Pharmacists, pharmaceuticals, and policy issues shaping the work force in pharmacy

In June 1938, President Franklin D. Roosevelt signed the Food, Drug, and Cosmetic Act, establishing the Food and Drug Administration (FDA). Since that time, more than 3,200 prescription drugs with FDA-approved indications have entered the U.S. market as new chemical entities.1 In addition, some 18,000 prescription and nonprescription products—containing more than 4,750 active ingredients—have been approved for marketing in the United States.2 Drug development and marketing are considered to be exceptionally good business ventures, reaping large dividends for pharmaceutical manufacturers and making such companies among the most profitable in the United States. Patients today are taking a record number of prescription medications. In 2003, 3.4 billion prescriptions were filled in the United States, representing a 60% increase from 1992.3 Drug therapy is increasingly relied on to supplement, and in many cases to supplant, physician office visits, hospitalizations, and surgical procedures. This growth in drug use is particularly prevalent in the treatment of chronic diseases. A number of factors have propelled this rise in prescription drug use, among them pharmaceutical innovation, direct-to-consumer advertising, and a steadily growing elderly patient population.4,–6