January 17, 2014

Measuring Expanded Scope For Pharmacy

by Beverley Herczegh, Director

For industry, it's a key question.  Does expanded scope for pharmacy have any significance to commercial success for brand pharma?  Often, at the ground level, Sales is absolutely convinced of the value of pharmacists to their brand, whether measurable or not.  From my perspective, long before expanded scope of practice came in to play, pharmacists have influenced not only adherence, but also product selection.  Patients ask pharmacists lots of questions and pharmacists speak most credibly about the products they understand the best.  Just the same, expanded scope is adding another layer to the pharmacy offerings.  Here are a few factoids that address the question of expanded scope uptake:

  • BC- 67% increase in claims for expanded scope services in year 3 (2012).
  • AB- 58% increase in the number of pharmacists with additional prescribing authority (APA) from Mar 2013 to Nov 2013 *ON- total billings for expanded scope have grown from $41M in 2010 to $85M in 2013.

Injecting- since 2007 we have gone from 1 province authorizing injections by pharmacists to 5 and seen the numbers of qualified injectors go from 600 in 2012/13 to 3500 in 2013/14 in Ontario. In fact, some expect flu shots by pharmacists in Ontario for this season to reach 1 million. Quite impressive compared to the 250,000 last season.

We already know that pharmacist involvement in patient care favourably impacts outcomes in these therapeutic areas:  hypertension, dyslipidemia, asthma, heart failure and coagulation.  And by the way, patients report satisfaction with the care. More evidence is forthcoming regarding the value of these services, in particular, Medschecks, Pharmaceutical Opinion and minor ailment prescribing.  Payers are attentive and if savings can be demonstrated, the pressure to reform how pharmacy is practiced will intensify further, perhaps with appropriate supports for pharmacists in the front lines.  

Things you may want to watch for going forward include payer response to studies on value of services and continued shifting of savings from generics pricing cuts over to valued pharmacy services. At some point you will have to decide for yourself if this is really a new and important stakeholder for your business.