Drug companies seeking market access for their products are usually competing for attention and funding not just with other pharma companies and other disease areas, but with defense, education, and other government-funded sectors. 1. Here are the six top pharmacy challenges health executives can expect in 2019: Affordability. Pharmacy workforce issues will be a challenge for 2019 as there is a technician shortage but a pharmacist oversupply. Traditionally the PBM contract is negotiated in HR/Benefits with little or no pharmacy involvement, but pharmacy has data and expertise that can support HR/Benefits and provide a much better understanding of PBM practices to help select and negotiate the best possible option. The top three pharmacy challenges for 2018: drug affordability, nonadherence, and pharmacist compensation, may come as no surprise to many of you. Efforts focused on PBMs feature prominently in President Trump and Secretary Azar’s Blueprint for Drug Cost Reduction. Hospitals are faced with increasing challenges as their bottom lines continue to be squeezed by lower medical reimbursements, healthcare reform, and double-digit prescription rate increases. On average, pharmacy benefit costs currently represent more than 15% of employers’ health care costs. Similar to last year, specialty drugs are hiking up the cost of pharmacy. Pharmacists represent the third largest profession globally; however, the distribution, in terms of practice and geographic area, sector, and sex, is uneven.1 The pharmacist:population ratio varies widely, from <5 to >200 pharmacists per 100,000 population. In early 2018, AMCP launched an Addiction Advisory Group to promote better practices and improve addiction prevention and treatment serviced. The PBM also works with providers to manage therapy and with retailers to prevent patients from filling the same prescription in multiple pharmacies. At the same time, healthcare spending is lower than in developed economies. 1. It is possible to become addicted after a single course of treatment and it is impossible to predict exactly who might have this addiction predilection. It should be noted that while 503A compounding remains the primary responsibility of State Boards of Pharmacy, the FDA can and will investigate any concerns in this space. Pharmacists highlighted two major challenges in the pharmacy. The FDA approved the first generic competitor to EpiPen in August 2018 made by Teva Pharmaceuticals. In 2012, public health … Here are three pharmacy challenges facing healthcare executives and a two-pronged solution to help solve them. © 2021 MJH Life Sciences and Managed Healthcare Executive. These challenges have required many countries to critically assess the size, skills, and competencies of the health work force. As a pharmacist, you need to deal with many patients regularly on your job. “Negotiating for best drug price shouldn’t present a barricade,” Gavras says. Hospital pharmacists are facing a large number of challenges in the next few years in the UK, which will shape the agenda of the Guild of Healthcare Pharmacists (GHP) We can and must do better in all of the above areas and everyone should hold all elected officials accountable for their performance on improving healthcare. The continued evolution of antimicrobial resistance remains a top threat worldwide. Opioid EpidemicUnfortunately, the current opioid epidemic shows no signs of abating in 2019. On the positive side, about 85% of people with commercial insurance pay less than $20 a month out of pocket. hospital system a significant amount of money. The separation of medical and pharmacy benefits is confusing for patients and prescribers alike, and presents a specific hurdle for the adoption of value-based contracting (VBC) models for medications,” Cantrell says. “Innovation with gene therapies and precision medicine increases the fight to afford specialty drugs,” says Susan A. Cantrell, RPh, CEO, Academy of Managed Care Pharmacy . For pharmacists, we expect market trends like an aging population and the introduction of complex medication therapies will lead to a higher demand and create more opportunities for pharmacists. Prescription pill addiction is a real problem across the United States. Below are 5 real issues facing hospital pharmacies today: 1. 1. Escalating Drug CostsThis year the total prescription drug spend is expected to exceed $460B and projections are that by the end of 2019 that total will be at half a trillion dollars. 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With medications representing the fastest growing element of US healthcare spending and the primary treatment modality for the majority of patients, pharmacy can play a significant role in addressing these challenges. Just last month LexisNexis Risk Solutions hosted its annual Pharmacy Partner Summit. It has also been a stated goal of CMS to move at least 90% of ambulatory payments to an ACO or bundled payment type arrangement over the next 10 years. Gomes, N. (2016). Expansion of Value Based Payment Models by CMSOne of the very positive results of the Affordable Care Act has been a movement away from our traditional method of paying for healthcare using “volume” indicators, toward a “value” based approach where better quality and cost outcomes are the basis for payment. Below are the top challenges facing the hospital pharmacies in 2019. Sterile Compounding. Author. 