More pharmacy vaccines could allow docs to take on thousands of new patients, researcher says

New Brunswick could save big money — and a lot of physicians' time — by allowing pharmacists to administer a wider variety of vaccines, according to a research project conducted by the New Brunswick Institute for Research Data and Training at the University of New Brunswick. 

In fact, adding two more vaccines to the list of vaccines administered by pharmacists would save $1.5 million a year, said Chris Folkins, the lead researcher on the study. 

Pharmacists are allowed to administer a variety of vaccines, but they're only reimbursed for two — tetanus and pneumonia. 

Adding those two to the list could save doctors more than 2,000 hours a year. That, he said, means doctors could take on nearly 3,000 new patients. 

Just as important was the time savings for physicians, said Folkins, who is also a pharmacist.

Folkins said he knew there would be a sizeable cost savings, but he was surprised that the biggest impact would be on the hours saved. 

He said the timing of the research project is also interesting, since the pandemic highlighted pharmacists' impact on the delivery of vaccines over the last several months. 

Folkins said the project, which was funded by a grant from the New Brunswick Innovation Foundation, used another vaccine to help predict the impact of pharmacists delivering tetanus and pneumonia.

In 2010, pharmacists in New Brunswick began giving influenza shots. Prior to that, only physicians administered those vaccines.

Folkins said pharmacists soon began doling out about 60 per cent of influenza shots. Researchers used that figure to calculate the number of tetanus and influenza vaccines that would hypothetically be given if they were opened up to pharmacists. 

"That adds up to a lot of physician hours that are saved. And the next logical outcome from that is: what could we do with those hours?" said Folkins. 

We would endorse a plan that helps to increase immunization rates.- Jake Reid

That's where researchers calculated that doctors could take on 2,676 new patients with the number of hours saved. 

They also calculated the savings in time away from work to be about $268,000 each year for those going to their doctor for a vaccine. 

Folkins said each doctor's visit was calculated to take about two hours away from work, but since pharmacies are open longer hours during the week as well as on weekends, people wouldn't have to take time off work.  

Increased vaccination rates

Folkins said that by expanding the publicly funded vaccines pharmacists can administer to include pneumonia vaccine, the health-care system could potentially save approximately $16,000 each year because fewer people would require  hospitalization for pneumonia.

That prediction was based on an actual increase in the number of people being vaccinated when pharmacists started delivering the influenza vaccine in 2010. Based on that number, Folkins predicts a similar increase of 12 per cent in vaccinations for pneumonia.

Having vaccinations available through pharmacies would also be beneficial to the tens of thousands of New Brunswickers who do not have a family doctor. 

"I think there's some real potential to make some positive changes, to give more people access to timely care, and also to potentially save some money for the system in the province as well," said Folkins. 

While it may take some adjustments on the part of pharmacists to provide more vaccinations, Folkins believes that "a lot of pharmacists are enthusiastic to take advantage of their full scope of practice."

It would definitely come with an increased workload for pharmacists, he said.

"But I think the pharmacy community has definitely demonstrated that they're up to the task and they're ready and willing to make that adaptation, especially when they know they can provide more care for their patients and better health system management."

'It was a stressful campaign'

With lessons of the COVID-19 vaccination rollout still fresh, the executive director of New Brunswick Pharmacists Association said his members are willing to take on more responsibility. 

Jake Reid said the COVID-19 vaccine program proved that pharmacists can deliver vaccinations on a wide scale. More than 40 per cent of all COVID-19 vaccines were delivered by pharmacists — all with very little time to prepare.

Reid said the vaccination program definitely tested the capacity of pharmacists. 

"It was a stressful campaign that really took everyone working long hours and, ultimately, overtime to accomplish this feat."

He said part-time pharmacists worked full-time hours and recently retired pharmacists came out of retirement in order to keep up with demand. 

Reid said pharmacists are willing to deliver more services — particularly if their rollout featured more resource planning than the pandemic allowed for.

"We would endorse a plan that helps to increase immunization rates, for instance, or provide for improved health outcomes, that frees up other health resources in the system," Reid said. "Those are the sort of measurable goals that we would be looking for in any particular plan."

The research project led by the New Brunswick Institute for Research Data and Training "reinforces a lot of what we've been saying as an association," he said, noting there are a lot of services that pharmacists are qualified to perform that are currently being carried out by doctors and nurses. 

While he's not sure about what kinds of savings could be realized, Reid said there's no question that access to health care would be greatly improved by allowing pharmacists to perform some of those services. 

"We shouldn't be primarily looking at cost savings," Reid said.

Factors such as higher immunization rates, improved health outcomes, being able to free up health resources, freeing up physicians to conduct other services and convenience and accessibility for patients are equally important, he said.

"Those are the sorts of measurables that we should be looking at. We can do all those things and potentially there's cost savings. Those are win-win."