Posts

Advocacy Event Reflection

Before taking this class, I had never even heard of the Ohio Pharmacists Association, otherwise known as OPA. Because I didn’t know that much about the organization, other than the fact that it lobbied the Ohio state legislature on healthcare and pharmacy related legislation, I didn’t really know what to expect from their Student Legislative Night event. I knew that it was some sort of precursor event for their Student Legislative Day event that was apparently happening pretty soon, but since I couldn’t go to it, I also wasn’t too sure how this event would benefit or affect me too much. And to be completely honest, I chose to go to this event mostly because I didn’t really have any other choice due to my classes. Despite all of my doubts though, I can say it was definitely worth more than I had originally thought.

What is OPA?

Before I go into the actual event itself, I’d like to talk a little about OPA itself. The Ohio Pharmacists Association is exactly what it sounds like: it is an organization for pharmacists who live in the state of Ohio. They work to better the situation for all pharmacists in the state and like most organizations today, there are elected officers, a board of trustees, and different subcommittees. While they’re not a purely political group, as far as I’m aware, most of the change they do comes from working with the state legislature and the Ohio Board of Pharmacy to pass legislature and rules.

OPA Student Legislative Night

This event featured three keynote speakers: Dr. Cathy Kuhn (the current president), Dr. Megan Marchal (who was also a member of the Ohio Board of Pharmacy), and Antonio Ciaccia (OPA’s lobbyist and Director of Government and Public Affairs). They each spoke about their own experiences, starting from how they got into pharmacy in the first place to how they got involved with OPA and what they do. I was really surprised to learn Dr. Kuhn hadn’t really participated in advocacy during her time at pharmacy school but was still able to climb to such a high position in the organization. Her main message, which was reiterated by the other speakers, was that whenever life presents an opportunity, say yes!

From Dr. Megan Marchal, I learned more about the Ohio Board of Pharmacy. It was interesting to see how OPA’s work intersected with her job at on the board, since the board was in charge of enforcing regulations and deciding how such regulations would be enforced. By having OPA work to have Congress give more freedom to the board, it allows for their professional input and allows them to quickly adapt regulations, rules, and laws in a way that works well for other professionals. Even though we already heard from Antonio Ciaccia in class, he was asked about what he thought was the most important problem facing pharmacists right now and I found his answer very fascinating. He talked about how the pharmacy benefit management industry is a huge mess right now and costing retail pharmacists. Apparently, the reimbursement program is costing retail pharmacists money and are a major reason why independent pharmacies have been closing.

Final Reflection

To be honest, I don’t think I was really part of the direct audience for this event because it was for to-be pharmacists in pharmacy school. However, I still found it to be interesting and I learned quite a bit from it. I had hoped to hear a bit more than just personal stories and not just about OPA’s influence on retail pharmacies. However, I believe this will be a good opportunity for me to do some research and find my own opportunities.

Hot Topics Discussion Reflection

Before this discussion, I really wasn’t aware that mandatory counseling, the idea that pharmacists would be required to counsel patients  was an issue in the pharmacy world. Because of this and my fairly brief research into the topic, I found that it was a little difficult for me to clearly take a side. Also, since I’ve never worked in a pharmacy before, I didn’t feel like I really had the tools available to form an educated opinion. Despite all of that, however, before the discussion, it seemed to me that overall, mandatory counseling was great in theory, but bad in practice.

Since my personal experience and knowledge was limited, I decided that focus my research on the opinions of pharmacists who worked in states with mandatory counseling. Fortunately, I was able to find forum posts like this one from Student Doctor or this one from the Pharmacy Subreddit. It seemed that the common consensus on the form was that mandatory counseling was added too many interruptions and heavily increased the workload of a pharmacist. Obviously, these posts don’t offer the viewpoint of every single pharmacist and it’s likely that those with a negative view of the law were more likely to post and complain about it. I do think, though, that it provided a realistic look into the problems someone might have to deal with in this situation.

Post-Discussion Thoughts

I was honestly pretty surprised at how complex this issue really was. The discussion really helped me see both sides better, thanks to the experiences and ideas offered up by others. For example, while productivity in a pharmacy is likely going to decrease, it will help patients stay knowledgeable about their medication, especially if they’re given the opportunity to ask questions they might otherwise not ask. There are the benefits to pharmacists as well. I hadn’t really thought about how mandatory counseling could provide a source of job security for pharmacists. A major issue in the pharmacy world, according to the article Future Reduction in Retail Pharmacist Jobs Explained by Jason Poquette for the Pharmacy Times, is that automation and more supportive personnel in the pharmacy are decreasing the need for an actual pharmacist. If each patient is required to be counseled by a pharmacist when they receive a prescription, obviously there needs to a pharmacist available to counsel the patient. Also, forcing pharmacists to counsel will allow them to take mental breaks and keep them from doing one task for too long.

The discussion also helped me see new negatives as well. This kind of law would increase costs for the state government because they would need to pay inspectors to make sure pharmacists are actually following the law. And without an actual law to discuss, a lot of a questions cropped up during the discussion. Would this law only affect retail pharmacists or would hospital pharmacists have to comply as well? How would counseling work with mail-orders or with someone else picking up the prescription? Who’s going to pay for the extra costs? Unfortunately, with so many questions and unknown details, I find it hard to support a legislation of this kind. For now, that means I am against mandatory counseling.

Discussion Reflection

Overall, I enjoyed the discussion. It was really nice to listen to those with differing perspectives on an issue I didn’t really know too much about. There were many arguments I would not have thought of myself. While splitting the discussion into a pro half and a con half was useful in breaking down the issue, I think the format restricted any type of free-flowing conversation we could have had. I personally would have preferred coming into the class and just sitting down and going back and forth between the issues, it did help keep the discussion on topic and gave it some sort of structure.

