Meg Marzella

Technology has begun playing a larger role in community pharmacy and the power of artificial intelligence (AI) is poised to transform the world of pharmacy as we know it.

 at the National Community Pharmacists Association 2022 Annual Convention, held October 1 through 4 in Kansas City, Missouri, Paige Clark, RPh, vice president of pharmacy programs and policy at Prescryptive Health discussed the advantages of incorporating AI into pharmacy practices and shared the results of a nationwide survey, conducted by Prescryptive Health, focused on the use of technology and AI in pharmacies.

“Here’s the promise of technology: 62% of decision makers say artificial intelligence will positively disrupt the pharmacy landscape within 1 to 2 years,” Clark said. “Ninety-one percent of decision makers believe that technology can improve their pharmacies’ profitability without question.”

In terms of pricing, AI is able to compare the prices of major chain pharmacies with local competitors and identify the granular details of pricing. This information could assist pharmacies in establishing the most competitive prices, positioning themselves at the most competitive spot in the market.

 featuring Jeff Harrell, PharmD, a multi-location pharmacy co-owner in the Pacific Northwest, to show just how effective AI-assisted pricing can be. According to Harrell, just 1 week using AI in his store led to an increase in revenue of 16%—and an additional 58% increase year to date for just 1 of his store locations.

Because of the power and predictability of AI, many health care environments are starting to invest in similar technologies. It’s especially important for community pharmacies to embrace AI and other technological advances to be able to compete with major chain pharmacies.

 also found that consumers are demanding technology, especially from their local pharmacies. Consumers want technology that will ensure a seamless experience.

“It’s imperative that we really start moving forward with this, stepping into the future and getting comfortable with it,” Clark said. “We’re all hoping that you will feel really comfortable embracing this technology and learning more about it.”

Drug Topics’ coverage of the 2022 NCPA Annual Convention and Expo is sponsored Prescryptive Health.

Clark P. Quick Consult: Going boldly into a new era—Artificial intelligence leveraging phenomenal technology to gain a competitive advantage, maximize profitability, and maintain customer loyalty. Presented at: National Community Pharmacists Associations 2022 Annual Convention; October 1-4 2022; Kansas City, MO.

Case study: Purdy Cost Less Pharmacy. Prescryptive Health. Accessed October 4, 2022. 

https://prescryptive.com/project/purdy-case-study/

Rewriting the script: Independent pharmacy trends. 2022 research report. Prescryptive Health. Accessed October 4, 2022. 

https://prescryptive.com/2022-pharmacy-study/

Articles

As technology advances in all areas of life, it is no surprise that technology is becoming more prevalent in independent pharmacy. 

Embrace Artificial Intelligence in the Pharmacy

Approximately 37.5 million Americans live with hearing loss. A pair of hearing aids can cost approximately $2,500 per device, totaling $5,000 for a pair of hearing aids––a cost rarely covered by insurance.

Starting on October 17, 2022, OTC hearing aids will become available nationwide. These devices will only cost $500 to $1,000 per pair compared to traditional hearing aids.

Lucas A. Berenbrok, PharmD, MS, associate professor at the University of Pittsburgh School of Pharmacy, shared his insights into just some of the knowledge and skills pharmacists will need to counsel patients on OTC hearing aids at this year’s NCPA Annual Convention, held October 1 through 4, 2022, in Kansas City, Missouri.

In 2017, a bill presented by senators Chuck Grassley (R-IA) and Elizabeth Warren (D-MA), was signed into law creating a new category of hearing aids that were to be sold OTC. These devices, however, are not a replacement for or alternative to traditional hearing aids. OTC hearing aids are only designed for adults with mild to moderate hearing loss, not for individuals with profound hearing loss.

Traditional hearing aids are professionally custom fit for each patient and require a prescription. OTC hearing aids will not require a prescription or the administration of any hearing tests or screens. With only roughly 14,000 audiologists in the country, patients with mild to moderate hearing loss will not have to worry about being able to access an audiologist.

“They [traditional hearing aids] are relatively inaccessible. They require a medical evaluation; you have to find an audiologist… The other thing is affordability…these are pretty pricey.”

With OTC availability, hearing aids will become more widely accessible to people with mild to moderate hearing loss who can’t afford traditional hearing aids. With an earbud-like design, patients will be able to fit their hearing aids themselves—and avoid the stigma that comes along with wearing traditional hearing aids.

“A patient can go into a pharmacy, can go on an online retailer, to an electronic store, [or] to a gas station, buy these products, put them in their ears and customize them for themselves, and start hearing better at home,” Berenbrok said.

