The rate of therapeutic drug use in the U.S. has steadily climbed over the years as more people fall ill and seek medical help. This increase should have resulted to a healthy economy among those in the pharmacy business, but what’s happening in real life is actually the opposite. Many independent pharmacies are struggling to make ends meet, and some even decide to close their doors since their losses are too great to recoup.
This is caused by a lot of factors, but one of the biggest culprits is direct and indirect remuneration or DIR fees. These started out as a legitimate charge levied by the Centers for Medicare and Medicaid Services (CMS). But, over time, they have evolved to describe arrangements between pharmacies, Medicare Part D plan providers, and pharmacy benefit managers (PBMs). Today, DIR fees are so steep that pharmacies — particularly independent ones — are struggling to pay them, with some barely breaking even and others even ending up in the red.
DIR FEES AND MEDICARE PART D
So where did DIR fees come from? As mentioned above, it was coined by CMS to make it easier for them to monitor the amount of rebates and other types of price adjustments that drug manufacturers place on their products. These adjustments need to be calculated since they can greatly impact the overall cost of medications under Medicare Part D, and the savings they can provide are passed from PBMs to CMS.
It’s important to note that DIR fees are charged retroactively. CMS requires PBMs and plan providers to submit DIR reports on a yearly basis. The agency then uses these reports in conjunction with Prescription Drug Event data to reconcile costs and see if they’re paying the right amounts to Medicare Part D plans.
A lot of people ask if DIR fees are legal. Well, in the case of CMS, the fees are legal since they’re intended to help the agency maximize its savings and reduce the overall cost of healthcare. The problem lies in the fact that plans and PBMs eventually used the term “DIR fees” to refer to the fees that they charge pharmacies.
DIR FEES FROM PBMS AND PLAN PROVIDERS
Today, “DIR fees” can mean a wide range of things, depending on the type of charges that plans and PBMs want to levy. In some cases, they can refer to the amount that a pharmacy must pay to join the network of a plan or PBM and be considered a “preferred pharmacy”. They can also refer to payment reconciliation, i.e. settling the difference between the projected medication costs and the actual costs.
DIR fees can even refer to the reimbursement that’s given to pharmacies for meeting certain performance metrics as well as to the fees levied to pharmacies that don’t meet these metrics. Many plans and PBMs consider the performance of each pharmacy in terms of refill rates, preferred product rates, audit error rates, and other factors. If pharmacies fall short on one or more of these metrics, they’ll most likely find themselves receiving less than what had been promised to them.
The Positive Side of DIR Fees
Plans and PBMs defend their version of DIR fees, saying that these help lower healthcare costs. Payment reconciliation, for example, allows them to pay for the exact price of the drugs and nothing else, which means they can save money down the road and keep down the costs of Medicare Part D plans. This, in turn, gives people access to low-cost plans that would fit their budget.
They also point out that, since DIR fees are given retroactively, they require pharmacies, PBMs, and plan providers to do thorough auditing and ensure they’re submitting the right data. This helps them easily spot any fraudulent transactions and prevent these from happening in the first place.
Unfortunately, despite these good intentions, DIR fees end up doing more harm than good. Pharmacies are assessed for these fees on a monthly, quarterly, or even annual basis, which means there’s a long stretch of time between the point of sale and the day they receive their assessment. This “lag time” makes it difficult for pharmacies to clearly evaluate how much reimbursement they should receive and/or calculate the exact amount they should pay to PBMs.
Of course, it’s important to note that many PBMs and plan providers abuse the concept of DIR fees. For instance, they set high estimated costs at the beginning of the year so they can charge high premiums. The costs are ultimately reconciled at the end of the year, but the companies are essentially getting an interest-free loan from the CMS.
Some even go a step further by tying payments to performance metrics then determining what these metrics are after the claims are paid. This is unfair since it prevents pharmacies from knowing exactly what quality measures they should be striving for. It also allows plan providers and PBMs to reduce the amount they would pay to pharmacies if the latter don’t meet the metrics.
Even if PBMs and plan providers don’t abuse their power, the fact remains that the retroactive nature of DIR fees make it difficult for pharmacists to map their future. Since they don’t know how much their revenue stream would be, they find it hard to make business plans and decide where they would take their venture in the coming months and years.
