Minority Student Perceptions of the Impact of Financial Cost of Pharmacy School and Career Choice at a Historically Black College and University (HBCU).

OBJECTIVE: One of the barriers that might prevent an underrepresented minority (URM) individual from pursuing a professional career in the United States is finances. The high disproportionate burden of student debt among URM students further perpetuates the racial wealth gap. Therefore, this study sought to evaluate the extent to which URM students' personal finance perceptions, and current and projected student loan indebtedness affect postgraduation career intentions. METHODS: A cross-sectional analysis was conducted using data from four cohorts of pharmacy students using a survey from November 2, 2022, to February 1, 2023. The financial perception survey included subscales namely personal finance self-efficacy, debt influence and pressure, and risk mitigation and retirement. Descriptive statistics, simple logistic regression, and multivariate logistic regression analyses were conducted. RESULTS: In total, 93 students completed the survey and had a mean age of 28.1 ± 5.3 years. Seventy-one percent of the respondents were female, and 67.7 % had completed a 4-year bachelor's degree. There was a significant association between age and the intention to pursue postgraduate training as well as a significant association between risk mitigation and retirement perceptions and intention to pursue postgraduate training after adjusting for other factors. CONCLUSION: Among students from largely minority backgrounds, age, and confidence in their ability to make wise investment decisions for retirement are associated with a greater likelihood of pursuing postgraduate training opportunities.

Cost-effectiveness and Economic Benefit of Continuous Professional Development for Drug Prescribing: A Systematic Review.

Importance: The economic impact of continuous professional development (CPD) education is incompletely understood. Objective: To systematically identify and synthesize published research examining the costs associated with physician CPD for drug prescribing. Evidence Review: MEDLINE, Embase, PsycInfo, and the Cochrane Database were searched from inception to April 23, 2020, for comparative studies that evaluated the cost of CPD focused on drug prescribing. Two reviewers independently screened all articles for inclusion and reviewed all included articles to extract data on participants, educational interventions, study designs, and outcomes (costs and effectiveness). Results were synthesized for educational costs, health care costs, and cost-effectiveness. Findings: Of 3338 articles screened, 38 were included in this analysis. These studies included at least 15 659 health care professionals and 1 963 197 patients. Twelve studies reported on educational costs, ranging from $281 to $183 554 (median, $15 664). When economic outcomes were evaluated, 31 of 33 studies (94%) comparing CPD with no intervention found that CPD was associated with reduced health care costs (drug costs), ranging from $4731 to $6 912 000 (median, $79 373). Four studies found reduced drug costs for 1-on-1 outreach compared with other CPD approaches. Regarding cost-effectiveness, among 5 studies that compared CPD with no intervention, the incremental cost-effectiveness ratio for a 10% improvement in prescribing ranged from $15 390 to $437 027 to train all program participants. Four comparisons of alternative CPD approaches found that 1-on-1 educational outreach was more effective but more expensive than group education or mailed materials (incremental cost-effectiveness ratio, $18-$4105 per physician trained). Conclusions and Relevance: In this systematic review, CPD for drug prescribing was associated with reduced health care (drug) costs. The educational costs and cost-effectiveness of CPD varied widely. Several CPD instructional approaches (including educational outreach) were more effective but more costly than comparators.

Economic Contributions of a College of Pharmacy to the Surrounding Communities and State.

Objective. To quantify the monetary value of economic contributions of a state-funded college of pharmacy as it pursues its missions of teaching, research, service, and patient care. Methods. An economic analysis was performed by applying the Impact Analysis for Planning (IMPLAN) Economic Input-Output Model to financial and enrollment data of the University of Tennessee Health Science Center College of Pharmacy. Results. A total of $94.1 million was attributed to the college in fiscal year 2018, which included $50.7 million of total direct expenditures by the college, its students, and visitors; the indirect effect of over $17 million; and the induced effect of $26.4 million. The college directly employed 117 full-time equivalent employees and 39 pharmacy residents, and supported 763 additional jobs through the economic activities it stimulated. In addition, the presence of the college and its economic contribution enabled federal, state, and local taxing authorities to collect $12 million in tax revenues to support government and public programs. Conclusion. Demonstrating the economic value of colleges of pharmacy is critical when seeking support from campus administrators, state legislators, charitable foundations, government agencies, and industry.

Analysis of Educational Debt and Income Among Pharmacists and Other Health Professionals.

