Pharmacy in the News: Hospitals Manufacturing Drugs?!

The following post is a response to the following articles published by the New York Times.

URL Link: Fed Up With Drug Companies, Hospitals Decide to Start Their Own

To summarize the article, a group of hospitals (~ 300), led by Intermountain Healthcare, a nonprofit hospital group based in Salt Lake City, is attempting to start their own drug manufacturing company. The main goal of this company is to supply these hospitals with medications at a reasonable price. However, the important take-away from this article is not just this new model for medication supply management, but the reasons for why these hospitals have decided to invest in drug manufacturing. While one of their main reasons was to avoid any drug shortages in the future, the main reason is hinted at by the title of the article itself; disgusted by some of the business practices of some drug manufacturers, these nonprofit hospital organizations has decided to ban together and strike back at investors who needlessly raise prices on important medication in order to profit off of patients and hospitals.

One notorious example involves the generic drug, Daraprim. The modus operandi of these investors is to secretly acquire all of the manufacturers of an off-patent drug in an attempt to monopolize the supply of that drug. Once a monopoly has been established, they will then raise the price of that drug significantly. In this way, Daraprim’s price went from $13.50 a pill to $750 almost overnight. This move, from the healthcare community,  is a statement that they will not stand by while profiteers seek to benefit from the poor and desperate.

On an alternate note, another reason that this hospital-focused manufacturing organization is being established is to prevent or minimize the effects of drug shortages on patient care. Even now, hospitals nationwide in the U.S. are still feeling the effect of drug shortages caused by natural disasters which occurred a few months back. For more information on this, please refer to a side article noted below.

URL link: U.S. Hospitals Wrestle With Shortages of Drug Supplies Made in Puerto Rico

The drug shortages are caused not only because medicines are being diverted to Puerto Rico as part of a relief effort, but also because many major drug manufacturing companies, like Baxter and Mylan, have bases located Puerto Rico whose operations were interrupted by the storm, Hurricane Maria. Supplies of commonly used drugs, like Tylenol, and more critical drugs, like HIV-treating drug Prezista, have been reduced and becoming scarce due to the storm. And while supplies of drugs are in shortages, other medical supplies are being affected too. For example, shipments of mesh and surgical scalpel that comes from the island has been reduced.

This move by Intermountain Healthcare to supply their own medication is a brilliant one. If other managed care organizations can follow their example, it will solve both the immediate problems like drug shortages and monopolies and also long-term problem of rising healthcare costs. This plan, named Project Rx, will allow healthcare organizations to more easily control the cost of medication production and cut out any unnecessary middlemen.

 

 

What is Pharmacy?

So this is one of the broadest question to be answered in a blog. The fact is, many of us go to school for years in order to learn what pharmacy is so it is almost impossible to summarize all or our experience on one blog page. Instead, I want to focus the topic of this blog on common misconceptions of what is pharmacy. A quick google search for the definition of pharmacy will give you these results:

“a store where medicinal drugs are dispensed and sold” and “the science or practice of the preparation and dispensing of medicinal drugs”.

While the first definition will often give the common folk a false impression that pharmacists are just glorified drug dealers, the second definition is much closer to the truth. However, I think that this definition is still lacking. It forgets to mention anything about the pharmacists and their role in patient care and controlling healthcare costs. Given that that this is meant to be a simple, short definition, it is still the first  thing that pops up in a google search. When I scroll down a little further to a college of pharmacy website and a wikipedia website, those two presented more thorough definitions. The definitions respectively are:

  1. “Pharmacists are medication experts who use their detailed knowledge of medicines to help patients get well. The methods they use vary from one practice setting to the next….”
  2. “Pharmacy is the science and technique of preparing and dispensing drugs. It is a health profession that links health sciences with chemical sciences and aims to ensure the safe and effective use of pharmaceutical drugs.”

One of the biggest misconception about pharmacy that almost every pharmacy student knows is the belief that pharmacists only count pills. I think one of the biggest reason for this misconception may that most pharmacists only meet their patient face-to-face at a retail pharmacy counter. Pharmacists who works for the private industry or hospitals may not get the chance to see their patients as often. This leads the general public to believe that pharmacists only ever works at a retail store. Another reason for this misconception may be that patients are never made aware about the complex machinations driving medication safety, efficacy, and finance. All of these are services that pharmacists perform without the patient ever knowing, nor would they need to know. Furthermore, pharmacists usually offer free services which the patients can sometimes take for granted. One example would be the offer to counsel. Based on my experience in retail setting so far, a good majority of the patients would usually refuse the offer either because they have taken the medication before or because they have discussed it with their physicians.

Given the causes for the misconceptions of the pharmacy profession, patient education alone is not enough to clear up the confusion. Pharmacists need to be allowed to perform more patient care services which falls within the scope of their expertise and be recognized and paid for these services. This is why advocacy is so important; it raises awareness and can get appropriate laws to be passed. I believe the attainment of provider status for the pharmacy profession is a step in the right direction and is a necessary step for the pharmacy profession to define itself and clear up any deeply-rooted misconception.