Does Pharmacy Specialization Have a Promising Future?
Vecchione, Anthony, Drug Topics
The need for specialized pharmacists is growing in all practice settings, thanks, in part, to the cost-conscious nature of managed care.
The demand for specialized pharmacists is in stark contrast to the flight from the use of expensive medical specialists by managed care plans and the growing use of primary care doctors in the role of patient case managers. But specialized pharmacists, especially in healthsystem settings, are a bargain compared to medical specialists, experts believe.
Because pharmacy specialists aren't paid directly as providers the way physicians are, from a pure dollars-and-cents perspective, the economic drivers that conspire against medical specialists serve to work in favor of pharmacy specialists. Further, compared with medical specialists, "there are significant differences in the economics of how specialty pharmacists are reimbursed and at what level they are reimbursed," explained David Witmer, director of ASHP's section of clinical specialists. In the current system, doctors are reimbursed according to their specialty, whereas R.Ph.s, regardless of whether they're specialists or generalists, are salaried employees. While a pharmacy specialist may be paid more than a staff pharmacist, the cost of having an oncology pharmacist, for example, monitor a patient's pain, would be far less costly than having a medical specialist do the same thing.
Richard Bertin, executive director of the Board of Pharmaceutical Specialties (BPS), the Washington, D.C.-based agency that's charged with formally recognizing and certifying pharmacy specialties, said, "As healthcare systems look to become more efficient, they're saying, 'Here are services that pharmacists can provide even better than doctors, and they cost less.' It's a natural for them to move in that [specialty] direction." According to BPS, there are currently 2,120 certified pharmacy specialists within the five recognized specialty areas (see chart below). But that number is likely to increase substantially over the next several years, industry insiders predict. "There is a great need on the part of patients and prescribers to have the kinds of sophisticated, high-quality services that specialized pharmacists can provide," Bertin said. …