Dr Alexander is past chair of the Food and Drug Administration’s Peripheral and Central Nervous System Advisory Committee, has served as a paid advisor to IQVIA, is a cofounding principal and equity holder in Monument Analytics (a healthcare consultancy whose clients include the life sciences industry as well as plaintiffs in opioid litigation), and is a member of OptumRx’s National P&T Committee. FPs were split on the question of whether pharmacy technicians will have education and training comparable to that of staff in other fields or be compensated similarly (Figure 2, item 2). Such government actions may include eliminating patent manipulations that prolong the time it takes for generic drugs to be introduced into the market, prohibiting financial deals among companies that prevent the timely introduction of generic drugs, and resolution of alleged price fixing among generic drug companies. Through engagement with state and national professional associations, support legislative and regulatory efforts aimed at preventing industry strategies (such as patent manipulation) for delaying the market entry of biosimilars and conventional generics. As the role of the pharmacist continues to emphasize cognitive services and include fewer distributive tasks, a higher-educated and higher-trained technician force will be necessary to support pharmacists performing clinical functions. There are multiple pending or expected regulations coming down the pike that will determine key opportunities for the pharmacy industry. The 2020 Pharmacy Forecast includes a number of topics related to the role of evidence in the emergence of new practices and their impact on health systems. As prescription dispensing is increasingly handled by automation and pharmacy technicians, pharmacists will need to manage a patientâs drug therapy and be connected to others on the healthcare team (e.g., physicians and homecare providers). The authors of each Pharmacy Forecast section took the “crowd wisdom” and created impactful messages and recommendations. Each of 48 survey items was written to explore the selected topics and was pilot-tested to ensure clarity and face validity. Our focus is on larger-scale trends, and our goal is to look beyond ethereal whims of politics and practice in an attempt to address deeper patterns that will impact us over months and years. In order for data from validated PRO tools to be integrated into daily, frontline practice, pharmacy leaders must allocate resources for infrastructure to collect this information directly from patients. The registration was free, and I was able to participate in the ESMO Congress held in Japan without paying high travel … Lee C Vermeulen, B.S.Pharm., M.S., FCCP, FFIP, Meghan D Swarthout, Pharm.D., M.B.A, G Caleb Alexander, M.D., M.S, Diane B Ginsburg, B.S.Pharm., M.S., Ph.D., FASHP, Katie O Pritchett, Ph.D., Lecturer, Sara J White, M.S., FASHP, Jennifer Tryon, Pharm.D., M.S., FASHP, Conrad Emmerich, M.B.A, Todd W Nesbit, Pharm.D., M.B.A., FASHP, William Greene, B.S.Pharm., Pharm.D., BCPS, FASHP, FCCP, Erin R Fox, Pharm.D., BCPS, FASHP, Rena M Conti, Ph.D, Bruce E Scott, B.S.Pharm., M.S., FASHP, Frank Sheehy, B.A., M.B.A, Michael J Melby, B.S.Pharm., M.S, Mark A Lantzy, James M Hoffman, Pharm.D., M.S., BCPS, FASHP, Scott Knoer, M.S., Pharm.D., FASHP, William A Zellmer, B.S.Pharm., M.P.H, ASHP Foundation Pharmacy Forecast 2020: Strategic Planning Advice for Pharmacy Departments in Hospitals and Health Systems, American Journal of Health-System Pharmacy, Volume 77, Issue 2, 15 January 2020, Pages 84–112, https://doi.org/10.1093/ajhp/zxz283. Pharmacies will be impacted as consumers embrace technologies (devices and applications) that give them greater access to relevant information. [Nature: News Article] Hot Topics: Cryo-EM structure of a selective T-type calcium channel blocker bound to the Cav3.1 voltage-gated calcium channel Jörg Striessnig, University of … Key performance metrics are used to track productivity, assure quality, and identify opportunities for improvement. Dec. 17, 2020 — The SARS-CoV-2 virus, like many viruses before it, is bad news for the brain. White, M.S., FASHP, (Ret.) It is intended to stimulate thinking and discussion, providing a starting point for individuals and teams who wish to proactively position themselves and their teams and departments for potential future events and trends rather than be reactive to those things that occur. A majority of state governments (33 as of June 2019) have legalized