. Many of the FPs hold the title of chief pharmacy officer or director of pharmacy (13% and 16% of FPs, respectively). Of all the items in this section of the Forecast, the strongest level of FP agreement was with the question examining pharmacists having comprehensive responsibility for a panel of patients across the continuum of care (Figure 1, 
item 3). The future of pharmacy has been an ongoing discussion for some years. With recent acquisitions, the growth of “mega pharmacies” is clearly a trend that will not drop off in 2019. The development of an accredited program by individual institutions is not cost-effective, nor is it an efficient means to provide this level of training. It is only through a continuous process that organizations can be responsive to changes that are sure to affect our profession, organizations, and patients. Product formulations and the associated active components of medical cannabis are not uniform, with resultant variability and unpredictability of response. Conduct an honest assessment of departmental structure and culture vis-à-vis conduciveness to black swan resiliency (see “Black Swans in Strategic Planning” above); make plans to address any critical deficiencies; consider the prospect of creating a strategy-accelerator network, as advocated by Kotter.3,4, Encourage pharmacy team members to pay attention to major scientific, economic, political, social, and cultural trends in the world at large that could evolve into black swans that affect the pharmacy enterprise.f. While the intent of pricing transparency is commendable, challenges in establishing a common charge master format and standardizing pricing information make it unlikely that the current proposals will provide meaningful information that could assist patients in making better decisions regarding their care. The combination of nontraditional residency training with graduate studies (e.g., executive M.B.A. degree programs) may also be attractive to pharmacists following a nontraditional career development path. Rather, the report is, at its core, a provocative stimulant for the thinking, discussion, and planning that must take place in every hospital and health system in order for those organizations to succeed in their mission of caring for patients and advancing the profession of pharmacy. Drug shortages are not improving. The evolution of the 21st century organization. Current Trends in Biotechnology and Pharmacy. Slightly more than half (53%) of FPs did not feel that new companies will decrease future shortages (Figure 5, item 3). DIR fees will continue to be a drain on profits with pharmacy reimbursements. European markets have realized significant savings through the use of biosimilars, with certain biosimilars capturing 90% market share in some European countries, resulting in 70% cost reductions relative to originator product costs.2 The European Medicines Agency has 53 products on its approved list of biosimilars, with each European Union country controlling how these agents are used within its borders.3 By comparison, within the United States there are 19 products approved by the Food and Drug Administration, and only 7 are marketed. 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). What this means is that now, more than ever, yo… Pharma industry 2020: Key emerging trends to watch for in the new year. Leverage the unique skill mix of pharmacy leaders by seeking leadership roles outside pharmacy (taking on other departments, institution-wide committees, etc.) Erin Fox and Rena Conti contribute a section on the pharmaceutical supply chain, with a particular emphasis on future challenges in medication shortage management. All past editions of the Pharmacy Forecast can be found on the ASHP Foundation website at http://www.ashpfoundation.org/pharmacyforecast. Pricing Pressures: “These have been around forever. 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. Taleb’s exposition1 includes rules for mitigating negative black swans and exploiting those that are positive. As senior leadership teams become smaller in order to reduce labor costs, pharmacy leaders may be asked to take on additional responsibilities. The importance of improving diversity in our workforce is a national priority in all fields. 2019 Pharma supply chain trends focused on cost cutting, R&D and patient outcomes . Health systems must appropriately compensate pharmacists and technicians who possess sterile products certifications in order to ensure an adequate workforce dedicated to this fundamental pharmacy responsibility. It’s been said, “the more things change, the more they stay the same.” In community pharmacy, this could be restated as “the more things change, the keys to success stay the same.” While no pharmacy operates in the same way as 100 years ago, some things are still the same. Interpretation of genetic results can be challenging, and an investment in infrastructure must be made so that appropriate interpretations are available in real time and errors are avoided. George Underwood. Finally, as pharmacists are increasingly relied upon to provide system-wide leadership, the Pharmacy Forecast addresses many issues that are relevant well beyond the traditional boundaries of pharmacy and the medication-use process. With advances in artificial intelligence and ‘fuzzy’ logic (an approach to computing based on ‘degrees of truth’), and in logistics and supply (e.g. program would be challenging to offer and unlikely to provide substantial payoff for graduates. Health-system pharmacy leaders possess skills that have often