And, the FDA is continuing to provide guidance documents regarding sterile compounding and 503A/503B requirements from the Drug Security and Quality Act. Below are the top challenges facing the hospital pharmacies in 2019. 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. 1. 27.5% out of 528 analysed prescriptions), mostly correlated to the quality of the prescriptions (n = 100, 60.6%) or to logistical matters (n = 54, 32.7%).A mere 36.8% of the patients received information pertaining to their medication while being hospitalized. 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. “We need to focus more on technology and be more vigilant of errors that can occur and overzealous about new drugs because not a lot of written information is available,” he says. 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. There are multiple pending or expected regulations coming down the pike that will determine key opportunities for the pharmacy industry. In addition, 36% of Americans say healthcare is the top issue facing America today, according to a recent poll. In addition, 36% of Americans say healthcare is the top issue facing America today, according to a recent poll. It is important that the hospital pharmacy has a safe, clean space to mix these lifesaving compounds. 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. As the pharmacy industry increases its use of enabling technologies, pharmacists may find themselves at a professional crossroads: either grow their role’s scope and value or face potential disintermediation. Author. 4 minute read Article Overview: Of late, the NHS faces a lot pressure for a host of economic, social and political reasons. Brown bag consults can be essential educational and safety tools to measure and ensure quality care. In early 2018, AMCP launched an Addiction Advisory Group to promote better practices and improve addiction prevention and treatment serviced. 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. 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. At the same time, healthcare spending is lower than in developed economies. 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. 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. In other words, those responsible for managing the pharmacy benefit may not have access to medical data,” she says. Clinical Pharmacist 5 FEB 2010. Take a look back: The top three pharmacy challenges of 2018. 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. Jill Drury, PharmD. High Pharmacy Benefits Manager (PBM) Costs. The top three pharmacy challenges for 2018: drug affordability, nonadherence, and pharmacist compensation, may come as no surprise to many of you. 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. 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. Copyright © 2021 Becker's Healthcare. Gomes, N. (2016). Join them, as they discuss ways pharmacy teams are tackling these problems. 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 biggest shortages have hit older, generic, injectable medications produced by only a small number of manufacturers, epinephrine as exemplified by Mylan jacking up the price of EpiPen 400%, and injectable analgesics. Do not underestimate the challenge facing the NHS. The new year, however, brings some additional challenges to the fore and further complicates the challenges the industry already faces, as outlined by industry experts. Launching URSP The University of Rochester started an integrated specialty pharmacy program in 2011 for patients with employer-sponsored insurance. 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. 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. On average, pharmacy benefit costs currently represent more than 15% of employers’ health care costs. • Hospital Pharmacy Transformation Plans (HPTP) offer an opportunity for pharmacists and pharmacy services to gain greater recognition at board level within the hospital. Pharmacists highlighted two major challenges in the pharmacy. Interested in linking to or reprinting our content? Jim’s top 10 issues facing hospital & health system pharmacy in 2019. According to the FDA, shortages decreased to 39 in 2017 from a peak of 251 in 2011. CMS also is working to change how the payment reduction applies to certain biosimilar products, reducing the size of the payment reduction for these products, and clarifies the application of the payment cut to new drugs. We can expect to see enhanced options for preparation, including guided prep systems and next generation robotics. While pharmacy assumes different challenges every year, affordability has stayed at the top of the list. 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. Antimicrobial Resistance. These changes would represent significant financial losses for some hospitals and should be monitored closely. Any pharmacist will tell you drug shortages are the number one nuisance in hospital pharmacy. Lauren Miller. 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Fear and anxiety of patients and caregivers. 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. Similar to last year, specialty drugs are hiking up the cost of pharmacy. 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. This continues to rate high as a 2019 challenge. Apr 10, 2019 | Uncategorized. However, the unintended consequence was an enormous increase in people addicted to prescription pain medications. 1. Attention to clinical pharmacy is not only a necessity in the hospital setting given the advent of multiple powerful medications for a host of chronic diseases but also clinical pharmacy is necessary in primary care practice.community pharmacies, especially in the developing world, could stand a strong dose of public health outreach to better serve communities with cost effective care. 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. 