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Pharmacists, Pharmacy and Idaho

Pharmacists, Pharmacy and Idaho. Providers of Health Care Today and Tomorrow. College of Pharmacy Idaho State University. First College on the ISU campus - 1920 First College in the North West Early adopter of the 4 year program – 1922

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Pharmacists, Pharmacy and Idaho

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  1. Pharmacists, Pharmacy and Idaho Providers of Health Care Today and Tomorrow

  2. College of PharmacyIdaho State University • First College on the ISU campus - 1920 • First College in the North West • Early adopter of the 4 year program – 1922 • 7th College in the US to adopt Pharm.D. as the only degree available. • Most successful and one of two remaining non-traditional programs

  3. College of Pharmacy • Admitted 60 students in 2008 • Admitted 70 students in 2009 – 2011 • Potential to grow to 100 students with current facilities.

  4. College of Pharmacy • Pocatello, Meridian, Coeur d’Alene • Meridian and the new facility • Member of the Division of Health Sciences

  5. Idaho’s College of Pharmacy • State wide recruiting • Equal preference for all residents • Preceptors located across Idaho

  6. Pharmacies in Idaho Counties

  7. BLS 10 Year Occupation Projection US (Idaho) US 2008 - 2018 *Fourth highest ranking “hot-job” per Idaho Department of Labor. Criteria: number of jobs, fastest growing, highest pay

  8. Conclusions: BLS Occupation Projections • US - pharmacist employment expected to grow much faster than total employment, 2008-2018 • Idaho 2008-2018 • Total Idaho employment to grow much faster than US • Idaho pharmacist employment growth nearly double growth of total Idaho employment • Idaho pharmacist employment to grow much faster than both US pharmacist and total US employment

  9. Conclusions: BLS Occupation Projections • Factors likely to reduce demand for pharmacists • BLS expects mail-order and online pharmacies to grow much faster than community pharmacies • BLS expects greater automation of drug dispensing • BLS expects greater employment of technicians/aides Why hasn’t more automation been deployed? Impact of more national involvement in healthcare? Role of electronic medical records?

  10. Conclusions: BLS Occupation Projections • Factors likely to increase demand for pharmacists • Aging of the population • Continued expansion of the potential for new drugs to treat diseases • Continued expansion of the role of pharmacists in primary and preventive care • New opportunities in disease management, research, informatics • New opportunities for pharmacists in managed care and elsewhere to analyze trends and patterns in medication use and in pharmacoeconomics

  11. Conclusions: BLS Occupation Projections • Notice that the BLS identified factors increasing demand for pharmacists also deepen pharmacy job content, adding to pharmacist responsibilities • Pharmacy professional societies pushed for the PharmD and are pushing for more pharmacist responsibilities • George Halvorson, Chairman, CEO Kaiser Health Plan “….clinical pharmacists are the most underutilized member of the healthcare team.” (6 April 2009) Will more national involvement in healthcare lead to job deepening & more clinical responsibilities for pharmacists?

  12. Impact of Current Recession • Recession appears to be impacting pharmacy, ie, some slowdown, but that impact appears to be limited so far. • Consistent with notion that healthcare is one of the least impacted sectors during economic downturns • However, pharmacy & healthcare in general are not totally immune to recessions, particularly severe downturns.

  13. Impact of Current Recession • Anecdotal Reports: Idaho • ISU COP placed all May 2010 graduates • Rite-Aide store closed Pocatello Spring 2010 • Less part-time hours • Anecdotal Reports: USA • Chains slowing expansion plans • Hospitals hiring less • Private school rumors

  14. US Prescription Spending

  15. Retail Prescription Drug Expenditure Growth and Share of National Health Expenditures Rx Growth 2009 10% Percent Share of NHE 2009 5% 5% Calendar Years Source: CMS, Office of the Actuary, National Health Statistics Group, 2009

  16. US Prescription (scripts) Growth, 1998-2009 IMS reports 2% prescription growth in 2009. Source: NACDS Chain Industry Profile, annual issues, based on IMS data.

  17. Effects of Price and Quantity on Retail Prescription Sales Growth Since 1993 about three-fourths of total growth of prescription drug spending has been real growth, meaning growth in utilization/quantity of drugs actually sold and consumed. Through 2019 prescription drug spending is expected to grow at about 5-6% annually.