WHAT NEEDS TO BE DONE
So what can independent pharmacies do to combat DIR fees? Well, the most obvious choice is to avoid signing up for a preferred network (or opting out if they have already joined one). However, this isn’t the ideal solution since it would increase the co-pays that their customers would have to pay and limit the target audience they can serve.
The best thing that pharmacists can do is to support bipartisan legislation that would get rid of retroactive DIR fees and help improve the transparency in Medicare Part D spending. If passed, H.R. 5951 and its companion legislation Senate Bill 3308 will prevent PBMs from unduly changing their reimbursements whenever they want. This, in turn, ensures that pharmacies know exactly how much they’ll earn at the point of sale.
Pharmacy Benefit Managers: The Mafia Of The Pharmaceutical Industry
The healthcare costs in the United States have steadily risen over the years. This has made it almost impossible for ordinary people to obtain early and ongoing medical attention, properly manage their health conditions, and stay away from serious illnesses and even death that could otherwise have been avoided. This increase can be attributed to many factors but, in terms of the rise of pharmaceutical costs, a lot of the blame can be piled on pharmacy benefit managers.
These organizations (which are better known as PBMs) were originally formed in the 1960s to help process the prescription transactions of health plans. Over the years, their scope has expanded to include other services. Now, many PBMs are in charge of creating and updating formularies, liaising with drug manufacturers and partner pharmacies, managing patient compliance programs, and doing other tasks.
On the surface, it would seem that pharmacy benefit managers are assisting employers and insurers in reducing their expenses while helping patients get the prescriptions they need at lower prices. But, if you look closer, you’ll realize that things aren’t what they really seem: the organizations that were designed to help people have transformed themselves into the PBM Mafia.
PBMs and Overcharging
Perhaps one of the most corrupt practices of the PBM Cartel is overcharging. PBMs have the power to instruct pharmacies on how much copay they should charge customers; if a PBM decides to charge sky-high copay, pharmacies can do nothing but obey. Customers, on their part, have no choice but to pay, just so they can have their prescriptions filled.
Earnings from copay don’t stay in pharmacies, though. Pharmacy benefit managers can take back a portion of the customers’ copay after they have determined how much they would pay the drugstores. Sometimes, pharmacies are left with enough money to enjoy a profit; other times, they’re left with barely enough to cover the cost of purchasing and dispensing the drug.
Other Dubious Practices
Aside from charging exorbitant copay amounts and underpaying pharmacies, the PBM Mafia can earn from many other ways. They can get huge discounts from drug manufacturers but refuse to pass on these savings to the insurers and patients. They can also reimburse pharmacies a certain rate for a certain type of drug, then charge employers and insurers a higher rate for the same drug — keeping the difference between the two amounts for themselves.
They can even accept deals from manufacturers to keep a certain drug on health plan formularies. Manufacturers usually need to pay a substantial amount to PBMs to push this deal through, but they can recoup this investment later on since customers under the health plan will be forced to buy their product. For the PBM Cartel and big pharma companies, it’s a win-win situation.
The PBM Mafia has the opportunity to pull these stunts simply because there are virtually no laws that regulate their actions. There are a few rules in place, but many companies simply find a way around them. Because of these, a lot of PBMs can include and exclude drugs from formularies whenever they want and change their pricing structure at will — leaving insurers, employers, and patients virtually helpless.
What Can We Do About It?
The Congress is currently looking into pharmacy benefit managers and will hopefully come up with laws that will regulate how these organizations behave. While waiting for these regulations, pharmacies, insurers, and employers can demand transparency from the PBM cartel they work with and perhaps even switch to smaller PBMs that charge a flat fee and have a transparent pricing model.
“There’s power in numbers.” You’ve probably heard this phrase thousands of times and think of it as a cliché. However, this statement has never been truer particularly when it comes to the pharmaceutical industry, and it’s brought to life by group purchasing organizations or GPO’s.
Pharmaceutical GPO's allows independent pharmacies to group together and use their numbers to buy drugs at lower prices. This, in turn, helps them reduce their overheads and maximize their profits. GPO’s can even use their power to negotiate discounts from drug manufacturers and demand fair treatment and transparent prices, which can further help individual pharmacies in improving their business.
GPO’s are also greatly helpful when there are drug shortages. On their own, pharmacies have no choice but to either pay higher rates for drugs that are low on stock or quit including these drugs in their product line. But, if they’re a part of a GPO, they’ll have someone who will look for alternative drugs, secure exclusive deals with manufacturers, or even help manufacturers to look obtain raw materials and speed up the production of these drugs.