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. In this post, we are going to discuss about the challenges that the pharmacists have to face in their daily job. Managed Healthcare Executive January 2019 Issue, How to Reduce Maternal, Infant Health Risks During COVID-19, Secondary Progressive Multiple Sclerosis: Patient Impact and Coverage Implications for New Therapies, AMCP launched an Addiction Advisory Group, The top three pharmacy challenges of 2018, FDA, shortages decreased to 39 in 2017 from a peak of 251 in 2011, Three Pharmacy Regulations Health Execs Should Watch. As part of its proposed payment regulation for hospitals under the Outpatient Prospective Payment System (OPPS) for 2019, CMS proposes continuation of the 30 percent payment reduction for Part B drugs implemented earlier this year for certain hospitals in the 340B drug pricing program, and further proposes to extend the payment reduction to drugs provided in non-excepted off-campus hospital outpatient departments (HOPDs) that are subject to reduced "site neutral" payments. Recently HHS Secretary Azar announced his intention to eliminate the “no risk” ACO payment option and move to the second model only. Sheshtyn Paola 27 /01/2017. “Drugs are eating up more and more of the healthcare pie,” says Jane Lutz, executive director, Pharmacy Benefit Management Institute (PBMI). Here are three pharmacy challenges facing healthcare executives and a two-pronged solution to help solve them. An ACO is typically a collaboration between a physician group and hospital group where they agree to be accountable for the care of a defined patient population for a defined time period, such as a Medicare ACO that requires a minimum of 5,000 covered lives for three years. by By Thorrun Govind: 21/06/2012: 0 comments: Features: From funding to demands on healthcare, there was plenty of food for thought at a talk last week attended by pharmacy student Thorrun Govind. Prescription pill addiction is a real problem across the United States. In emerging economies, the challenge is more complex. The program was staffed by a pharmacist and a pharmacy technician. “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 (AMCP). All rights reserved. “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. Below are 5 real issues facing hospital pharmacies today: 1. The PBM also works with providers to manage therapy and with retailers to prevent patients from filling the same prescription in multiple pharmacies. • Hospital pharmacy is under the spotlight, the traditional model of a pharmacy department will change and this presents challenges and opportunities. 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. 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. Brown Bagging Is an Essential Educational and Safety Tool to Help Older Individuals With Adherence. Mari Edlin, a frequent contributor to Managed Healthcare Executive, is based in Sonoma, California. Well-trained and experienced technicians are essential for a robust medication safety program, but high-turnover rates have been an issue. It is up to PBMs and plans to decide which benefit should cover specialty,” Lutz says. 340B ProgramThe 340B Program has grown considerably since its inception and now represents approximately 4% of the total US prescription drug spend. Many hospitals rely heavily on sterile compounds. 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 … Lucio is looking forward to potential biosimilars-especially in oncology-entering the marketplace in 2019 to help mitigate costs through competition. 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. 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. Related article: Three Pharmacy Regulations Health Execs Should Watch. - Mike Kyler, Director of Pharmacy, Grand River Hospital and Medical Center, Rifle, CO. Other challenges included increasing regulatory and … “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. Interested in LINKING to or REPRINTING this content? Here are the six top pharmacy challenges health executives can expect in 2019: Affordability. Multiple prescriptions also add to the cost of drugs for individuals. Dispensing medicines to addicts. Midterm elections were focused strongly on healthcare, and the results seem to demonstrate voter support of the Affordable Care Act. 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. Prescription drugs now represent approximately 17% of the total US healthcare spending. On the other hand, Lutz believes that no model exists that can support the development and distribution of orphan and genomic drugs and biosimilars. For 2019 hospitals and health systems should have better opioid management as a priority and consider an Opioid Stewardship program. 1995 Sep;26 (1-3):131-8. For health systems with their own retail and specialty pharmacies, “insourcing” more employee prescriptions may also offer significant cost reduction opportunities. “We need to change reimbursement to a value-based model; manage outcomes and patients; and tie reimbursement to outcomes to prevent adverse effects and hospitalization and increase survival.”. We spend over 18% of our total GDP at $3.3 trillion dollars annually on healthcare. Massoomi calls drug shortages the “silent epidemic.”. Drug shortages. Issue #1: Too Many Employee Pharmacists. 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. Community pharmacists faced 165 challenges from 145 hospital discharge prescriptions (i.e. Provider status is a legislative slippery slope for pharmacists and one that often impacts being paid for services provided. “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. There are multiple pending or expected regulations coming down the pike that will determine key opportunities for the pharmacy industry. 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. In the second model the same basic quality and cost targets are present but there are enhanced levels of payments, however these come with a “down-side” risk of reduced payments if the targets are not reached. 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. Pharmacy workforce issues will be a challenge for 2019 as there is a technician shortage but a pharmacist oversupply. There is no set standard as to what the norm for hospital pharmacist:population ratio should be. What experts say will be the year’s biggest problems, and what can be done about them. Every day, more than 115 people in the United States die after overdosing on opioids and the total "economic burden" of prescription opioid misuse alone in the United States is approximately $80B annually and rising. From next year, and for the following three years, it will be cut. Dr Smith presented at our Pharmacy: the key to a transformed NHS? The intervention resulted in a four-fold increase in members receiving naloxone, an overdose reversal agent. 1. 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. “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. Some are used in surgeries, while others are needed to bring a person back to stability after an accident. 2016 was a year of major change for healthcare organizations. Just last month LexisNexis Risk Solutions hosted its annual Pharmacy Partner Summit. 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. Challenges Facing The NHS – Medical School Interviews. Patient EducCouns. Underrecognition, low wages: pharmacy’s biggest challenges. 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. 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. 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.