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Evolution of American Pharmacy


Out with the Old, in with the NewImage result for modern pharmacy

Beginning in 1950 pharmacy begin to change in many ways due to advances in technology. Just twenty years earlier pharmacists still compounded prescription medications. But with new technology and innovative pharmaceutical practices, the profession saw a twenty-five percent decrease in the need for compounding. New marketing techniques allowed for the production of packaged ready-made drugs. As a result, large pharmaceutical companies sprang up to keep up with demand.

Post World War II

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After the second world war ended in 1945, many veterans dealt with drug addiction and became susceptible to adverse reactions due to taking dangerous medications. Government agencies together with watch groups worked to monitor the problem and find ways to reduce unnecessary injury and death resulting from the consumption of unmonitored drugs. Lawmakers addressed the issue by passing strict guidelines for the use and dispense of medication.  Later in 1951 Congressman, Frank B. Keefe, of Wisconsin, put forth an amendment to the 1938 Federal Food, Drug, and Cosmetic Act. This change defined the difference between over the counter and behind the counter meds.

1950s

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This decade saw a growth in the availability of medications. Penicillin hit the market. Hospitals developed a system that allowed a pharmacist to dispense a generic product that mimicked a name brand product. Many pharmaceutical manufacturers’ protested this idea arguing that this would open up an unfair competitive product but complied with the law anyway.

1960s

Pharmaceutical centers begin with Eugene V. White who turned his drug store into an office type setting. He set the example for other pharmacy professionals to follow. Pharmacists’ role evolved to acting as a pharmaceutical consultant to customers. As a consultant, the pharmacist could apply more efficient safety controls for patients. Consulting was fruitful and lead to an ethics code established by the American Pharmacist Association and later cooperation with Medicare and Medicaid. As a result, expert pharmacists became the first line of inspection for accuracy and the communication of drug information between regulators and consumers. Third-party programs such as insurance agencies also required a pharmacist’s observation for accuracy and the necessity of prescriptions but still influenced consumers to purchase name brand drugs. Because of this, a thorough set up of further laws were in enacted to protect consumers.

1970s

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Computers added relief to the pharmacy with the replacement of paperwork and tracked harmful drug interactions, doses, etc., thus improving prescription care for patients.

1980s

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It seemed that over night, Walmart stores opened up in small towns across America and impacted small businesses to include corner drug stores. Many of these mall drug stores closed. A new demand for mail service prescriptions appeared as well. Managed patient care also became the norm. Pharmacies in the middle between patient and management companies needed to find ways to evolve with the times and so, pharmacy store management firms were created.

The 1990s and Beyond

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Pharmacists worked to meet the demand of growing populations in need of pharmaceutical care. The pharmacy today is run by a bunch of support positions. Pharmacists are at the top of this management. As the new technologies, innovations and improvements are made in medical care, the support for pharmacy operation does as well.

The Future of Pharmacy

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What will pharmacies look like in the future? What innovations can be created to speed up the waiting period for customers and their medications? How can we lower cost for these prescriptions for the consumer? What is the future role of pharmacist technicians and the pharmacists themselves?

These are a few questions to contemplate about when thinking about the future of pharmacy and may predict how the pharmacy profession will evolve for generations to come.

References:

Higby, Gregory J. “The Continuing Evolution of American Pharmacy Practice, 1952–2002.” Journal of the American Pharmaceutical Association (1996), vol. 42, no. 1, 2002, pp. 12–15., doi:10.1331/108658002763538017.

All pictures courtesy of Google Images.

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Development of the American Pharmacy


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In 1852, American pharmacists’ met at a conference in Philadelphia, Pennsylvania to create a pharmaceutical profession that would preserve their craft and separate it from the commercialization of drugs and remedies. American medicine was full of replication by ordinary folks who aimed to make a living selling a cheap or convenient product. Most of these products, peddled by salespersons, were not legitimate, but placebos labeled to deceive the buyer and rob them of their hard-earned money. (1)