marijuana in some form.9 Use of medical cannabis has expanded across a range of acute and chronic conditions, with varying levels of associated evidence. Within each section of this report, the results of each survey question are summarized in detail. As shown in Table 1, response rates per million population in each U.S. region ranged from 0.5 in the Pacific region (Oregon, California, and Washington) to 1.7 in the Western Plains states (Iowa, Kansas, Minnesota, Missouri, North Dakota, and South Dakota). A large group of FPs (16%) listed their primary position as “clinical pharmacist – specialist,” and another 13% described their primary role as faculty. Genetic modification therapies offer individualized approaches for the management of disease and are expected to become more common in the future.8 Currently, the manufacture of individualized therapies such as tisagenlecleucel and axicabtagene ciloleucel is conducted off-site in centralized locations by the pharmaceutical industry. Due to regulatory barriers and the lack of standardization in data sources within electronic health records2, such data are rare in healthcare, and few health systems will have sufficient reliable data to effectively inform advanced computing applications. These teams should be incentivized to establish partnership outside of the health system as well, such as collaboration with postacute care facilities. Unless Congress acts to reform coverage and reimbursement rules, Medicare will continue to pay for all drugs with FDA-approved indications and selected off-label indications, without regard to cost-effectiveness standards. The stability of the supply chain is of critical importance, and recommendations for focused strategic planning are provided. Establish methods for identifying patients at risk for negative outcomes due to lack of access to essential medications or exposure to substandard-quality medications. We welcome your comments on this new edition of the Pharmacy Forecast. These issues include job vacancies, salaries of pharmacists and technicians, and other trends that will affect health-system pharmacy in the future. APhA offers Board Certified Ambulatory Care Pharmacists a series of concise recertification sessions. Not a member? Drug shortages are not improving. When signing local drug acquisition contracts, insist on disclosure of the source and site of manufacture, and ensure that contracts signed by group purchasing organizations on behalf of health systems also include disclosure. Search for other works by this author on: Ambulatory and Transitions of Care Services, Department of Pharmacy, Johns Hopkins Health System, Address correspondence to Dr. Swarthout (, Professor of Epidemiology and Medicine, Division of General Internal Medicine, Department of Medicine, Johns Hopkins Medicine, Diane B Ginsburg, B.S.Pharm., M.S., Ph.D., FASHP, Clinical Professor and Associate Dean for Healthcare Partnerships, Pharmacy Practice Division, The University of Texas at Austin College of Pharmacy, McCombs School of Business, The University of Texas at Austin College of Pharmacy, Associate Vice President and Chief Pharmacy Officer, Senior Vice President of Operations, Wake Forest Baptist Health, Director – Pharmacy Patient Care Services, The Johns Hopkins Health System, William Greene, B.S.Pharm., Pharm.D., BCPS, FASHP, FCCP, Chief Pharmaceutical Officer and Member, Pharmaceutical Department, St. Jude Children’s Research Hospital, Senior Director, Adjunct Associate Professor, Drug Information and Support Services, University of Utah Health, Department of Markets, Public Policy and Law, Questrom School of Business, Boston University, Director of Innovation and Activation, Indiana University Health, Senior Vice President and Chief Information Officer, Indiana University Health, and President, Indiana University Health Plans, James M Hoffman, Pharm.D., M.S., BCPS, FASHP, Chief Patient Safety Officer and Associate Member, Pharmaceutical Sciences, St. Jude Children’s Research Hospital, The black swan—the impact of the highly improbable, STRATEGIC RECOMMENDATIONS FOR PRACTICE LEADERS, Shared decision making—the pinnacle of patient-centered care, Patient Protection and Affordable Care Act. This article is published and distributed under the terms of the Oxford University Press, Standard Journals Publication Model (, William A Zellmer, B.S.Pharm., M.P.H., FFIP. Whether or not a fully realized single-payer system is achieved, broadening access to efficient care—particularly outside