  18. Pharmacist Shortage • Short Run Demand: Pharmacist Shortage • Supply Response to Pharmacist Shortage • Pharmacist Demographics

  19. Pharmacist Shortage • National pharmacist shortage recognized 1998-99 • Major national report completed in 2000* • The current shortage may have been exacerbated by the switch to the longer 4-year PharmD degree Note: there were earlier pharmacist shortages, e.g. 1991 *Health Resources and Services Administration. The pharmacist workforce: A study of supply and demand for pharmacists. Rockville, Md.: US Department Of Health & Human Services, 2000.

  20. Aggregate Demand Index (ADI) ADI survey utilizes a 5-point scale where 3.0 indicates a balance in demand/supply, higher values a shortage and lower values a surplus

  21. Aggregate Demand Index: Moderate Shortage ADI survey utilizes a 5-point scale where 3.0 indicates a balance in demand/supply and 4.0 indicates a moderate shortage, some difficulty filling open positions. Source: Aggregate Demand Index. http://www.pharmacymanpower.com/index.html (accessed 5-20-10)

  22. ADI: Shortage/Surplus Ratings June 2010 Source: Aggregate Demand Index. http://www.pharmacymanpower.com/index.html (accessed 9-20-10)

  23. ADI: Shortage/Surplus Ratings by States Bordering Idaho Source: Aggregate Demand Index. http://www.pharmacymanpower.com/index.html (accessed 9-20-10)

  24. ISU College of Pharmacy Graduating PharmD Student Survey 2010: Distribution of Employment Source: ISU College of Pharmacy Graduating PharmD Student Survey

  25. Supply of New Pharmacists • New graduates • First year enrollment • Projections based on first year enrollment and existing attrition rates • Number of Colleges/schools of pharmacy

  26. Number  of  U.S.  Pharmacy  School Graduates: 1960‐2008 11000 10000 9000 8000 7000 6000 5000 4000 3000 2000 1000 0 1960 1965 1970 1975 1980 1985 1990 1995 2000 2005 Source: Data from AACP website, www.aacp.org Source:  The  National  Pharmacist Workforce  Study,  March  2009

  27. Supply of New Pharmacists, 2001-2009 11,000 7,000 In the 2001-2009 period the supply of new pharmacists increased 57% over the entire eight year period. Source: AACP Profile of Pharmacy Students, Fall academic data issued each Spring of following year.

  28. First Year Professional Enrollment, 2000-2009 United States 12,705 Source: AACP Profile of Pharmacy Students, Fall academic data issued each May of following year

  29. US Pharmacy Schools/Colleges 2000-2010 *Includes 4 institutions anticipating inaugural class Fall 2010 Source: AACP Profile of Pharmacy Students & Academic Pharmacy’s Vital Statistics, Fall academic data issued each Spring of following year

  30. Workforce Summary • Review of available data indicates • Some easing of pharmacist shortage in nation & Idaho. • Significant growth in pharmacist supply 7,000 graduates 2001, 11,500+ by 2012 • Caveats • Important to review data but…. • Future role of automation/technology • Future impact of changing healthcare system

  31. Pharmacy’s Future • Pharmacy’s evolution • Legislative changes • Professional changes • Roles • ISU College of Pharmacy

  32. Evolution of Pharmacy • Pharmacy is much more than dispensing pills • Although….3.6 BILLION Rx’s filled in US in 2009 – 12 Rx’s for every US citizen • Pharmacists play integral role in health care delivery • Most visited health professional • Medication mis-adventures result in $70 billion+ in excess expenditures • Pharmacy’s role • Medication Therapy Management • Health care quality

  33. Legislative Changes • Practice evolution • Medicare Part D • Legislation in Idaho • Pharmaceutical care rule • Telepharmacy • E-prescribing • Limited prescribing by pharmacists • Immunizations, fluoride • Registration of non-dispensing outlets that provide pharmaceutical care only • Practitioner status

  34. Residency Requirements • Several major pharmacy organizations endorse the requirement of a residency for entry into clinical pharmacy practice • Many residency types – cardiology, psychiatric, oncology, ambulatory care, primary care, managed care, pediatrics, infectious disease, etc. • Federal funding for residencies • An even more qualified professional

  35. Health Care Reform and Pharmacy • Changing role of pharmacist • Collaborative care delivery • Medical home • Underserved populations – 340B pharmacies • Rural issues • Care delivery extension • Immunizations • Protocol-driven patient management

  36. Role of the College • Present • Teaching – state-wide • Practice – state-wide, VA • Service – Meridian compounding lab • Research • College-State Collaborations – top DUR program in nation • Basic science programs • Boise VA • Clinical trials – ACCORD, ALLHAT, AIM-HIGH • Care delivery - ECHIP • Quality - TLC • Future • Division of Health Science focus on rural care delivery • Telepharmacy?

  37. Questions?

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