Pharmacy is changing rapidly as a result of advances in technology and changes in the economy. Here are a few of the major issues that will continue to confront the industry in 2018.
Use of DIR fees
Direct and indirect remuneration fees will continue to plague pharmacies this year. There are several factors that make these fees real headaches. One is the fact they are delayed. It could be months after a transaction that pharmacy benefits managers will take money back. Another problem is the criteria for determining the fees are not transparent. Pharmacists don’t know what factors are being considered and what time period.
Pharmacy groups are trying to change the current situation through government action. CMS has put forth a proposal that would do away with the DIR fees for about one-third of the prescriptions covered by Medicare Part D.
Applying the fee at the time of sale would make a big difference as well, according to pharmacy officials.
Mergers and acquisitions
Like many industries, healthcare organizations are merging into larger ones, or buying other companies. It is happening with drug manufacturers, pharmacy chains and insurance companies. One of the largest planned acquisitions is the takeover of Aetna, an insurance company, by the CVS pharmacy chain, one of the largest in the country.
The market share of specialty drugs will continue to expand. During the next four years it is expected to account for more than 40 percent of all drug revenue. Currently, large specialty pharmacies dominate the market for these kinds of drugs. To remain viable, community pharmacies will need to push into this market, which has unique clinical requirements.
Electronic devices that people can wear to monitor their activity will play a greater role in treatment programs, such as improving patients’ adherence to their medication regimen for chronic conditions like diabetes. Pharmacy groups are predicting that insurance companies will begin offering incentives to people who use this technology to show they are following their treatment plans.
This could lead to new kinds of device and software monitoring that will require patient training, opening the door to pharmacists to provide this kind of service.
It is not going away. 2017 was the second year in a row the life expectancy for Americans dropped, mostly because of deaths resulting from opioid abuse. To combat this problem, pharmacists can expect to see more programs to limit prescriptions of controlled substances, greater use of electronic prescriptions for controlled substances and more close monitoring of the disposal of these drugs. More states are also developing prescription drug monitoring programs.
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