Pharmacy Forecast: Patients Want Personalized Care, Pharmacogenomics

The “Pharmacy Next: Health Consumer Medication Trends” survey commissioned by Wolters Kluwer shows that patients in 2023 want personalized medicine, including the promising benefits of pharmacogenomics.

“Despite the availability of specific published guidance for more than 160 drug-gene combinations, the use of genomics to inform prescribing, also known as pharmacogenomics, is still limited,” writes Daniel S. Streetman, PharmD, MS, in Pharmacy Times. “When provided with an overview of pharmacogenomics, more than 70 percent of Americans would provide a blood sample for genomic analysis if it meant that they’d receive more personalized medical care.”

That insight was one of several gained in the survey conducted with 1,006 U.S. adults, 18 and older, between September 19-26, 2022.

“Insights such as those gleaned [from the survey] can offer a valuable direction for what we can expect in the near future based on consumer needs and the evolving pharmacy landscape. The data reflects a resounding shift toward the role of pharmacies as becoming sites for primary care, as well as provides clarity on some of the tradeoffs consumers are willing to make for more affordable and personalized care,” wrote Streetman.

The Rise of Personalized Medicine and PGx

Patients are keen to receive personalized care and want tailored medication prescribing, including pharmacogenomics (PGx) testing which is fast becoming the new standard of care when prescribing medications in relation to how genetic differences can affect individual responses to drugs, in terms of therapeutic effects as well as adverse effects.

“Thanks in part to the rise of mainstream genomic testing like Ancestry.com or 23andMe, patients are increasingly expressing interest in using these insights to inform their medications,” writes Streetman.

The survey found that:

• 7 in 10 Americans (72 percent) say they would be likely to provide a sample for genomic analysis if it was used to make their medical care more personalized to them.
  
  
• 68 percent of Americans believe their individual genomic information could effectively guide prescription decisions for them by providers. Notably, Gen Z, Millennials, and Gen Xers are more likely to believe this than those who identify as Boomers or above.
  
  
• More than 80 percent would provide a sample for genomic testing if it meant that their prescriptions would be more effective or safer.
  
  
• 88 percent of patients see an incentive for health insurance plans to cover genomic testing costs if it helps to avoid healthcare costs on ineffective or unnecessary prescriptions.

“It is important to note that pharmacogenomics represents just one aspect of the effort to personalize a patient's drug therapy. Avoiding hazards like dangerous drug interactions, duplicative therapy, drug-disease interactions, or allergies may be of even more value than using genomics to guide prescribing,” wrote Streetman.

Finding Ways to Reduce Medication Costs

Consumers are always searching for ways to reduce medication costs and the survey found that 77 percent think making widely used safer prescription drugs available over the counter (OTC) will help lower costs without compromising safety.

The survey also found that 77 percent of consumers prefer to receive medications by the mail if it meant lower costs.

A majority of those surveyed (65 percent) say medication prices have increased over the past few years and, sadly, some 44 percent have admitted to skipping medications due to high costs, including 56 percent of those without health insurance.

That last finding is not surprising as Streetman says that between “July 2021 and July 2022, more than 1200 medications had a price increase that exceeded the rate of inflation (8.5 percent), with the average increase for these products a substantial 31.6 percent.”

Besides mail-order medications, patients are also seeking to lower costs by:

• 56 percent of those surveyed often ask their prescriber about less costly alternatives.
  
  
• 43 percent have asked their pharmacist about less costly options.

“Meeting this demand for information will require additional training for pharmacists, and access to tools that can help make safe recommendations that also address patients’ concerns around cost,” concludes Streetman.

Primary Care Services Shifting to Pharmacies

The survey finds a high level of trust with pharmacists with 97 percent saying that their pharmacist should have responsibility for informing them about the safety and/or efficacy of their medications.

The pharmacy, in general, has started a transition to offering primary care services, a trend that accelerated during the pandemic.

“The COVID-19 pandemic accelerated the transformation of the pharmacy from an end-point for consumers to pick up drugs to an integrated health partner, improving access to vital care and vaccinations within communities,” said the survey executive summary. “The roles of clinicians at pharmacies and small clinics are quickly elevating to that of a crucial member of the care team – a trend that could mean improved access to care for many.”

The survey also found that:

• 78 percent of consumers are willing to receive medication advice from a clinician other than a primary care physician.
  
  
• 61 percent of consumers believe that in 5 years most of their primary care services will be provided at pharmacies, retail clinics, or pharmacy clinics, and not at doctor’s offices.
  
  
• 50 percent of consumers are worried about problems or errors because their pharmacy is understaffed.

Cost is a big driver with 56 percent of patients trusting a pharmacist to provide them with their prescriptions instead of their doctor if it meant lower costs, and 34 percent willing to trust that prescription role to a pharmacy clinic nurse if it leads to lower costs.

All of these findings will put pharmacists in the spotlight in 2023 and beyond.

“This underscores the pressure on the pharmacy industry with the opportunity to improve access to care deep within communities - including rural and marginalized communities - and provide more personalized, targeted medication, with the ultimate goal of more equitable care for all,” said the survey executive summary.