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To understand how the pharmaceutical profession came to be, as we know it in our current time, consider how the evolution of American pharmacy influenced the need to professionalize the medicine trade. Early American doctors came to America already trained, so medicine was not new, but it was made very different than today. For example, doctors had to make medications in their kitchens. But as populations of settlers increased so did the demand for medicine. As a result, apothecary shops opened and druggists’ (commonly known at the time) began selling medications and medicinal remedies wholesale to the apothecaries and general stores. Some doctors and druggists’ began to patent their medicines because drugs, imported from overseas, were unregulated, and anyone could purchase them and sell them. The Revolutionary War, too, changed the availability of medicinal products because of high demand.(2)

1820-First-Pharmacopoeia

By the early 1800s, physicians began to attend medical schools for professional training. A portion of their courses taught them to write prescriptions for medications and send them to the apothecaries. The apothecaries could oversee the dispense of medications to many individuals at once rather than one individual or household at a time. In 1820, pharmacists’ endorsed the Pharmacopoeia of the United States of America and by 1828, they published one standard for drug production across America. Increased demand and specialization of pharmaceutical production spurred the establishment of college programs created for the specific study of medications. By taking the production of and marketing of drugs solely away from physicians, druggists’ created a way to specialize in medicine beyond doctors, clinics, and hospitals. This change was a critical turning point in the commercialization of medicine in America because specialization meant greater amount of production, and it provided increased availability to the buyer. (3)

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The commercialization of pharmacy in America inadvertently changed the relationship between physicians and pharmacists. As doctors increasingly attended medical school, they were able to broaden their clinical experiences with patients in hospitals and offices. Between 1808 and 1820, a national convention of physicians created a central book explaining all the necessary information about drugs. The book created a way for the physicians to separate themselves from the pharmacists. Doctors began to rely more on the pharmacy to dispense medications thus giving them more time to tend to patients. Druggists could now devote their time to a pharmaceutical career. The War of 1812 further spurred specialization of both careers because of the need for mass production of medicines. (4)

Soon after the end of the war, pharmacists established pharmaceutical colleges and American Pharmacy began its marketing. Between 1820 and 1860 grocery stores, apothecary shops, and drug stores all added specialized medications and treatments in order to make them more readily available to consumers. Pharmacy became big business and because pharmacists’ patented their medications they separated the real ones from fake. Patenting secured their sales because the buyer could purchase a trusted and legitimate product. However, these businesses drove a wedge between pharmacists and physicians who increasingly competed for business. Pharmacists began writing prescriptions without a doctor’s note and with the number of physicians increased by medical school training, Americans had access to more doctors than ever before.(5)

When the American Medical Association noted the amount of shoddy drugs that Europe imported into America, Congress enacted The Drug Importation Act of 1848. This act set standards for how drugs were imported, manufactured and sold in the United States. In 1852, pharmacists established the American Pharmaceutical Association.(6)

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Between 1800 and 1952 innovative physicians and druggists changed the American pharmacy from private to public enterprise. These professionals not only improved the availability but also the quality of medication for buyers. Pharmacists established business models and improved the welfare of Americans by separating the profession of doctor and pharmacy. Physicians and pharmacists made changes to better regulate how medication was to be dispensed. Even the federal government intervened to enforce laws to protect buyers against fraud. As the pharmacy became well established in American society, people could now choose for themselves which way they preferred to have their medications prescribed. They could choose physician or pharmacist for this. Either way, American consumers could trust doctors and pharmacists to sell them a product they could expect to be pure and legitimate.

1. American Pharmacy Before 1852 in Gregory Higby and Elaine Condouris Stroud, American Pharmacy (1852-2002): A Collection of Historical Essays (Madison, WI: American Institute of the History of Pharmacy, 2005), pg. ix.

2. Ibid.

3. Ibid., x.

4. Ibid.

5. Ibid., xi.

6. Ibid., “Significant Dates in U.S. Food and Drug Law History,” Significant Dates in U.S. Food and Drug Law History, section goes here, accessed March 26, 2015, http://www.fda.gov/AboutFDA/WhatWeDo/History/Milestones/ucm128305.htm.; “The Story of the Laws Behind the Labels.” The Story of the Laws Behind the Labels. Accessed March 26, 2015. http://www.fda.gov/AboutFDA/WhatWeDo/History/Overviews/ucm056044.htm.

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