COVID-19 Impact Will Continue to Dominate in 2022

Pharmacy Times Health Systems Edition, November 2021, Volume 10, Issue 6

Trends to watch include increased spending on drugs and treatments, expansion of pharmacists' role, and ongoing interest in home infusion therapy.

The new year will likely bring a continued focus on COVID-19’s substantial effect on prices and utilization of services.

In its annual report, health care services company Vizient predicts a 3.1% increase in total pharmaceutical spending in 2022. Oncology drugs will account for about 25% of the increase, with continued spending on pharmacotherapy related to COVID-19.1

The sustained impact of COVID-19 on health care is due to the continuing emergence of disease variants coupled with vaccine hesitancy, according to Vizient.1

The company also predicts that specialty pharmaceutical pricing will grow at a rate of 4.68% in 2022, driven by the likely approval of new therapies as well as price increases for adalimumab, a specialty drug used to treat autoimmune diseases.

Further, Vizient estimates that with recent endorsements from diabetes management guidelines and organizations the cost of influential diabetes agents such as glucagon-like peptide 1 and 2 and insulin, will increase by 2.63% next year. These novel diabetes drugs are gaining diverse indications beyond the management of blood glucose, such as for the prevention of cardiovascular events and other disease complications.

The report states that “when combined with the increasing prevalence of the disease, health systems are expected to see growing use of these products in their patient populations.”

The COVID-19 pandemic brought challenges that overwhelmed the health care system and required greater flexibility in cooperation and responsibilities from all essential health care providers, including pharmacists. In 2022, there will likely be continuing evolvement and expansion of the pharmacist’s role with their recognition as critical frontline workers in the fight against COVID-19. Additionally, pharmacists are extensively involved in education and research, while remaining active members of inpatient and outpatient COVID-19 recovery clinic multidisciplinary teams and vaccination efforts. Moreover, with the increased use of telehealth during the pandemic, health systems are investing more in digital innovation. Pharmacists are taking advantage of virtual postintensive care syndrome clinics, among others, to adjust medications and to counsel and educate patients. The results of a recent study show that in the beginning of 2020, 0.1% of Medicare primary care visits were conducted using telehealth, but this number increased to 43% within 3 months because of the pandemic.2 This growth is expected to continue, and some experts recommend that organizations start aligning their virtual strategies with the evolving needs.

Meanwhile, Amazon’s entry into pharmacy services may have a large impact in 2022. Consumers are so accustomed to using Amazon to order a whole slew of merchandise and it will be interesting to see how the prescription services landscape will be affected.

In 2022, organizations will continue to take a holistic approach to infusion care covering extended sites, including home infusion. Home infusion services had previously existed in health systems but some had stopped providing the service because of increased competition and payor rates. However, the pandemic led to more patients preferring to receive infusion therapy at home, leading to a heightened interest in providing these services.

Over the past decade, more than 500 health system and hospital mergers have occurred. An advantage of this partnership is the availability of large data sets that can guide health care delivery programs, prevention efforts, and wellness with wide-ranging medication management. The pursuit of medication errors prevention and quality improvement has led to a growing interest in artificial intelligence (AI) and precision medicine. An example of AI technology gaining traction in health care is machine learning, which focuses on the development and use of computer systems that can adapt and emulate without following explicit instructions. The systems use algorithms and statistical models to analyze and draw inferences from data patterns.3 AI has been hailed as a transformational force in health care. In the past few years, the AI health market has experienced explosive growth, with investments worth billions of dollars, and in 2022, huge investments will likely continue to be made on the digital front. Health care is embracing AI for a range of applications, including clinical research, drug development, and robotic surgery. In addition, AI is being adopted as a practical tool to improve medication safety and patient outcomes, monitor medication adherence, reduce drug costs, replace labor-intensive and repetitive tasks that are prone to error, and streamline prior authorizations. These applications of AI will transform medication management. Thorough digestion and utilization of health care data are crucial, once the data analyses have been completed; equally important is knowing what to do based on the findings. Increasingly, real-time data assessment, models, and predictions are being used to help detect and prevent patient deterioration and manage health care crises. As data sets require the expertise and skills of data scientists, pharmacy departments will need to recruit these scientists to support predictive modeling to drive health care delivery. In 2022, AI will continue to be a priority and will have a positive and profound effect on the delivery of health care and medication management. On a similar front, genetics will continue to play a key role in personalized medication treatment to achieve the desired therapeutic effects.

Another growing trend that will continue to garner attention is the emphasis on gender inequity and sexual harassment in the pharmacy profession. In 2020, a petition titled End Gender Inequality in Clinical Pharmacy led to a response from several major pharmacy organizations. The petition advocates for gender equality, the development of policies against such behavior, and guidance and support for members of the profession who encounter gender bias, harassment, predatory conduct, or other intimidating or threatening behaviors. These organizations stand on values such as a culture that strongly supports diversity, equality, and inclusion. Major underpinning is required to promote gender equity more effectively within the profession, but this work is critical to ensuring future sustained infrastructure. Gender inequity and sexual harassment are widespread in the medical community, the pharmacy profession, and our society. All members of the pharmacy profession should have equal opportunity and support to reach their highest potential. However, major gaps in support of the diverse membership of the pharmacy profession have highlighted a lack of awareness of harassment resulting from gender and gender inequity issues. Fostering greater diversity in the workforce cultivates innovation, decreases health disparities, and improves communication, health care access, patient satisfaction, and problem solving for complex challenges.4 The potential benefits of gender equity are vast, including economic benefits, patient satisfaction, and the cultivation of diversity, innovation, and a unified profession. Women in pharmacy have started the discussion using online platforms and professional networks, but the drivers of continued change will be through organizational leadership and advocacy as well as through awareness by individual pharmacists.5

Conclusion

In light of the pandemic’s challenges, the new year will see a continued focus on health care delivery through continued testing, vaccination, and treatment. Other important trends will include rising health care costs and an increase in digital health care. Moreover, it is hoped that progress will be made in addressing gender equity and sexual harassment in the pharmacy profession.

Deepali Dixit, PharmD, BCPS, BCCCP, FCCM, is a clinical associate professor at Ernest Mario School of Pharmacy at Rutgers, The State University of New Jersey in Piscataway, and a clinical pharmacy specialist in critical care at Robert Wood Johnson University Hospital in New Brunswick, New Jersey.

REFERENCE

1. Pharmacy market outlook. Vizient. Accessed October 1, 2021. https:/info.vizientinc.com/pharmacy-market-outlook

2. Martin G. Top 10 emerging trends in health care for 2021: the new normal. AHA Trustee Services. Accessed October 1, 2021.https://trustees.aha.org/top-10-emerging-trends-health-care-2021-new-normal

3. Aungst TD, Franzese C, Kim Y. Digital health implications for clinical pharmacists services: a primer on the current landscape and future concerns. J Am Coll Clin Pharm. 2021;4(4):514-524. doi.org/10.1002/jac5.1382

4. Institute of Medicine (US) Committee on the Robert Wood Johnson Foundation Initiative on the Future of Nursing, at the Institute of Medicine. The Future of Nursing: Leading Change, Advancing Health. National Academies Press (US); 2011.

5. Bissell BD, Johnston JP, Smith RR, et al. Gender inequity and sexual harassment in the pharmacy profession: evidence and call to action. Am J Health Syst Pharm. Published online July 7, 2021. doi:10.1093/ajhp/zxab275