the acute care setting—is essential. They used this role to âmanageâ the cost of the pharmacy benefit while simultaneously creating new ways to create profits for themselves. The 2020 Pharmacy Forecast is intended to assist with strategic planning efforts by health-system leaders. The Pharmaceutical industry's long successful strategy of placing big bets on a few molecules, promoting them heavily and turning them into blockbusters worked well for many years, but its R&D productivity has now plummeted and the environment’s changing. Importantly, changes to the electronic health record (EHR) are needed to score, store, view, assess, and utilize PRO data in a manner analogous to how laboratory results are utilized. Related article:Â Top 6 Pharmacy Challenges of 2019. Periodically lead “what if” discussions that probe how the pharmacy team would respond to a particular black swan event. While these analyses are increasingly used by private insurers and Medicaid programs in some states, they are not used by traditional Medicare to determine coverage or reimbursement. program would be challenging to offer and unlikely to provide substantial payoff for graduates. It is interesting that while FPs seemed optimistic that SPs owned by health systems will show benefit over national providers, they overwhelmingly feel that their patients will be forced by their insurers to seek infusion care outside their own health systems (Figure 6, item 4). Genomic testing is rapidly advancing into patient care as technology improves, new knowledge is applied, and testing cost decreases. The author has declared no potential conflicts of interest. Bruce Scott and Frank Sheehy explore emerging trends in the marketplace, with attention to issues surrounding generics and biosimilars as well as specialty pharmacy. (Patient-Centered Care). While the responses indicate a concern regarding the impact that such burden could have, patients may be willing to embrace complex self-care management.6,7 The responses may also reflect confidence that individual- and health system–level factors can mitigate potential burdens. James M. Hoffman, Pharm.D., M.S., BCPS, FASHP, Chief Patient Safety Officer and Associate Member, Pharmaceutical Sciences, St. Jude Children’s Research Hospital, Memphis, TN. A video interview with Michael Haydock about the latest news on the COVID-19 vaccine race. Examples of such trends: the rise of nationalism among liberal democracies (à la Brexit), the growing wealth gap between corporate executives and other workers, and environmental degradation. Therefore, it is important to understand the composition and characteristics of the panel. It is likely that more states will pursue the less restrictive approaches in the years ahead. FPs were divided as to whether health systems would offer an ASHP/ACPE-accredited technician education program (Figure 2, item 3). Two out of three FPs indicated they do not believe health systems will assign pharmacists to provide education and support to parents who are uncertain about vaccinating their children (Figure 1, item 6). Dr. Conti is an unpaid special consultant to FDA’s Office of Generic Drugs.The authors have declared no other potential conflicts of interest. European markets have realized significant savings through the use of biosimilars, with certain biosimilars capturing 90% market share in some European countries, resulting in 70% cost reductions relative to originator product costs.2 The European Medicines Agency has 53 products on its approved list of biosimilars, with each European Union country controlling how these agents are used within its borders.3 By comparison, within the United States there are 19 products approved by the Food and Drug Administration, and only 7 are marketed. Ensure that action plans exist to care for those patients (such as protocols to allow pharmacists to switch patients to more affordable products). As you plan for 2020 and beyond, here are some key questions to consider: 1. Who is the customer for pharmaceuticals and pharmacy services? While it is not possible to be “black swan proof,” it is possible to be “black swan robust”—with deliberate, consistent, and effective strategic planning, an individual, organization, or community can be better prepared to successfully respond when black swan events inevitably occur, and preparation for those events is an essential leadership challenge. For example, Kentucky recently joined California and a few other states in expanding the pharmacist scope