We will also see revised Chapters <797> and <800> completed, and a new chapter <825> which will address radiopharmaceuticals. Jonathan Gavras, MD, senior vice president and chief medical officer of Prime Therapeutics, a PBM headquartered in Eagan, Minnesota, believes it is important to anticipate what’s coming down the pipeline, especially high-cost specialty drugs; develop appropriate policies around cost to be affordable for payers and patients; and keep ahead of drug approvals, many of which are fast tracked. • Hospital pharmacy is under the spotlight, the traditional model of a pharmacy department will change and this presents challenges and opportunities. “We want pharmacists to operate a patient-safe environment, but a business model doesn’t exist to enable that but with so many products and technologies that can cause problems,” says Norman Tomaka, BS, Pharm, MS, clinical consulting pharmacist based in Melbourne, Florida. Here are three pharmacy challenges facing healthcare executives and a two-pronged solution to help solve them. 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. Some are used in surgeries, while others are needed to bring a person back to stability after an accident. All rights reserved. Dr Smith presented at our Pharmacy: the key to a transformed NHS? The future of pharmacy: Disruption creates transformative opportunities and challenges Download the PDF Technology-driven disruption happens fast Many pharmacies operate on a legacy business model that is only just beginning to embrace the technologies and customer service innovation. What follows are strategies used by the University of Rochester Specialty Pharmacy (URSP) in New York to overcome common challenges. Multiple prescriptions also add to the cost of drugs for individuals. For health systems with their own retail and specialty pharmacies, “insourcing” more employee prescriptions may also offer significant cost reduction opportunities. Some of the changes affect pharmacists in all four home countries of England, Scotland, Wales and Northern Ireland in different ways as we have greater devolution and … Prescription drugs now represent approximately 17% of the total US healthcare spending. Mari Edlin, a frequent contributor to Managed Healthcare Executive, is based in Sonoma, California. According to the FDA, shortages decreased to 39 in 2017 from a peak of 251 in 2011. Join them, as they discuss ways pharmacy teams are tackling these problems. Fear and anxiety of patients and caregivers. 340B ProgramThe 340B Program has grown considerably since its inception and now represents approximately 4% of the total US prescription drug spend. Fred Massoomi, PharmD, senior director, Visante Inc., a medication management consulting company headquartered in St. Paul, Minnesota, agrees with Cantrell that the epidemic is a multifactorial problem, placing blame on the inability to accurately document doses and dispose of waste. The three biggest challenges hospital and health system pharmacy teams are facing include drug shortages, drug diversion, and drug utilization. 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. 1. Provider status is a legislative slippery slope for pharmacists and one that often impacts being paid for services provided. Patient EducCouns. Barriers and challenges in training health care providers for patient education. 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. In addition, 36% of Americans say healthcare is the top issue facing America today, according to a recent poll. 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. Pharmacy workforce issues will be a challenge for 2019 as there is a technician shortage but a pharmacist oversupply. Sheshtyn Paola 27 /01/2017. Government funding for the NHS has increased annually for over 60 years. Brown Bagging Is an Essential Educational and Safety Tool to Help Older Individuals With Adherence. 2016 was a year of major change for healthcare organizations. 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. For 2019, hospitals and health systems would be wise to evaluate their current PBM performance for their employees and any “at risk” populations they are responsible for – and pharmacy should be part of this analysis. 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There are multiple pending or expected regulations coming down the pike that will determine key opportunities for the pharmacy industry. 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) who provide professional and industrial representation. • Hospital pharmacy is under the spotlight, the traditional model of a pharmacy department will change and this presents challenges and opportunities. At the same time that USP standards are in process, State Boards of Pharmacy are also actively working on enhancements to their regulations as well as continuing to elevate the training around sterile compounding compliance for their inspectors. For 2019, CMS is suggesting further reductions in payments to 340B hospitals for Part B drugs and biologicals. 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. Healthcare workers need comprehensive support as every aspect of care is reorganised Delivery of every aspect of care by all clinical and non-clinical departments in the UK’s NHS is being reassessed and fundamentally reorganised in the expectation of an imminent surge of patients with covid-19.1 Modelling of the outbreak assumes an infection fatality ratio of 0.9% and a hospital … 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) In today’s health care ecosystem, the pharmacist is a trusted, critical, and—often—underutilized resource. One, the rising cost of drugs, and two, lack of human and financial resources to perform the growing number of responsibilities placed on the pharmacy. Apr 10, 2019 | Uncategorized. 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. How these issues get resolved will have a major impact on the future of pharmacy practice. Hospital pharmacy transformation programmes (HPTP), the meltdown of A&E services with an undercurrent of financial pressures and low morale owing to workplace pressures are some of the issues facing hospital pharmacy. 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. 