6 Predictions shaping the future of pharmacy in 2019

The pharmacy industry in Australia is undergoing significant digital and regulatory transformation. In this article, we take a look at some key issues within pharmacy and medicines information that are set to shape the year ahead.

1. Pharmacy burnout and mental health

Increased rates of stress, anxiety and a higher than average suicide rate in the pharmaceutical industry will continue to take the forefront as a pressing issue in 2019.

Already, the increasing rate of mental health issues and suicide has prompted the Pharmacists’ Support Service to launch a new resource to better support pharmacists. Alarmingly, call rates to the PSS spiked in 2017 to around an average of 5 to 7 pharmacists per week, and have since, remained at that level.

According to research carried out by Monash University’s Emeritus Professor Colin Chapman, together with Master Research Australasia and the Pharmacists’ Support Service, half of Australia’s pharmacists are dissatisfied with their work-life balance. Meanwhile barriers to seeking mental help or counseling included fears of reprisal, of experiencing stigma, and feeling intimidated or embarrassed.

For 2019 to be a happier, mentally healthier and less stressful year for pharmacy professionals, there needs to be more proactive measures, guidance and resources available to tackle this growing epidemic.

 2.Electronic prescribing

Electronic prescribing will continue to gain momentum across Australia, following the Federal Government’s decision in 2018 to increase its investment in new medicines by $2.4 billion.

The decision means $28.2 million will be injected into the initiative over five years from 2017–18 to 2021-2022, to upgrade the e-prescribing software system used by clinicians to prescribe medicines.

The move is set to contribute towards greater Pharmaceutical Benefits Scheme (PBS) efficiency, compliance, drug safety and data collection. It will also create an electronic prescribing framework that will provide an option for prescribers and their patients to have a fully electronic PBS prescription as an alternative to paper-based PBS prescriptions.

3. Transforming clinical decision support (CDS)

The future of CDS looks exciting, with new inroads in semantic interoperability set to help reduce the length of time it takes from the moment new clinical knowledge is released, to the time it is practically applied in a healthcare setting.

Already, a study by the American Journal of Health System Pharmacy, Improving medication-related clinical decision support, has revealed how CDS systems should incorporate more patient-specific information into decision-making algorithms and employ human factors design principles.

Importantly, the report called for healthcare teams to be more accountable for improving interoperability, and ensure more regular updates of CDS systems to optimise accurate information sharing.

Taking this a step further, “Semantic” interoperability provides interoperability at the highest level, enabling two or more systems or elements to exchange information and to use the information that has been exchanged.

Applied to healthcare, this level of interoperability has the potential to support the electronic exchange of patient health information and data via health digital ecosystems, with the aim to improve quality, safety, efficiency, and efficacy of healthcare delivery.

So imagine a future where we have a digital ecosystem of semantic interoperability. Where we have AI-enabled CDS systems can analyse a patient’s characteristics and provide tailored recommendations for diagnosis, treatment, patient education, adequate follow-up, and timely monitoring of disease indicators – all at a fraction of the time and with more accuracy than ever before.

4. The natural medicines trend

Natural medicines are playing a more integral part in the pharmacy, hospital and clinical decision-making process, and will continue to be a part of the industry’s lexicon on 2019.

Already, the rise of patient demand for natural and alternative approaches to medicine means our healthcare system has become more agile to adapt and meet patient expectations. In fact, as early as 2000, the increased demand was recognised as something public health needed to take more seriously.

Research from the University of Western Sydney revealed that in 2000 alone an estimated $2.3 billion was spent by Australians on complementary medicine (CM) products and therapists. Half to three quarters of Australians used a CM product each year and between 15-30% visited a practitioner.

Fast-track to today, and Australian industry has now been estimated to be worth $3.5 billion in 2015, expecting to grow to $4.6 billion in 2017-2018, and even more in the years to come.

Meanwhile, as healthcare becomes more digitally empowered, there are now a number of innovations set to facilitate even better clinical, hospital and pharmaceutical decision-making when it comes to natural medicines now and in the future.

5. Medicinal cannabis regulation and online support

In 2018, we saw an increasing interest in the use of cannabis for medical purposes, with Governments at both Commonwealth and State and Territory levels in Australia implementing a raft of legislative and policy change to allow the cultivation, manufacture, prescribing and dispensing of medicinal cannabis products for patients in Australia.

In March 2018 The NSW Department of Health announced it was the first state to simplify medicinal cannabis access and instead of both the Commonwealth and NSW Health overseeing the approvals, NSW will rely on a single clinical assessment by the Therapeutic Goods Administration (TGA).

The year ahead will see further measures by the TGA in place to support, streamline and offer further transparency around this issue, including a move towards accepting submissions of Special Access Scheme (SAS) applications and notifications electronically by 1 July 2019.

6. The pharmacogenomics debate continues

Advances in genome sequencing and the associated field of genomics are set to offer us better understanding of how drugs affect different individuals. With the genetic profile of a person’s disease and knowledge of their response to treatment, it should be possible to find out more about the likely effectiveness of medical interventions such as prescribing drugs to treat a disease (pharmacogenomics).

A recent report published by the RACGP predicted drug development based on pharmacogenomics has the potential to result in a more ‘personalised’ medications plan. This plan involves more predictable responses in patient subpopulations and can be targeted to accommodate individual genetic variation.

However the report also stressed there are key challenges to be mindful of in order to successfully implement the concept of pharmacogenomics. These include finding suitable biomarkers, reducing the cost of laboratory investigations, and making drug development processes based on pharmacogenomics economically viable for pharmaceutical companies.