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IV.
Current and Future Adequacy of Pharmacist
Supply
The Bureau of Labor Statistics defines
a shortage in a market economy as a situation
“when the demand for workers for
a particular occupation is greater than
the supply of workers who are qualified,
available, and willing to do that job.”
While this report looks at the current
shortfall of pharmacists, the focus of
this study is to assess the future adequacy
of supply taking into consideration key
trends in supply and demand determinants.
While there is evidence of a current
national shortage of pharmacists, the
size of the shortage seems to have declined
in recent years. A 2004 study by the
American Society of Health-System Pharmacists
reports that 5 percent of hospitals’
budgeted pharmacist positions were vacant—a
decline from 8.9 percent in 2000.[46]
A July 2004 survey by the National Association
of Chain Drug Stores (NACDS) Foundation
found that chain store pharmacies reported
approximately 4,000 vacancies (a vacancy
rate of 5 percent).[47]
Combining information from different
sources, it was estimated that in 2004
(the base year for the projection model)
there were an estimated 10,400 unfilled
FTE positions across all settings that
employ pharmacists, or a vacancy rate
of approximately 5 percent.[48]
The Pharmacy Manpower Project, sponsored
by a consortium of organizations interested
in collecting, analyzing, and disseminating
data on the adequacy of pharmacist supply,
developed the Aggregate Demand Index (ADI)
to track the level of employer difficulty
in hiring pharmacists over time and across
States. The ADI suggests that in March
2007 most employers across the Nation
were experiencing some difficulty in filling
open positions, with the level of difficulty
down slightly from March 2006. Among the
50 States plus the District of Columbia,
the ADI suggests that 46 States are experiencing
some difficulty filling open positions,
three States (Alabama, Kentucky and California)
report significant difficulty filling
open positions, and two States (Rhode
Island and Vermont) report that supply
seems to be in balance with demand in
their State.[49]
No States reported having an excess supply
of pharmacists.
The shortfall of pharmacists has contributed
to rising earnings for pharmacists, with
an analysis of BLS data finding that average
salaries for pharmacists have risen about
6 percent per year over the past several
years. The median compensation for pharmacists
in the United States is approximately
$100,000.[50]
Rising compensation levels have the following
short term impacts on supply: (1) some
inactive pharmacists are drawn back into
the labor force, (2) some pharmacists
work more hours (e.g., working full time
instead of part time, or working multiple
jobs), (3) some pharmacists work fewer
hours (e.g., finding that their pay is
adequate working just one full time job
and no longer needing to work multiple
jobs), and (4) some pharmacists delay
retirement. In the longer term, interest
in pharmacy as a profession rises and
more people enroll in schools of pharmacy.
Rising salaries also depress demand for
pharmacists, with some pharmacies reducing
hours rather than pay higher labor costs,
and some pharmacies investing in equipment
and non-pharmacist labor (e.g., technicians)
to increase the productivity of their
existing pharmacists.
Political and regulatory forces also
influence the adequacy of pharmacist supply.
The National Association of Boards of
Pharmacy (NABP) conducts an annual Survey
of Pharmacy Law documenting the laws,
rules, and regulations that govern pharmacy
in each State, the District of Columbia,
and Puerto Rico. Comparing the 2000-01
Survey of Pharmacy Law to the 2006 edition,
eleven States, or 20 percent, have increased
or eliminated the maximum allowable ratio
of pharmacist technicians to pharmacists
in ambulatory care settings. Between
2000 and 2006, the number of States allowing
technicians to compound medications for
dispensing increased from 39 to 48, and
the number of States allowing technicians
to call physician offices for refill authorization
increased from 34 to 40. Since HRSA’s
2000 Report to Congress - The Pharmacist
Workforce: A Study of the Supply and Demand
for Pharmacists, the number of pharmacy
technicians employed has increased significantly.
BLS reports a nearly 40 percent increase
in numbers of pharmacy technicians, from
about 191,000 in 2000 to nearly 267,000
in 2005. BLS figures on pharmacists over
this same time period show an 8 percent
increase.
Comparison of the baseline supply and
demand projections produced for this report
suggests that the future supply will be
adequate only when combining an optimistic
supply scenario with a conservative demand
scenario (Exhibits 42 and
43). Growth in supply is sufficient
to serve the projected demand of a growing
and aging population only if per capita
consumption of pharmaceuticals remains
at current levels. Per capita consumption
is likely to grow, however, as new medical
advances increase the types of diseases
that can be treated and new preventive
medicines are discovered.