Objective. To evaluate educational debt-to-income trends in pharmacy, dentistry, medicine, optometry, and veterinary medicine in the United States from 2010 to 2016. Methods. A retrospective analysis of educational debt and income for selected health professions was conducted. Data on student loan debt were collected from professional organizations and data on income were collected from the American Community Survey. Ratios of the mean educational debt of graduating students to the median annual income for their respective profession were calculated for 2010 through 2016. Average change per year in debt, income, and debt-to-income ratio were calculated. Results. Debt-to-income ratios for all selected health professions except medicine exceeded 100%. For physicians, debt-to-income ratios ranged from 89% to 95%. On average, physicians (-0.3 percentage point) and optometrists (-0.5 percentage point) had negative changes in their debt-to-income ratios from 2010 to 2016. Average increases per year in debt-to-income ratio of veterinarians, pharmacists, and dentists were 5.5, 5.7, and 6.0 percentage points, respectively. From 2010 to 2016, dentists had the largest average increase per year in debt ($10,525), while physicians had the largest average increase per year in income ($6667) and a minimal average debt increase per year ($5436). Pharmacists had the second largest average increase per year in debt ($8356). Conclusion. Educational debt-to-income ratios in the United States increased considerably over the past decade among pharmacists, dentists, and veterinarians and can negatively impact health professionals as well as patient care. Innovative strategies are needed to alleviate the educational debt burden.

Before We Talk About Student Debt Cancelation, Can We Talk About Interest Rates?

Recently, several presidential candidates in the Democratic primary have created media buzz with policy proposals to eliminate debt (either partially, or completely) for millions of Americans.1 Given the rise in tuition prices and growing debt for pharmacy graduates over the past decade, these proposals may offer hope for those still drowning in debt and potentially resentment for others who sacrificed making other investments to pay down student loans.2-4 While bold policy proposals help make great sound bites and campaign ads, they may also divert attention from more pragmatic solutions where a larger majority of people with different political biases could come to consensus. This commentary focuses less on flashy political rhetoric and more on a boring aspect of student loans: the mathematical components of debt. Using the Class of 2017 exiting survey data published by the American Association of Colleges of Pharmacy (AACP) Office of Institutional Research & Effectiveness,5 this article aims to demonstrate how more moderate steps to reduce interest rates may offer relief for pharmacy graduates while avoiding potential resentment and other unintended consequences.4.

Inclusion of Socioeconomic Status as an Additional Criterion in Holistic Pharmacy School Admission Processes.

Objective. To investigate the impact of socioeconomic status as an admissions criterion for pharmacy school admissions. Methods. Using de-identified data from two PharmCAS application cycles (2012-2013 and 2015-2016), a new socio-economic status indicator was crafted based on complex parental education and occupation information provided by applicants. The indicator was calibrated on federal standards to ensure uniform composition regardless of the applicant's location. The indicator was then used to describe acceptance patterns within each pharmacy application cycle, explore correlations with other demographic and academic indicators, and develop a regression model to understand the impact of this indicator on applicants' acceptance into pharmacy school. Results. The new education and occupation (EO) indicator for an applicant's parent(s) provided new insight into complex applicant demographic information. The number of academically qualified applicants that could have received further admission consideration based on identification of a low socioeconomic status for parent one were 2016; n=435, 13%, 2103; n=767, 14%. The EO indicator by itself had limited value for predicting acceptance rates and became less predictive when academic performance variables were incorporated, demonstrating socioeconomic status was not accounted for in admissions. Conclusion. Based on the Accreditation Council of Pharmacy Education Standards 2016, schools are required to admit a diverse group of students. The addition of the EO indicator will be valuable in identifying diverse and promising future pharmacists during each pharmacy school's holistic review process.

A Cost-Benefit Analysis of Teaching and Learning Technology in a Faculty of Pharmaceutical Sciences.

Objective. To conduct a cost-benefit analysis (CBA) of investment in teaching and learning technology (TLT) by a college of pharmacy in a large, research-intensive university in Canada. Methods. Document analysis was used to determine the goals and objectives of the university and college for TLT use. Semi-structured interviews were conducted with faculty members to understand their perspectives on the value of technology for teaching and learning, their metrics to assess value, and an estimate of social value using a willingness to pay (WTP) exercise. A CBA was used to compare the social value against the cost of the investment in TLT. Results. Twenty-one faculty members participated in semi-structured interviews. National, university, and college goals for TLT were diffuse and nonspecific in terms of the intended use or the metrics by which implementation and impacts on the quality of teaching could be assessed. The mean WTP for this technology was Can$4.38M and the cost of investment was Can$4.25M. The primary analysis showed a small positive net benefit of the investment (Can$134,456), although this difference was not significant. All dollar figures are given in Canadian dollars (CAD). Conclusion. The college's monetary investment in TLT was approximately equal to the social value placed on TLT by faculty users. Conducting a CBA on technology can bring greater understanding among faculty members of the college's curriculum and pedagogical practices as well as financial decision-making. Greater clarity about the goals and objectives for TLT could help to maximize the value of investment in this area.