Pharmacy in the Media

The NPR article Rural Hospitals Struggle To Stock Expensive Drugs That Could Save Lives and it’s accompanying radio segment is a perfect example of probably the biggest problem regular people have when they think about pharmacy: high drug prices. This article talks about how certain drugs that treat rare diseases are much more expensive for rural hospitals so it becomes much more difficult for these hospitals and hospital pharmacists to keep life-saving drugs stocked. According to the article, Activase, a drug that can save people suffering from a stroke by busting blood clots, cost a rural hospital in Arkansas an outrageous $8,010 per dose! Even more shocking, however, is the fact that a larger hospital less than 40 miles away was able to buy the drug for $1,600 per dose!

 

Differences in Drug Costs

The reason why there is such an absurd difference is thanks to some laws. Something called the 340B Drug Pricing Program allows for eligible hospitals that serve low-income populations to buy certain medicines for a lower cost. While this is a very helpful program, unfortunately, it excludes rural hospitals. When the Affordable Care Act (better known as Obamacare) was passed in 2010, rural hospitals were added to the program. However, rural hospitals were still unable to get discounts on expensive medication that treated rare diseases, thanks to an exclusion added into the ACA. Because of these laws working together, rural hospital pharmacists find it much more difficult to keep expensive drugs in stock.

 

What this Means for Pharmacists

Unfortunately, or maybe fortunately, this problem won’t directly affect many pharmacists because it is such a specific one. Still, people’s lives are at risk and this should especially relevant here because there’s a lot of rural land in Ohio. To the pharmacists who may choose to work in a rural hospital, this is just another problem they will have to deal with. They may one day have to struggle with problem of losing a patient because a life-saving drug was too expensive to keep in stock. Indirectly, however, the entire profession of pharmacy is affected because this is only a extreme example of a much larger problem. High drug costs are a problem for both consumers AND pharmacists and the fight to keep them down is a continuous battle. In fact, an article published by Reuters earlier this month shows that drugmakers are already raising prices on drugs. The article does say that the rises in drug prices have been slowing in the past year, but that doesn’t mean we must let down our guard.

 

A Few Closing Remarks

NPR is one of my most trusted American news sources, and while bias does exists, I believe that it does a great job of reporting news accurately. Since this is a news article, I don’t really think pharmacy itself is framed in a strictly negative or positive light. It highlights a problem pharmacists face and I don’t think it would have benefited from any additional bias. Either way, I’m glad that they are bringing attention to smaller and “less exciting” issues like these high drug prices in rural hospitals because they’re still important, they still impact Americans, and so they still deserve to be heard.

Original Article: https://www.npr.org/sections/health-shots/2017/09/15/550179668/rural-hospitals-struggle-to-stock-expensive-drugs-that-could-save-lives

340B Drug Pricing Program Information: https://www.hrsa.gov/opa/

Reuter’s Article: https://www.reuters.com/article/us-usa-healthcare/drugmakers-raise-2018-u-s-prices-stick-to-self-imposed-limits-idUSKBN1ER1UL

What is Pharmacy?

 

What is Pharmacy?

As a first year student in the Bachelor’s of Pharmaceutical Sciences program, this is a question I really think about a lot and I expect its answer will change a lot for me in the next 3.5 (or more?) years.  I think to the majority of people, pharmacists are the people who work at Walgreens or CVS and provide customers the medication that they need. To be quite honest, I’ll admit that I also thought this way for quite a long time.  Now, as I’m carefully exploring the world of pharmacy, I’m learning just how pivotal the role of pharmacy is to a team of health care providers and to the community. While I’ve still got a lot to learn, I know not to understate the importance of pharmacy.

 

The Roles of Pharmacy

I think what’s really interesting about pharmacy is how many different fields it can cover. Besides working in a community pharmacy to dispense medication, pharmacists can work in a hospital. They’ll work with other health care providers and with patients to ensure that the patient is taking the drugs safely and that they are the best fit. However, many people may choose to steer away from patient care. They can work with the government or pharmaceutical companies to regulate the industry and make sure it is safe and fair to everyone involved. There are many who choose to work within the pharmaceutical industry as well to sell drugs or research (whether it’s clinical or development related) drugs. And, of course, many people in the world of pharmacy will go into academics.

 

The Impact and Importance of Pharmacy

Obviously, the impact and importance of pharmacy on both the patients and the community cannot be downplayed. Patient safety is the number one priority, so making sure that the benefits of a medication are not outweighed by the drawbacks is an important job for pharmacists. They’ll use this information to give important advice to physicians and others in the health care industry. Pharmacists will also educate patients on the usage of different drugs. Beyond patient interaction, however, there is a lot that happens behind the scenes. As more individuals become increasingly involved with their own health care, pharmacists are important as they work on reducing the costs of medication or improving how well the drug works or reducing their side/toxic effects. It’s honestly a little strange thinking how different (and dangerous!) the world would be without pharmacy.

 

What Pharmacy is to Me

To me, pharmacy is a lot more than just the drugs. While I know that there are some people who may question my decision to pick this area of study, I feel like there is a lot more to pharmacy than people usually think of. The influence a pharmacist can have on a patient and a community and the sheer number of different areas a pharmacist can impact is really what makes this field stand out to me. Since I’m so new to the world of pharmacy, I admit that I’m not the most knowledgeable about it. But, I’ve got to say that that only makes more more excited about it since I have so much to learn.