A Bright Future for Hospital Pharmacy

For hospital pharmacies, the coronavirus disease 2019 (COVID-19) pandemic sparked an abrupt and intensive reevaluation of nearly every aspect of their operations, from the logistics of drug procurement to the relationships that are so critical to delivering quality care. As difficult as it may be to imagine today, the pandemic eventually will be under control. Exactly how and when that will happen is unknown.

But now is the time for pharmacies to determine what changes to keep as they move forward—and to ensure they have the right partners to support a bright future.

The state of hospital pharmacy

The pressure on hospital pharmacies was immense for those in the Northeast, the epicenter of COVID-19 at the start of the pandemic. At the same time, it challenged pharmacists and their vendor partners to work together to rise to the occasion.

“I saw a lot of people maturing rapidly, because they had never experienced anything like this before,” said Robert Bepko, senior director for Network Pharmacy Services, Nuvance Health.

Bepko was part of a pharmacy team in which the health system’s 7 hospitals combined their resources to help treat the virus.

“Working hand-in-hand with our pharmaceutical distributor, we are proud to say that not 1 patient in the 7 hospitals went without the drugs they needed,” he said.

New ways of working together

For Nuvance Health, McKesson’s newly created Critical Care Drug Task Force was instrumental in helping them to overcome supply chain challenges that emerged as the pandemic gained ground. The team of pharmacists, administrators, and procurement specialists used data analytics to track trends in COVID-19 treatment to understand the use of different drugs and what supply volumes hospitals would need.

The task force is already expanding its analysis to include non-COVID-19 drugs to help pharmacies maintain the same level of visibility and confidence post-pandemic. The team is also looking beyond medications to items such as needles, syringes, and personal protective equipment to develop predictive models for procurement and supply assurance.

In these scenarios, pharmaceutical distributors are evolving into business subject matter experts for distribution-related groups, whether they need data and analytics, procurement forecasts, or customer interaction information.

The role of pharmacists as health care providers

Bepko believes that the value of professional pharmacists in the health care industry has long been underestimated. But COVID-19 elevated the pharmacist’s role, since the knowledge of how drugs work and what treatments might be useful for the virus was so important.

In hospitals, pharmacists were key in setting up temporary COVID-19 units and field hospitals, particularly with patients on ventilators.

“Titration for people on ventilators is an art,” Bepko said. “With pharmacists rotating in those intensive care units, their services were well appreciated.”

The pandemic has indeed underscored the essential role of pharmacists in patient care. Yet in order to continue elevating the profession, it’s up to pharmacists to get involved beyond the walls of their own health systems. Being more active in health system pharmacist societies, for example, helps encourage those in the profession work together and more collaboratively.

Telemedicine and digital connections are here to stay

One of the biggest changes to health care as a whole has been the evolution of telemedicine. The technology for virtual health care has been in place for years, but widespread quarantines forced both physicians and patients to interact outside of the office setting.

Telemedicine will play an increasingly important role in the interaction between pharmacists and patients, as well as colleagues and supply partners. Connecting digitally provides flexibility in the day-to-day operation of a health system pharmacy and increases medication management efficiency. Distributors are able to interact more frequently with pharmacies to keep needed medications in stock and learn what back-up supplies are most beneficial.

Patient assistance programs and revenue recovery

The wide-scale unemployment that resulted from the COVID-19 pandemic meant that many people lost their employer-provided health insurance. Hospitals admitted critically ill patients with no assurance of reimbursement for expensive treatments.

Fortunately, many pharmaceutical manufacturers allowed their products used for COVID-19 treatment to be eligible for patient assistance programs (PAPs). According to McKesson customer data, some hospitals have already seen a 15% increase in identified patients needing financial support.

Until the unemployment rate improves, the population in need of financial help will remain high. Several states have expanded Medicaid; however, if other states follow suit, the type of assistance patients are eligible for may shift from PAPs to programs that help patients afford what insurance does not cover—such as co-pays and deductibles.

The importance of partnership

When a crisis such as COVID-19 strikes, pharmacies focus on having the drugs and supplies they need, when they need it. In some cases, however, getting what they need takes time.

Manufacturers or ingredient suppliers may be out of the country, using inexpensive shipping methods to keep costs down, but extending the length of the supply chain. Health systems not only deserve transparency on these issues, they also need a distribution partner with advanced data and analytics capabilities to find and reallocate products to pharmacies with immediate needs.

Bepko acknowledged that the performance of his pharmacy team was closely tied to a strong partnership with their vendor.

“We were confident when we reported our supply status twice a day that McKesson was doing everything it could for us,” he said. “I was able to get on network calls with hospital presidents and chief medical officers and assure them that every location would have what it needed for the next 72 hours, regardless of patient influx. You have no idea how that picked up everybody’s spirits.”

As scenarios such as these so vividly illustrated during the height of the pandemic, the future of pharmacy depends on close relationships between distributors and pharmacists. For example, field account managers can help pharmacists focus on progress by listening to their needs and filling that gap—either by enhancing a current product or developing a new one.

What’s next?

The health care industry continues to rise to the challenge of maintaining supplies in a changing treatment environment. To continue that trend of success, pharmacists must use the lessons learned during COVID-19, refining the adaptations that worked and moving on from what didn’t.

Perhaps the most vital lesson to remember moving forward is the importance of collaboration. Working with trusted partners, hospital pharmacies can solve today's problems and explore new opportunities, ensuring a bright future after COVID-19.