Experts: The Pharmaceutical Industry Is Settling Into a “New Normal,” 2.5 Years Into the COVID-19 Pandemic

In an interview with Pharmacy Times at the National Association of Chain Drug Stores (NACDS) 2022 Total Store Expo, Scott Biggs and Doug Long of IQVIA discussed where the pharmacy industry stands now and what they predict for the future.

Q: The COVID-19 pandemic upended pharmacy trends and the trajectory of the pharmacy field. Now, nearly 2.5 years into the pandemic, do you see the dust settling?

Scott Biggs: Yeah, we see the dust settling, we're kind of settling into it. Doug and I have been talking a lot about a new normal, you know, where we're seeing things kind of come back to almost to where we saw them pre-pandemic levels. You know, we see new Rxs is settling back in, we see acute care kind of returning back to where they were. I think prescribing patterns are starting to settle back in, but we're really calling it a new normal. We're not exactly where we were, but the IQVIA Institute predicts that probably by 2023, we'll see things kind of returned to where they were pre-pandemic levels.

Doug Long: Yeah, and now we're dealing with inflation. It's hard to tell what that's going to mean. Generally, health care is kind of immune from inflation, but we have this health care index. And while the new Rx is recovered, the elective procedures are down there, they've never recovered. And I would think that with inflation, that might be a decision people are making, [saying] we're going to postpone that. Then, you know, part of the new normal is that we lost a million people in United States, 70% of them were over 65. And they're the ones that use the most prescriptions. But, you know, COVID-19 was a big boost to retail pharmacy and that's kind of washed away now, and they're still growing.

Q: One of the major trends has been the push for provider status. Do you see this happening in the future and if so, how would it change the health care system?

Scott Biggs: Yeah, I think the retail pharmacy really stepped up. And really, people got to see pharmacists already a trusted profession by everybody, I think. And retail pharmacy really stepped up with their role in providing COVID vaccines. And we've seen NACDS provide some information that shows Paxlovid has now been able to specify all 50 states and there are other things are allowed to be dispensed. We see the number of services that pharmacists can provide continuing to grow, and more and more state to authorizing different services levels in pharmacy. So, I think that's going to be something that continue to grow, as they see, as a consumer sees, retail pharmacy as another place to be a health care provider.

Doug Long: That's probably going to be the destination for most kinds of vaccines now that he did the flu, they stepped up, you know, on COVID. And why not do the rest of them there?

Q: Can you discuss Paxlovid and any data around the use of that, as well as how pharmacists’ prescribing authority impacts accessibility and the use of it?

Scott Biggs: Paxlovid, all 50 states have allowed the pharmacists to administer Paxlovid. The challenges that I think some of the pharmacies are seeing is that there has to be testing done to determine exactly is it COVID-19, things like that. So, there's some challenges there. But we continue to see it increase in volumes across the different classes of trade chain being the largest one.

Doug Long: One of the challenges that overriding this or underlying this, is that staffing. It’s how you do the things you used to do? And how do you do the new things? But so far, they've overcame that because think about last year, they were doing flu vaccines the same time that you’re doing COVID-19 vaccines. So, they stepped up but you know, there's staffing shortages. Some pharmacies are cutting hours, particularly shortage on technicians. So that's a big concern.

Q: The pandemic also upended pharmaceutical trends in terms of what drugs were utilized, what patients could access, etc. Have these trends returned to normal?

Scott Biggs: We're talking about the new normal. So, if you look back in time, what was affected most was new prescriptions for acute drugs. How do you get those when doctors’ offices are closed, hospitals were closed, institutions are closed, of course telehealth stepped up. At one time that was 50% of all the visits are telehealth, and now it's down to about 4.

Doug Long: Yeah, we talked during the height of the pandemic, we saw acute and new really dropped down. Maintenance and refills stay constant through that whole time. So, there's no problem there. People were switching to 90-day scripts, they didn't have to go out as much. And I think that we're seeing some of those patterns return.