The Aggregate Demand Index: A Report of the Two-Year Performance of a Tool Measuring the Balance between Supply and Demand for Pharmacist Positions



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Journal of the American Pharmacists Association









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Objective: To describe the development and 2-year performance of the Aggregate Demand Index (ADI) survey, a tool for longitudinally tracking the difficulty of filling open pharmacist positions throughout the United States.

Design: From August 1999 through July 2001, panelists completed a monthly survey on the difficulty of filling open pharmacist positions by state. Results are reported on the Web (

Setting: Panelists estimated difficulty filling pharmacist vacancies in the community, institutional, both community and institutional, and nonpatient care pharmacy settings.

Participants: A panel of individuals involved in the direct hiring of pharmacists.

Intervention: A monthly survey.

Main Outcome Measures: Monthly indices reflecting the level of difficulty filling open pharmacy positions at the state, regional, and national levels and by pharmacy position type. Over time, these data formed a longitudinal record of the balance between the supply of and demand for pharmacists.

Results: Cumulative data from 50 states and the District of Columbia showed, on average, excess demand over available supply. The five states with the highest unmet demand level (i.e., where it was most difficult to fill open positions) were Minnesota, California, Wisconsin, Iowa, and Kentucky. The only states in which demand was in balance with supply were Hawaii and Rhode Island. Over 2 years, at least 92% of the U.S. population each month resided in areas where demand for pharmacists exceeded supply. The demand level in the Northeast was significantly lower than in other regions. Unmet demand was greatest for organizations with both community and institutional positions and least for organizations with primarily community positions.

Conclusion: For the study period, the demand for pharmacists exceeded the available supply in the United States; ADI survey data indicated than open pharmacist positions were “somewhat difficult” to “difficult” to fill. Substantial but unexplained differences were noted by state, by region, and by type of pharmacy position. Other health care professions could use the ADI survey methodology to study workforce issues.