Over the years, many pharmacists have realized the importance of belonging to a group purchasing organizations, and this has resulted to the increase in the number of pharmaceutical GPO's in the country as well as to their rise in popularity. There are more or less than 600 GPO’s serving the healthcare industry, although it’s important to note that not all of them are created equal and that some of them offer better services than others.
Two of the largest GPO’s in the country are MedAssets and Novation. MedAssets had more than 500,000 affiliate beds in 2013, and it served more than 4,000 hospitals and over 120,000 non-acute healthcare providers. Novation had almost 300,000 affiliate beds in 2013 and was handling over 600 suppliers with contracts worth $49 billion, and it was named as one of the World's Most Ethical Companies in 2014. MedAssets and Novation now both belong to the same parent company Vizient, which is one of the leading healthcare services company in the U.S.
Another excellent GPO is Amerinet, which has almost 400,000 affiliate beds. Established in 1986, the company had four subsidiaries that focused on different fields like non-acute marketplace solutions and healthcare market analysis. Amerinet has rebranded itself as Intalere in 2016 and remains to be one of the leaders in the industry.
Still anther great option is PBA Health, which offers a wholesaler negotiation service called ProfitGuard. It provides a set of business intelligence tools that help you manage your purchases, maximize your rebates, and ensure you get the best possible value for your money. Many pharmacists swear by ProfitGuard, pointing out that the service has helped them greatly especially in seeking out new generic drugs and choosing those that are available at the most reasonable prices.
These are some of the largest pharmaceutical GPO's in the market. They’re definitely not the only options out there, but they’re a good place to begin particularly if you’re new to the world of group purchasing. Do your research now to see which GPO best suits your needs!
The subject of medical cannabis has been a source of widespread debate for decades. This has become even more true in April 2016, when pharmacy giant Walgreen's published a blog post entitled “Clarifying Clinical Cannabis”.
Walgreen’s post defines medical cannabis, lists the illnesses and conditions it can help manage, and outlines its various methods of administration. It also explains how the substance affects the body, what its potential side effects are, and how patients can get a prescription for it. The article even talks about why the use of clinical cannabis has been debated for so long, pointing out that it’s associated with negative effects but has also been discovered to help with appetite improvement, muscle stiffness, and pain relief.
The blog post, which was written by Dahlia Sultan (a resident pharmacist at Walgreen's and the University of Illinois-Chicago) surprised many medical cannabis advocates. The fact alone that Walgreen's decided to talk about this topic was a shock, considering that many corporations either decline to comment about it or avoid the subject altogether.
A lot of people were also astonished at the neutral tone of Walgreen’s blog post and the informative approach it took. Many took this as a good sign, since the post doesn’t only open the doors for discussion but also educates patients that opioid painkillers are not the only option. In fact, the blog post states, “If you’d like more information about the use of medical marijuana.” This is an important message since a lot of patients nowadays are dealing with chronic pain, but their doctors are hesitant to suggest clinical cannabis.
Alan Brochstein of New Cannabis Ventures sums up the thoughts of many medical cannabis advocates by saying, “I can’t recall any S&P 500 company ever sharing such a supportive view.” This is particularly even more significant for Walgreen's which, as Brochstein points out, is actively involved in the lives of patients and is considered to be a reliable source of healthcare advice.
Pharmacies and Medical Cannabis
Another interesting sentence from Walgreen's blog post is its disclaimer that the company is “not a licensed medical marijuana provider.” According to Ricardo Baca of The Cannabist, Walgreens might have recognized that pharmacies may soon get the permit to be a legal supplier. This is especially true now that prescription drugs made of cannabis derivatives are working toward getting an FDA permit. Brochstein also asks if Walgreen's has smelled a huge opportunity, considering that Canadian pharmacies have stated that they want to be a part of the medical cannabis program.
It might be true that Walgreen's wants to cash in on the clinical cannabis trend and is taking steps toward getting the license to sell the substance. However, this doesn’t change the fact that, as of the moment, pharmacies in the U.S. are not allowed to supply this substance — even in states where the use of medical and recreational cannabis is already allowed. Any pharmacist who disobeys this rule will lose his or her license and will no longer be allowed to dispense controlled substances to patients.
