It is estimated that there are more than 330,000 pharmacists in America,1 and demand is expected to grow as the health care model evolves to prioritize a more clinically integrated, value-based system. The pharmacist today—whose role has historically been limited to dispensing medications—has more clinical responsibility than ever before and is uniquely positioned to enable patients and their care teams with the resources and support needed to both access and adhere to essential medications.
Even so, across the health care ecosystem, burnout and labor shortages have created a more fragmented patient experience. Add to that the rise of retail pharmacy closures, and people are increasingly challenged with accessing the medications they need. Pharmacists are one of the most frequent touch points in a patient’s care journey and interact with patients twice as often as a physician, making this a vital role in the care team.2 Over the last decade, pharmacists’ responsibilities have grown to include patient education, initiating therapies, and in some states, prescribing rights. These abilities help to achieve optimal health outcomes, improve quality and safety, and ensure continuity of care.
Pharmacists Can Alleviate Common Barriers to Access
With their growing responsibilities and close patient relationships, pharmacists can help patients navigate common barriers to access. In particular, they can alleviate 3 of the most common barriers: limited access in rural and hard-to-reach communities, inconvenient or inaccessible sites of care, and financial barriers.
Limited access to care is common in rural and hard-to-reach communities.
Individuals living in rural and hard-to-reach communities often have limited access to health care, which means pharmacists can be one of the most accessible and consistent points of care. Patients and their providers rely on pharmacists’ depth of knowledge about health conditions to advise patients about the right therapies, diagnoses, and adverse effects, and to track outcomes.
One of the reasons this is important is because approximately 1 in 4 neighborhoods—disproportionately in underserved and rural communities—are pharmacy deserts,3 and additional barriers such as transportation, clinical shortages, or other social inequities can make it difficult for people to access essential medications. Additionally, more people are seeking an experience that mirrors the convenience found in other retail sectors, including direct-to-consumer and home delivery, when appropriate. In these cases, virtual and mail order pharmacy care can help facilitate access to pharmacy care and provide convenient solutions. For example, if patients choose to have their medications delivered to their homes, some programs also provide 24/7 access to pharmacists.
Rural or hard-to-reach communities also typically have higher populations of un- or under-insured populations with low vaccination rates, providing an opportunity for pharmacists to educate people about preventable disease and the importance of vaccines.
Site of care is often inconvenient or inaccessible.
Another common barrier to pharmacy care is location, limited hours, and long wait times, especially for the many patients who require intravenous medications such as immunotherapy or antibiotics to treat acute and complex conditions. Access to infusion medications for these acute and complex conditions are often necessary to sustain life.
Infusion pharmacists can work with patients to determine a site of care strategy that is comfortable, convenient, and cost-effective for their individual medication and dose regimen. This might include receiving therapy at an infusion pharmacy or suite, like Optum Infusion Pharmacy, where there are extended hours on nights and weekends, or in the comfort of a patient’s home. Pharmacists can collaborate with infusion nurses and prescribers to appropriately compound and administer these life-sustaining medications.
Yet again, pharmacists have an opportunity to be experts on these acute and chronic conditions. In fact, physicians today rely on the pharmacist to extend the care experience and provide disease-specific education and support. More consumers are also taking an active role in their health, which makes it important to deliver knowledgeable, specialized care.
About the Author
Chris Stidman was named president of Optum Rx Integrated Pharmacies in November 2021. In this role, Chris is responsible for driving performance and overseeing strategic direction and financial management of Optum's pharmacy services, which includes Genoa community pharmacies, specialty pharmacy, orphan drug and rare disease pharmacy, and home delivery and multidose packaging solutions.
Financial barriers, including the rising cost of specialty medications, present significant challenges.
Adherence is a critical step in medication management and is linked to better health outcomes, but prescription drugs are useless if patients cannot access or afford them. In fact, data show that 1 in 4 people have a difficult time affording their medication, with more than half likely to abandon their medication when it is $250 or more.4,5 Pharmacists play a leading role in educating patients about financial assistance resources and helping them identify less expensive medications, such as biosimilars and generic drugs.
Affordability is especially important for specialty medications, which can cost up to 13 times more than brand name, non-specialty drugs. Patient assistance options from pharmaceutical manufacturers and non-profit organizations exist, but patients may not know about them or may be reluctant to ask for help. With the help of new tools and technology, pharmacy teams can help minimize barriers to access and automatically connect patients with financial resources.
Pharmacists can be a part of a patient’s care journey from the moment they are prescribed a therapy, and ongoing through dose optimization and adverse effect management. Before ever dispensing a drug, pharmacists educate patients about the medication, work to understand their personal goals for quality of life, and monitor them throughout therapy to ensure outcomes and goals are met.
Across the industry, pharmacists are demonstrating their ability to serve as a navigator for patients, partner with prescribers, and improve the overall care experience. As we see a shift toward more value-based care, continued coordination across stakeholders will be key to ensuring access and achieving optimal health outcomes.
REFERENCES
1. Pharmacists: Occupational Outlook Handbook. Updated August 29, 2024. Accessed October 16, 2024. https://www.bls.gov/ooh/healthcare/pharmacists.htm
2. Valliant SN, Burbage SC, Pathak S, Urick BY. Pharmacists as accessible health care providers: quantifying the opportunity. J Manag Care Spec Pharm. 2022;28(1):85-90. doi:10.118553/jmcp.2022.28.1.85
3. ICYMI: Maps show increased closures and pharmacy deserts. News release. NCPA. June 20, 2024. Accessed October 16, 2024. https://ncpa.org/newsroom/qam/2024/06/20/icymi-maps-show-increased-closures-and-pharmacy-deserts
4. Poll: Nearly 1 in 4 Americans Taking Prescription Drugs Say It’s Difficult to Afford Their Medications, including Larger Shares Among Those with Health Issues, with Low Incomes and Nearing Medicare Age. News release. KFF. March 1, 2019. Accessed October 16, 2024. https://www.kff.org/health-costs/press-release/poll-nearly-1-in-4-americans-taking-prescription-drugs-say-its-difficult-to-afford-medicines-including-larger-shares-with-low-incomes/
5. Campbell H. 69 percent of patients abandon medicines when cost sharing is more than $250. PhRMA. August 23, 2018. Accessed October 16, 2024. https://phrma.org/en/Blog/69-percent-of-patients-abandon-medicines-when-cost-sharing-is-more-than-250