2019-01-26 15:00:00. In 2016, the United States spent 18% of gross domestic product on healthcare-nearly twice the rate of 10 other high-income countries, according to a study in the Journal of the American Medical Association. Apr 10, 2019 | Uncategorized. Pharmacists Face Challenges When Dispensing Medications to Elderly Patients . As a solution, he recommends developing a strong, proactive pipeline management system anticipating costs and ensuring the right indication, right drug, and right person are aligned. Fear and anxiety of patients and caregivers. On the other hand, Lutz believes that no model exists that can support the development and distribution of orphan and genomic drugs and biosimilars. Drug shortages. In emerging economies, the challenge is more complex. Just last month LexisNexis Risk Solutions hosted its annual Pharmacy Partner Summit. Barriers and challenges in training health care providers for patient education. “Pharmacy is the most frequently-used benefit, and it’s a real-time benefit-you know what you are going to pay when you pick up a prescription.”. Continuing Drug ShortagesWe have seen no significant abatement of the ongoing issues surrounding drug shortages this year and there are no indications that this situation will improve in 2019. PBM Evolution toward New Delivery Models The PBM industry has made significant contributions to better management of the US prescription drug spend yet it has come under increasing criticism. For 2019 hospitals and health systems should have better opioid management as a priority and consider an Opioid Stewardship program. Dr Smith presented at our Pharmacy: the key to a transformed NHS? 4 minute read Article Overview: Of late, the NHS faces a lot pressure for a host of economic, social and political reasons. The biggest issues confronting pharmacists in 2017 are lack of recognition as healthcare professionals, low wages and declining PBS income, according to an AJP poll. It is important that the hospital pharmacy has a safe, clean space to mix these lifesaving compounds. All rights reserved. The three biggest challenges hospital and health system pharmacy teams are facing include drug shortages, drug diversion, and drug utilization. Government funding for the NHS has increased annually for over 60 years. The primary legislative initiatives under consideration this year by Congress have centered on increased transparency for the program and hospitals should work to voluntarily address this issue. 1. Provider status is a legislative slippery slope for pharmacists and one that often impacts being paid for services provided. • Hospital pharmacy is under the spotlight, the traditional model of a pharmacy department will change and this presents challenges and opportunities. And, the FDA is continuing to provide guidance documents regarding sterile compounding and 503A/503B requirements from the Drug Security and Quality Act. Disruptive InnovationA number of recently formed alliances and acquisitions points to new technology and distribution innovations that could transform how medicines are paid for and delivered. Gavras says that Prime Therapeutics has been identifying high prescribers since 2010, along with users abusing opioids based on a predictive modeling process. Hospitals are faced with increasing challenges as their bottom lines continue to be squeezed by lower medical reimbursements, healthcare reform, and double-digit prescription rate increases. The program was staffed by a pharmacist and a pharmacy technician. “Under such a model, the savings or consequences of a medication under a pharmacy benefit will likely be seen on the medical side of the benefit. On average, pharmacy benefit costs currently represent more than 15% of employers’ health care costs. “Drugs are eating up more and more of the healthcare pie,” says Jane Lutz, executive director, Pharmacy Benefit Management Institute (PBMI). While providing many benefits, there are still many elements that could benefit from a revised approach, such as high monthly premiums, limited access in some areas, affordability, and adequate funding. Specialty medication usually involves complex medication regimens, which can cause fear and anxiety for patients and their caregivers. Some are used in surgeries, while others are needed to bring a person back to stability after an accident. Among those patients, some of them can be addicts and dispensing … Lucio makes technology sound like a necessary evil when he says it is expensive but enables the pharmacy industry to work more safely and effectively. - Mike