Post on 28-Aug-2020
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The Current and Future State of the
Pharmacy Work Force
Hannah K. Vanderpool, Pharm.D., M.A.
Vice President, Office of Member RelaFons
ObjecFves • To describe the current state of the pharmacy workforce • To compare the factors that determine supply versus
demand • To forecast the availability of residency posiFons in the
future • To analyze potenFal implicaFons for NMSHP and ASHP.
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Na+onal Pharmacist Workforce Survey 2014
Pharmacy Workforce Center, Inc. • American AssociaFon of
Colleges of Pharmacy (AACP) • American College of Clinical
Pharmacy (ACCP) • American Pharmacists
AssociaFon (APhA) • American Society of Health-‐
System Pharmacists (ASHP) • Board of Pharmacy SpecialFes
(BPS) • Bureau of Health Professions
(BHPr)
• NaFonal Alliance of State Pharmacy AssociaFons (NASPA)
• NaFonal AssociaFon of Boards of Pharmacy (NABP)
• NaFonal AssociaFon of Chain Drug Stores (NACDS) FoundaFon
• NaFonal Community Pharmacists AssociaFon (NCPA)
• Pharmacy Technician CerFficaFon Board (PTCB)
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Highest Degree Earned by Licensed Pharmacists
74
71
66
52
14
19
22
38
12
10
12
10
0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%
2000
2004
2009
2014
BS Pharmacy PharmD Other (MS/MBA/PhD)
Race/Ethnicity of Licensed Pharmacists
88%
88%
87%
85%
7%
7%
8%
9%
2%
2%
2%
2%
2%
2%
3%
3%
0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%
2000
2004
2009
2014
White Asian Black Hispanic American Indian Other
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Percent of AcFvely PracFcing Pharmacists that are Female: 1990-‐2014
0.0%
10.0%
20.0%
30.0%
40.0%
50.0%
60.0%
1990 2000 2004 2009 2014
31.3%
44.8% 45.9% 46.4%
57.1%
Mean Full-‐Time Equivalent (FTE) ContribuFons by Age & Gender
1.03 1.03
0.98
1.1
1.04 1.01 1.00
0.88
0.62
0.61
0.99 1.00 0.96
0.9 0.9
0.98
0.85 0.87
0.69
0.44
0
0.2
0.4
0.6
0.8
1
1.2
<30 31-35 36-40 41-45 46-50 51-55 56-60 61-65 66-70 >70
Males
Females
2009 Females: 0.82 Males: 0.92
2014 Females: 0.93 Males: 0.95
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PracFce Sebngs
Community: Independent, Chain, Mass Merchandiser, Supermarket Hospital: In-‐paFent or out-‐paFent hospital sebngs Other PaFent Care Sebngs: long term care, nuclear, clinic-‐based, central fill, home health/infusion, and specialty pharmacies Other Non-‐PaFent Care Sebngs: pharmacy benefit administraFon, academic, government administraFon, pharmaceuFcal industry, consulFng, professional associaFons, and other organizaFons that were not licensed as a pharmacy
PracFce Sebng shics: 2009 vs. 2014
54%
27%
10% 9%
44%
30%
16% 10%
0%
10%
20%
30%
40%
50%
60%
Community Hospital Other, Pa+ent Care SeQng
Other, Non-‐Pa+ent Care
SeQng
2009
2014
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RaFngs of Workload as High or Excessively High* by Work Sebng: 2004, 2009 & 2014
63%
0% 10% 20% 30% 40% 50% 60% 70% 80% 90%
Indep Chain MM Super Hosp OPC Other Overall
2004 2009 2014 * High is a summated score of five items (1 = strongly disagree to 5 = strongly agree) > midpoint (15)
Pharmacists with High Job SaFsfacFon by PracFce Sebng: 2000, 2004, & 2014
68%
0%
20%
40%
60%
80%
100%
Indep Chain MM Super Hosp OPC ONPC Overall
2000 2004 2014
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41% 40%
25%22%
16%18%
12%13%
6% 7%
0%
5%
10%
15%
20%
25%
30%
35%
40%
45%
MedicationProvider
MedicationProvider whoalso ProvidesPatient Care
