The Future of Pharmacy – Spark plugs, Z – Packs, TPNs and Harry Potter books

I’ve had a lot of kind contributors make guest contributions and when I read this post, I wanted to share it with all of you.  I’ve thought a lot about the future of pharmacy. and this is definitely a thought provoking post on the future of pharmacy and where we are headed.  Please feel free to leave a comment and a special thanks to James Rinehart for contributing to the discussion with an excellent post!

 

Spark plugs, Z – Packs, TPNs and Harry Potter books. What do these items have in common?  What they have in common is that that are considered ‘supply items’ to individuals who need/desire them whether the individuals are auto enthusiasts, patients, or book readers. 

 

I listened recently to  Jim Cramer discuss on CNBC how Jeff Bezos of Amazon may limit, to a degree, the  pending economic inflation by reducing the cost margins of ‘supply items’ via the use of automation. He mentioned specifically the high cost margins of healthcare supply items and the impact Amazon has had on the distribution of auto parts and books using technology to reduce costs/prices.  It will be interesting to see what other new potential business ventures (e.g. the pending merger of Walgreens with AmerisourceBergen) will have on the distribution of healthcare supply items. 

 

As consumers it is important to remember that that what we need/want are the actual supplies (the spark plug, the Z – Pack, the TPN, the Harry Potter book) and not the intermediate costly steps of distribution. Automation and technology are increasingly being used to eliminate / reduce the intermediate costly steps of distribution. Think of the impact ATM machines, automated boarding passes, travel booking sites, etc. have had on process efficiencies and decreasing personnel associated costs.

 

Rapidly fading, and in many cases gone, are the ‘mystique’ of the retail brick and mortar auto parts store and the bookstore. In many cases the actual brick and mortar stores have disappeared in addition to the disappearing ‘mystique’ of such stores.  Will brick and mortar pharmacies in the community and hospital settings be next to lose their ‘mystique’ associated with  being intermediate steps in providing supplies (medications) to the patient? To what extent will the physical brick and mortar pharmacy spaces disappear due to the increased use of technologies?

 

The value of a product is the calculated benefit of the product divided by the cost of the product.

 

Clinical pharmacy services are primarily knowledge based services.  To what extent are / will clinical pharmacy services be considered a ‘supply item’ to patients and caregivers?   The distribution of clinical pharmacy supply items (services) has already been automated, to a degree, through the use of drug information software and ‘apps’. (Remember when providing drug information to patients and caregivers was almost exclusively considered a pharmacist provided clinical pharmacy service?)  Artificial intelligence is increasingly being used in the development and use of medication therapeutic algorithms.  

 

How will the ‘value’ of pharmacist provided clinical pharmacy services (supply items) be considered in the advent of increasing technology development and applications?  What steps will be taken via the use of technology go reduce the unnecessary costly steps incurred to provide these clinical pharmacy services (supply items)? 

 

If the future has any semblance of the recent past I am not optimistic that the value of clinical pharmacy services will be sufficiently recognized, as intermediate medication related process costs are flattened. 

 

The pharmacy profession has been remiss and missing in action in developing evidenced based, professionally endorsed metrics to measure, in a useful and pragmatic manner, the routine ongoing pharmacist productivity and value of clinical pharmacy services comprehensively at the community and local hospital / health-system settings.  Pockets of such measurements do exist however such measurements are not applied comprehensively and consistently across healthcare settings in the United States. 

 

To what extent will our society continue to expend funds on healthcare supplies (and related distribution costs) whose value cannot be measured and/or for whose value is considered to be low?

 

Clinical pharmacy supply items (services) will be, and in many cases already are, the next frontier for technology and system innovation to provide the discrete clinical pharmacy supply item (service) in terms of what is actually needed by patients and caregivers, based upon a calculated acceptable value. Inefficient methods (including personnel and physical locations) of providing the clinical pharmacy supply items (services) will be eliminated. Clinical pharmacy supply items (services) without a calculated value and/or of low calculated value will be eliminated.

 

Our profession will not survive in the future solely due to its historical ‘mystique’.

 

Special thanks to James R. Rinehart, RPh, MS, FASHP for his post on the future of pharmacy!

 

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2 Comments

  1. Grant C

    Knowledge does not equal wisdom..At least in some settings it will continue to take someone with skill to interpret that drug information software and flesh out what is clinically significant and intervene. Metrics for the most part seem relegated to dispensing numbers and profit which have already flattened out but could probably go even lower taken on a large enough scale.

    It would be nice to have system to document pharmacist interventions and assign a value to them. Outcomes/MTM type programs have attempted to do this but I’m not sure how successful it actually is.

    I don’t think legally or practically one can completely eliminate the Pharmacist as an intermediary step. We serve as a system of checks and balances.

    The future of Retail might look a lot like mail order pharmacy. No more brick and mortar rather, strategically located warehouses and improved distribution channels for ‘Prime’ same day delivery of medication..?

    Reply
  2. Alan Vogenberg

    The mandatory PharmD was a huge mistake. NO ONE wants to pay for Pharmacist “services”.
    OBRA 90 mandated Pharmacist counseling for Medicaid patients (later extended to all patients).
    BUT, there was no mechanism for payment of the “service”. Therefore Pharmacists avoid counseling
    like the plague, especially at the chain Pharmacies. Too many other metrics to be met.

    Reply

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Written By Eric Christianson

March 14, 2018

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