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    A call for a moratorium on new pharmacy schools


    Frederick S. Mayer
    In the past few months I have overheard something that in my 55 years as a practicing pharmacist has never been discussed: There are too many pharmacists in the marketplace and too many schools of pharmacy cranking out pharmacists in the United States.




    Graduates outpace population

    From 2000 to 2010, the U.S. population rose by 9.7%, from about 281 million to 309 million. During the same period, the number of pharmacy schools (including preaccredited schools) increased by 50% to 120, according to Robert L. Day, PharmD, associate dean, University of California School of Pharmacy, San Francisco.

    If you look at the U.S. census figures for 2010 and extrapolate to 2013, there will be 317 million, a 12.6% increase in population in the United States since 2000. The number of pharmacy graduates is expected to come close to doubling, climbing from 7,300 in 2010 to an annual graduate potential in 2013 of 13,247.

    New, reimbursible roles needed

    There are many reasons that additional pharmacists are needed in America, including the graying of baby boomers and the proposed increase of prescriptions from 5 billion to 10 billion, once the new Affordable Care Act (ACA) provides access to health insurance to the 40 million Americans who are now uninsured.

    However, without reimbursement and a new role for pharmacists in the ACA to help manage diabetes, asthma, cholesterol, stroke, etc., it is very unlikely that the pharmacy profession will need this increase of schools and pharmacists.

    Some pharmacy students cannot find internship positions to complete their pharmacy studies to obtain licenses. Many of these pharmacy students have 8 years of college and have student loans amounting to more than $300,000, which must be repaid.

    Technicians, technology, and shrinking salaries

    Pharmacist Planning Service, Inc. (PPSI) has seen this oversupply of pharmacists reduce wages by 20% on a national scale. This will continue as e-prescribing increases, the technician's role is expanded, and pharmacy benefit managers (PBMs) restrict distribution systems and force patients into the mail-order system.

    In fact, Kaiser Permanente has 2 mail-order delivery systems in California, 1 in the north, 1 in the south; each system fills 80,000 prescriptions each day by automation and robotics. A third facility is scheduled to be built in central California. Do we need all these pharmacists, if they are going to count, pour, and type, and not practice what they are taught for better patient care?

    According to the Harvard University study led by Lucien Leape, MD, 107,000 Americans are dying each year from adverse drug effects, drug interactions, and failure of pharmacists to counsel patients and check patients' histories. Can we, as pharmacists, continue to carry on in the "same old/same old" manner under the ACA?

    Can't speak up without a mouthpiece

    The long and short of this issue is that there are too many pharmacists for the current U.S. population. Coupled with that, pharmacists are not receiving adequate compensation for their training and knowledge, and are currently underused.

    PPSI strongly proposes that someone is needed to negotiate standards of practice with the federal government, since it will be the new payer for all healthcare for all Americans.

    Unless pharmacy has a union or guild to negotiate standards of practice with the federal government's managed care organizations and insurance companies, the increase in numbers of pharmacists and schools of pharmacy is not warranted.

    There should be a moratorium on all new schools of pharmacy in the United States until pharmacists delineate their roles and organize a national union or guild to represent their call for better healthcare for their patients.

    Fred Mayer is a Drug Topics editorial advisor, a practicing pharmacist, and CEO of Pharmacists Planning Service, Inc. (PPSI), a 501 C (3) nonprofit, public health, consumer, and pharmacy education organization. He welcomes comments at
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    Frederick S. Mayer, PharmD, MPH
    Fred Mayer is a Drug Topics editorial advisor and CEO of Pharmacists Planning Service, Inc. (PPSI), a 501 C (3) nonprofit, public ...