There is an interesting interview in the November 1st issue of Drug Discovery Today. Vincent H.L. Lee, the ex-USC faculty member, is now an Associate Director at the FDA. He notes:
Let's assume consumers of the future will be very much in tune with managing their own health, lifestyle, and everything else by accessing the Internet. But who in the health care team should be charged with assisting the consumers to interpret the deluge of information? Perhaps the time has come for a major restructuring of health care delivery as well. As I alluded to earlier, the pharmacist is that health care professional who should step forward, but she must have access to the consumer's genetics and lifestyle profiles in order to map a 'personalized' side-effect profile and engage the consumer to be on the alert for those side effects.
He goes on to say
Such a scenario [where drugs are dispensed right from the manufacturing site as opposed to a pharmacy] challenges the definition of licensure of pharmacists and ultimately the geographical boundaries of where pharmacists practice. Society will need pharmacists as epidemiologists...
Interesting points:
He's right that the pharmacist is probably the only person on the health care team who can take the role of patient adviser, especially when many patients see multiple physicians, but have their prescriptions filled in one pharmacy. But, when pharmacists are asked to fill hundreds of prescriptions a day, who has time to counsel patients?
The current pharmacy model remains retail-centric, descending from the independent store model, much like bakers, shoe stores, book sellers, cheese makers, and the like. Now, I can buy shoes on the net. Why not fill my script that way? Because concerns regarding quality and security (coupled with antiquated laws) prevents on-line prescription-filling. As Dr. Lee points out, what if those issues can be resolved? The the retail pharmacist becomes the full time adviser, available 24/7/365 day via email/Skype/800.
A pharmacist will need both data and training to do this. As physicians become increasingly comfortable with genomic data, for example, will these data be shared with a pharmacist? How will the latter be trained to interpret these data? How will their IT systems be integrated? Will the pharmacy schools take the lead and train their students accordingly?
I started pharmacy school in 1985. For 20 years, I've been hearing about the imminent demise of the pharmacy profession. Back then, robotics were being installed in hospital and high-volume retail pharmacies in an attempt to reduce personnel costs. The trend back then was to shift from a retail/dispensing model towards a clinical practice model. Today, dispensing still remains a very "manual" exercise, dependent on a team of pharmacists and technicians to fill prescriptions which are still being written on paper. However, this is a far greater threat and opportunity for the pharmacy profession to step forward and modernize itself. There may be interesting opportunities for:
1. Companies to develop software products which integrate medical and pharmacy data, allowing data to be shared across physicians and pharmacies securely via the web.
2. Pharmacists to think about what it will mean to be a pharmacist in 2025, and to design curricula and licensure procedures to reflect this vision. Pharmacy is already a 6-year program. Why not re-imagine it to reflect these emerging trends?
3. Insurance companies to step forward and invest in these systems, recognizing that they will save the expense of treating drug-induced side effects and medication errors.
Others?
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