There are many reasons why U.S. pharmacies are not allowed to dispense medical cannabis. One of the biggest reasons is that pharmacies are required to sell only drugs that are approved by the Food and Drug Administration. Cannabis, unfortunately, is a long way from getting FDA approval.
In fact, it’s stuck in a catch-22: it’s classified as a Schedule I substance, which means it has a high potential for abuse and has “no currently accepted medical use”. (Heroin is another substance placed under this category.) This makes it difficult for researchers to study cannabis and identify its medical uses, which would have helped remove it from Schedule I and downgrade it to a less severe schedule.
Because of this classification, researchers find it hard to get grants and even obtain cannabis plants to experiment on. This means that they can’t put cannabis through the standard drug development research process, like what commercially available medications have gone through. This process is important since it would have allowed scientists to study the potentially active chemicals in the plant and understand how they interact with each other and with other substances. These information, in turn, can help reduce the public stigma of cannabis and convince the government, the healthcare system, and patients that medical cannabis is a viable treatment option.
It’s also important to note that many Big Pharma companies are not interested in creating FDA-approved drugs based on cannabis — simply because it doesn’t have a lot of earning potential. They can’t claim ownership of cannabis outright since it’s impossible to patent a plant. This means they’d have to spend time and money on developing an extraction process for one of cannabis’s active chemicals then file a patent for that process. However, even this won’t give them protection since other companies can still extract the chemical using virtually the same procedure with slight variations.
The legalization of medical and recreational cannabis use has also discouraged Big Pharma from pushing the matter forward. After all, if people can easily buy the substance from dispensaries, why would they opt for more expensive versions? This lack of assurance in a stable market has resulted to a slowdown in the development of FDA-approved cannabis-based drugs.
The Future of Medical Cannabis
Fortunately, the future of clinical cannabis isn’t bleak. Many organizations and companies are swimming against the current to learn more about the plant and its active chemicals and discover how they can be used in the medical setting. British company GW Pharmaceuticals has been studying a drug called Sativex, which is made of THC and CBD (the two major chemicals from cannabis). The Multidisciplinary Association of Psychedelic Studies, meanwhile, wants to compare cannabis smoking and vaporizing to see which is the safer administration method.
Some countries have also realized that dispensing drugs through pharmacies is a smart step to take. The Canadian Pharmacy Association, for example, has expressed its belief that pharmacies provide the safest means of dispensing cannabis, compared to dispensaries and compassion clubs. This approach will hopefully spread to the United States and eventually make it possible for the substance to be sold in pharmacies.
Organizations are even providing training to help people become more knowledgeable in the clinical use of cannabis. One of these is Americans For Safe Access, which has created the Medical Cannabis Advocate's Training Center for those who want to learn more about citizen lobbying, grassroots campaigning, and other activities.
Are you looking to start or further your career in the pharmaceutical industry? You are sure to find career options on job boards, on a pharmaceutical company’s website, recruitment agencies and through LinkedIn pharmaceutical career search.
Why it's good to use LinkedIn
LinkedIn is a social network where business owners, organizations, employees and professionals meet to establish their profiles and take advantage of the online platform’s many features. It offers plenty of benefits as well.
Why LinkedIn is good for a niche like pharmacy and pharmaceutical careers
Most profiles are listed as a specialty, or classified according to your industry or career. So whenever someone searches for a pharmacist or one with related qualifications, LinkedIn will point you in the right direction with accuracy. You can bet that a search result will be related to the pharmaceutical industry. This effectively narrows down your options, and helps you find prospective employers.
How to use LinkedIn to find a job in the pharmaceutical industry
By sell, it means a profile that catches attention and conveys a message that a potential employer wants to see. Three of the most important things you need to showcase is your headline, name and photo. A good headline must be creative without being too informal or unprofessional, and memorable.
Giacomo Bracci Helsen provides an excellent example with a headline that says “He's a left/right brainer design thinking strategist”, instead of the usual marketing and advertising specialist.
Your profile should say a lot about you being a job seeker and not just someone being part of the social network. A good headline should send a shout out to recruiters and employers looking for a pharmacist or similar careers.
LinkedIn lets you add videos, blog posts and other tools that can boost your profile. So why stick with the usual way to present your work experience, achievements, and the like?