Other ActivityPharmacist
Patient CareProvider whoalso Provides
Medication
Patient CareProvider
ProporFon of U.S. Pharmacists by Segment in Descending Size (2009 data in lighter tone and 2014 data in darker tone)
ProporFons of Community Pharmacists in U.S. Pharmacist Segments in 2009 and 2014
60%
32%
3% 5% 0%
61%
29%
6% 4% 0%
0%
10%
20%
30%
40%
50%
60%
70%
Medica+on Providers
Medica+on Providers who also Provide
Pa+ent Care
Other Ac+vity Pharmacists
Pa+ent Care Providers who also Provide
Medica+on
Pa+ent Care Providers
2009
2014
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ProporFons of Hospital Sebng Pharmacists in U.S. Pharmacist Segments in 2009 and 2014
23% 24%
17%
23%
13%
23% 20%
14%
31%
12%
0%
5%
10%
15%
20%
25%
30%
35%
Medica+on Providers
Medica+on Providers who also Provide
Pa+ent Care
Other Ac+vity Pharmacists
Pa+ent Care Providers who also Provide
Medica+on
Pa+ent Care Providers
2009
2014
ProporFon with Residency Training for U.S. Pharmacist Segments in 2009 and 2014
3% 4%
19%
25% 26%
6% 5%
27% 30% 34%
0% 5% 10% 15% 20% 25% 30% 35% 40%
Medica+on Providers
Medica+on Providers who also Provide
Pa+ent Care
Other Ac+vity Pharmacists
Pa+ent Care Providers who also Provide
Medica+on
Pa+ent Care Providers
2009
2014
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Workforce Supply vs. Demand
How many pharmacists are there? • The Department of Labor, Bureau of Labor Sta+s+cs (BLS),
reports that in 2012 there were 286,400 pharmacists • BLS projects 14% growth by 2022, or 327,800 pharmacists • They project employment figures, not supply and demand
Bureau of Labor Sta+s+cs, U.S. Department of Labor, Occupa&onal Outlook Handbook, 2014-‐15 Edi&on, Pharmacists, on the Internet at h_p://www.bls.gov/ooh/healthcare/pharmacists.htm (visited April 24, 2015).
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NaFonal Center for Health Workforce Analysis
Health Workforce ProjecFon: Pharmacists
• Released December 2014 • Uses HRSA Health Workforce SimulaFon Model • Accounts for changes in supply (new entrants,
reFrement, hours worked palerns) • Accounts for changes in demand (ACA Rx coverage,
populaFon demographics, demand for prescripFon medicaFons)
• Does not account for future growth in paFent care services/roles of pharmacists, provider status, changes in part D coverage
NaFonal Center for Health Workforce Analysis
Health Workforce ProjecFon: Pharmacists
• Released December 2014 • Uses HRSA Health Workforce SimulaFon Model • Accounts for changes in supply (new entrants,
reFrement, hours worked palerns) • Accounts for changes in demand (ACA Rx coverage,
populaFon demographics, demand for prescripFon medicaFons)
• Does not account for future growth in paFent care services/roles of pharmacists, provider status, changes in part D coverage
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EsFmated Supply and Demand for Pharmacists 2012-‐2025
Source: HRSA Na+onal Center for Healthcare Workforce Analysis
ASHP Surveys show peak pharmacist shortage in 2000, with decline in vacancy rates
0 1 2 3 4 5 6 7 8 9
2000 2002 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014
8.9
7.2
5.7 6.3
5.7 6.3 5.9
3.7 2.8 2.4 2.7
2.1 2.2
Perc
ent V
acan
cies
Hospital Pharmacist Vacancy Rates
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Supply of Pharmacists: Graduates from US Pharmacy Schools: 1960 -‐ 2014
0
2000
4000
6000
8000
10000
12000
14000
16000 1960
1963
1966
1969
1972
1975
1978
1981
1984
1987
1990
1993
1996
1999
2002
2005
2008
2011
2014