With widespread availability, it will become increasingly important for pharmacists and audiologists to work together to refer patients to the proper course of care. For example, pharmacists, must be able to recognize when a patient’s hearing loss is beyond the point where an OTC hearing aid will be helpful. Audiologists must be able to refer patients to a pharmacy for an OTC hearing aid when it is appropriate.

“There’s about 38 million people in America that have hearing loss,” Berenbrok said. “About 30 million of those [who] have hearing loss can be treated with a hearing aid, but they do not use a hearing aid. So, our market here is about 30 million people who need access to hearing aids.”

Berenbrok L. Quick consults: OTC opportunities: Hearing aids. Presented at: National Community Pharmacists Association 2022 Annual Convention; October 1-4, 2022; Kansas City, MO.

OTC hearing aids will be available nationwide on October 17, 2022. 

OTC Hearing Aids Increase Accessibility for Patients with Mild to Moderate Hearing Loss

It’s no surprise that there is currently a major push for labor reform. Individuals are no longer settling for jobs that do not accommodate them and their needs. In 2021, more than 47 million Americans voluntarily quit their jobs, an event being called “The Great Resignation.”

This mass exodus of employees is in part due to the COVID-19 pandemic. Many families struggled to find childcare, pushing parents out of their jobs. But many other workers simply saw the flexibility that was possible amid the pandemic and wanted that same flexibility in their day-to-day jobs.

As a result of the Great Resignation, it is more important than ever to keep your team motivated and incentivized to continue doing the level of work that pharmacies require in order to operate efficiently.

During a presentation at the NCPA 2022 Annual Convention, held October 1 through 4 in Kansas City, Missouri, Ashley Moose, PharmD, co-owner and manager of Moose Pharmacy and director of network development and marketing at CPESN USA, shared successful models currently in use across independent pharmacies to motivate and incentivize their employees.

Model 1: Achieve a Task & Receive a Bonus

The name of this model is fairly self-explanatory: when a staff member achieves something, like completing a certain training program, the receive a bonus. Under this model, employees see wage increases that coordinate with specific achievements. For example, an employee can make an additional $1.00 per hour for becoming a certified pharmacy technician, or an additional $1.50 per hour for earning a community health worker certificate.

This model encourages staff knowledge expansion, job satisfaction, marketable staff credentials, enhanced services, OTC revenue growth, and more.

The goals of this model are to improve pharmacy technician performance and reward employees for high performance, stimulate and provide pathways for technician growth, and create streamlined and straightforward tools to quickly evaluate and promote technicians.

This model clearly lays out different levels that pharmacy technicians can achieve based on their accomplishments, what work they do day-to-day.

This simple model includes hanging a poster in the pharmacy that shows completion rates for different Pharmacy Management System learning modules for each employee. For every 10% of the program completed, employees receive a $10 bonus. When they completely finish the program, they will have received a total of $100 in bonuses.

This model aims to improve and reward employee attendance and punctuality, reduce employee callouts and unexcused absences, and enhance team relationships. Within this model, employees can receive monthly, quarterly, and/or yearly bonuses based on their attendance. This includes both punctuality and ensuring that employees clock in on time and stay at work for the full duration of their shift.

In this model, certain metrics are set at the beginning of the year and must be completed in order to receive a bonus. Goals like completion of medication therapy management training, administering a certain number of vaccines, and completing a certain number of chart reviews are all put in place in order to improve patient care and outcomes and reward pharmacists for their clinical work.

This model rewards staff members for every new patient they can recruit to the pharmacy. Staff members document on an internal form the referral name and date of the prescription pick-up and send a handwritten welcome note to the new patient. The staff member than receives a bonus of $15 to $20 for each referral they make.

Moose A. 7 fool-proof ideas for incentivizing and motivating your team. Presented at: National Community Pharmacists Association 2022 Annual Convention; October 1-4, 2022; Kansas City, MO.

It’s more important than ever to keep your team motivated and incentivized. 

Motivate, Incentivize Your Team After the “Great Resignation”

Pharmacies have evolved and are now expected to do more than just dispense medication. They’re also expected to connect with community members and be a resource for both medical and non-medical needs.

According to Tripp Logan, PharmD, co-owner of L&S Pharmacy and Medical Arts Pharmacy, “We [pharmacists] are where people were born, grow, work, live, and age…” Logan spoke during a session at this year’s NCPA Annual Convention, held October 1 through 4, 2022, in Kansas City, Missouri.

 Because of this, pharmacists take on a degree of responsibility for social determinants of health (SDOH).

