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Clinical value optimization vs transactional price navigation: Rethinking pharmacist roles in medication
1University of Toledo College of Pharmacy and Pharmaceutical Sciences.
Journal of the American Pharmacists Association : Japha
|July 10, 2026
Summary
Pharmacists should differentiate between clinical value optimization for specialty drugs and transactional price navigation for common medications. This distinction optimizes expertise and reduces workforce burden.
Area of Science:
- Pharmacy practice
- Health economics
- Medication affordability
Background:
- Increasing prescription drug discount programs necessitate pharmacist involvement in price identification.
- The pharmacy profession currently lacks a clear distinction between different types of drug affordability work.
Purpose of the Study:
- To propose a two-tier framework to differentiate pharmacist roles in drug affordability.
- To address the misallocation of expertise and labor burden in current practices.
Main Methods:
- A commentary proposing a conceptual framework for pharmacist involvement in drug pricing.
- Distinguishing between Clinical Value Optimization (Tier 1) and Transactional Price Navigation (Tier 2).
Main Results:
- Clinical Value Optimization (Tier 1) involves assessing cost-effectiveness for high-cost/specialty therapies.
- Transactional Price Navigation (Tier 2) involves comparing prices for commodity medications at the point of dispensing.
- Current conflation leads to misallocation of doctoral expertise and labor burden.
Conclusions:
- Tier 1 work (Clinical Value Optimization) should be formalized, trained, and reimbursed as a clinical service.
- Tier 2 work (Transactional Price Navigation) should be delegated to technicians or digital tools.
- This framework offers a more rational and sustainable model for pharmacist involvement in medication affordability.
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