Opportunities in Specialty Practice

As the role of the practicing pharmacist changed regarding medication information activities, so has the role of the specialist. The role of the medication information specialist has changed from an individual who specifically answers questions to one who focuses on the development of medication policies and provides information on complex medication information questions. A specialist in medication information can provide leadership in a contract drug information center, medical informatics, health maintenance organizations (HMOs) and pharmacy benefit management organizations (PBMs), managed care organizations, scientific writing and medical communications, poison control, pharmaceutical industry, and academia. In a recent survey that examined the career paths of pharmacists who completed a drug information specialty residency in 2000 and 2001, the types of careers were diverse. However, the most common positions were in industry (32%), academia (21%), medical writing (12%), and as a specialist in an institution (9%). A specialist in medication information can be involved in multiple activities in establishments listed in the following section.

Contract Drug Information Center (Fee-for-Service)

The need for accurate information pertaining to drug therapy is more acute today than ever before in the history of health care. One estimate suggests that prescription drug expenditures will increase at an average rate of 11.1% between 2002 and 2012. Within the next decade health care costs will increase at an alarming rate, with total expenditures reaching the $2.1 trillion mark. A majority of these costs will be shouldered by the private sector with a significant increase in prescription drug costs. Drug information practitioners are in an enviable position to provide a service that will improve patient outcomes and decrease health care costs through the provision of unbiased information that supports rational, cost-effective, patient- and disease-specific drug therapy. One of the best ways to deliver such information is by contracting with a drug information service with formally trained health care professionals. Potential clients include managed care groups, contract pharmacy services, pharmacy benefits managers, buying groups, small rural hospitals, chain pharmacies, and independent pharmacies. Several different fee structures have been used. A client may be charged a simple fee per question, or may be offered a detailed menu of services (written medication evaluations, continuing education programs, guideline development for particular diseases) with the final cost dependent on the number and types of services chosen by the contracting party.

Services provided within these contracts may include providing answers to drug information requests, preparation of new drug evaluation monographs, formulary drug class reviews, development of MUE criteria, providing journal reprints, pharmacoeconomics evaluations, writing a pharmacotherapy newsletter, and providing continuing education programming. Additional services the center may make available are access to online resources, access to in-house question files for sharing information on commonly asked questions, and direct access to the center's Internet home page for review of medical use evaluations, formulary reviews, and newsletters. One center reports providing information on drug shortages to the American Society of Health-System Pharmacists through a grant. Frequently, the contracting drug information center also has responsibilities for pharmacy services (drug information, drug policy) as part of an entire health system.