What better way to know if your target company is hiring new employees, than to follow them on LinkedIn via their company page? Get the latest update, newsletters and other information that you can use to reach out to hiring managers.
Similar to other social networks, LinkedIn lets you connect with colleagues, friends and other professionals in the pharmaceutical industry, some of which know someone in the business. This is the easiest way to increase your visibility and get first-hand information for any job offers and openings.
If you and someone in your network has a common connection with your target company or person, ask them to introduce you. This works in the virtual world as well as it does in the real world.
Do you have a target company in mind? Using the Advanced People Search feature in LinkedIn, you will be able to identify the hiring manager of the company you wish to work with. Simply type in the company name and the title of the hiring manager.
When you know more about a company, you can create a sales pitch that will conform to its vision, mission or culture. Who doesn't want a candidate that fits?
If you use a target company’s name in the Advanced Search page, you will know who in your network are connected, one way or another, with the organization. Talk to them and get details.
Don’t be that job seeker who waits and does nothing after completing their profile. Even if your headline grabs attention, you should find ways to exploit LinkedIn to your advantage.
How to improve your profile and resume
Take into account all the tips listed above, and improve your profile and resume accordingly. Remember to make your headline count, and upload other tools to boost your online visibility.
Created by the US federal government in 1992, the 340B Drug Pricing Program was supposed to help poor patients acquire outpatient drugs at significantly reduced prices. It mandates drug manufacturers to allow covered entities to reach as many eligible patients as possible by stretching scarce federal resources. Unfortunately, the pricing program has now become a source of pain, rather than cure, for many patients.
A clever lawyer discovered a massive loophole in the 340B Drug Pricing Program, turning it from an obscure government program into a means for hospitals to make money at the expense of patients. 340B specifies that drug manufacturers provide discounts for poor people, not whoever provides the outpatient drugs. This gave hospitals the idea to keep the discounts for themselves, instead of passing it on to patients. Pharmacies, especially brand new stores, are exploiting the loophole as well.
But the benefits that hospitals and pharmacies are enjoying right now are at risk of coming to an end. A report by AIR 340B, a group linked to drug makers, revealed that the 340B Drug Pricing Program has gone unchecked for too long, resulting in an estimated program sales of $16.1 billion in 2016 and an expected total drug sales to reach $23 billion by 2021. The group is urging policymakers to reexamine theprogram, and ensure that it serves its original intent. They're also pushing to limit the program's expansion.
In an AIR 340B-sponsored roundtable discussion, senior legislative assistant for Rep. Chris Collins (R-N.Y.), Ted Alexander said that Collins is looking to improve transparency of the program, but nothing is certain about what will happen to it. What is certain, however, is that a number of different health care bills will be submitted next Congress, and stakeholders would do well to gather information as to how the340B Drug Pricing Program will affect federal spending
Last November, the Health Resources and Services Administration (HRSA) has released an addendum to the 340B Drug Pricing Program. This required drug manufacturers to include in their existing PPA the following terms:
With the new changes coming, the fight to discredit the drug pricing program is renewed.
Hospitals, pharmacies and other safety-net providers, however, claim that the program must be protected, since it allows entities to provide improved healthcare services with little to no insurance.
In a December email to Bloomberg BNA, 340B Health’s vice president of communications, Randy Barrett, accused the drug industry to have “commissioned a cynical report designed to protect future profits”. Any move that will cut back the program could have an adverse effect to the poor across America, since this will result in an increase in medicine prices and a decrease in access to clinical care.
With the ongoing debate and opposing moves, the future of the 340B Drug Pricing Program is definitely uncertain.
Do you want to be a part of a lucrative business while helping other people? Your best bet is to join a pharmacy franchise, where you not only sell medicines, but also provide other forms of assistance to patients who need them. It is also a great way to gain business confidence, considering that you've been entrusted to use someone else's brand and help market it.
Why join a pharmacy franchise?
In a franchise, every aspect of a business is taken care of before it is handed to you. Unlike a regular startup, you don't need to create a business plan, study the trends and your target market, or find a suitable location for your business. You may need to take out a business loan or borrow money to pay for the franchise, but everything else will be handled on your behalf. In some cases, even hiring employees will be handled by the mother company. So if you want to start a business in the pharmaceutical industry, a pharmacy franchise is a great idea.
