Bonnie Lai, PhD, Vice President of Pharmacy Solutions, recently attended the 2017 annual meeting of the Council of Pharmacy Executives and Suppliers (CPES). Below, she answers a few questions about key topics.
Lumere: Based on what you heard at CPES, what are the biggest challenges for pharmacy executives?
Bonnie Lai: Many pharmacy leaders talked about how difficult it is to measure value or total cost of care for drugs—particularly expensive ones—when they can’t access evidence on patient outcomes. Providers today often rely on surrogate or corollary outcomes markers, and they crave visibility into “true outcomes” related to disease progression or ability for patients to return to activities of daily living. However, challenges remain around collecting this kind of longitudinal data, especially considering other factors that can influence outcomes.
Lumere: How effectively have organizations engaged in evidence-based medicine?
BL: Despite a desire to practice evidence-based medicine, many hospitals aren’t adequately doing so. Talking to physicians about changing their prescribing behaviors can be contentious; they often rely heavily on anecdotal observations and pharmaceutical company marketing. However, hospitals with strong clinical pharmacy teams have seen evidence-based medication policies yield strong results (e.g. flat inpatient drug spend).
Lumere: How are pharmacy executives navigating the changing reimbursement landscape?
A number of pharmacy execs are struggling to adapt as payers become increasingly prescriptive about drug selection and site of care. Many of them lack the visibility into reimbursement that they need to manage these changes from payers. Some pharmacy leaders are taking matters into their own hands by devoting more and more time to payer negotiations.
Lumere: At the same time, is it accurate to say that now more than ever before, pharmacy departments are becoming not only cost centers, but profit centers?
BL: That’s very accurate. As one executive said, “It’s not always clear which hat I’m wearing—cost reduction or revenue generation.” Pharmacies are increasingly contributing to the health system’s bottom line. For a few health systems we heard from, pharmacy provides over 30% of the enterprise net income. Some non-profit systems are even standing up new for-profit pharmacy businesses.
Lumere: And all of this is playing out against the backdrop of an industry that doesn’t operate according to traditional market rules.
BL: Drug pricing is not an economically rational system, as 4sight Health’s David Johnson reminded us in his keynote. In healthcare, supply creates its own demand. This is the reality that all pharmacy leaders face, and there’s no reason to believe it will change any time soon.
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