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Patient-centric regional pharmacies play an important role in many small towns and communities throughout the United States

With strong ties, established trust and familiarity with their patients, regional pharmacy chains make a strong impact in the areas they operate in.
thrifty white exterior

As the overall number of pharmacies continues to dwindle, some regions have not only survived during these turbulent times but have managed to stand out among the crowd. What is the common denominator they share? They are relentlessly focused on helping their patients achieve better health outcomes.

COVID-19 has highlighted the fact that local community pharmacies were uniquely positioned to step in and offer vaccines and other related services. Regional pharmacies, with their strong ties to the community, established trust and familiarity with the neighborhoods they operate in, which helped encourage many people who might not have otherwise obtained COVID-19 vaccination. Moreover, during this time, many pharmacists and their staff eagerly traveled to nursing homes and long-term care and mental health facilities in their communities to administer the shots.

“Through our partnership, we are able to fulfill the medication, schedule the appointment and have our pharmacist deliver the injection in the comfort of our private suites, saving the patient time while also allowing the provider to care for more patients.”
Jeremy Faulks, vice president of pharmacy operations, Thrifty White.

Thrifty White retailer info

  • Year founded: Its roots date back to 1884
  • Headquarters: Plymouth, Minn.
  • Employs: More than 1,300 employee owners
  • Leadership: Robert Narveson, chairman and CEO; Matt Ode, CIO/executive vice president; Justin Heiser, COO; Tanya Schmidt, vice president, central operations; Senell Jaster, vice president/general counsel; and Jeremy Faulks, vice president of pharmacy operations
  • Area of operation: Iowa, Minnesota, Montana, North Dakota and South Dakota
  • Number of pharmacies: More than 90

- Services:

  • Prescriptions: Ready refill, Rx MedSync and Healthy Pack Rx
  • URAC and ACHC Accredited Specialty Pharmacy
  • Home-delivery pharmacy
  • Vaccines and medication injection
  • Pharmacy counseling
  • 24-hour automated voice response
  • Medication therapy management
  • Durable medical equipment
  • Alternate care pharmacy
  • Device training
  • Point-of-care testing
  • Health screenings
  • Drug interventions
  • Affiliated Pharmacy Program Clinical Services

Jeremy Faulks, vice president of pharmacy operations at Thrifty White Pharmacy based in Plymouth, Minn., said his company’s focus on driving clinical engagement is a key factor in its success over the years.

“We believe it’s imperative to leverage the patient-pharmacist relationship beyond traditional dispensing, and our strategies align to unlock this potential, through providing clinical services, closing gaps in care and delivering better quality care to our patients,” Faulks said. These outcomes unlock additional partnership opportunities with industry stakeholders, circling back to create better patient experiences, he said.  

Employee-owned, most of Thrifty Whites’ pharmacies are in small, rural Midwest towns that range from 1,000 to 90,000 in population.

While drug stores have come and gone in their operating area of West Virginia, Point Pleasant-based Fruth Pharmacy is one of the survivors. Lynne Fruth, president and chairman, said the key to remaining competitive is the company’s focus on delivering the best personal care it can to every patient. “Good customer service, offering extras like home delivery and caring long-tenured pharmacists are the secrets to competing,” Fruth said. 

At the same time, her company is vocal regarding its capabilities and pushes for access to products and services its communities need, especially during times of urgency like the pandemic. 

[Read More: Retailers bolster specialty pharmacy capabilities as its role in the industry grows]

Many Faces of Competition
Surviving in today’s ultra-competitive world gets harder and harder each year. Competition is coming at regional pharmacies from many places, both physical and virtual. The rise of digital pharmacy start-ups offering mail delivery, cash pricing and disease-state-specific services is one of the most recent operators vying for market share. 

Another issue regional pharmacies are facing is the growth of health-system specialty pharmacies. They are not only competing against the large payer-owned specialty pharmacies but also against the local health systems that are trying to capture and keep these patients within their pharmacy. 

By having similar offerings of their own and doubling down on the patient-pharmacist relationship, Faulks said Thrifty White has been successful in holding its customers’ attention and retaining their business.

Alongside the growth of health-system owned specialty pharmacies, shifts have occurred in the 340b program, which is encouraging health systems to focus on increasing their patient capture rate for a broader spectrum of therapies.

“Good customer service, offering extras like home delivery and caring long-tenured pharmacists are the secrets to competing.”
Lynne Fruth, president and chairman, Fruth Pharmacy.
fruth pharmacy exterior

Officials at Fruth Pharmacy have been pushing for fair reimbursement and to level the playing field. The company is involved at the local, state and federal levels to lobby on behalf of fair competition, fair reimbursement and access to patients. 