SDoH are “conditions in which people are born, grow, work, live, age, and a wider set of forces and systems shaping the conditions of daily life.” One example of a SDOH is a person’s ability to access food. If, for example, an individual is unable to access food on a regular basis, it will have direct consequences on their health.

One vital player in caring for SDOH are community health workers. These are trusted community members who have a closer understanding of the community and liaise between health and social services. Community health workers in the pharmacy can help patients navigate the healthcare system, access local services, and promote healthy behaviors, and be a liaison for payer and provider partners.

It is important to have community health workers in pharmacies, said presenter Annie Eisenbeis, PharmD, MBA, director of practice development at the Missouri Pharmacy Association, because “pharmacy is also a healthcare resource that is sometimes the only option or opportunity for patients to have a touch point with a healthcare professional.”

Community health workers are what Logan calls a “value driver;” they increase the value of a pharmacy. The good news is? Training for community health workers is expanding. There are certification programs, community organizations that offer training, and even college programs that aim to train community health workers.

Community health work training can include things like mental health first aid certificates, motivational interviewing certificates, OTC product training certificates, and more.

There are many positive outcomes that come with caring for the SDoH of the community. One of these positive outcomes is improved medication adherence.

When Amy Hampton, health program manager at the Missouri Department of Health and Senior Services, learned about the rates of hypertension and diabetes in Missouri and patients’ dissatisfaction with their medications, she was shocked. “I reached out and said, ‘Well, how can we prevent them from stopping taking this medication?’... And so, I learned about medication therapy management,” Hampton explained.

“I learned about the education that pharmacies are [providing] across the state of Missouri. I said, ‘How can we help the pharmacy to be able to continue to give that medication when they’re so inundated with their daily tasks and how can we work this into the pharmacy flow?’”

It can be difficult to convince pharmacy staff to undergo the necessary additional training, but as Logan said, there are ways to incentivize staff members.

“What we’ve done is we’ve worked with the state and found incentive grants and other opportunities where the pharmacy is incentivized from a workforce development standpoint to create a sustainable place for community health workers.”

Eisenbeis A, Logan T, Hampton A. Teaming up with community partners to address social determinants of health. Presented at: National Community Pharmacists Association 2022 Annual Convention; October 1-4, 2022; Kansas City, MO.

In an age where pharmacies are expected to do more than provide medication, community health workers add necessary value. 

Community Health Workers Drive Value in Pharmacies

 sat down with Kennedy Erickson, National President of the American Pharmacists Association-Academy of Student Pharmacists (APhA-ASP) for a Student Spotlight in honor of AmericanPharmacists Month.

Erickson is a pharmacy student in her final year at the Washington State University College of Pharmacy in Spokane, Washington.

 Tell us what you do in your role as National President of APhA-ASP.

 As the national president, I get to wear several different hats, which has been a joy. Right now, I’m currently on student outreach visits which is also part of my APhA[Advanced Pharmacy Practice Experience]. What we’re doing for the National Executive Committee is visiting different schools and colleges of pharmacy, and we’re engaging with people who may be members, letting them know how to maximize their membership or engaging with people who aren’t members and encouraging them to register for a membership and join the organization.

Beyond that I also serve on the APhA Board of Trustees representing the voice of student pharmacists. I also serve as a liaison to the international standing committee, and then my president elect year the awards gaming committee. I got to see 2different standing committees, which was really cool. I also help with putting together the conferences that we put on every year; right now we’re working on the major regional meeting for the APhA-ASP. Those are coming back live and in person this year, so there’s definitely a little bit more work to do. I also got to help with the Summer Leadership institute in July, which was a ton of fun. It brought together all the different chapter presidents and president-elects from around the country.There’s a summit on building leadership skills and planning for the year in Washington, D.C., so that was really cool.

 How has your role as national president shaped your identity as a pharmacy student and future pharmacist?

 This position has shown me the power of being an advocate and connecting with others. And I think that, as a pharmacist, those skills are just going to continue to grow with me and I’m going to continue to look for opportunities to build in most areas.

I’m already really looking forward to precepting my students and showing them how valuable it is to advocate for our profession [as well as]how to advocate for themselves as people who need to set balance in their lives and set boundaries. That’s something I’m really looking forward to.I’m also looking forward to connecting with my patients. I’m planning to work in community pharmacy after graduation and I just love getting to talk to people and get to know them. I’m excited to keep building those skills, especially as an educator and community leader.

 Are there any areas of pharmacy that are particularly interesting to you, or that you hope to focus on in your career?

 I have a lot of different interests in pharmacy. I love APhA because it encompasses all of pharmacy, but right now I really enjoy mental health…I'm hoping in my role to provide more mental health services to the community in an outpatient setting. I also really love pharmacogenomics. So, hopefully, maybe one day I can do a project [in that area] and help others in the community with that. Reproductive health has been a passion of mine during pharmacy school, and I’m looking for ways to incorporate that in my next position.