made them candidates for positions outside pharmacy. Sustaining delivery of care in rural areas is an important necessity of our healthcare systems. Healthcare Executive, Eden Prairie, MN. Research Code: 9AB9-00-6A-00-00 . Barnes T, Winfrow M, Laboi P, Wilkie M. Vermeulen LC, Eddington ND, Gourdine MA et al. The emergence of health system–based specialty pharmacy programs is an example of ventures that many institutions have implemented to create new revenue streams. Recently, a new type of pharmacy job called medication therapy management (MTM) pharmacist or personal pharmacist has emerged and is growing. Other Pharmacy Trends. Address correspondence to Dr. Swarthout (mdavlin1@jhmi.edu). The University of Utah Drug Information Service (UUDIS) has a contract to provide Vizient (a group purchasing organization) with drug shortage information. Key performance metrics are used to track productivity, assure quality, and identify opportunities for improvement. While FPs did not feel it is likely that insurers will restrict their beneficiaries from having prescriptions filled at pharmacies where they receive their care (Figure 7, item 6), it seems a likely possibility given similar trends seen in specialty pharmacy, where insurers and manufacturers drive the care of patients away from their health-system providers, leading to inefficiency and higher risk. Forecast Panelists’ responses to the question, “How likely is it that the following will occur by the year 2024 in the geographic region where you work?”. Involving an institutional patient and family advisory council to guide this process can help mitigate this risk. We’ve been watching the coming trends for 2019 and are here to share the top 6 (and ways to beat them). As we enter a new decade, the role of the pharmacist will continue to broaden to fill gaps in patient care and provide even more value to healthcare consumers, who are demanding quality, convenience and control in their health and wellness journey. Please check for further notifications by email. Responses were received from 283 (an 87.1% response rate, up slightly from the 85.4% response rate in 2019). Actively participate in discussions around legislation that decreases the cost of medications and ties the cost to the value each medication provides. These include economic factors, as well as advances in technology and science. Here's what they have to say: 1. 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2FAMADoc%2FHOD.xml-H-480.940.xmi, http://www.usp.org/sites/default/files/usp/document/our-work/healthcare-quality-safety/general-chapter-800.pdf, https://www.osha.gov/SLTC/hazardousdrugs/controlling_occex_hazardousdrugs.html, https://www.governing.com/gov-data/safety-justice/state-marijuana-laws-map-medical-recreational.html, https://healthpolicy.duke.edu/events/drug-shortage-task-force, https://www.ashp.org/news/2018/09/19/summit-on-drug-shortages-to-examine-impact-on-national-security-and-health-care-infrastructure, http://nationalacademies.org/hmd/Reports/2018/medical-product-shortages-during-disasters-brief.aspx, https://www.bloomberg.com/news/features/2019-01-29/america-s-love-affair-with-cheap-drugs-has-a-hidden-cost, https://www.who.int/medicines/publications/essentialmedicines/en/, https://voxeu.org/article/cancer-drug-prices-rise-no-end-sight, https://www.forbes.com/sites/joshuacohen/2018/06/20/whats-holding-back-market-uptake-of-biosimilars/#2282394c691a, https://www.biosimilarsip.com/2019/05/07/how-the-u-s-compares-to-europe-on-biosimilar-approvals-and-products-in-the-pipeline-4/, https://www.drugchannels.net/2019/04/the-specialty-pharmacy-boom-our.html, https://www.drugchannels.net/2019/04/the-top-15-specialty-pharmacies-of-2018.html, https://www.pharmacist.com/article/kentucky-pharmacists-have-new-authorities-improve-patient-public-health, https://www.commonwealthfund.org/publications/issue-briefs/2019/feb/health-insurance-coverage-eight-years-after-aca, https://www.shrm.org/resourcesandtools/hr-topics/benefits/pages/employers-adjust-health-benefits-for-2019.aspx, https://abcsrcm.com/healthcare-industry-consolidation-walmart-humana-merger-medicare-advantage-plans/, https://medcitynews.com/2016/06/boeing-and-memorialcare-contract/, https://www.nytimes.com/2019/07/31/health/medicare-insurance.html, https://www.youtube.com/watch?v=Pc7EVXnF2aI, https://academic.oup.com/journals/pages/open_access/funder_policies/chorus/standard_publication_model, Receive exclusive offers and updates from Oxford Academic, New England (Maine, New Hampshire, Vermont, Massachusetts, 
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Nebraska, Kansas), Middle South (Arkansas, Louisiana, Oklahoma, Texas), Mountain (Montana, Idaho, Wyoming, Colorado, New Mexico, Arizona, Utah, Nevada), Pacific (Washington, Oregon, California, Alaska, Hawaii), Copyright © 2021 American Society of Health-System Pharmacists. These issues include job vacancies, salaries of pharmacists in medically underserved communities ’ responses to survey items was to. Develop and implement improved documentation systems that discretely capture pharmacy impact and analysis. Improve access to essential medications or exposure to substandard-quality medications exposition1 includes rules for mitigating negative black and! Of things to come this means is that now, more products are,. A majority of FPs indicated they believe this is largely due to lack access... Were recruited to complete the Forecast survey recommendations for focused strategic planning should be offered in settings! 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