The new Year is likely to involve a continued focus on the substantial impact of COVID-19 on prices and service usage.
In its annual report, healthcare company Vizient forecasts a 3.1% increase in total pharmaceutical spending by 2022. Oncology drugs will account for approximately 25% of the increase, with continued spending on pharmacotherapy related to COVID-19.1
According to Vizient, the continued impact of COVID-19 on healthcare is due to the continued emergence of disease variants coupled with hesitation about vaccines.1
The company also forecasts that specialty pharmaceutical prices will rise 4.68% by 2022, driven by likely approval of new therapies and price hikes for adalimumab, a specialty drug used to treat autoimmune diseases.
Furthermore, Vizient estimates that with recent approvals of diabetes management guidelines and organizations, the costs of influential diabetes drugs such as glucagon-like peptides 1 and 2 and insulin will increase by 2.63% next year. These new diabetes drugs have several indications beyond blood glucose management, such as for the prevention of cardiovascular events and other disease complications.
The report states that “coupled with the increasing prevalence of the disease, health systems are expected to see increased use of these products in their patient populations.”
The COVID-19 pandemic brought challenges that overwhelmed the healthcare system and required greater flexibility in collaboration and responsibilities from all essential healthcare providers, including pharmacists. In 2022, the role of pharmacists is likely to continue to evolve and expand with their recognition as critical frontline workers in the fight against COVID-19. In addition, pharmacists are extensively involved in education and research while remaining active members of the multidisciplinary teams of inpatient and outpatient COVID-19 recovery clinics and vaccination efforts. Moreover, with the increased use of telehealth during the pandemic, health systems are investing more in digital innovation. Pharmacists use, among other things, virtual post-intensive care syndrome clinics to adapt medicines and to advise and educate patients. The results of a recent study show that at the beginning of 2020 0.1% of Medicare primary care visits were via telehealth, but this number rose to 43% within 3 months due to the pandemic.2 This growth is expected to continue and some experts are advising organizations to adapt their virtual strategies to changing needs.
Meanwhile, Amazon’s entry into pharmacy services in 2022 could have a big impact. Consumers are so used to using Amazon to order a whole range of goods and it will be interesting to see how the landscape of prescription services will be affected.
In 2022, organizations will continue to adopt a holistic approach to infusion care for extended sites, including home infusion. Home drip services existed in health systems before, but some had stopped providing the service due to increased competition and payment rates. However, the pandemic led to more patients preferring infusion therapy at home, leading to increased interest in providing these services.
More than 500 mergers of healthcare systems and hospitals have taken place in the past ten years. An advantage of this collaboration is the availability of large data sets that can guide programs for the delivery of health care, prevention efforts and wellness with broad drug management. The drive to prevent medication errors and improve quality has led to a growing interest in artificial intelligence (AI) and precision medicine. An example of AI technology gaining ground in healthcare is machine learning, which focuses on the development and use of computer systems that can adapt and emulate without following explicit instructions. The systems use algorithms and statistical models to analyze data patterns and draw conclusions.3 AI is being hailed as a transformative force in healthcare. In recent years, the AI health market has seen explosive growth, with investments worth billions of dollars, and massive investments on the digital front are likely to be made in 2022. Healthcare is embracing AI for a range of applications, including clinical research, drug development and robotic surgery. In addition, AI is used as a practical tool to improve drug safety and patient outcomes, monitor adherence, reduce drug costs, replace labor-intensive and repetitive tasks that are prone to error, and streamline previous authorizations. These applications of AI will transform drug management. Thorough digestion and utilization of healthcare data is crucial, once the data analyzes have been completed; equally important is knowing what to do based on the findings. Increasingly, real-time data assessment, models and predictions are being used to detect and prevent patient deterioration and manage healthcare crises. As data sets require the expertise and skills of data scientists, pharmacy departments will need to recruit these scientists to support predictive modeling to drive healthcare delivery. In 2022, AI will remain a priority and will have a positive and profound impact on healthcare delivery and drug management. On a similar front, genetics will continue to play a key role in personalized drug treatment to achieve desired therapeutic effects.
Another growing trend that will continue to draw attention is the emphasis on gender inequality and sexual harassment in the pharmacy profession. In 2020, a petition titled End Gender Inequality in Clinical Pharmacy sparked a response from several major pharmacy organizations. The petition advocates for gender equality, the development of policies against such behaviour, and guidance and support for members of the profession who experience gender bias, harassment, predatory behavior or other harassing or threatening behaviour. These organizations insist on values such as a culture that strongly supports diversity, equality and inclusion. Significant underpinnings are needed to more effectively promote gender equality in the profession, but this work is critical to ensuring the future sustainable infrastructure. Gender inequality and sexual harassment are widespread in the medical community, the pharmacy profession and our society. All members of the pharmacy profession should be given equal opportunity and support to reach their highest potential. However, significant gaps in support for diverse membership of the pharmacy profession have demonstrated a lack of awareness of harassment due to gender and gender inequality. Promoting greater diversity in the workforce promotes innovation, reduces health inequalities and improves communication, access to healthcare, patient satisfaction and problem solving for complex challenges.4 The potential benefits of gender equality are enormous, including economic benefits, patient satisfaction and cultivating diversity, innovation and a unified profession. Women in pharmacy have started the discussion using online platforms and professional networks, but the driving force behind continued change will be organizational leadership and advocacy, as well as awareness by individual pharmacists.5
In light of the challenges of the pandemic, the new year will see an ongoing focus on the delivery of health care through ongoing testing, vaccination and treatment. Other important trends include rising healthcare costs and an increase in digital healthcare. In addition, it is hoped that progress will be made in addressing gender equality and sexual harassment in the pharmacy profession.
Deepali Dixit, PharmD, BCPS, BCCCP, FCCM, is a clinical associate professor at the Ernest Mario School of Pharmacy in Rutgers, The State University of New Jersey at Piscataway, and a clinical pharmacy specialist in critical care at Robert Wood Johnson University Hospital in New Brunswick, New Jersey.
1. Pharmacy Market Outlook. visor. Accessed October 1, 2021. https://info.vizientinc.com/pharmacy-market-outlook
2. Martin G. Top 10 emerging healthcare trends for 2021: the new normal. AHA Trustee Services. Accessed October 1, 2021.https://trustees.aha.org/top-10-emerging-trends-health-care-2021-new-normal
3. Aungst TD, Franzese C, Kim Y. Digital health implications for clinical pharmacy services: an introduction to the current landscape and future concerns. J Am Coll Clin Pharm. 2021;4(4):514-524. doi.org/10.1002/jac5.1382
4. Institute of Medicine (US) Committee for the Robert Wood Johnson Foundation Initiative on the Future of Nursing, at the Institute of Medicine. The Future of Nursing: Leading Change, Promoting Health. National Academies Press (US); 2011.
5. Bissell BD, Johnston JP, Smith RR, et al. Gender inequality and sexual harassment in the pharmacy profession: evidence and call to action. Ben J Health Syst Pharm. Published online July 7, 2021. doi:10.1093/ajhp/zxab275