The Pharmacy as We Know It Is Doomed

Robots are cheaper, more efficient, and could spell the end to human pharmacists as we know them.

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The pharmacy of the future is going to be faster, less personable, and probably the domain of a drug-slinging robot.

The basic structure of pharmacies has changed little over the decades, for better and worse. Yet as baby boomers continue to age, they’re going to need more drugs, faster, more efficiently, more safely. The thing making sure we get the correct medications won’t be a living, breathing person. The biggest point in favor of robot pharmacists is efficiency. Tuned well enough, safety of customers would follow closely.

Case in point: The UCSF Medical Center’s PillPick Automated Packaging and Dispensing System, developed by a company called Swisslog and installed in two UCSF area hospitals in 2011. PillPick takes pills from large, pre-packed boxes and inserts them into barcoded plastic bags that identify. If patients require multiple prescriptions, PillPack hooks all of them together onto a convenient, idiot-proof ring to be distributed by nurses to each patient — signed, sealed, and delivered. Slap one of these in the back pharmacy in Duane Reade or CVS, and you’ll be picking up prescriptions faster and with fewer human errors.

The pharmacist as a unique occupation has been dwindling for some time. The local guys who have manned stores for generations, the old-world gems who know your family history, have become as rare as family doctors who make house calls. Pharmacists in the big chains do little more than what a computer already tells them to do: package these pills, cross-reference information with the patient’s healthcare provider, rinse and repeat.

Pharmacists used to have more specialized medical responsibilities. They counted pills and mixed concoctions into medicine, and provided on-call advice for regular customers or for people who needed quick medical pointers. That version of the pharmacist has faded. When was the last time you actually asked your pharmacist for medical advice instead of just calling in prescriptions days ahead of pickup for a simple in-and-out visit?

If most pharmacists nowadays seem like white-coated middlemen between you and your doctor, recall that most remain employed simply because of laws that require a licensed pharmacist to be present when drugs are dispensed to patients. Outdated laws, more than medical expertise, keeps them in place. They’re medicine’s answer to the neighborhood video rental store clerks.

Robots like PillPick simply remove the majority of potential human error from the equation. Specifically, PillPick filled out 350,000 prescriptions in its initial trial at UCSF before it made a single error, one likely caused by a problem with its printer. Humans simply can’t compete with flawless. Doctors in the United States write about 3.2 billion prescriptions per year. Of that total about 1.5 million patient injuries result from human errors in wrong prescriptions alone.

Despite PillPick’s hefty $7 million installation cost, a pharmacy-ready consumer version of a robot pharmacist costs about $200,000. Factor that number into the surprisingly high average yearly salary for a single full-time pharmacist at a little more than $118,000 per year, and the pharma-bot seems like a steal.

Adding one of these machines to your local drugstore wouldn’t mean removing humans from the equation altogether. Pharmacies will need point people, aid workers. The model will remind you of the wandering clerks who help out with the self-checkout kiosks at grocery stores big-box retailers.

Medical questions could be directed to the doctor that prescribed you the medication. If she’s not available, video conferencing or a simple on-site call service could make doctors or pharmacology experts available remotely. These ideas aren’t so terribly futuristic. Automated “Telepharmacies” are up and running in a few states already.

A robot pharmacist is closer to being within our reach than most robot tech. The impediment is squeamishness about losing jobs, even though automated medication dispensing is a reasonable and beneficial progression. Mechanizing this process will be straight-up cheaper and safer.

The pharmacists I spoke to for this story didn’t take my questions about robots seriously, with their single-syllable objections simply writing them off with a laugh or lamenting that they’d just get glitches or errors. The could be true, but they’re just ignoring a quickly approaching reality that could put their profession in serious jeopardy. In this case, bring on the robots.

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