Drug Shortages, Affordability Remain Top Concerns in Managed Care Pharmacy
Approximately, 62% of respondents stated that the number of active drug shortages could potentially increase by more than 25% within the next 5 years.
Drug shortages remain an area of concern for the pharmacy industry, with 62% of respondents stating that the number of active drug shortages could potentially increase by more than 25% within the next 5 years, according to data from the Journal of Managed Care & Specialty Pharmacy.1
The top 3 most likely issues to affect the respondents’ organizations in the next 5 years included federal and state policy changes, cell and gene therapies, and AI’s impact on operations. | Image Credit: ImageFlow | stock.adobe.com
Affordability is also an important issue, particularly for payment models and biosimilars. Approximately 54% of respondents believe that at least 50% of states will have prescription drug affordability boards, with an uptick in specialty drugs, particularly with glucagon-like peptide-1 (GLP-1) medication usage growing due to popularity and expanded indications.1
Additionally, AI is expected to become more prevalent, with 92% of respondents saying that AI will be incorporated into more than 50% of prior authorizations. They also believe AI will boost cybersecurity and vigilance against potential attacks.
In the survey, the Academy of Manage Care Pharmacy (AMCP) and the AMCP Foundation included an advisory panel of experts from managed care pharmacy, the pharmaceutical industry, pharmacy practice, academia, and consultations. In the quantitative survey, a larger group was included. The advisory panel was included in 2 virtual focus groups that lasted 90 minutes each.
For the first meeting, the experts had a general overview of the project, the project’s aim, and a series of questions on the trends anticipated for the next 3 to 5 years. As part of the second meeting, there was a brief recap, and experts were able to give additional information and suggestions on the 4 initial domains: science, technology, economics, and policy.2
Based on the focus groups, individual items were created under each domain, and survey participants were asked how likely they believed that item would occur within the next 5 years. The advisory panel consisted of 18 experts, who created a total of 53 scenario statements, with 17 being the choices for the top 3 issues that will impact the respondent’s organization within the next 5 years. They also expanded the domains into 5: information technology, therapeutics and diagnostics, payment models, pharmacy operations, and public policy.2
Out of 1238 individuals who were invited to participate in the survey, 201 completed it, with 53.2% having more than 20 years of experience and 27.9% having 10 to 20 years of experience. Approximately 80.1% of respondents were pharmacists, followed by 14.9% who had no clinical experience.2
Of the 53 scenarios, 12 had more than 79.5% or more of respondents classifying it as highly or somewhat likely to occur in the next 5 years. The 12 included2:
- The use of GLP-1 receptor agonists will increase by at least 25% (96.6%)
- At least 1 major data breach in health care that is disruptive to managed care (96.1%)
- More than 10 new orphan drugs will be approved (94.9%)
- AI will be incorporated into more than 50% of prior authorization reviews (92.2%)
- More than 40% of pharmaceutical spending will be for large specialty drug populations (90.8%)
- Most managed care organizations will have multiple jobs related to AI (88.3%)
- The number of reference biologics that biosimilars are approved for will increase by at least 25% (87.4%)
- More than 5 new vaccines will be developed for either infectious diseases and/or chronic conditions (81.7)
- Following the presidential election, if there is a democrat in office, efforts to reduce prescription cost will increase (86.5%)
- Following the presidential election, if there is a democrat in office, new policies for pharmacy benefit manager reform (PBM) for price negotiation and price determination will be implemented (81.8%)
- The number of community pharmacy closures will increase by 25% (80.1%)
- At least 25% of pharmacist jobs will be either virtual or offer a remote component (79.5%)
Of note, the survey was conducted prior to the November 2024 election, according to the study authors.2
As for the scenarios that were least likely to occur, respondents placed prescription drug products being made with 3D printing, the Inflation Reduction Act undergoing significant changes, drones being used for home delivery, patients using an implanted device for chronic conditions, PBMs leaving the market for Medicare and Medicaid, drug importation from Canada increasing, manufacturers reducing list prices for high-cost products, new drug approvals being based in part on patient-experience data, and the FDA accelerated approval process expanding by 50.2
The top 3 most likely issues to affect the respondents’ organizations in the next 5 years included federal and state policy changes (18.5%), cell and gene therapies (11.8%), and AI’s impact on operations (10.4%).2
