Are Advanced Practice Providers (APPs) Replacing Physicians?

In 2020, one out of every three (~33%) US health care providers (HCPs) were nurse practitioners (NPs) or physician assistants (PAs), which is a substantial increase from just 17% in 2010. Collectively called advanced practice providers (APPs), NPs/PAs represent more than 430,000 providers in the US. According to estimates from the Bureau of Labor Statistics, APPs are expected to make up 45% of HCPs by 2030. APPs are also increasingly seen in specialties other than primary care, with over 30% of NPs and 67% of PAs specializing in non-primary-care areas in 2020. 

Autonomy of APPs

Over the past decade, NPs/PAs have become more independent and see more medically complex patients. Recent nationwide trends show a continued increase in the autonomy of APPs. 

In 2016, the Department of Veterans Affairs issued full practice authority to NPs, without an overseeing physician. In Virginia, NPs will be issued full practice authority after practicing for 5 years and 9,000 hours. Florida also passed a law to allow APPs to prescribe controlled substances. Additionally, in 2020, Iowa passed legislation that allows PAs to prescribe Schedule II controlled medications and removes chart co-signature requirements.

Prescribing Power of APPs

Over 95% of NPs and 94% of PAs in the US prescribe medications for both acute and chronic illnesses. Studies show that over 95% of NPs write an average of 23 prescriptions a day. Moreover, 3 out of 5 APPs see their own unique group of patients whom physicians do not typically see.

However, Pharma and medical device marketers don’t have an exclusive communications strategy specifically for NPs/PAs. This means that they are missing out on opportunities to build valuable relationships with APPs, who are a crucial and growing prescriber segment.

Role of APPs in Purchasing and Formulary Boards

Studies show that NPs/PAs are increasingly seizing key leadership roles in hospital management. A 2019 report by the Society of Hospital Medicine suggested an exponential growth in the role of APPs in hospitals, with almost 80% of hospital medicine groups (HMGs) employing NPs/PAs. This increasing APP voice makes them key stakeholders and influencers in the purchase of formulary and medical devices. Therefore, there is a compelling need for Pharma and medical device companies to focus specifically on APPs.

Improving collaboration with APPs

Pharma and medical device marketers need to work alongside NP/PA experts and conduct in-depth market research to obtain an accurate picture to adjust their annual budgets and strategies.

Identifying key opinion leaders (KOLs) within NP/PA communities and tailoring communication plans specific to NPs/PAs will go a long way in finding ways to collaborate with APPs. Moreover, recognizing APPs’ knowledge gaps and brand perceptions and working with NPs/PAs in the fight against nonadherence will be a win-win for APPs and Pharma/medical device companies. Open communication with NPs/PAs and close collaboration with all stakeholders will be crucial in achieving this. 


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