 What made you decide to pursue a career in pharmacy?

 It's kind of a journey, so bear with me a little bit. When I was an undergrad, I was super interested in becoming a neurosurgeon, so I decided to pursue a degree in behavioral neuroscience.Along the way, after shadowing an array of different providers—including pharmacists—I found myself aligning with some of the other positions that weren't neurosurgery, such as the pharmacists.

I took psychopharmacology, a class that was required for my degree, and I loved it. And then a position opened up at a long-term care pharmacy near where I was living, and I decided to explore my interests there, and I absolutely fell in love with it. With the encouragement of the pharmacist and the pharmacy technicians there, I ended up applying for pharmacy school a year later. It was a long story, but I'm glad it took me where I am today.

 Something we’re seeing a lot right now is burnout among pharmacists. How do you handle burnout and what is your advice for other pharmacy students dealing with burnout?

 I don't think there's a recipe for it,but I personally handle [burnout] is by setting boundaries for myself. For example, in pharmacy school it's so easy to say yes to everything,“Yes, I want to do this. Yes, I can do this.” And that's a great way to burn yourself out. SoI made a list during my second year of pharmacy school of 3things that I was very passionate about and 3goals I wanted to accomplish with those passions. If events that I thought I wanted to attend didn't align with those goals, I would set that boundary and I would not [attend], because I also needed to make time for myself and my well-being.

Making that a priority, at least in my agenda, is something that's helped me with burnout—actually setting aside the time even if it's 20 minutes. If that is at all helpful to anyone, that would be my advice:set those boundaries, and to make time for the little things that help you to relax at night.[Take time for] self-reflection on why you went into pharmacy,what your passions are in pharmacy, and what you're doing to nourish those passions.

Erickson shares her tips on managing burnout as a student pharmacist. 

Student Pharmacist Spotlight: Kennedy Erickson 

In August 2022, Congress enacted prescription drug pricing reform in accordance with the Inflation Reduction Act. This is the most profound policy changes in prescription drug prices since 2003.

This law allows the secretary of the Department of Health and Human Services to negotiate prices for some brandname drugs with the most spending going to clinician-administered drugs and retail drugs. The law allows only 10 drugs to be negotiated annually in 2026 but will increase to 20 drugs annually in 2029.

The law also allows Medicare––the largest purchaser of prescription drugs in the United States––to directly negotiate drug prices. However, the legislation does come with limitations for Medicare.

“The legislation imposes upper bounds on the negotiated price: no greater than 75%, 65%, and 40% of the nonfederal average manufacturer price for drugs 9 to 12 years, 12 to 16 years, and more than 16 years after approval respectively,”wrote Aaron S. Kesselheim, MD, JD, MPH, and colleagues in a viewpoint article published in JAMA.

Prices will be eligible for negotiation 9 years after drug approval,or for 13 years for biologics, until a generic or biosimilar competitor is introduced. Once a negotiated price is settled, Medicare Part D plans will be required to cover the drugs on their formularies.

Drugs that account for less than $200 million of annual Medicare spending and drugs that are approved for single rare diseases will be exempt from negotiations. Prices can additionally be renegotiated if material changes occur, like the approval of a new indication.

Another major aspect of the Inflation Reduction Act is that manufacturers will be penalized for increasing drug prices faster than inflation, starting in October 2022. In 2024, annual out-of-pocket costs will be capped, allowing more low-income Medicare patients to qualify for subsidized out-of-pocket costs.

Cost-sharing for insulin products will be capped at $35 per month for Medicare beneficiaries as well. Many top-selling drugs in the Medicare program will likely be eligible for negotiation under this act.

With the passage of this law, implementation of these pricing reforms now becomes the main focus. It is up to Medicare to ensure that selecting drugs to be negotiated and the evidence that supports these choices is clear.

“The drug pricing provisions in the Inflation Reduction Act mark important reforms to the Medicare Part D program and a step toward greater affordability of prescription drugs for Medicare beneficiaries,” the authors wrote.“Current and future administrations will be able to use their executive authority to address limitations in the legislation and to work with Congress to potentially extend these reforms to privately insured and uninsured patients.”

One author reported a financial disclosure. For details, see the full text of the study.

New reforms to prescription drug pricing in the US. Opportunities and challenges.

JAMA. Published online August 19, 2022. doi:10.1001/jama.2022.15268

Medicare users will see prescription drug pricing reform thanks to the Inflation Reduction Act.  