A Bitter Pill to Swallow
Rx for Disaster?
The Effect on You continued...
Topping the prescription-pad list of reasons for the shortage
of pharmacists, experts say, is an increased demand for medications.
"I am going to stop saying 'shortage' and begin referring
to it as an excessive demand," says Maine. "That really is what is
happening here: an increased demand for processing prescriptions."
"The demand has really gone gangbuster," he says.
"In 1992 there were approximately two billion prescriptions dispensed on an
outpatient basis; by 1999 it had risen to three billion and is expected to
increase to four billion by 2005. I must tell you, we have not seen an increase
even approaching that in terms of infrastructure for pharmaceutical
The Ever-Increasing Demand
Why the boom? The baby boom chiefly, says Roberts, as members
of that needy, numerous generation are reaching the age of peak consumption of
Coupled with that, more medications are out there to treat
diseases -- including chronic ailments requiring multiple drugs, like AIDS, and
conditions like erectile dysfunction that, before Viagra, really had no
treatment. The final factor is the explosion of direct-to-consumer advertising
that prompts well-informed patients to walk into their doctor's office and
demand a prescription.
And of course, people are living longer. "What's keeping
them alive?" asks Roberts. "It's longer living through
On the other side of the equation is the nationwide shift from
a five-year bachelor's degree in pharmacy to the six-year doctor of pharmacy
degree. This means some may skip an advanced degree in pharmacy in favor of,
say, a business or law degree.
The new PharmD degree requirement has another unintended
"Our graduates are very well educated and are finding many
more career opportunities," says Roberts. Careers exist not only as a
pharmacist at a hospital, large chain, or independent store, but also at
pharmaceutical companies, in managed care organizations, and insurance
companies. Oftentimes these new opportunities mean better money, less stress,
and more job satisfaction.
In addition to the growing number of prescriptions waiting to
be filled, and the fact that the number of trained pharmacists isn't growing at
the same explosive rate, there is another issue. More Americans are taking
complex drug regimens requiring counseling and checking for interactions and
contraindications. Additionally, more Americans are taking herbal medicines,
which can also interfere with prescription medications.
"Our [new] curriculum places greater emphasis in patient
care," says Roberts. "Unfortunately, this high demand is working
counter to pharmacists being able to spend quality time with patients and help
them understand why they have to take medication, understand how to use it, and
appreciate side effects."
Possible Rx for a Growing Problem
"Unfortunately, we can't snap our finger and respond to
this instantly," says Roberts. The first step, he says, is improving
educational opportunities. "It needs to start in education facilities so
that we have capacity to produce more graduates."