What is your company’s vision and mission? How are employees expected to act? What type of services should they offer? The answer to these are already provided, so you don't need to develop your own rules and policies. Just follow what has already been established and proven effective.
In franchising, you are selling a brand that usually has an established market or following. This provides better branding and marketing, which will prove advantageous to a franchise owner. After all, they are not only marketing the brand, but the quality of service as well. This gives you an edge over new, and unknown startups.
How you pay for your franchise will depend on agreed terms and policies. When franchising a pharmacy, you may be required to pay a one-off franchise fee, followed by a royalty fee paid monthly. With a predictable payment option, a franchise owner need not worry about fees changing without notice, and they know how much they need to make to cover payments and gain a profit.
When you join a pharmacy franchise, you don't need to worry as to where you can source medicines and other supplies, since these will be provided for you. Just keep your inventory updated and you won't have to run out of stocks. Different franchises, however, may have different levels of requirements in terms of the look and feel of a pharmacy, which will dictate as to which stocks you can and can’t carry.
In business, however, not everything is all sunshine and happiness. Joining a pharmacy franchise is no different, and its biggest risk would be the company’s reputation. It only takes one franchise to ruin an entire company. But, if you choose a trusted and well-known brand, it will take a lot to ruin its reputation.
With the advantages outweighing the disadvantages, you should not hesitate to join a pharmacy franchise.
Request more information about joining a Pharmacy Franchise Now!
Donald Trump’s new administration is causing many marijuana users to worry about the future of the marijuana policy. Trump’s statements in the past and his actions following his win were both pro- and anti-marijuana, throwing people into a state of uncertainty.
While his statements have been pro-marijuana, he has appointed anti-marijuana people in key positions, such as Jeff Sessions as Attorney General. Sessions has been described by colleagues as someone who had a problem with the Ku Klux Klan, particularly because they smoke cannabis. Many believe that it is unlikely that Sessions has changed his stance against marijuana.
This has pushed marijuana activists and the American Legion, the largest veterans organization in the United States, to urge Trump toreschedule marijuana. The legion is asking the new administration to reschedule the status of marijuana from Schedule I to Schedule III, which will “allow easier access to pure strains of the substance to cultivate quantifiable research and statistics regarding marijuana’s medical benefits”.
At present, its designation as Schedule I puts marijuana in the same level as Ecstasy, heroin, Quaaludes, LSD, and peyote. But veterans are adamant that marijuana is made more accessible or, at least, research into its medical benefits be continued, because of its potential to treat post-traumatic stress disorder (PTSD) and traumatic brain injury.
Considering that many veterans suffer from PTSD, pushing for a reschedule is definitely worth fighting for, what with the possibility of marijuana providing a possible cure. The Legion further pushes for the amendment of the legislation, so that cannabis will be recognized as a drug with a potential medical value.
The Drug Enforcement Agency has approved the study on the effectiveness of cannabis for treating PTSD. The agency has already approved the use of marijuana to treat the disorder through inhalation. This makes the move to reschedule marijuana more logical than ever.
During a meeting between the Legion and Trump’s transition team, it was noted that the new administration’s officials were guarded in giving feedback, but when the subject of cannabis potentially healing war wounds of military veterans came up, the team’s reaction changed significantly.
National director of the Legion’s veterans affairs and rehabilitation division, Louis Celli, told Marijuana.com that Trump officials were a little caught off guard when that piece of information was revealed.
But is it enough to convince the administration to reschedule marijuana?
The Legion certainly hoped that there wouldn’t be a roll back on the progress of marijuana research because of its potential to cure PTSD. Everything else seems ineffective.
Former Veterans Affairs psychiatrist and lead researcher Dr. Sue Sisley said that veterans feel like guinea pigs being used to test various treatments for PTSD, but with no positive results. They are simply exhausted and getting desperate.
With the failure of traditional medications to address the problem, Sisley hopes to pursue further her research on cannabis as a treatment for mental health conditions.
According to her, “While I can’t say definitively that medical marijuana works for PTSD -- we are three years away from published data -- we owe it to veterans to study this plant”.
Between marijuana activists and the American Legion, the latter is much more respected in the eyes of Trump officials. If they can convince a reschedule and get the pharmaceutical industry in on research and development, PTSD may finally have a cure.
