According to initial results of the landmark "Project Destiny" initiative, community pharmacy can ensure its healthcare services beyond dispensing medication are embraced broadly, if it acts decisively and cooperatively with healthcare industry stakeholders. The three pharmacy groups advancing the initiative now are developing a strategic plan to advance the concepts identified in the first phase, which hold promise for healthcare quality, access and affordability.

Project Destiny is a joint initiative of the American Pharmacists Association (APhA), the National Association of Chain Drug Stores (NACDS) and the National Community Pharmacists Association (NCPA). Pharmaceutical companies supporting the project financially include sanofi-aventis, GlaxoSmithKline, Boehringer Ingelheim Pharmaceuticals, Pfizer U.S. Pharmaceuticals and Wyeth.

The stated objective of Project Destiny is to develop a replicable, scalable, measurable, and economically viable future model for community pharmacy. The project seeks to identify ways that patients and the healthcare system can benefit from community pharmacy's medication expertise, in a way that is economically viable for all parties.

To that end, the groups hired BearingPoint, which conducted extensive research and interviews with patient and provider groups, and private and public payers. BearingPoint also led the intensive analysis of the interview results, as well as the development of potential next steps for community pharmacy.

The Executive Summary of the report on Project Destiny's first phase identifies the following key findings:

- A significant unmet consumer need to manage medication therapy exists in the market, as exemplified by increases in chronic conditions and avoidable healthcare costs.

- A viable market opportunity exists.

- Pharmacists are well positioned to address unmet needs.

- The medication management market is being defined, as community pharmacy, nurses, physicians, payers and pharmacy benefit managers all are engaging to some degree.

- Industry stakeholders are interested in assisting pharmacy in the process of developing service offerings and bringing the services to market.

- Significant hurdles exist, and these range from the magnitude of the industry-wide effort, to regulatory restrictions related to pharmacists and pharmacist extenders, and time constraints on pharmacists currently.

One key concept that emerged from the first phase of the project is that of a "primary care pharmacist," who would work collaboratively with the healthcare delivery and financing systems and focus on managing medications, positively impacting health outcomes, reducing overall healthcare system costs and empowering consumers to actively manage their health. Putting this concept into practice would require the development of pharmacy-based Patient Care Management Services that are consistent nationwide while maintaining the autonomy of individual pharmacies.

The Patient Care Management Services envisioned in the model go beyond a narrow definition of medication therapy management and include interventions targeting 15 conditions plus polypharmacy (the use of multiple medications by a patient) that drive demand for avoidable healthcare utilization. Project Destiny would seek to leverage, and not reinvent, the work of entities already demonstrating value in some segments.

Project Destiny is anticipated to be a long-term evolution, with complete strategic implementation. The organizations are developing and executing near-term tactics for the first part of 2008, including complete plan development with an emphasis on legal and regulatory considerations, internal communications with members of the partner organizations, continued dialogue with stakeholders, and identifying required human and financial resources.

"Pharmacists make a difference everyday in the lives of patients that needs to be recognized by the system, according to John A. Gans, PharmD, APhA Executive Vice President and CEO. "Phase One of Project Destiny has identified a journey map for community pharmacy focused on the health care business and value of pharmacists' services. The Project has demonstrated a willingness among stakeholders to collaborate for the benefit of the patient, utilizing the patient-care services of the pharmacist."

"The first phase results of Project Destiny provide further evidence that the government, healthcare stakeholders and pharmacy itself should look at pharmacy as part of the answer to the nation's healthcare questions," said Steven C. Anderson, IOM, CAE, NACDS President and CEO. "Instead of facing a continuing devaluation of pharmacy's services, we need to be identifying and pursuing the ways to maximize the opportunities that they provide, and that is what Project Destiny is all about."

"As the healthcare industry evolves and changes, it comes as no surprise to all of our members that the pharmacist remains integral to the healthcare system," said Bruce Roberts, RPh, NCPA Executive Vice President and CEO. The initial findings in this first phase of Project Destiny are encouraging and will help all members of the healthcare community chart a course for success."

"We will not succeed in our efforts to improve health and save money without innovative new steps to coordinate care," said Mark B. McClellan, M.D., Ph.D. Director, Engelberg Center for Health Care Reform; Senior Fellow, Economic Studies; Leonard D. Schaeffer Director's Chair in Health Policy; Brookings Institution. "Helping pharmacists work together with physicians, payers, and other stakeholders is critical to achieving the goal of affordable, accessible, quality health care."

Dr. McClellan is also the former administrator for the Centers for Medicare and Medicaid Services (CMS) and former commissioner of the Food and Drug Administration (FDA) in the U.S. Department of Health and Human Services.

The Executive Summary of the initial report of Project Destiny is available online at, and

About The American Pharmacists Association (APhA)

The American Pharmacists Association , founded in 1852 as the American Pharmaceutical Association, represents more than 60,000 practicing pharmacists, pharmaceutical scientists, student pharmacists, pharmacy technicians, and others interested in advancing the profession. APhA, dedicated to helping all pharmacists improve medication use and advance patient care, is the first-established and largest association of pharmacists in the United States.

About the National Association of Chain Drug Stores (NACDS)

The National Association of Chain Drug Stores represents the nation's leading retail chain pharmacies and suppliers, helping them better meet the changing needs of their patients and customers. Chain pharmacies operate more than 39,000 pharmacies, employ 114,000 pharmacists, fill more than 2.4 billion prescriptions yearly, and have annual sales of over $700 billion. Other members include 1,010 suppliers of products and services to the chain drug industry. NACDS international membership includes 101 members from 29 countries. For more information about NACDS, visit

About the National Community Pharmacists Association (NCPA)

The National Community Pharmacists Association, founded in 1898, represents the nation's community pharmacists, including the owners of more than 24,000 pharmacies. The nation's independent pharmacies, independent pharmacy franchises, and independent chains dispense nearly half of the nation's retail prescription medicines.

National Community Pharmacists Association