Publisher’s Window: September/October 2013

<!–– A Changing Landscape ––>

We are moving into the era of personalized medicine — or, to use the new label it has been given, precision medicine. In his article in a recent issue of Penn Medicine, J. Larry Jameson, M.D., Ph.D., executive vice president of the University of Pennsylvania for the health system and dean of the Perelman School of Medicine, cited the statistics that an estimated 10 billion doses of medicine are dispensed each year in the United States, and that only one in three treated patients derives a benefit from this; one in three does not, he noted, and one in 10 patients experiences side effects — some serious.

The new emphasis is on a person’s genetic makeup as the basis for tailoring drug therapy for the desired outcome, which I find interesting. A few years ago Calvin Knowlton, a pharmacist and successful entrepreneur whom I’ve known over the years, gave a talk at an American Society for Automation in Pharmacy conference and touched on this very point. A lot of prescribed therapy will not work for certain people, and in fact can do more harm than good. Knowlton had a good read on where we were headed.

In pharmacy we are now dealing with an entirely new breed of drugs made from living organisms rather than from plant and chemical compounds. This biotechnology trend has spawned what’s called specialty pharmacy and is placing new software demands on the pharmacy computer companies, based on the record-keeping requirements and management of very expensive drug inventories.

In the meantime, I see more and more press on the importance of patient adherence to therapy. This was the topic of a Wall Street Journal article back in May. Keeping people from being admitted to the hospital due to failure to adhere is bound to save a lot of money. The article referenced the New England Healthcare Institute’s estimate that “some $290 billion in costs is wasted each year on unnecessary hospital and doctor visits by people who failed to comply with their medication schedule.” Now there are start-up companies developing new prescription vials that are designed to increase adherence. These “smart” prescription vials feature embedded chips that can remind people when a dose should betaken and monitor adherence.

Pharmacy stands to benefit from patient adherence, as it can bring in more prescription revenue while at the same time benefiting patient outcomes. That’s an incentive for every pharmacy to offer some type of adherence program. The need for adherence is not something new. The first adherence program I can remember was brought to market 25 years ago. It’s just that lately adherence seems to be a much higher pharmacy priority, as it should be.

Times are definitely changing. CT

Bill Lockwood, chairman/publisher, can be reached at