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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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7  

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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16  

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?