The transformation to value-based care in early 2000s had the unintended consequences of overburdening Health Care Professionals (HCPs) which lead to a decline individual health resources, as well as the attractiveness of becoming health care professional. Combine this with the rapid evolution of artificial intelligence and other technological efficiencies, and we see a disturbing trend, namely, accelerating the removal of humans from a process that is deeply personal.
Health systems will always need highly trained, empathetic, and educated professionals to monitor and manage all choke points in the health care value chain. Given pharmacists reside at the cross-roads between patients, physicians, providers, and payers, the time has come to reimagine one of the most under-leveraged and overlooked disciplines in the healthcare continuum.
Why Pharmacists?
Pharmacists reach nearly all patient populations and they serve as a connection between therapeutic recommendations and personal continuity via an ongoing trusted relationship with patients. According to data presented in a recent article[1], the unspoken truth is revealed in British Columbia (BC), Canada, where “pharmacists recently gained the ability to administer more vaccines and renew or adjust prescriptions for a wider range of drugs”.
As of October 2022, the types of potential modifications they may impact include:
- Directions for use of a prescription
- Therapeutic substitution
- Changes to dosage
- Changes to formulation
These are major levers for monitoring adherence, patient safety and gathering patient insights that may inform fundamental changes to therapeutic regimen, titration or even the drug itself. We know that healthcare is better when it’s local, when a person is talking to a trusted expert who can hear, intuit, and understand their concerns. Given the personal value, and the evolving administrative burden among all HCPs, there is a case for shifting some powers to a more local care expert and decision maker, the pharmacist.
Recent BC government data showed nearly 60,000 prescriptions were renewed or modified by pharmacists in January 2023, which is more than double the monthly average of about 27,200 in the previous year. This data indicates a 120% increase in the number of residents renewing or adjusting prescriptions, via their pharmacists, after their powers changed. The trend to expand powers being given to pharmacists is growing as we see it in Ireland[2], Ontario, (Canada)[3], the US[4], APAC, the EU[5] and elsewhere.
Across the HCP ecosystem there are numerous individuals involved in therapeutic outcomes, but pharmacists are in a pivotal role. In some instances, pharmacists are seen by patients more frequently than any other HCP[6]. In independent studies, pharmacists are consistently ranked as highly trusted HCPs just behind doctors and nurses[7], thus their recognition as a prescribing and support entity in the health ecosystem continues to grow.
Pharmacists Can Expand their Role into 4 Key Areas
The best way to embrace their functionality is to consider a few typical health scenarios and the presented professional communications opportunity for pharmacists: prevention, diagnostics, therapy and monitoring. Pharmacists can play a key role in each scenario.
At the pharmacy counter – arguably the second-most important point of care – the opportunities to get patients on appropriate therapy, and keep them on, fall directly to the pharmacist.
In many jurisdictions they advise and help patients with 1) directions for use of a prescription, 2) therapeutic substitution and 3) changes to dosage and 4) formulation. With hands-on involvement at the transaction level, they are literally on the front-line of Rx starts, ongoing therapy and treatment adherence. Given global health “support” demand, pharmacists will likely assume a more impactful role at all stages of care.
Healthcare institutions will continue to amend their care journeys, and pharmacists stand out as a highly leverageable resource. With new approaches to designing and delivering Med Ed, investing in pharmacists should prove valuable, accounting for their contribution to pharmacoeconomic analysis, thus warranting greater investments as thier roles expand. Additionally, as a subset of HCPs, their specialty drives efficiencies in channel mix and effectiveness in messaging, education and empowerment, and engagement might even be facilitated in cooperation with traditional retail channels.
SUMMARY
While the data coming from the BC scenario is a tantalizing snippet of the real value of the pharmacist audience, a variety of value-based strategy questions should be examined:
- Can value be assigned using solid analytics to validate the importance of pharmacists within Rx attribution models?
- What are the most impactful channels to reach and educate pharmacists?
- Is there an opportunity to design and deliver Med Ed specifically for the pharmacist
- Are patient support materials better leveraged through the pharmacist
- Will dispensing fees need to be modified to support the expanded remit?
While all health care professionals are key players in treatment, pharmacists are and always will be critically important in care delivery – and the opportunity is to leverage their patient access and front-line insights to influence patient success, patient reported outcomes and quality of life while reducing the burden on physicians, clinical support teams and provider networks.
4news.gallup.com/poll/467804/nurses-retain-top-ethics-rating-below-2020-high.aspx
[1] Globe and Mail, May 18, 2023. BC reports 120% increase in prescriptions after pharmacists gain new powers
[2] New powers to be given to Pharmacists | Carson McDowell (carson-mcdowell.com)
[3] Ontario considering expanding pharmacists’ powers to treat more common ailments (citynews.ca)
[4] Pharmacists’ Role to Expand Amid Pandemic and Provider Shortages | Columbia University Mailman School of Public Health
[5] Reform of the EU pharmaceutical legislation – European Commission (europa.eu)
[6] Most patients see pharmacists as crucial part of their health care team
[7] Nurses Retain Top Ethics Rating in U.S., but Below 2020 High (gallup.com)