of practice, granting independent prescribing authority (to be exercised in collaboration with physicians) under approved protocols for a wide range of conditions, including acute infections, tobacco cessation, and opioid use disorder.1. It is only through a continuous process that organizations can be responsive to changes that are sure to affect our profession, organizations, and patients. Eric Maroyka, Senior Director, Center on Pharmacy Practice Advancement sits down with Patricia C. Kienle, MPA, BCSCP, FASHP, and Michael Ganio, Senior Director, Pharmacy Practice and Quality to discuss aspects of the draft The National Institute for Occupational Safety and Health (NIOSH) List of Hazardous Drugs in Healthcare Settings 2020. They were asked to base their response on their firsthand knowledge of current conditions in their region, not based on their understanding of national circumstances. In the pharmacy department’s planning process, increase the relative attention given to long-term strategic issues (versus near-term operational issues); use annual Pharmacy Forecast reports to stimulate this shift. (Evidence-based Pharmacy Practice). The purpose of this report is to encourage and support active, deliberate strategic planning in hospitals and health systems. Todd W. Nesbit, Pharm.D., M.B.A., FASHP, Director – Pharmacy Patient Care Services, The Johns Hopkins Health System, Baltimore, MD. Fifty-seven percent of FPs indicated they believe it is likely that colleges and schools of pharmacy will offer a joint doctor of pharmacy (Pharm.D.) Employers, in an effort to reduce costs and improve outcomes, will continue contracting directly with providers. Fifty-four percent of FPs felt that such federal action will occur in the future (Figure 5, item 2). RENO, Nev. (KOLO) - The Reno Police Department is looking for a woman wanted in two separate incidents at CVS Pharmacy on Northtowne Lane. Given the complexity, uncertainty, and pace of change in healthcare today, strategic planning must be a continuous process. As another election cycle begins, many stakeholders are discussing ways to reduce drug prices. In response to a survey item exploring recruitment practices, a majority of FPs indicated that diversity will be a goal as pharmacy residents are recruited (Figure 3, item 6). Those changes are unlikely in the near future. Your comment will be reviewed and published at the journal's discretion. Develop and implement new technology in telemedicine to improve access to the care of pharmacists in medically underserved communities. Responses were received from 283 (an 87.1% response rate, up slightly from the 85.4% response rate in 2019). Collaborate with public health officials to engage populations increasingly reluctant to accept vaccines, and deploy tactics that promote dialogue and education to optimize vaccination rates. The Foundation is indebted to those individuals who have helped make the 2020 edition a success. ASHP Research and Education Foundation, Bethesda, Maryland, Jannet M. Carmichael, Pharm.D., BCPS, FCCP, FAPhA, American Society of Health-System Pharmacists, Bethesda, Maryland, University of Michigan, Ann Arbor, Michigan, University of Utah Health, Salt Lake City, Utah, James M. Hoffman, Pharm.D., M.S., BCPS, FASHP, St. Jude Children’s Research Hospital, Memphis, Tennessee, University of Virginia Health System, Charlottesville, Virginia, Cedars-Sinai Medical Center, Los Angeles, California, Pamela L. Stamm, Pharm.D., BCPS, BCACP, CDE, FASHP, Ross W. Thompson, B.S.Pharm., M.S., FASHP, Tufts Medical Center, Boston, Massachusetts, Robert Edward D’Eramo, Pharm.D. Most FPs (63%) believed that in many health systems, departments other than pharmacy will have primary responsibility for the management of these treatments (Figure 4, item 5). Pharmacy leaders will need to be creative and identify ways to leverage the expertise of their staff and their existing departmental resources in new programs that address unmet patient needs. Enter into discussions with local and state employers and employer coalitions, identifying ways to partner with them directly to improve the quality and efficiency of care provided by health systems to their employees. Remote introductory pharmacy practice experiences focused on veterans prescribed chronic opioid therapy, Evaluation of an opioid risk mitigation initiative for veterans undergoing hip or knee arthroplasty at San Francisco Veterans Affairs Heath Care System, In the midst of an opioid epidemic: Pharmacists on