The challenges facing the profession in 2019 are likely familiar to pharmacists as these problems represent ongoing issues related to drug costs, shortages and regulations, among others. Here is a rundown of a few of those issues.
This is an ongoing problem in healthcare. One of the main drivers of medication cost increases is specialty drugs, such as those that involve gene therapy and precision medications.
The average annual cost for specialty drugs is $52,000 a year. The median wage in the United States is a little under $49,000, and almost 60 percent of adults in the United States have less than $1,000 in savings for healthcare expenses. It is possible that biosimilars entering the market in 2019 will mitigate the cost increases somewhat because of competitive pressures exerted by these alternatives.
Multiple prescriptions also drive up the cost of medications.
This is a multifaceted drug crisis, highlighted by the inability of medical personnel to accurately document dosage and dispose of waste. Some PBMs are working to identify providers who prescribe significant quantities of these drugs, as well as those who abuse them. These PBMs also work with providers to assist with opioid therapy and with retailers to stop patients from filling the same prescription at more than one pharmacy.
Medical and Pharmacy Benefits
The healthcare system now is complex and compartmentalized, and nowhere is this more apparent than in the ways medications are billed. The breakdown of medical and pharmacy benefits can be confusing to patients, as well as providers.
Often, the savings that result from a pharmacy benefit may show up on the medical side. But because the two benefits are separated, recording the pharmacy benefit appropriately can be difficult to do.
Shortages of some drugs still present challenges. These shortages can result from spikes in usage because of things like natural disasters or from low profit margins that cause manufacturers to curtail production. Healthcare officials are hopeful that the FDA can address the problem by approving substitutes, such as generics.
In 2011, there was a shortage of about 250 drugs, which dwindled to just around 40 in 2017, according to the FDA. The shortages appear to affect older, generic, injectable medications more often, such as epinephrine.
Some of the most stringent regulations approved recently affect the compounding of drugs. The rigor of these standards and the difficulty in interpreting them accurately have presented difficulties for pharmacists.
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