In 2015, Market research firm Packaged Facts published a report called Pet Medications in the U.S.: Over-the-counter and Prescription Remedies as Consumer Products, 3rd Edition which estimated the pet medication market to be a $10 billion industry by 2018. More families are now keeping pets and are treating them as members of the family which means that owners are willing to spend for grooming and medication for their furry creatures. It’s this concern for the welfare of animal companions that will drive the growth of the pet medication market. In fact, the American Pet Products Association estimates expenditure in the pet industry to be $69.36 billion in 2017.
In 2013, pet medication sales hovered at $7.6 billion. That figure is now bound to increase at an annual growth rate of 5% by 2018 to $10.2 billion. The study by Packaged Facts looked into different areas including parasite prevention and control, behavioral health, cognitive dysfunction, heart health, ear care, obesity/overweight, and allergies.
Veterinarians have, for years, dominated sales of veterinary prescription and over-the-counter drugs. However, that started to change in the late 90s when establishments such as brick-and-mortar shops and online retailers began to take larger control of the market share. In 2013, veterinarians accounted for 58% of pet medications – although still a large amount, the percentage two years prior was 63% which shows that there is growing competition from retail stores.
Independent pharmacies can take advantage of the growth of the pet medication industry by offering pet prescription medication. This idea could work best in areas where residents need to travel many miles just to get to a specialist store that sells medications for pets. Doing this is advantageous for local pharmacies because they will be making it more convenient for pet owners to get prescription medication for their dogs or cats without having to travel a long way.
Providing pet prescription medication also allows an independent pharmacy to build relationships with the local veterinary clinics. Clinics can refer their pet owners to an independent pharmacy which provides the prescriptions they need for their furry companion.
There is growing concern among veterinarians that pet owners will no longer be turning to them for advice to rely on lay people instead. Independent pharmacies can address this concern by establishing relationships with veterinarians in their local area. For example, pharmacies can supply the medication prescribed by a vet for a local resident’s pet. The scenario would be one of collaboration instead of competition.
Independent pharmacies can even partner with local veterinarians to provide information needed by pet owners to keep their companions happy and healthy. On top of that, local pharmacies can also supply specialty pet products.
While it’s true that some veterinarians might lose profits with pharmacies and other retail outlets taking a share of the pet prescription market, there are always areas where they can join heads for the benefit of local pet owners and their furry creatures. Besides, the Federal Trade Commission criticized the established policy of selling medications only through veterinarians in 2015. In a report called Competition in the Pet Medications Industry Prescription Portability and Distribution Practices released in May 2015, the FTC cited broader access to portable prescriptions, greater choice of generic drugs, and wide access by non-veterinary retailers to supplies as consumer benefits of the increased completion in the pet medications market.
Around 20 years ago, the pharmacy industry offered the best opportunity to students: a six-figure income, a respected job title, a rewarding career that allows them to help people, and plenty of jobs waiting for them after they graduate. Today, however, this is NO longer the case.
The pharmacist job market has become over-saturated to the point that student pharmacists are finding it hard to land a job. A 2013 study conducted by eight Midwest schools found out that, out of 783 pharmacy students who were about to graduate in four weeks, only 81 percent had found employment or was getting into a post-graduate program. Sixteen percent had not found a job, and three percent had not begun looking for employment. These figures contrast starkly with the observations of pharmacy professor Daniel L. Brown, who noted that, before 2009, almost 100 percent of pharmacy students had jobs waiting for them around six months before they graduated.
Purdue University, which has one of the leading pharmacy schools in the country, has also observed this upward trend in unemployment among graduating pharmacy students. In 2009, Purdue’s pharmacy students had 12 job offers before they graduated, but that number dwindled to one to three offers a few years later. In 2008, only one student out of the entire graduating class was still looking for work; in 2013, 12 students were still looking for a job a few weeks before graduation.
Data collected by the Pharmacist Demand Indicator (formerly the Aggregate Demand Index) also reflect the challenges in the pharmacist job market. Its Quarter 4 2016 report shows that only a handful of states have high employment demands and are finding it hard to fill positions. The rest have moderate demand or are maintaining a precarious balance between demand and supply, and some even don’t have enough jobs for the number of pharmacists in the area.
Why Is This Happening?
There are many factors that contribute to the downward trend of the pharmacy job market. Laws that would have expanded the roles of pharmacists and allow them to take on some client counseling responsibilities have not yet been approved both on state and federal levels. This means that pharmacists can’t charge for their counseling and advisory services and that the industry as a whole cannot financially support the influx of more pharmacy professionals.
