Megatrends in Pharmacy: What the Future Holds

A look at the top 10 trends in pharmacy that promise to change the profession in the coming years.

My early introduction to futurism as a science was initiated by John Nesbitt and his 1982 book, Megatrends. Although written mainly for an American audience, the trends discussed ended up influencing the whole world. As we start a new decade, reflecting on the key megatrends that might transform the pharmacy profession could be useful. Here are the 10 megatrends that I believe will transform pharmacy as we know it. We will be commenting on them throughout 2012 in print and on our Web site. Also look for future entries on my blog, “The Reinvented Pharmacist."

1| Market Concentration—Consolidation of Players: This trend has been in existence for a while now. PBMs, pharma companies, and hospitals are merging or buying each other out. Could we begin to see mergers or other forms of consolidation within pharmacy organizations this next decade? I think we might, and it would be good for the profession. As we practice more as a health team, will new organizations emerge that include multidisciplinary membership? I think it will happen as the majority of health professionals become employees.

2| Economic Downturn: What was to be a short negative blip in our economy has lingered and some suggest may last throughout this decade before we see a turnaround. As we learn to do more with less, will patients become more self-reliant? Will this lead to more focus on prevention and self-care? Will the economic downturn create an opportunity for the pharmacist to become more engaged in helping patients with lifestyle management?

3| Health Care Reform: Everyone realizes that our current health care system is not sustainable. Health care reform in some form must occur. With changes come new opportunities. Where will the pharmacy leadership come from to help guide this reform in a positive way? What I see in health care reform is an opportunity. As things consolidate, it creates opportunity for smaller players to meet niche markets. I think health care reform will provide the same opportunity for pharmacy.

4| Medication Therapy Management (MTM): As our health care world changes, MTM will emerge as an important role for pharmacists. Although not yet a product line that can support many pharmacists, what we are hearing from many quarters is that we need to use drugs properly to get value from them. As pharmacists step up to meet that need, I believe that a revenue stream will follow. We need to straddle between dispensing and cognitive services for a while, but our future will be MTM by the end of the decade.

5| Drug Product as a Commodity: We may be there already with mandatory mail order, $4 generics, and $25 coupons to switch your prescription. Most in pharmacy see this as a negative development because we make our money on the product spread rather than services provided. To survive in the future, most pharmacists will have to focus on services rather than products. In the end this will be good for patients and the pharmacy profession.

6| Oversupply of Pharmacists: We have the best-educated pharmacists graduating today. They are trained for a role that many can’t find a job doing. As a result, I believe we will see pharmacists pursuing jobs in new fields. They will demonstrate the value of the pharmacist’s education and open more doors for pharmacists in new arenas. We will look back at the end of this decade and see the positive results of our expansion of graduates.

7| Pharmacogenetics: We are only in our infancy of understanding how genetics affect drug actions. We only dose a few drugs based on the patient’s genetic makeup. But those who know this field predict that great opportunities for this science will emerge during this decade. Pharmacists are in a position to take a leadership role in introducing this science into practice. Will this be a new area for pharmacy graduate employment by the end of this decade?

8| Shortage of Primary Care Workers: As we focus on establishing medical homes for all patients, we are seeing a shortage of primary care workers to serve these patients. Nurse practitioners and physician assistants have emerged to help fill this void. Couldn’t newly graduated pharmacists be quickly trained to assume a primary care role? As drug products become more of a commodity 

9| Community Pharmacy as a Community Health Center: We are already beginning to see this transition as pharmacists administer immunizations in pharmacies. The incorporation of urgent care centers within a community pharmacy contributes to this image. Could it be possible that by the end of this decade many community pharmacies will be transitioned into true Community Health Centers employing a multidisciplinary workforce, which includes physicians, that enables them to become the patient’s medical home?

10| Longevity: We are living longer, although we really don’t know why. I still look forward to going to work every day as I approach my 73rd birthday, so I am personally experiencing this trend. As baby boomers live longer, how will this decade change and how will it affect pharmacy? As I mentioned under Megatrend #2, Economic Downturn, I believe this trend will give pharmacists an opportunity to focus on prevention. Nutraceuticals—food or food products that provide health and medical benefits— will become more common in pharmacy. Will more pharmacies become associated with fitness centers?

I hope I live long enough to see how well I’ve done with my Megatrends and that longevity continues to be part of my life too! PT

More on Pharmacy Megatrends!

Editor-in-Chief Fred M. Eckel, RPh, MS, will have much more to say about these 10 Megatrends as the new year unfolds. He will discuss these topics on his blog, so watch for these insights. Additionally, we will offer articles and resources for each of these key trends. Watch for these online at www.pharmacytimes.com/blogs/reinvented-pharmacist.

Mr. Eckel is a professor at the Eshelman School of Pharmacy, University of North Carolina at Chapel Hill. He serves as executive director of the North Carolina Association of Pharmacists.