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. “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. Many hospitals rely heavily on sterile compounds. Shortages happen for many reasons, including manufacturing issues, natural disasters, supply issues, raw material issues and discontinuation. Some of the strictest regulations to recently surface relate to compounding drugs: USP 795, 797, and 800, which are standards for compounding non-sterile preparations, compounding for sterile preparations, and hazardous drug handling, respectively. Community pharmacists faced 165 challenges from 145 hospital discharge prescriptions (i.e. Pharmacists highlighted two major challenges in the pharmacy. “Drugs are eating up more and more of the healthcare pie,” says Jane Lutz, executive director, Pharmacy Benefit Management Institute (PBMI). 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. The issue of lack of interoperability in many hospital digital systems results in inefficiencies and duplication of work, putting further pressure on the system and introducing a risk to … Feature: Challenges facing pharmacy. That is nine more than record-breaking 2017, which had the highest number of approvals in more than two decades, according to an April 12, 2018 Health Policy Report in the New England Journal of Medicine. By Gareth Malson, MRPharmS. It is important that the hospital pharmacy has a safe, clean space to mix these lifesaving compounds. In other words, those responsible for managing the pharmacy benefit may not have access to medical data,” she says. While pharmacy assumes different challenges every year, affordability has stayed at the top of the list. “Negotiating for best drug price shouldn’t present a barricade,” Gavras says. A paradigm shift in the approach to these practice standards as requirements to meet compliance must change to a desire to meet standards and exceed them for patient and employee safety. 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. Take a look back: The top three pharmacy challenges of 2018. Last week, Roy Lilley, who describes himself as an NHS writer, broadcaster, commentator and conference speaker, came to Manchester to discuss the challenges facing pharmacy in the new NHS with Greater Manchester LPCs. “Solving this problem takes a multistakeholder approach; it is important to manage utilization without compromising care,” Cantrell says. Issue #1: Too Many Employee Pharmacists. The impact of drug shortages is significant and includes the expense and time to provide alternative medications, communicate statuses with staff, keep IT and automation updated with new products, purchase cost of non-contracted products, and more. This has meant changes in approaches to service delivery across all levels of care, posing challenges to the primary-care and hospital-care roles of pharmacy. Jill Drury, PharmD. “Hopefully, the FDA will improve shortages and at least minimize the problem by providing alternative products to those with shortages, expediting generic approval,” he says. Massoomi calls drug shortages the “silent epidemic.”. “Specialty medications are responsible for churn and volatility because they can be covered under both medical or pharmacy benefits but require a high-touch model because of side effects, changes in dosages, and comorbidities. Related article: Three Pharmacy Regulations Health Execs Should Watch. 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Clinical Pharmacist 5 FEB 2010. The FDA approved 55 drugs as of early December 2018, in therapeutic areas as diverse as influenza, breast cancer, immunodeficiency, pneumonia, and migraines. 7 Challenges Facing Hospitals and Their Outpatient Pharmacies. It is felt that lack of focus on quality of service is causing much harm for the professional growth of Indian pharmacist and health care professional. Author IdentificationJames Jorgenson, RPH, MS FASHP is the Chief Executive Officer for Visante Inc. 101 E. 5th Street, #2220, St Paul, MN 55101jjorgenson@visanteinc.com(317) 997-2004. 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. 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Drug shortages. We can expect to see enhanced options for preparation, including guided prep systems and next generation robotics. 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. At the same time, healthcare spending is lower than in developed economies. 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. On the other hand, Lutz believes that no model exists that can support the development and distribution of orphan and genomic drugs and biosimilars. Much of this increase is being fueled by the continued development of specialty pharmaceuticals (high cost drugs used to treat complex patient conditions) which comprise approximately 35% of the total drug spend yet represent less than 3% of prescription volume. Just last month LexisNexis Risk Solutions hosted its annual Pharmacy Partner Summit. © 2021 MJH Life Sciences™ and Managed Healthcare Executive. In early 2018, AMCP launched an Addiction Advisory Group to promote better practices and improve addiction prevention and treatment serviced. Well-trained and experienced technicians are essential for a robust medication safety program, but high-turnover rates have been an issue. Prescription pill addiction is a real problem across the United States. 4 minute read Article Overview: Of late, the NHS faces a lot pressure for a host of economic, social and political reasons. However, the unintended consequence was an enormous increase in people addicted to prescription pain medications. High Pharmacy Benefits Manager (PBM) Costs. Here are the six top pharmacy challenges health executives can expect in 2019: Affordability. Last year, non-adherence and pharmacist compensation capped off the top three, but in 2019, industry experts are identifying new barriers that have even more impact. 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. Although Steve Lucio, associate vice president, Vizient, a performance improvement company located in Irving, Texas, recognizes the effectiveness of specialty drugs, such as those for immunotherapy, he says they can saddle patients with high costs. 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