Fruth Pharmacy faces the same issues most regional chains do: unsustainable reimbursement, unfair practices by PBMs and problems with enforcing current laws. In fact, many chains, including Fruth Pharmacy, view PBMs as their main competitor. Fruth said her company is positioned to compete with any pharmacy, but it cannot overcome PBM practices that force mail order, steer patients or otherwise shut out competition by offering reimbursement that won’t cover the cost of doing business “while taking huge profits as the middleman.”

thrifty white counter

Standing Out 
Continuing with its focus on the patient, Thrifty White’s offerings have been developed to drive clinical engagement with its patients, and partnerships with health plans, employers and providers. “In one instance, we created a program with a local health plan where they send us a list of patients with certain gaps in care. Our pharmacy teams receive alerts in workflow, identify the specific gap — perhaps a missing A1C value or vaccination — and provide instructions on steps they should take to address,” Faulk said.

Once the gap is addressed, this information is communicated back to the health plan and provider, either through HL7 secure messaging or directly via an electronic medical claim, and the health plan receives credit for closing that gap. These clinical interventions create additional patient engagement opportunities and allow the pharmacist to be a true partner in that patient’s continuum of care, he said.

[Read More: Retailers build out their specialty pharmacy offerings]

Fruth Pharmacy retailer info

  • Year founded: 1952 by Jack Fruth
  • Headquarters: Point Pleasant, W.V.
  • Employs: More than 150 people
  • Leadership: Lynne Fruth has served as president of Fruth Pharmacy since 2010; John Galvan, vice president of operations; Charles “Drew” Massey, director of pharmacy operations; Andy Becker, vice president of pharmacy; Larry Anderson, director of purchasing/marketing; and Dee Weaver, specialty care coordinator
  • Area of operation: West Virginia, Ohio and Kentucky
  • Number of pharmacies: More than two dozen 

- Services:

  • Customized medication (flavoring available upon request)
  • Vitamin and nutritional supplements
  • Medication therapy management 
  • Compliance packaging service at select locations
  • Home delivery service
  • Immunizations
  • Synchronization service
  • Specialty medications

Thrifty White has also developed partnerships with behavioral health clinics to better support their patients taking long-acting injectable medications. Historically, these patients had to return to a clinic multiple times a month just to receive injections, but as Faulk noted, many clinics don’t have the bandwidth to manage these injections. “Through our partnership, we are able to fulfill the medication, schedule the appointment and have our pharmacist deliver the injection in the comfort of our private suites, saving the patient time while also allowing the provider to care for more patients,” he said. 

Among other things, offering vaccines to the public has also allowed regionals to maintain their close community connection. During the past year, Thrifty White has delivered nearly 400,000 COVID-19 vaccinations. Faulk said by offering a simple, streamlined scheduling process and a well-run pharmacy experience, the company has enhanced its reputation in the region, even in markets where it doesn’t have physical locations, enabling additional opportunities for growth.  

A similar story unfolded at Fruth Pharmacy. During the pandemic, Fruth worked closely with officials from West Virginia and Ohio to provide testing, vaccinations and other services. “This type of relationship with state governments allowed us to quickly engage in different areas and prove that we could deliver for our communities,” Fruth said. “The regional pharmacies all have areas of geographical significance that makes us a critical partner in any state. Fruth, along with other regionals, has demonstrated the huge impact that we can have in any state.”

In the coming months, Fruth Pharmacy is preparing to roll out a program in West Virginia that will be funded by the WV Drug Intervention Institute to provide free naloxone with opioid prescriptions. This program will include a counseling component at dispensing and a follow-up call later. Fruth said as a family-owned business, the company is in a unique position to lead the way against drug abuse.

Fruth Pharmacy is also working on some innovative ways to be able to dispense the new oral antivirals in conjunction with testing sites. Additionally, it has been communicating with state task force members to devise ways to get more high-risk COVID-19 positive patients in treatment sooner. 

Through a new partnership with the University of Charleston School of Pharmacy, Fruth Pharmacy has found a distinct way to drive patient engagement. It will have a UC professor and pharmacy students on site part time to engage in Comprehensive Medication Reviews and other follow-ups needed. “Our aim is to improve adherence and overall health while getting patients more accustomed to having follow-up calls and counseling sessions with pharmacists,” Fruth said.

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