Shedding Light on the Challenges in Pharmacy Industry

Neil Creasey serves as the System Director of Pharmacy Operations at Holzer Health System, bringing over two decades of experience in the pharmacy sector to his role. Before ascending to his current directorial position, he was instrumental in overseeing the operations and regulatory compliance of multiple pharmacies and clinics across the Holzer Health System in Southern Ohio. His remit extended beyond operational oversight, encompassing business growth initiatives, staff development programs and strategic contract negotiations.

Creasey’s professional journey in pharmacy began at the foundational level as a pharmacy technician with Walgreens, where he cultivated a deep understanding of pharmacy operations and patient care. His career trajectory took a significant turn when he assumed the role of managing ambulatory operations at the Cleveland Clinic's flagship store on Euclid Avenue in Cleveland. Throughout his career, Creasey has demonstrated a commitment to excellence in pharmacy management, evidenced by his strategic leadership and innovative approach to healthcare service delivery.

Through this article, Creasey shares his insights on the challenges encountered by the pharmacy industry and its future.

Could you shed more light on the major challenges the healthcare industry is currently facing?

The healthcare sector is dealing with numerous challenges, but three major ones stand out due to their widespread impact and complexity.

Staffing shortages have emerged as a critical issue. Recent regulatory changes in Ohio and other states demanding certification for technicians for specific duties have exacerbated this challenge. This situation is worsened by a lack of educational programs for technicians, contributing to a shortage of qualified professionals. Historically, technician roles have been perceived as entry-level despite their critical support to pharmacists, akin to nurses on the floor. This perception has been a barrier to recognizing these positions as viable career paths, leading to high turnover rates. Efforts to rectify this involve offering competitive wages and clear career advancement opportunities to enhance job satisfaction and stability.

"There’s a misconception that protecting your own turf is the way to success. but the broader picture tells us something different–the health and well-being of our global community hinge on our ability to work together and share knowledge and resources"

Drug supply disruptions stand as another constant battle. Influenced by global events, including wars and supply chain complications, these disruptions are highlighted during events like hurricanes, which can lead to significant shortages of critical medications. The COVID-19 pandemic further strained the system, with shortages of antivirals, steroids, and currently, essential medications like lidocaine. These instances underscore the fragility of our supply chains and the need for robust solutions to maintain medication availability.

The healthcare payer system presents a substantial barrier to delivering effective care. The operations of pharmacy benefit managers (PBMs) and health maintenance organizations (HMOs) significantly influence the cost and delivery of medical services. This system restricts the services that can be offered to patients, placing financial constraints on healthcare providers and limiting their ability to deliver care based on clinical judgment and patient needs.

How do you see the landscape of the industry evolving in the near future, specifically in the next 18 to 24 months?

Thinking about the near term doesn’t quite capture the scale of change I anticipate; my vision extends beyond just the next couple of years. However, in the immediate 18-to-24-month timeframe, we’re set to witness significant developments, notably the continued introduction of biosimilars. This wave of biosimilars will play a pivotal role in shaping our payer networks, influencing how we manage costs and pricing. But that’s just part of the story.

What truly captures my attention is the evolving role of pharmacists within the healthcare ecosystem. The pandemic underscored the potential of pharmacists to serve as mid-level practitioners, with several states adapting their legislation to incorporate this expanded role. Looking ahead, I’m keen on leveraging the clinical skills of my pharmacy team to bridge the gaps in the mid-level provider network. This strategy optimizes our existing resources and introduces new revenue streams without incurring additional costs. More importantly, it empowers my team to practice at the peak of their capabilities, which they find incredibly fulfilling.

 The shift from a transactional, ‘pill mill’ model to a more clinical, holistic approach to patient care marks a significant departure from the past. The opioid crisis has fundamentally altered the landscape, pushing the pharmacy sector away from a focus on dispensing medications toward a more integrated role in patient care. This transition isn’t just a shortterm adjustment; it’s part of a broader, systemic shift toward comprehensive care that considers the whole patient over the long term rather than just addressing isolated symptoms.

So, while the next 18 to 24 months will bring its share of changes, the horizon I’m looking toward is much broader. We’re on the cusp of a transformation that will redefine pharmacy’s role in healthcare over the next three to five years, moving toward a model that emphasizes overall wellness and continuous care.

What advice would you offer someone aspiring to succeed in your field, especially with the current changes in the industry?

It’s all about inter-collaboration. In the healthcare industry, there’s a tendency to guard our patient base and our operational territories zealously. But here’s the thing–every health system has its strengths and unique contributions. Embracing the opportunity to collaborate to share insights and challenges with leaders from other systems is where true growth happens.

Don’t hesitate to reach out or build critical relationships with fellow executives. Discuss the hurdles you’re facing and celebrate your victories together. The collective progress in healthcare and the strides we’ve made in improving health outcomes and extending life expectancy stem from this spirit of cooperation.

There’s a misconception that protecting your own turf is the way to success. But the broader picture tells us something different–the health and well-being of our global community hinge on our ability to work together and share knowledge and resources.