Exhibit 42. Pharmacist Shortfall
under Alternate Scenarios
 [D]
Source: Projections from the PhSRM.
Exhibit 43. FTE Shortfall Projections
|
Demand
Scenario: |
Likely
Scenario |
Shortfall
Under Alternate Scenarios |
|
Moderate
Rx/capita Growth |
Shortfall |
High
Rx/capita Growth |
Low
Rx/capita Growth |
Moderate
Rx/capita Growth |
Moderate
Rx/capita Growth with Current System
Stressed by 10% |
| Supply
Scenario: |
Baseline
|
|
Baseline |
Baseline |
No
Growth in Educational Capacity Post
2008 |
Baseline |
| 2004 |
191,200 |
201,600 |
10,400 |
5% |
10,400 |
10,400 |
10,400 |
29,500 |
| 2005 |
193,900 |
205,500 |
11,600 |
6% |
12,900 |
10,400 |
11,600 |
31,100 |
| 2006 |
196,900 |
212,500 |
15,600 |
7% |
18,300 |
13,100 |
15,600 |
35,800 |
| 2007 |
201,200 |
217,600 |
16,400 |
8% |
20,700 |
12,000 |
16,400 |
37,000 |
| 2008 |
205,600 |
222,900 |
17,300 |
8% |
23,400 |
11,000 |
17,300 |
38,400 |
| 2009 |
210,100 |
228,100 |
18,000 |
8% |
26,200 |
9,600 |
18,100 |
39,600 |
|
2010 |
214,400 |
233,200 |
18,800 |
8% |
29,000 |
8,600 |
19,100 |
40,900 |
|
2011 |
218,600 |
238,200 |
19,600 |
8% |
31,900 |
7,300 |
20,200 |
42,200 |
| 2012 |
222,900 |
243,400 |
20,500 |
8% |
34,700 |
6,000 |
21,500 |
43,600 |
|
2013 |
227,200 |
248,700 |
21,500 |
9% |
38,000 |
5,100 |
23,000 |
45,100 |
|
2014 |
231,500 |
254,200 |
22,700 |
9% |
41,300 |
4,000 |
24,800 |
46,800 |
|
2015 |
235,700 |
259,800 |
24,100 |
9% |
45,000 |
3,100 |
26,800 |
48,700 |
| 2016 |
240,300 |
265,400 |
25,100 |
9% |
48,300 |
1,800 |
28,700 |
50,300 |
|
2017 |
244,900 |
271,100 |
26,200 |
10% |
51,900 |
600 |
30,600 |
51,900 |
|
2018 |
249,800 |
276,900 |
27,100 |
10% |
55,100 |
-1,100 |
32,400 |
53,400 |
|
2019 |
254,800 |
282,700 |
27,900 |
10% |
58,500 |
-2,500 |
34,300 |
54,700 |
|
2020 |
259,900 |
288,800 |
28,900 |
10% |
62,000 |
-4,200 |
36,400 |
56,300 |
|
2021 |
265,400 |
294,800 |
29,400 |
10% |
65,100 |
-6,200 |
38,100 |
57,400 |
| 2022 |
271,200 |
301,300 |
30,100 |
10% |
68,500 |
-8,200 |
40,100 |
58,700 |
|
2023 |
277,100 |
308,000 |
30,900 |
10% |
71,900 |
-10,300 |
42,300 |
60,100 |
| 2024 |
282,800 |
314,600 |
31,800 |
10% |
75,800 |
-12,100 |
44,600 |
61,600 |
| 2025 |
288,500 |
321,600 |
33,100 |
10% |
80,000 |
-13,700 |
47,500 |
63,600 |
|
2026 |
294,400 |
328,400 |
34,000 |
10% |
84,000 |
-15,700 |
50,000 |
65,100 |
| 2027 |
300,400 |
335,600 |
35,200 |
10% |
87,800 |
-17,700 |
53,000 |
67,000 |
|
2028 |
306,400 |
342,500 |
36,100 |
11% |
92,000 |
-19,700 |
55,800 |
68,600 |
|
2029 |
312,500 |
349,600 |
37,100 |
11% |
96,100 |
-22,100 |
58,600 |
70,300 |
|
2030 |
318,800 |
356,700 |
37,900 |
11% |
100,000 |
-24,300 |
61,500 |
71,700 |
Source: Projections from the PhSRM.
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