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Trends in Health-System Pharmacy – 2018 Pharmacy Forecast
by Travis Hunerdosse, PharmD, MBA President, ICHP
The 2017 Midyear Clinical Meeting has come and gone, but the experience, connections, and fresh ideas carries us into the New Year. The Midyear meeting is a great time to catch up with old friends and colleagues, establish new connections, and gain fresh perspectives and ideas to bring back to our practices. This year’s programming included a spotlight on the ASHP Foundation’s 2018 Pharmacy Forecast. I had the opportunity to attend two sessions on the Pharmacy Forecast. The first was a presentation by contributors of the Pharmacy Forecast that highlighted major trends and sections of the Forecast. The second session was a networking session on how ASHP affiliate organizations could use the Pharmacy Forecast for strategic planning. Both sessions provided great insights from both a state affiliate organization and individual practice perspective.
The ASHP Foundation Pharmacy Forecast is a free report published by the ASHP Foundation that appeared in the January 15, 2018 issue of the American Journal of Health-System Pharmacy (AJHP). The Pharmacy Forecast is a report that highlights emerging trends in health system pharmacy practice and serves to support and improve strategic planning effectiveness. The report analyzes predicted trends and contains practice recommendations in key areas of pharmacy practice. The areas include therapeutic innovation, data, analytics, and technology, business of pharmacy, pharmacy and health-system leadership, advanced pharmacy technician roles, population health management, public health imperatives, and coping with uncertainty and chaos. The report assists health-system and state affiliate leaders to look beyond immediate operational challenges and trends outside of pharmacy’s immediate purview to plan for key issues that impact the profession of pharmacy.
Today, there is a fair amount of uncertainty and chaos in health care. Programs such as the Affordable Care Act and the 340 B program are under question with the current administration and could have significant impacts on health-system revenues. The number of drug shortages and recalls has risen to levels that are equal or worse than those experienced several years ago. Pharmacy revenues are also being pressured by egregious drug price increases, DIR (direct and indirect remuneration) fees, and PBM (pharmacy benefit manager) lockouts. With these forces in mind, the forecast recommendation is to be prepared for significant reductions in revenue through good stewardship of organizational resources and focus on core business operations like sterile compounding, automation, and inventory management to reduce waste. Also, recognize and seize opportunities to advance services and create new business lines.
Key trends that that have implications for state affiliates include the opioid crisis, telehealth, and uniform technician regulations. The report identified that 75% of health-systems have a major campaign focused on the prescribing of opioids. In Illinois, legislation has passed to increase prescriber and pharmacist use of the prescription monitoring program to aid in identifying individuals who are at risk for controlled substance abuse. Pharmacy benefit managers (PBMs) are putting mandatory reviews and authorizations in place around opioid selection and quantities prescribed. Health-systems are also playing a role at the local level to implement safer prescribing practices.
Telehealth is another key area that has implications for state affiliates. In at least 25% of health systems, most chronic care patients will receive some of their ongoing health through telehealth applications. Areas of potential impact include the pharmacy practice act, board of pharmacy rules, reimbursement for care, and provider support. We are fortunate in Illinois to have generous telehealth regulations and health-systems are able to adopt telehealth technologies with minimal barriers.
National uniformity of regulations regarding technician training and duties also has implications at the state affiliate level. The Forecast identified that the trend will be for state boards of pharmacy to move towards a more uniform standard for technician training. ICHP, with support from its Government Affairs Division, plays a key role in providing input on regulations impacting technician training and duties.
As we consider these trends, and their implications as a state affiliate, we can use the following framework to guide our efforts to support our members. Start with asking what are the key underlying issues from a state society strategic planning perspective. Next rank the impact (high, medium, low) on strategic implications for ICHP and the opportunity for ICHP to have an impact. Finally identify the potential actions in the areas of education, policy advocacy, public communication, and partnerships with other professional organizations.
I encourage you to review the 2018 Pharmacy Forecast and reflect on trends that impact your practice site and have implications for ICHP. Consider how you can use the report to elevate your teams and the profession. I look forward to working with members and the division leaders to incorporate key trends into future planning and initiatives.