Student Pharmacists' Personal Finance Perceptions, Projected Indebtedness Upon Graduation, and Career Decision-making.

Objective. To evaluate the extent to which Doctor of Pharmacy students' personal finance perceptions, projected student loan indebtedness, and demographic characteristics predict postgraduation career intentions. Methods. Students at three pharmacy colleges completed a 31-item survey instrument that assessed personal finance perceptions, self-efficacy beliefs, anticipated student loan debt upon graduation, postgraduate intentions, anticipated practice setting upon graduation, and demographic characteristics. Logistic regression models were used to examine the extent to which personal finance perceptions, student loan indebtedness, and demographic characteristics predicted postgraduate intentions and anticipated practice setting. Results. There were 763 usable responses obtained (response rate=90.3%). Students reported an anticipated personal student loan debt at graduation of $162,747 (SD=$87,093) and an estimated 7.4 (SD=5.8) years to pay off non-mortgage debt postgraduation. Fifty-three percent of students reported planning to practice in a community pharmacy setting postgraduation, and 54% indicated they intended to enter practice directly. Student loan indebtedness was not a significant predictor of whether students planned to pursue postgraduate training. There was a significant association between debt influence and pressure perceptions and students' plans to pursue postgraduate training (aOR=0.78; 95% CI=0.65-0.94). The odds of indicating hospital (vs chain community) pharmacy as the anticipated setting decreased 36% with every one point increase in debt influence and pressure perceptions (aOR=0.64; 95% CI=0.50-0.81). Conclusion. Pharmacy students' perceived debt pressure and influence predicted their intention to enter practice directly (vs pursuing postgraduate training) and to select a career in chain community pharmacy (vs hospital pharmacy). Student loan indebtedness was not a significant predictor of postgraduate training intentions. These findings suggest that interventions that equip students to manage the pressure associated with large student loan debts should be explored.

Pharmacy-led ward-based education reduces pharmaceutical waste and saves money.

OBJECTIVES: To measure the effectiveness of pharmacy-led ward-based education sessions for pharmaceutical waste. METHODS: A pharmacy technician delivery pharmaceutical waste education in 2017. To measure the impact, results from pharmaceutical wastage audits from 2016 and 2018 were compared. KEY FINDINGS: Pharmacy-led ward-based education reduces pharmaceutical waste and saves money. It was calculated that the cost of medication wastage was reduced by $1715.67 in the audit period, extrapolating to an annual saving of $44 607.45. CONCLUSIONS: The findings highlighted the importance of pharmacy technicians and provided evidence for an advanced scope pharmacy technician ward role to reduce pharmaceutical wastage.

The Impact of the National Institute for Pharmaceutical Technology and Education on Academic Research.

Surveys of institutional representatives of member institutions and faculty members engaged in the National Institute for Pharmaceutical Technology and Education (NIPTE) revealed that NIPTE is having a positive impact on academic research in the area of pharmaceutical technology by aligning research directions with FDA needs, by providing funding that may not be available elsewhere, and by creating a collegial and collaborative relationship among researchers in this area from various institutions. NIPTE is contributing to the viability of pharmaceutics and pharmaceutical engineering research in academic settings. Some responders cite the fluctuations in funding and relative low levels of funding received as a problem in maintaining programs, but most perceived a positive impact.

Differentiating predatory scholarship: best practices in scholarly publication.

OBJECTIVE: The intent of this article is to define predatory publishing, identify the risks and costs associated with publishing scholarship with these types of organizations and to provide recommendations for best practices how a potential author can protect themselves against predatory organizations. METHODS: A thorough review of the literature concerning predatory publishing was conducted and gleaned for best practices along with the authors' experiences. KEY FINDINGS: Pharmacy scholars and researchers worldwide recognize the virtues of the open access (OA) publication system, which is intended to freely disseminate research electronically, stimulate innovation and improve access to scholarship. Both subscription-based and OA publication systems, however, have potential areas of conflicts, including coordination of the peer-review process and the potential for the publisher to capitalize on selling the commodity in a capitalistic society. The intent of OA is welcomed; however, publishers are still in a business and profits need to be made. It is by the exploitation of the model that has given rise to a small but growing subset known as predatory publishers. CONCLUSIONS: Pharmacy researchers and clinicians alike need to be aware of predatory organizations, both publishers and meeting organizers, when seeking a venue to publish their own scholarly research. Additionally, this knowledge is critical when evaluating medical literature in providing direct patient care services to assure the best available evidence is utilized.

Criteria for evaluating global health partnerships in colleges of pharmacy and health sciences.

