Major issues facing the pharmaceutical industry and their relationship to clinical pharmacy.

There are two major issues that have potential for positive interactions between the industry and clinical pharmacy. These are drug selection and reimbursement, and clinical research. The first issue embodies the drug prescribing process, which has been, until recently, almost the sole purview of physicians. For this reason, pharmaceutical manufacturers have marketed their products primarily to this group. Changes are occurring; other licensed practitioners, including clinical pharmacists, are gaining prescribing authority. Schools of pharmacy have trained several thousand clinical pharmacists over the past decade, while the pharmacology component of medical education and the time devoted to clinical therapeutics either has stagnated or declined during the same period. Meanwhile, drug information has increased and the need to monitor drug selection to curtail costs has widened the opportunities for clinical pharmacists to exert an influence. The pharmaceutical industry needs to recognize the role clinical pharmacists play in drug selection. Drug selection decisions obviously influence drug reimbursement decisions, which influence drug sales, which influence profits. Clinical research is the backbone of a company's financial success and is becoming technologically sophisticated. Companies are becoming aware that many clinical pharmacists are able to collect and analyze clinical drug data as well as, or possibly better than, physicians. Clinical pharmacists can play a significant role in monitoring the safety and efficacy of marketed drugs. Good postmarketing surveillance data collection systems need to be developed.