US Survey Signals Big Shifts in Primary Care to Pharmacy & Clinic Settings as Consumers Seek Lower Medication and Healthcare Costs

As American consumers look for healthcare that is easier to access and not one-size-fits-all, together with prescription medications that are safer and more affordable, a new survey commissioned by Wolters Kluwer shows how willing consumers are to dramatically transform the primary care landscape, changing the roles, systems, and institutions we know today. The survey reveals surprising inter-generational trends among Americans ready to extend their trust for care beyond traditional settings ? even to genomic testing ? if it means lower costs and better health outcomes.

"Americans made it clear: it's time for healthcare to get ready for big changes. Gen Z and Millennials are thinking differently about the who and where of healthcare and medication prescribing, compared to Boomers and Gen Xers," said Peter Bonis, MD, Chief Medical Officer, Wolters Kluwer, Health.

Key Survey Findings:
Primary care moving to pharmacy and retail clinic settings
According to the survey, titled Pharmacy Next: Health Consumer Medication Trends, Americans are bullish on the shift of primary care from the traditional primary care provider (PCP) office to newer models for care. But that outlook varies among generations:

• Looking ahead five years, three out of five American health consumers (61%) can envision most primary care services being provided at pharmacies, retail clinics and/or pharmacy clinics instead of going to a PCP. However:
  • 70% Millennials anticipate a move to new care settings. Gen Z and Gen X trail closely at 66% and 65%.
  • Among Baby Boomers and older Americans (Boomers+), only 43% see this transition taking place.
• At least half of Americans see potential savings on medical expenses as an incentive to look beyond solely physician-credentialed providers.
• To staff these new settings, consumers would trust pharmacists (56%), nurse practitioners (55%) and physician assistants (50%) to provide healthcare and prescriptions if it meant lower costs.
• Trust varies greatly along gender lines in the above question, with women 20% more likely than men to trust a nurse practitioner (65% vs. 45%) and 9% more likely to trust a physician assistant (55% vs. 46%).

Americans are ready for the pharmacist as prescriber
When the FDA authorized pharmacists to prescribe Paxlovid to widen access to timely treatment, it signaled a recognition that pharmacists' roles can indeed expand to include prescribing, even in limited ways.

• Around three-quarters of Americans (72%) would be open to having medications prescribed by a specially-trained pharmacist instead of a doctor.
• Gen Z, Millennials, and Gen X stand out as much more open (78%, 80%, and 74%) than Baby Boomers and older Americans (Boomers+) (58%).

Pharmacogenomics: a key to safer, more personalized, more effective prescriptions
Pharmacogenomics, the science of using a person's genes to determine more targeted, person-specific medications was also explored in the survey. When provided with an overview of pharmacogenomics, Americans are very receptive to this more personalized approach to their care:

• Over seven in ten Americans say YES to providing a blood sample for genomic analysis if it meant that they'd receive more personalized, targeted medical care.
• While Americans in the Northeast, Midwest, and South shared similar responses (70%, 67% and 72%), Westerners stand out as potential early adopters, with 81% likely to say they would provide a sample for genomic analysis to make care more personalized.
• Will pharmacogenomics mean more personalized prescriptions? Over two-thirds of Americans (68%) believe their individual genomic information could play a future role in their providers' decisions about what medicines to prescribe.
• Over 4 in 5 Americans (82%) today would provide a sample for genomic testing if it meant that their prescriptions would be safer or more effective.
• 88% of Americans see an incentive for health insurance plans to cover genomic testing costs if it helps payers avoid wasted spending on ineffective or unnecessary medications.

Headwinds stalling transformation
To get to that future state, the survey found that there are pressing concerns today that need to be overcome first. From pharmacy staff being stretched to the limit to medication safety and cost woes, solutions for today's challenges must be part of a viable forward-looking strategy.

Customers worry about retail pharmacist burnout

• Half of Americans (51%) worry about potential problems with their prescriptions stemming from understaffed pharmacies.
• Gen Z and Millennials are even more likely (59% and 60%) to say they're worried about pharmacy staffing gaps than Gen X and Boomers+ (44% and 38%).
• Plus, half of consumers worry about getting the wrong dosage (50%), the wrong medication (50%) or the wrong instructions (47%). Altogether, these concerns highlight challenges that may be remedied by technology, workflow, and improved staffing.

Unanswered safety concerns at the pharmacy counter

• "Do you have any questions about your medications?" Despite hurried pharmacists and techs saying those words and prompting consumers to tap NO on the point-of-sale touch screen, there may be a huge unmet need for more answers to patients' questions about how safe a prescription is.
• For many consumers, their medications may not play well with other meds, causing undesired interactions and side effects that range from unpleasant to fatal. This concern weighs heavily on US health consumers: unknown interactions worry almost two-thirds of Americans. 65% are concerned possible interactions weren't identified when they or a loved one were prescribed medications.
• A whopping 97% of Americans say a pharmacist should have responsibility for informing them about the safety and/or effectiveness of their medications.
• Three out of five feel very strongly about this (60%), saying pharmacists should have a great deal of responsibility for this.

From skipping meds to mail-order Rx, Americans try to counter rising prescription costs

• As Americans struggle with rising expenses from inflation, almost two-thirds (64%) say prices for their medications have gone up over the past few years.
• Of those, almost one-third (35%) say their prescription costs have jumped 6-10%. This range is in line with inflation rates in the last 12 months (Oct. 2021-Nov. 2022 range: 6.222%-9.060%).
• Sadly, a staggering 44% of Americans admit to choosing not to fill a prescription because of the cost.
• That number of Americans skipping medications due to costs jumps to 56% among those without health insurance, compared to 42% for the insured.
• Looking for ways to lower costs and manage expenses, more than half (56%) often talk to their provider about prescribing alternate medications that cost less while fewer opt to approach their pharmacist (43%).
• Over three-quarters (77%) say if it meant lower costs, they would prefer to receive medication by mail.

Dr. Bonis adds, "From hospitals to doctors' offices, from pharmacies to pharma and beyond, healthcare must move to more affordable and accessible primary care models, adopt innovations that help deliver more personalized care, and address persistent safety and cost concerns that consumers have about their medications."

For more information and insights, visit the Wolters Kluwer Pharmacy Next resource page to download the survey executive summary and watch our expert panel discussion.

The Pharmacy Next: Health Consumer Medication Trends survey included 1,006 U.S. adults, 18 and older and is weighed by age, gender, household income, and education to be representative of the total U.S. population according to the U.S. Census Bureau. The survey was conducted online between September 19-26, 2022.

About Wolters Kluwer
Wolters Kluwer (WKL) is a global leader in professional information, software solutions, and services for the clinicians, nurses, accountants, lawyers, and tax, finance, audit, risk, compliance, and regulatory sectors. We help our customers make critical decisions every day by providing expert solutions that combine deep domain knowledge with advanced technology and services.

Wolters Kluwer reported 2021 annual revenues of ?4.8 billion. The group serves customers in over 180 countries, maintains operations in over 40 countries, and employs approximately 19,800 people worldwide. The company is headquartered in Alphen aan den Rijn, the Netherlands.

Wolters Kluwer provides trusted clinical technology and evidence-based solutions that engage clinicians, patients, researchers and students in effective decision-making and outcomes across healthcare. We support clinical effectiveness, learning and research, clinical surveillance and compliance, as well as data solutions. For more information about our solutions, visit https://www.wolterskluwer.com/en/health and follow us on LinkedIn and Twitter @WKHealth.

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