Greater Pharmacist Role Improves Pharma Supply Chain Management

Components of the Pharmaceutical Supply Chain

The pharmaceutical supply chain comprises many stakeholders, including manufacturers, wholesale distributors, pharmacy benefit managers (PBMs), regulatory organizations like the FDA, and pharmacists. A wide range of stakeholders is involved in the varying components of the pharmaceutical supply chain, including manufacturers, distribution systems, drug procurement, medical decision-making, other pharmacy services, and more.

Each stakeholder is critical in getting patients their medications at an appropriate time. For example, manufacturers are responsible for sourcing each drug product’s material and creating the drug supply.

Beyond obtaining the resources for drug development, manufacturers, often led by pharmaceutical companies, may also be involved in drug development or research, packaging products, and distribution to patients and healthcare facilities.

As products enter the pharmaceutical supply chain for manufacturing and distribution, they are regulated by the United States Food and Drug Administration. In addition to initial market approval, the FDA is also responsible for monitoring ongoing production and overseeing all manufacturing for pharmaceutical products sold in the US to ensure that therapies are safe and effective.

The FDA also manages recalls and drug shortages, disseminating information to healthcare professionals and industry leaders.

Other players, including PBMs, are positioned to negotiate drug prices with pharmaceutical manufacturers. As costs change, the pharmaceutical supply chain adjusts to varying costs and demands. While the concept of pharmacy managers had good intentions, recent criticism has claimed that PBMs do not benefit patients, the pharmacy network, or the pharmacy supply chain as intended since they often pocket much of the “savings.”

Pharmacist’s Role

Finally, pharmacists play a considerable role in the supply chain process. According to the US Bureau of Labor Statistics, there are four different kinds of pharmacists: community, clinical, consultant, and pharmaceutical industry pharmacists. Each type of pharmacist has a slightly different job description, taking on varying roles in the supply chain and its management.

Community pharmacists — retail pharmacists — are the most widely known type of pharmacist. They can be found at chain drug stores or independent pharmacies. One of their most critical roles in the pharmaceutical supply chain is inventory management for their location, distributing products to patients, reporting any adverse side effects or shortages, and informing patients of recalls or other announcements relating to their prescriptions.

Clinical pharmacists have similar responsibilities to community pharmacists; however, they work in hospitals, clinics, and other healthcare facilities, providing direct patient care by looking at a patient’s holistic treatment plan.

Consultant pharmacists may also work at healthcare facilities or be hired by insurers to explain the appropriate uses for each medication type.

Finally, pharmaceutical industry pharmacists are known for their work with pharmaceutical manufacturers, conducting research, developing new drugs, and consulting on the marketing and safety of medications.

Complications in the Pharmaceutical Supply Chain

Considering the complex nature of the pharmaceutical supply chain and the high stakes, including patient outcomes, medication access, and manufacturer standing associated with the supply chain, many areas are susceptible to errors. Complications in the pharmaceutical supply chain may impact patient care, drug distribution, and overall public health.

The supply chain is continuously plagued by challenges that make management difficult, including visibility issues, drug counterfeiting, and high prescription drug prices. 

Visibility

In an article by TechTarget, Katie Terrell Hanna defines supply chain visibility as “the ability of parts, components or products in transit to be tracked from manufacturer to final destination.” Focusing on the pharmaceutical supply chain, a recent article by PharmaNewsIntelligence identified supply chain visibility as one of its top ten challenges.

Data published by McKinsey highlights results from a survey, noting that roughly one-quarter of pharmaceutical executives identified visibility issues as the primary source of vulnerability in the pharmaceutical supply chain. While adequate supply chain visibility is critical for reducing error margins, the pharmaceutical industry has yet to identify a visibility solution or management system that meets all its needs.

For example, most existing visibility solutions fail to account for variations in the pharmaceutical supply chains, including cold chain shipping, raw material availability, shipment security, stringent temperature, quality control measures, and high inventory costs, which make it unique from supply chains in other industries.

A lack of visibility into a supply chain can cause companies to lose track of their supply network, resulting in excessive or insufficient inventory at different points in the supply chain. Additionally, recent estimates found that more than 10% of all global pharmaceuticals are counterfeit because of poor visibility.  

Beyond the many options proposed for improving supply chain visibility, including end-to-end transparency, in-depth data analysis, and resilience metric reviews, it is critical that all stakeholders in the supply chain readily communicate to facilitate visibility.

High Drug Costs

Another challenge in the pharmaceutical supply chain is the high cost of prescription drugs. Globally, the US pharmaceutical supply chain has contributed to the highest drug prices among developed nations.

An analysis conducted by 46brooklyn determined that, in January 2023, 452 prescription drugs had a rise in drug list price. The median wholesale acquisition cost (WAC) increase for list price increases in January 2023 hovered around 5%.