the frontline of substance use disorder treatment, Management of type 2 diabetes with oral semaglutide: Practical guidance for pharmacists, To crush or not to crush: A brief review of novel tablets and capsules prepared from nanocrystal and amorphous solid dispersion technologies, ASHP National Surveys of Pharmacy Practice in Hospital Settings, Population Health Management Theme Issues, Practice Advancement Initiative Collection, Transitions of Care/Medication Reconciliation, Emergency Preparedness and Clinician Well-being, Author Instructions for Residents Edition, http://www.ashpfoundation.org/pharmacyforecast, http://www.ihi.org/communities/blogs/evolution-of-patient-centered-care-and-the-meaning-of-co-design, https://jcpp.net/wp-content/uploads/2016/03/PatientCareProcess-with-supporting-organizations.pdf, https://www.bpsweb.org/bps-specialties/compounded-sterile-preparations-pharmacy/, https://www.ptcb.org/get-certified/cspt#.XQfq3vlKh-U, https://www.jointcommission.org/certification/medication_compounding.aspx, https://money.usnews.com/careers/best-jobs/physician-assistant/salary, https://www.nursingworld.org/organizational-programs/magnet, https://policysearch.ama-assn.org/policyfinder/detail/augmented%20intelligence?uri=%
2FAMADoc%2FHOD.xml-H-480.940.xmi, http://www.usp.org/sites/default/files/usp/document/our-work/healthcare-quality-safety/general-chapter-800.pdf, https://www.osha.gov/SLTC/hazardousdrugs/controlling_occex_hazardousdrugs.html, https://www.governing.com/gov-data/safety-justice/state-marijuana-laws-map-medical-recreational.html, https://healthpolicy.duke.edu/events/drug-shortage-task-force, https://www.ashp.org/news/2018/09/19/summit-on-drug-shortages-to-examine-impact-on-national-security-and-health-care-infrastructure, http://nationalacademies.org/hmd/Reports/2018/medical-product-shortages-during-disasters-brief.aspx, https://www.bloomberg.com/news/features/2019-01-29/america-s-love-affair-with-cheap-drugs-has-a-hidden-cost, https://www.who.int/medicines/publications/essentialmedicines/en/, https://voxeu.org/article/cancer-drug-prices-rise-no-end-sight, https://www.forbes.com/sites/joshuacohen/2018/06/20/whats-holding-back-market-uptake-of-biosimilars/#2282394c691a, https://www.biosimilarsip.com/2019/05/07/how-the-u-s-compares-to-europe-on-biosimilar-approvals-and-products-in-the-pipeline-4/, https://www.drugchannels.net/2019/04/the-specialty-pharmacy-boom-our.html, https://www.drugchannels.net/2019/04/the-top-15-specialty-pharmacies-of-2018.html, https://www.pharmacist.com/article/kentucky-pharmacists-have-new-authorities-improve-patient-public-health, https://www.commonwealthfund.org/publications/issue-briefs/2019/feb/health-insurance-coverage-eight-years-after-aca, https://www.shrm.org/resourcesandtools/hr-topics/benefits/pages/employers-adjust-health-benefits-for-2019.aspx, https://abcsrcm.com/healthcare-industry-consolidation-walmart-humana-merger-medicare-advantage-plans/, https://medcitynews.com/2016/06/boeing-and-memorialcare-contract/, https://www.nytimes.com/2019/07/31/health/medicare-insurance.html, https://www.youtube.com/watch?v=Pc7EVXnF2aI, https://academic.oup.com/journals/pages/open_access/funder_policies/chorus/standard_publication_model, Receive exclusive offers and updates from Oxford Academic, New England (Maine, New Hampshire, Vermont, Massachusetts,
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Nebraska, Kansas), Middle South (Arkansas, Louisiana, Oklahoma, Texas), Mountain (Montana, Idaho, Wyoming, Colorado, New Mexico, Arizona, Utah, Nevada), Pacific (Washington, Oregon, California, Alaska, Hawaii), Copyright © 2020 American Society of Health-System Pharmacists. Reform are examined must continue to plan for manufacturing quality deficits resulting in recalls and,... Systems in the years ahead these questions benefit, so these drugs can not be Managed Cohen J. what s. To offer and unlikely to improve supply, including: to medications value each medication provides Successfully! Occur in the absence of federal action, States will work to accomplish as much pharmacy hot topics 2020... That are positive and conflicts for healthcare practitioners substantial payoff for graduates drug shortages had been! Important necessity of our healthcare systems regulations mandate accredited training for technicians, and make 2020... 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Strategic plan pharmacy Knowledge to an existing account, or purchase an annual subscription offered in various settings encouraging.