BACKGROUND AND PURPOSE: The demand for international experiences as part of education and training for healthcare providers continues to increase. As schools/colleges of pharmacy increase training opportunities in global health, there is a demand for a strategic way to evaluate opportunities. Evaluation tools can be utilized to facilitate this type of assessment. EDUCATIONAL ACTIVITY AND SETTING: The purpose of this article is to highlight two different international experiential education site evaluation tools, discuss lessons learned when applying these tools in the field, and outline steps for a college of pharmacy to create their own tool to meet institution specific needs. FINDINGS: The involvement of key stakeholders is important to developing an evaluation tool. Identification and prioritization of key criteria for assessing partnerships is essential. There are many criteria and each institution may consider a unique set of criteria, the most appropriate way to evaluate these, and who should be completing this evaluation. DISCUSSION AND SUMMARY: An evaluation tool may serve as a framework of discussion for new and existing international partnerships. The use of a global partnership evaluation tool allows for a more consistent discussion when deciding if the partnership is appropriate for both parties, helps the involved faculty know what criteria are required to be evaluated and outlines what resources should be considered.

Creating an Arms Race? Examining School Costs and Motivations for Providing NAPLEX and PCOA Preparation.

Objective. To examine the extent of financial and faculty resources dedicated to preparing students for NAPLEX and PCOA examinations, and how these investments compare with NAPLEX pass rates. Methods. A 23-item survey was administered to assessment professionals in U.S. colleges and schools of pharmacy (C/SOPs). Institutions were compared by type, age, and student cohort size. Institutional differences were explored according to the costs and types of NAPLEX and PCOA preparation provided, if any, and mean NAPLEX pass rates. Results. Of 134 C/SOPs that received the survey invitation, 91 responded. Nearly 80% of these respondents reported providing some form of NAPLEX preparation. Significantly higher 2015 mean NAPLEX pass rates were found in public institutions, schools that do not provide NAPLEX prep, and schools spending less than $10,000 annually on NAPLEX prep. Only 18 schools reported providing PCOA preparation. Conclusion. Investment in NAPLEX and PCOA preparation resources vary widely across C/SOPs but may increase in the next few years, due to dropping NAPLEX pass rates and depending upon how PCOA data are used.

Associations Between Pharmacy Students' Attitudes Toward Debt, Stress, and Student Loans.

Objective. To assess graduating pharmacy students' attitudes toward debt and determine associations with stress, student loan debt, financial need, current employment, post-graduation plans, and expected length of time to repay loans. Methods. Survey was conducted using an attitudes-toward-debt scale (sub-scales: tolerant attitudes toward debt; contemplation and knowledge about loans; fear of debt), Perceived Stress Scale, and questions concerning current employment, estimated total student loan debt, post-graduation plans, and expected length of time to repay loans. Federal loan data were collected using financial aid records. Independent samples t-test, ANOVA, and Pearson's r correlations were conducted. Results. There were 147 students (96.7%) who participated. The majority were female (59.2%), white (69.4%), and had federal student loans (90.5%). Mean total loan amount was $153,276 (SD $59,810), which included federal students loans accumulated before and during pharmacy school. No significant differences were noted on attitudes toward debt or stress based on whether respondents had federal student loans. Greater "fear of debt" was correlated with increased stress, estimated total student loan debt, total federal loan debt, and pharmacy school loan debt. Greater "contemplation and knowledge about loans" was correlated with lower estimated total student loan debt, total federal loan amount, and pharmacy school loan amount. Students with higher "contemplation and knowledge" scores expected to repay loans within a shorter time frame than students with lower scores. Conclusion. Increased fear of debt was related to greater perceived stress and higher student loan amounts borrowed, while increased contemplation and knowledge about loans was associated with lower amounts borrowed. Educational programming concerning loans, debt, and personal financial management may help reduce stress and amount borrowed.

Evaluating the Changing Financial Burdens for Graduating Pharmacists.

Objective. To compare new practitioners in 2009 and 2014 by modeling net income from available salary, expenditure, and student loan data. Methods. A Monte Carlo simulation with probabilistic sensitivity analysis was conducted to model net income for graduating pharmacists in 2009 and 2014. Mean and standard deviations were recorded for each model parameter. Student t-tests were used to compare the mean differences between 2009 and 2014 cohorts. Results. Pharmacist salary and disposable income were higher on average in 2014 compared with 2009. Consumer expenditures were higher in 2014, offsetting the higher salary resulting in a 2014 discretionary income that was less than in 2009 [95% CI: -$2,336, -$1,587]. Net income decreased from 2009 to 2014 for all pharmacy school types. Conclusion. Regardless of loan payment strategy, net incomes for pharmacists graduating from public and private institutions were less in 2014 compared with 2009.