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Practice Trends
Practice Trends
Pharmaceuti'cals Are They Merely a Commodity? s long as the research-intensive pharmaceutical industry continues to produce chemical and biologic agents that prove superior in the management of illness, pharmaceuticals will replace other fonns of therapy," states Henri R. Manasse, Jr., PhD, in Wellcome Trends in Pharmacy (February 1989). "Is it any wonder, then," Manasse asks, "that big business has latched on to the prescription marketplace , as the area to do its bidding? There is a profit to be made and, notwithstanding the cries of community pharmacy owners and managers, commercial enterprises [such as mail-order pharmacy] with little concern for the patient will continue to exploit the pharmaceutical needs of the patient." One of the most significant effects of the bottom-line approach to dispensing is the changing of a prescription order to a "mere commodr ity." The net result has the typical pharmacy asking the question, ! "How many prescriptions did we , sell today?" Although many potential solutions have been discussed or proposed, Manasse says the only way for the community pharmacist to put an end to mail-order prescription sales is to make the option so unattractive to the patient that such companies will simply die a slow death. In order to effect such , a change, pharmacists must prove their unquestionable worth as patient counselors. Manasse points out three reasons that pharmaceutical agents will continue to playa major role in the marketplace. First, drugs are the mainstay of noninvasive therapeutics and are likely to remain so because they are cost-effective. Second, legislation has given segments of the population rights to government-supported prescription services. 'Estimates are that the Medicare catastrophic act will lead to a 40% to 60% increase in normal outpatient prescribing patterns for the elderly. The third reason is cost con-
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The skills of pharmacy practice, formally taught in the pharmacist's education, must be refined and put to the service of the patient. Manasse concludes that this trend "will also require us to step outside of the sheltered cloister we call the 'pharmacy section' and get face-to-face with patients and prescribers. Most of all, it will demand that the bond with the patient supersede the bond with the almighty dollar." ®
tainment. The low cost of pharmaceuticals, their efficacy relative to other treatments, and studies that indicate that elderly patients treated with drugs have lower hospital-admission rates all support the likely continuation of the current trend.
Median Family Income Increase Slight After Inflation Adjustment
A
• In 1987, median family income varied considerably by race and ethnicity. White families had a median income of $32,274, compared to $20,306 for Hispanic families and $18,098 for black families; • From 1986 to 1987, black families experienced a 1% decline in median income, while Hispanic families' income decreased by 2%. The profile was compiled by Cecilia Ottinger of the Division of Policy Analysis and Research of the American Council on Education and was published in Higher Education & National Affairs (February 13,1989).@
fter adjusting for inflation, the 1987 median family income was $30,853, or only a 1% inflationadjusted increase over 1986, reports the U.S. Bureau of the Census. Other data in the report are: • From 1982 to 1987, median family income increased 12% after adjusting for inflation; • In 1987, the median income of families headed by college-educated adults was $46,533, compared to $29,937 for families headed by high-school-educated adults; • Female-headed families, with no husband present, had the lowest median income in 1987: $14,620; Income in thousands
D
32.3
1982 1987
Median Income by Race and Ethnicity (in 1987 dollars)
$
White * Persons of
American Pharmacy, Vol. NS29, No.5 May 1989/319
Black
Hispanic* /
Hispanic origin may be of any race.
11
Pharmaceuti'cals Are They Merely a Commodity? s long as the research-intensive pharmaceutical industry continues to produce chemical and biologic agents that prove superior in the management of illness, pharmaceuticals will replace other fonns of therapy," states Henri R. Manasse, Jr., PhD, in Wellcome Trends in Pharmacy (February 1989). "Is it any wonder, then," Manasse asks, "that big business has latched on to the prescription marketplace , as the area to do its bidding? There is a profit to be made and, notwithstanding the cries of community pharmacy owners and managers, commercial enterprises [such as mail-order pharmacy] with little concern for the patient will continue to exploit the pharmaceutical needs of the patient." One of the most significant effects of the bottom-line approach to dispensing is the changing of a prescription order to a "mere commodr ity." The net result has the typical pharmacy asking the question, ! "How many prescriptions did we , sell today?" Although many potential solutions have been discussed or proposed, Manasse says the only way for the community pharmacist to put an end to mail-order prescription sales is to make the option so unattractive to the patient that such companies will simply die a slow death. In order to effect such , a change, pharmacists must prove their unquestionable worth as patient counselors. Manasse points out three reasons that pharmaceutical agents will continue to playa major role in the marketplace. First, drugs are the mainstay of noninvasive therapeutics and are likely to remain so because they are cost-effective. Second, legislation has given segments of the population rights to government-supported prescription services. 'Estimates are that the Medicare catastrophic act will lead to a 40% to 60% increase in normal outpatient prescribing patterns for the elderly. The third reason is cost con-
A
I
The skills of pharmacy practice, formally taught in the pharmacist's education, must be refined and put to the service of the patient. Manasse concludes that this trend "will also require us to step outside of the sheltered cloister we call the 'pharmacy section' and get face-to-face with patients and prescribers. Most of all, it will demand that the bond with the patient supersede the bond with the almighty dollar." ®
tainment. The low cost of pharmaceuticals, their efficacy relative to other treatments, and studies that indicate that elderly patients treated with drugs have lower hospital-admission rates all support the likely continuation of the current trend.
Median Family Income Increase Slight After Inflation Adjustment
A
• In 1987, median family income varied considerably by race and ethnicity. White families had a median income of $32,274, compared to $20,306 for Hispanic families and $18,098 for black families; • From 1986 to 1987, black families experienced a 1% decline in median income, while Hispanic families' income decreased by 2%. The profile was compiled by Cecilia Ottinger of the Division of Policy Analysis and Research of the American Council on Education and was published in Higher Education & National Affairs (February 13,1989).@
fter adjusting for inflation, the 1987 median family income was $30,853, or only a 1% inflationadjusted increase over 1986, reports the U.S. Bureau of the Census. Other data in the report are: • From 1982 to 1987, median family income increased 12% after adjusting for inflation; • In 1987, the median income of families headed by college-educated adults was $46,533, compared to $29,937 for families headed by high-school-educated adults; • Female-headed families, with no husband present, had the lowest median income in 1987: $14,620; Income in thousands
D
32.3
1982 1987
Median Income by Race and Ethnicity (in 1987 dollars)
$
White * Persons of
American Pharmacy, Vol. NS29, No.5 May 1989/319
Black
Hispanic* /
Hispanic origin may be of any race.
11