Pharmacy OneSource Blog

Clinical Corner: Pharmacy is Getting Bigger (and Smaller)

Posted on 07/10/15

Pills depicting a pharmacy

My first paying job in pharmacy occurred after my high school graduation as a pharmacy technician at Laverdiere’s Pharmacy in Caribou, Maine. The local pharmacy was a pillar in the community and a place where people went to seek medical advice from the most trusted profession. I can remember my first day on the job with my newly pressed white lab coat and the pride I felt with helping people. I soon learned how to count by fives and the concept of fast movers.  

Soon after my entrance into the pharmacy world I experienced consolidation when Rite Aid Pharmacy acquired Laverdiere’s and integrated the Maine stores into its growing national network. Our little drug store was now part of a large network of stores helping people across the United States. This change was very exciting for a young pharmacy technician in northern Maine!

Fast forward more than 20 years later and pharmacy is getting even smaller: Hospitals across the nation are consolidating into Integrated Delivery Networks and corner drug stores have been acquired by national chains are now being further consolidated through acquisition. New care delivery models are emerging with retail pharmacies providing direct care through mid-level practitioner services.

For example:

  • CVS Health plans to acquire 1,600 drugstores from Target and in a separate deal, plans to acquire Omnicare in 2015
  • According to the American Hospital Association, more than 3,007 hospitals (roughly 53 percent) are part of a health system.
  • Aetna and Humana, the nation’s third and fourth health insurance companies by revenue respectively, plan to merge in 2015

While market consolidation shrinks the pharmacy landscape, pharmacy is also getting bigger: New care models and expanded roles have placed the pharmacist at the center of medication management for patients and continues to push the boundaries of traditional pharmacy practice.

For example:

  • Washington passed a bill that makes Washington the first state in the country to require that pharmacists are included in health insurance provider networks.
  • Currently, 48 states (94%) have legislative provisions for Collaborative Drug Therapy Management that establish agreements that permits the clinical pharmacist to assume responsibility for performing patient assessments; ordering drug therapy–related laboratory tests; administering drugs; and selecting, initiating, monitoring, continuing, and adjusting drug regimens.  

It really is amazing how the industry has evolved and pharmacy practice has changed along with it.  It makes me wonder how pharmacy will look in the future.  Amazon Prime Pharmacy? Drone delivered medications?  Globalization and virtualization of pharmacy services?  Fully integrated wearable/implantable technology health monitoring? Counting by tens?

 

References:

http://www.forbes.com/sites/dandiamond/2015/07/03/aetna-buys-humana-for-34-billion-but-deal-doesnt-add-up/

https://www.accp.com/docs/positions/whitePapers/CDTM%20CMM%202015%20Final.pdf

http://www.pharmacytimes.com/news/big-win-for-pharmacist-provider-status-in-washington-state

Topics: Clinical Pharmacy

About the Author

Christian Hartman, PharmD, MBA, FSMSO