By: Kent Groves, PhD; Chief Strategy Officer, Dentsu Health; Jeff Godish, Principal, Delta Strada; Croom Lawrence, Principal, Predictive Healthcare

We have all seen the never-ending stream of global headlines predicting the demise of western health care as we know it. This includes overburdened Health Care Professionals (HCPs), declines in enrollment in academic health disciplines, insufficient physical resources and infrastructure, drug shortages, rising costs and increasing demand. Perhaps it is time to shine the light on one of the most under-leveraged and oft-overlooked disciplines in the HCP armamentarium, namely, pharmacists.

Not surprisingly, pharmacists continue to have a significant impact on their patient populations, according to data presented in a recent article^[1].  While this may be new to the general population, the pharma-health industry always knew this unspoken truth. The described situation is in British Columbia (BC), Canada, where “pharmacists recently gained the ability to administer more vaccines and renew or adjust prescriptions for a wider range of drugs …”.  This change began in October 2022.  The types of potential modifications they now have control over include changes to:

• directions for use of a prescription
• therapeutic substitution
• changes to dosage
• or changes to formulation

Recent BC government data showed nearly 60,000 prescriptions were renewed or modified by pharmacists in January 2023, which is more than double the monthly average of about 27,200 in the year before the changes.  This data indicates a 120% increase in the number of residents renewing or adjusting prescriptions, via their pharmacists, after their powers changed.

This scenario is quite useful in helping health strategy and marketing professionals qualify and quantify the everyday influence pharmacists have with their patients.  While not a controlled study per se, there is a clear in-market “before and after” timeframe and the date of the change in prescribing abilities is exactly known.  Further, the types of changes are clearly identifiable, and the number of renewed/modified prescriptions is from government sources.  In summary, the data appears stable, providing firm ground from which to draw a variety of business and marketing observations and insights on the critical importance of pharmacists in the delivery of successful treatment.

As context, across the HCP ecosystem there are numerous individuals involved in therapeutic outcomes, but the new study data confirms pharmacists are in a truly pivotal role. In some instances, pharmacists, likely by virtue of their (retail) accessibility, are seen by patients more frequently than any other HCP².  Also, pharmacists have never been as well educated as they are today; most graduates over the past 10+ years have earned a PharmD. and those that have been in the industry longer remain among the highest trained as R.Ph-degreed professionals.

Further, in independent studies they are consistently ranked as highly trusted HCPs just behind doctors and nurses³, thus their recognition as a prescribing and support entity in the health ecosystem continues to grow.

The best way to embrace their functionality is to consider a few typical health scenarios and the presented professional communications opportunity for pharmacists:

1. At the pharmacy counter - arguably the second-most important point of care - the opportunities to get patients on appropriate therapy, and keep them on, fall directly to the pharmacist.
   • Insight: For Rx brands distributed through retail, the relative importance of pharmacists (compared to physicians) has been underestimated and under-attributed. 
2. Given their level of education and professional CE requirements, it stands to reason pharmacists are extremely educable.
   • Insight: With new approaches to designing and delivering Med Ed, investing in pharmacists should yield a high return.
3. Pharmacists, as an Rx brand strategic audience, are very reachable and targetable.
   • Insight: As a subset of HCPs, their specialty drives efficiencies in channel mix and effectiveness in messaging.  Audience reach, frequency, and most importantly, composition, are attainable and may even be done in cooperation with the retail chains themselves, all of which improve the efficacy of pharmacist communication.
4. Pharmacists advise and help patients with 1) directions for use of a prescription, 2) therapeutic substitution and 3) changes to dosage and (4) formulation.
   • Insight: With hands-on involvement at the transaction level, they are literally on the front-line of Rx starts (NBRx and NRx), ongoing (adherent) therapy and drivers of market share and financial impact. 

The data that came out of the BC scenario is a tantalizing snippet of the potential value of the pharmacist audience.  It also triggers a variety of Rx brand strategy questions.  For example, can value be assigned and is there a way to develop more solid analytics that will validate the importance of pharmacists within Rx attribution models?  What are the most impactful channels with which to reach pharmacists?  Is there an opportunity to design and deliver Med Ed specifically for the pharmacist?

While all health care professionals are key players in treatment, pharmacists are and always will be critically important in care delivery – and the opportunity is to leverage their patient access and front-line insights to influence patient success, patient reported outcomes and quality of life while reducing the burden on physicians and their clinical support teams.

^[1] Globe and Mail, May 18, 2023.  BC reports 120% increase in prescriptions after pharmacists gain new powers

²www.pharmacist.com/APhA-Press-Releases/most-patients-see-pharmacists-as-crucial-part-of-their-health-care-team

³news.gallup.com/poll/467804/nurses-retain-top-ethics-rating-below-2020-high.aspx