COMMENTARY

The Pharmacist Shortage: Where Do We Stand?

Charlotte A. Kenreigh, PharmD; Linda Timm Wagner, PharmD

Disclosures

January 13, 2006

In This Article

A Changing Workforce

Seven years ago, the first reports of a significant pharmacist shortage began making the news. The shortage was attributed to an increased demand for pharmacists and an inability to meet that need. Today, the shortage persists even as the pharmacist's role in patient care has expanded far beyond the traditional drug-dispensing function.

Professional organizations have been monitoring the pharmacist workforce and studying related issues. The Pharmacy Manpower Project (PMP) was formed in 1989 to collect, analyze, and distribute data on the supply of licensed pharmacists and the demand for their services throughout the United States. The PMP is a nonprofit corporation established by national pharmacy groups to address workforce issues. By evaluating data from monthly surveys of pharmacist employers, the coalition produces the Aggregate Demand Index (ADI),[1] a snapshot of the current demand for pharmacists and how it has changed over time. National, regional, and state demand indices are provided. The National Association of Chain Drug Stores (NACDS)[2] and the American Society of Health-System Pharmacists[3] also track the supply and demand of pharmacists for their specific areas of practice.

Several factors helped contribute to the pharmacist shortage: unprecedented increases in the volume of prescriptions (more than a 30% increase from 1992 to 1999); growth in the population 65 years or older, which uses a disproportionately high share of prescription drugs; greater administrative requirements for handling third-party payments, which consume 10%-20% of pharmacists' time; and a decline in the number of applications to pharmacy schools in the late 1990s, which led to reduced class sizes.[4] The downward enrollment trend has now been reversed and the number of graduates has increased, but this has created a new problem with the greater demand for pharmacy faculty to teach and mentor the growing student population.

Using a conservative growth rate of 5% for outpatient prescription orders, researchers have calculated that the volume of prescriptions filled in 2020 would reach 7.2 billion.[5] The prediction of such historic growth does not even reflect the anticipated impact of the aging population, making it possible that the prescription volume could actually exceed this number.

The composition of the workforce and the nature of pharmacy practice have also changed and impacted the shortage. The majority of pharmacists are now female; according to studies, women tend to work 6% fewer hours per week on average.[5] This could further fuel the shortage.

As the clinical role of pharmacists continues to evolve, the need for more pharmacists will continue to rise. Pharmacists are now expected to spend more time in face-to-face interactions with patients and with other healthcare workers. In addition, the impact of the new Medicare prescription benefit on the administrative time required to process payments has yet to be realized.

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