According to the Centers for Medicare and Medicaid Services (CMS), Americans pay more than $1,500 per person for prescription drugs annually, significantly higher than other similarly developed nations.

Statista notes that Americans spent $577 billion on medicine in 2021, with projected growth in the coming years. Additionally, each US household spends an average of $422 on over-the-counter drugs yearly.

Comparatively, in the United Kingdom, consumers only spent $13.57 billion on pharmaceutical products in 2021.

Data and expert testimony have linked high drug prices to flaws in the pharmaceutical supply chain and its oversight.

There has never been a greater need to operate more efficiently and cost-effectively, Dennis Wright, senior director of product marketing at Omnicell, told PharmaNewsIntelligence. 

Personnel and Labor Shortages

Another significant challenge in the pharmaceutical supply chain is workforce shortages. The COVID-19 pandemic highlighted many gaps in the pharmaceutical supply chain, especially labor shortages. As many people were affected and experienced burnout due to the pandemic, it is clear that the pharmaceutical industry — especially pharmacies and pharmacists — is short-staffed.

“While staffing levels are diminishing, medication costs are skyrocketing, making the need to curb waste through tighter inventory control an imperative,” Wright said. 

Nationally, many pharmacies have been short-staffed, resulting in reduced hours and higher rates of burnout among remaining pharmacy workers. An article published in Drug Topics notes that 71% of pharmacists in 2019 reported a high or excessive workload contributing to burnout.

Despite an unusually high need for more pharmacists and pharmacy technicians, the US Bureau of Labor Statistics identifies a 6% decline in pharmacists between 2019 and 2021. Additionally, pharmaceutical employment is projected to grow 2% between 2021 and 2031, a significantly slower growth rate than other fields.

“Labor shortages can create a downward spiral. When an organization is short-staffed, those who remain face more stress and strain, leading to more resignations. The challenge of staffing shortages has reached a point where it puts patient care at risk,” Wright stated.

The Evolving Role of Pharmacists

As the supply chain adapts to changes from world events and industry growth, the role of pharmacists continues to evolve.

Experts believe that empowering pharmacists to become more involved in patient health management gives patients and caregivers a more personalized and proactive approach to care, helping facilitate improved supply chain visibility and control.

Pharmacists in the US are well-trusted by patients. They are projected to play an increasingly crucial role in healthcare management, offering safe and appropriate treatment options tailored to individual needs. 

In the Prescription of Trust report, researchers noted that, by 2030, most pharmacists will transition from transactional care to more direct patient care responsibilities. 

Pharmacists in ambulatory clinics, health systems, and home delivery pharmacies are at the forefront of this trend. About 80% of patients stated that they see pharmacists as an integral part of their healthcare system. 

Additionally, providers have a 90% trust in pharmacists’ activities, including dispensing medications, communicating with health professionals, counseling patients on their medications, and administering vaccines. 

Strengthening Pharmacists’ Supply Chain Role

An International Pharmaceutical Federation (FIP) report concluded that investment in training and education is needed to strengthen pharmacists’ roles in pharmaceutical supply chains.  

The key to optimizing pharmacists in the supply chain is real-time inventory visibility through a shift to cloud-based platforms, advancements in robotic technology, and integrated business intelligence solutions. 

Pharmaceutical automation reduces the risk of human error, eliminating some vulnerabilities in the pharmaceutical supply chain and improving efficacy. Many automation technologies can complete administrative or repetitive tasks, freeing up time for pharmacists and pharmacy technicians to care for patients and manage other critical supply chain components.

“Pharmacy is one of the highest cost centers in the health system and involves significant staff time across multiple disciplines such as pharmacy. Pharmacy leaders are being challenged to find opportunities to reduce overall medication spend and medication waste while driving better staff efficiency,” Wright said.

According to Drug Topics, Tom Gierwatoski, RPh, installed a dispensing robot in his pharmacy in 2016. Data from the article suggests that this automation boosts prescription volume by 50%.

This technology allows the pharmacy to automate in ways that can improve efficiency while ensuring reliability and reducing risk. 

Wright noted Omnicell’s launch of the IVX Station helps hospitals and health systems gain control of risky supply chains by allowing pharmacies to control the quality and availability of medications produced.  

These robotic solutions standardize workflows, improving dose accuracy and increasing therapeutic effectiveness. 

“Now is the time to elevate the pharmacist’s role to play a larger role in health system operations and patient care. Pharmacy leaders can build stronger relationships across the organization to streamline operations, improve outcomes, and ultimately deliver the safest, most efficient care for patients,” Wright stated.   

“Through an intelligent infrastructure of automation, data analytics, and technology-enabled services, pharmacies can improve medication safety, optimize the supply chain, and address the growing risk of pervasive staffing shortages,” he concluded.