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Tomorrow's pharmacists and pharmacies will need to find ways to increase profit margins by reducing the cost of prescribing, embracing technology, and focusing more on patient counseling, immunizations, education, and other offshoots of their clinical expertise.

The death of a teenager led Congress to pass the Ryan Haight Online Pharmacy Consumer Protection Act in 2008, amending the Controlled Substances Act to prohibit delivery, distribution, or dispensing of controlled substances over the Internet without a valid prescription.

Commercial medication therapy management programs are gaining in strength and popularity for medical, financial, and practical reasons. In Minnesota, a pilot program for state employees was so successful that two years later it expanded into a program for all fully insured members. Another program is in use by Minnesota Medicaid and General Mills. And in North Carolina, the Asheville Project is still going strong.

The kids are going back to school, and opportunities for exposure to head lice abound. In the U.S., an estimated 6 million to 12 million infestations occur each year among children 3 to 11 years old. This year, some new products offer relief.

Pharmacy mistakes can sometimes lead to injury or even death. Pharmacists can be held liable in a civil suit for money damages; now a pharmacist in Ohio may be convicted of a criminal charge in the accidental death of a two-year-old girl. It is possible that the effect of criminal liability upon professional practices will worsen outcomes rather than improve them.

Pharmacy in the 21st century will be more integrated into provision of health services than ever before. Electronic health records will become increasingly important, as will e-prescribing, prescription data, pharmacist intervention/counseling, and collaboration with other healthcare providers.

In coming years, nearly half of all newly approved drugs could come from biotechnology. With stakes so high, Congress is working to create a more direct pathway for the FDA to approve "biosimilars", the generic or "follow-on" versions of biologics. Two bills before Congress approach the issues differently.

As the American population is aging, so are retail pharmacy owners. In light of this reality, it is in the best interest of pharmacists and pharmacy owners to have a succession plan in place when they retire or prepare to sell their businesses, said Robert Wilbur, PharmD, pharmacy specialist with The Healthcare Acquisitions Group, Coral Gables, Fla., addressing attendees at the recent McKesson?s Pharmacy Strategies Conference in Orlando, Fla.