Gathered around Dean Peter Doukas are the future of pharmacy. From left: Navneet Bassi, first year; Shawn Spencer, graduate student; Doukas; Gina Scott, second year; Manuel Espinosa, first year; Dainius Didzbalis, second year; and Sakinah Purnell, second year.

What is the current role of pharmacists?

Until recently, pharmacists were charged primarily with the lawful distribution of drugs, highly potent chemicals that require professional oversight. This important responsibility in isolation, however, fails to take full and proper advantage of the medication-related expertise pharmacists can contribute to patient care. The patient orientation of the profession continues to grow with the national transition to the Pharm.D. as the sole entry-level degree. Pharmacists are the health professionals most accessible to the public, interacting on a daily basis with more patients than any other health practitioner. The managed care environment, with its emphasis on cost containment, continues to place increasing numbers of patients with complicated health problems in an ambulatory setting, with the expectation that sophisticated drug therapy will diminish the need for hospitalizations. Simultaneously, physicians are expected to serve larger numbers of patients within a tighter time frame. Current health care relies heavily on a “team approach” to patient treatment, wherein the pharmacist serves as the drug expert.

Where do you see the field of Pharmacy going in the future?

The provision of what is now being called “pharmacist care” complements the role of physicians and provides a means for improving patient compliance with a therapeutic  regimen, helping to ensure better outcomes. This is an increasing trend that is responding to the growing number of literature citations documenting the positive contributions of pharmacist cognitive services to the quality of patient care while simultaneously promoting cost savings. We will see more complicated therapies derived from the biotechnology revolution, coupled with an aging population. The number of annual prescriptions will soar to well over four billion within five years. My expectation is that the pharmacies that you see currently will change in some measure to become local clinical data gathering sites as well. In addition to providing your prescriptions, there may be certain device-based clinical tests that will be performed right there at the pharmacy. The data will then be transmitted directly to the physician. You’re probably going to see more and more patient care partnerships between pharmacists and physicians in which there’s rapid exchange of information concerning monitoring and care of the patient.

What is the current role of pharmacists? What opportunities will exist for current and future graduates of TUSP?

Graduates have a broad array of opportunities in professional and corporate settings, and this is reflected in specific elective tracks within our program that permit differentiation of the degree. Our initiatives with the pharmaceutical industry, the FDA, the Institute for Safe Medication Practices, the Fox School of Business and our new Center for Pharmaceutical Health Services Research enrich the intellectual environment in which students seek to develop their potential. Our educational program will continually evolve to reflect changes in the field and will be especially influenced by developments in the industry.

You’ve mentioned that drug therapy is going to change drastically in years to come. Can you explain that further?

The technological ability to collect, transmit and analyze large amounts of data will provide the basis for population-based therapeutic models. This same data analysis capability, coupled with completion of the human genome project, will bring about more individualized therapies. The hope is that certain therapies will become tailored more exactly to what a patient needs. Many of the new drugs will require novel delivery systems. It’s really an entirely different way of approaching the issue.

Is there a single aspect of what students now learn that you think will be radically  different in the future? Perhaps something that doesn’t even exist today?

Yes, absolutely: the drugs themselves. We’re going to be shifting to a whole new set of drugs that will be the knowledge that has come from the genome. Seventy percent of the drugs that we have today weren’t around just 30 years ago. There are currently about 100 or so relatively small biotechnology companies in existence, each seeking to exploit the knowledge of the genome to produce unique, efficacious therapies.

It seems like with the changes to come, there will be no limit as to the number of new drugs that will be created.

That’s true. The drugs that we’ve been dealing with up until now have roughly 500 molecular targets. With the genome project, the number of targets will increase to about 10,000. That’s a 20-fold increase in the number of potential targets that you’re looking to influence in treating certain problems or diseases. There’s going to be a tremendous increase in the number of compounds that will require professional oversight.

As it stands now, the only real way we have to individualize a drug is through dosage levels, correct? Will we be combining two or more drugs to treat specific diseases or conditions?

In fact, we routinely use drug combinations now. Not in all cases, but in certain disease states in the future we’re going to take into account the particular genetic library that a patient has. What do I mean by that? You can target particular genes for particular diseases, but you also have issues of drug metabolism. Certain people either have an excess or a relative lack of metabolizing enzymes for eliminating drugs. You’ll be better able to target the drug to the person’s own system from the standpoint of his or her ability to metabolize the compound.

Do you think the pharmacist who now works behind a counter dispensing drugs will even exist in the future?

For solid dosage forms — powders and capsules — robotics will take care of the dispensing, similar to what you see currently in many hospital pharmacies. For most liquids, we’ll probably also be able to come up with a way to dispense from a large machine. Technicians will oversee the robotics, but you’re still going to need the pharmacist to educate the patient and to be in control of these highly potent materials.

There has been a trend for several years now for drugs to become available over the counter much more quickly than in years past. Do you see this continuing?

Yes. It will continue for a variety of reasons that are mostly economic. Nevertheless, it can be a dangerous practice since these materials are quite powerful. Pharmacists will need to better educate patients about drugs that they purchase over the counter, as well as about prescriptions. Pharmacists should, for safety reasons, be involved in educating patients about all of the medications they take.

If you had to describe the ideal job for a future practicing pharmacist, how would you do it?

The scenario of the pharmacist partnering in a therapeutic relationship with the physician and patient is certainly the clinical ideal. That is what will ensure the best quality of life and health for the patient and the full and efficient use of our human and material resources.

What changes do you think the Temple University School of Pharmacy will undergo in years to come?

We will get even better at maximizing our resources and our professional relationships with our medical colleagues, the industry and the FDA and will continue to provide an excellent intellectual environment for students, faculty and staff.