Academic expansion is also an issue. When the Pharmacy Workforce Center predicted in 2001 there would be a shortage of over 150,000 pharmacists in the next two decades, colleges and universities all over the U.S. opened new pharmacy programs and increased their class sizes. As a result, more and more students received pharmacy degrees, saturating the market and competing with each other for limited job vacancies.
With everything that’s happening in the job market, the American Pharmacy Purchasing Alliance (APPA) decided to conduct a student pharmacists job market survey. It took place in April 2017 and had 122 participants, who were asked to answer five questions about the job market.
The purpose of this survey was to find out how students feel about their job prospects and the future of pharmacy as a career. Their opinions are an important part of the job market discussion because they are the demographic that is most impacted by the decrease in demand of professional pharmacists. With fewer job opportunities plus rising student loan debts, many student pharmacists can find themselves in difficult situations after graduation.
The APPA student pharmacists job market survey found out that a lot of students feel there is currently a surplus of PharmD graduates. Some have noted that many of their fellow student pharmacists have left their hometowns to secure employment. Others have observed that doing Postgraduate Year One (PGY1) is no longer enough to distinguish pharmacists, which pushes many professionals to do PGY2. According to one participant, there might come a time when third-year postgraduate studies become necessary for pharmacists to stand out and be noticed by employers.
A lot of student pharmacists feel that pharmacy schools should consider decreasing their student enrollment since the rising number of graduates contributes to the over-saturation of the job market. Some point out that the current state of enrollment rates decreases the amount of competition to get into pharmacy schools and produces graduates who are less competent in their field. Others, meanwhile, feel that the increasing number of people with PharmD degrees decreases the value of the degree.
The student pharmacists job market survey also touched on the issue of pharmacists who study abroad and have less schooling than those who study in the United States. Many of the participants have noticed that these overseas-educated pharmacists do have an impact on the U.S. pharmacy job market, especially in the retail and community setting. Some of the study participants point out that the issue might be influenced by American pharmacists’ belief that pharmacy education abroad does not match the United States’ standards.
The study participants were also asked to give advice to current pharmacy students on how they could secure employment right after graduation. Many important tips were given, including positioning themselves as a leader even while they’re still in school and doing networking activities to build relationships with other professionals and potential employees. Joining relevant clubs, obtaining internships, and doing volunteer activities in the pharmacy community are other strategies to stand out as a candidate, either for a job or for a residency position.
The final question of the APPA student pharmacists job market survey asked the participants if they would consider picking another profession, considering what they know about the employment outlook for pharmacy students. A lot of the participants revealed that they would NOT switch professions even if the current job market presents challenges instead of opportunities.
Some revealed that being a pharmacist was their dream since it allows them to help other people, so giving it up is not an option. Others state that, aside from reducing the number of pharmacy schools and making class sizes smaller, another way to improve the job market is to make the profession more focused on people and service and less on sales. Still others point out that all job markets — not just pharmacy — are saturated, so it all boils down to finding a niche in your industry where you can build your success.
How Can You Find Success in the Current Job Market?
Among the topics tackled in APPA’s student pharmacists job market survey, perhaps the most important is the strategies that students can use to improve their employment practices. As mentioned above, there are several ways for students to secure a job before or right after they graduate. One of the most effective is getting into a niche market.
Many pharmacy niches are not as saturated as the traditional markets, which means you’ll deal with less competition and find it easier to stand out from the crowd. A lot of niches focus on new and interesting branches of pharmacy, making them a great option if you’re looking for exciting and challenging work that test your skills and knowledge.
If you decide to use strategy, the next thing you should do is to pick a pharmacy niche to focus on. We’ve listed some of them below to help you choose the right option:
These are just some of the pharmacy niches you can explore. Choosing the right niche to specialize in can be overwhelming, so it’s important to take the time to make your decision. Consult your professors and mentors and get their perspective; they can help you go over possible niches and choose one that best suits your strengths. Once you’ve identified a niche that you might like, look for volunteer opportunities that will give you the chance to test the waters and see if this niche really is the right choice for you.
The APPA is an organization created to become a valuable tool for the pharmaceutical purchasing industry. The APPA’s mission is to assist its members to achieve the highest standard of excellence.
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