23 Source: AACP
A lot of press on possible surplus of pharmacists
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ASHP Policy PosiFon 1108
QUALITY OF PHARMACY EDUCATION AND EXPANSION OF COLLEGES OF PHARMACY Source: Council on EducaFon and Workforce Development
To support the AccreditaFon Council for Pharmacy EducaFon’s conFnuing role of promulgaFng accreditaFon standards and guidelines and engaging in sound accreditaFon processes to ensure quality in the educaFon provided by colleges of pharmacy; further, To acknowledge that, in addiFon to a robust curriculum, access to quality experienFal educaFonal sites and the availability of qualified faculty (including preceptors and specialty-‐trained clinical faculty) are essenFal determinants of the ability to expand enrollment in exisFng or addiFonal colleges of pharmacy; further, To oppose expansion of enrollment in exisFng or new colleges of pharmacy unless well-‐designed projecFons demonstrate that such enrollment increases are necessary to maintain a viable pharmacist workforce.
Factors influencing the “supply”
• The number of pharmacy graduates
• State of the economy – Impact on the number of pharmacists re+ring – Impact on part +me to full +me shib
• The gender mix (slowly growing)
• The number of internaFonal pharmacy graduates (minimal)
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Factors influencing the “demand”
• The demand by employers
– State of the economy – Prescrip+on volume – NEW roles of pharmacists – Changing role of pharmacists – Changing role of pharmacy technicians – Impact of automa+on and technology
Availability of Pharmacy Residency PosiFons
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0
200
400
600
800
1000
1200
1400
1600
1800
2000
ASHP Accredited Pharmacy Residency Program Growth (1980-2015) as of 1/5/15
Hospital Pharmacy Practice PGY1 Clinical Specialized PGY2
1,861
1900 2092
2508
2915
3277
3706 3933
4142 4358
1612 1769
1873 1951 2173
2413
2694 2862
3081
1343 1487
1651 1801
2027 2268
2495 2640
2811
0
500
1000
1500
2000
2500
3000
3500
4000
4500
5000
2007 2008 2009 2010 2011 2012 2013 2014 2015
ASHP Residency Matching Program 2007-‐2015
PGY1
# applicants
# posi+ons
# matched
91% fill for all PGY1
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239
330 384
483 541
677
777
917 1002
286 334
380 439
514
585
692
792
906
195 267
297
369 438
505
601
706
794
41 81 88
114 144 179
230 260
297
0
200
400
600
800
1000
1200
2007 2008 2009 2010 2011 2012 2013 2014 2015
ASHP Residency Matching Program 2007-‐2015
PGY2
# applicants (includes early commits)
# posi+ons (includes early commits)
# total match (early commit+match)
# early comit
88% fill for PGY2
288 323
635
964
1104
1293 1239
1491 1373
0
200
400
600
800
1000
1200
1400
1600
1800
2007 2008 2009 2010 2011 2012 2013 2014 2015
Shortage of PGY1 posiFons -‐ based on match parFcipants and available PGY1 posiFons
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ImplicaFons and Discussion
ImplicaFons
• Good implicaFons: Workload, job saFsfacFon, proporFon of paFent care duFes is posiFve for our members
• Challenges: Ongoing monitoring of supply vs. demand,
advancing the roles of pharmacists
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What can ASHP and NMSHP Do?
• ProacFvely monitor workforce trends • Communicate implicaFons with members • IdenFfy and move forward acFons that support the ASHP
strategic plan related to workforce trends • Advocate with stakeholders to advance pharmacy pracFce
QuesFons/Discussion?