Kyler, Director of Pharmacy, Grand River Hospital and Medical Center, Rifle, CO. Lauren Miller. Brown Bagging Is an Essential Educational and Safety Tool to Help Older Individuals With Adherence. Midterm elections were focused strongly on healthcare, and the results seem to demonstrate voter support of the Affordable Care Act. • Hospital Pharmacy Transformation Plans (HPTP) offer an opportunity for pharmacists and pharmacy services to gain greater recognition at board level within the hospital. The students are required to be trained in practical skills to confidently face the challenges of clinical and hospital pharmacy on one hand and industrial pharmacy/ pharmaceutical technology on the other. Lutz is all for technology, considering it to be a critical part of the solution of keeping drug costs down-especially the use of online tools. There is no set standard as to what the norm for hospital pharmacist:population ratio should be. Underrecognition, low wages: pharmacy’s biggest challenges. There are two basic approaches to ACOs and value-based payment. The healthcare industry is facing many changes that pose new challenges to medical organizations big and small. In addition, 36% of Americans say healthcare is the top issue facing America today, according to a recent poll. Here are the six top pharmacy challenges health executives can expect in 2019: Similar to last year, specialty drugs are hiking up the cost of pharmacy. Other challenges included increasing regulatory and … Rising drug costs pose a financial challenge to hospitals for inpatients, but high cost drugs are also an opportunity for the hospital’s outpatient business. He also believes that patients have to weigh a drug’s relative value against its price tag. These changes would represent significant financial losses for some hospitals and should be monitored closely. Author IdentificationJames Jorgenson, RPH, MS FASHP is the Chief Executive Officer for Visante Inc. 101 E. 5th Street, #2220, St Paul, MN [email protected](317) 997-2004. In particular, the fast-evolving government regulations, technological innovations, and patient expectations create a new environment in which running a medical practice isn’t just about treating patients anymore. In this post, we are going to discuss about the challenges that the pharmacists have to face in their daily job. Copyright © 2021 Becker's Healthcare. As many as 57% of U.S. adults have less than $1,000 in savings to cover health expenses, and nearly 25% have less than $100, according to PBMI. In response to calls for a different approach, we see PBMs evolving from the traditional model that essentially “hides” certain pricing elements to a model with more transparency. Join them, as they discuss ways pharmacy teams are tackling these problems. She is concerned that the price of drugs is outweighing income when the average annual cost of a specialty drug is $52,000 and the median wage in 2016 in this country was $48,665. In this video Dr Judith Smith, author of the Nuffield Trust research report Now more than ever: why pharmacy needs to act and Director of Policy at the Trust, outlines the impact that the report has had on pharmacists, practitioners and policy makers and remaining issues for pharmacy and pharmacists. Related article: Three Pharmacy Regulations Health Execs Should Watch. It is up to PBMs and plans to decide which benefit should cover specialty,” Lutz says. View our policies by clicking here. “Solving this problem takes a multistakeholder approach; it is important to manage utilization without compromising care,” Cantrell says. The new fully transparent PBM programs eliminate concerns about hidden fees, rebate amounts, Maximum Allowable Cost list and spread manipulations. “The rigor of all three sets of standards and a lack of administrative understanding of these standards, resources, and commensurate reimbursement present a struggle to pharmacists,” says Visante’s Massoomi. As of this publication there are well over 200 drugs in shortage situations. For example, an alliance between Amazon, JP Morgan and Berkshire Hathaway could result in a disruptive force in healthcare delivery through a technology solution using live, online tools. How might those working in hospital pharmacies be affected? Any pharmacist will tell you drug shortages are the number one nuisance in hospital pharmacy. Join them, as they discuss ways pharmacy teams are tackling these problems. We also see the introduction of new terminology with companies like Ventegra now branding itself as a Pharmacy Services Administrator (PSA) as opposed to a traditional PBM and offering a fully transparent approach and a greater emphasis on 340B and specialty pharmacy options along with enhanced medication therapy management programs. When an employee at a self-insured hospital uses an outside pharmacy, the hospital can expect to pay their PBM anywhere from $25 to upwards of $100 per prescription. 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