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Flipping the script: The state of the pharmacy industry

What’s driving the pharmacy business these days? Besides the usual concerns about government legislation, sales and profits, and the endless battle to find the right pharmacist to man the counter, retailers and suppliers point to a number of other trends that could — if properly developed — help pharmacy operators streamline their operations, increase efficiencies and improve the quality of patient care.

There is no doubt that retailers have their hands full with their pharmacy business, but, at the same time, many merchants are becoming more and more convinced that such things as automated robotic prescription dispensing, pharmacy counseling and medication management, immunizations, home delivery of prescription drugs, and discount prescription pharmacy cards can help them better connect with consumers.

In the end, many have said, retailers need to include many of these services and technologies if they want to stay ahead of the curve and keep their pharmacy counters relevant and profitable.

The question, of course, is what to focus on and how to implement the strategies that best work for individual chains. Finding the money to put these programs into place also is an important issue, though many industry officials emphasized that they often quickly pay for themselves by bringing in new business.

Expanded Care
Pharmacies no longer being able to turn a profit on volume alone has proven a boon to pharmacists looking to flex their clinical muscles. Pharmacy services that go beyond filling prescriptions — from medication therapy management and medication synchronization to vaccines and disease state management — are an increasing part of the pharmacy’s offerings and opportunities for reimbursement.

When it comes to disease state management, one of the largest need areas is in counseling patients with diabetes who tend to visit the pharmacy three times more than an average shopper. In order to help enable such counseling, Franklin Lakes, N.J.-based BD provides education kits supporting such educational opportunities as proper insulin injection techniques.

“We’re moving away from treating patients with diabetes by just dispensing a script and device to how do I get to the patient and help them across the store, from their prescription to OTCs, to foods,” said Stephan Braun, BD’s vice president of retail sales. “For retailers, there’s a whole angle to disease state management and wellness across the entire store, and they can integrate that via an app and counseling sessions so they can become more relevant and create engagement with their shoppers.”

More services from pharmacists who aren’t behind the counter translate to healthier patients, and a boost in sales for the store, Braun said.
“When a pharmacist talks to patients, they get higher loyalty rates,” Braun said. “When a pharmacist discusses regimens, they get higher levels of adherence. [Plus,] about 60% of patients who talk to a pharmacist will end up buying another product other than the script they came in to fill. That’s a tangible benefit, and it’s a real differentiator for the pharmacy.”

Another area of engagement through which pharmacists work to boost adherence is medication therapy management, which Sandra Canally, CEO of the Compliance Team, said is a path to both enhanced patient care and more revenue. Such clinical services leverage the pharmacy’s role in its patients’ lives to offer services that help them.

“It’s about identifying the needs in your community and actually reaching out to meet those needs through medication therapy management,” Canally, who founded the pharmacy accreditation organization 24 years ago, said. “These are growing areas for the pharmacy to identify as business opportunities and adding services to better meet their patient population.”

Helping patients with chronic pain manage opioid prescriptions and medical marijuana are two additional trends that bode well for pharmacies’ profitability. “There are ways to prevent the opioid crisis as part of the pharmacist’s role in medication management, and monitoring the patient so patients don’t have difficulty moving forward,” Canally said, noting that they open an avenue for pharmacists and physicians to work closely. “Care coordination between prescribers and pharmacists is key.”

Vaccines and travel clinics also are offerings that pharmacy operators are exploring to expand their clinical reach.

“There are a lot of pharmacies adding additional vaccines and counseling for healthcare workers, executives and others who travel to other countries,” Canally said. “That’s a growing opportunity, especially with medical tourism and folks traveling for medical services to other countries. Prior to going to these countries, they need to know what vaccinations they need, as well as any public health issues.”

More pharmacies also are offering point-of-care testing for patients. Recently approved devices that can help diagnose a patient with diabetes have joined other tests for such conditions as the flu and strep throat — BD’s Veritor Plus system can help detect the flu, strep and respiratory syncytial virus — giving pharmacies the ability to provide test results in minutes and differentiate themselves from competitors.
Yet these patient interactions necessitate a private space, which pharmacies also need to be able to use for MTM to vaccinations. Corona, Calif.-based Uniweb is focused on space solutions for pharmacies — and a growing part of its business has been creating consultation areas in places where space is tight, according to Ron Mackert, Uniweb vice president of marketing and sales.

“All pharmacies are trying to be more of a total healthcare provider. We build private rooms that can be multipurposed,” he said, noting that the company built a 1,300-sq.-ft. room for Costco that included a counseling station, a store manager station, a pharmacy area and a restroom. Uniweb also offers modular rooms and modular components that can adjust and fit to existing pharmacy space. “The smallest is 8 [feet] by 8 [feet,] and there are larger sizes to meet pharmacies’ needs. Theses rooms are perfect for one-on-one consultations or for giving vaccinations.”

It also is worth noting that the increased clinical role of the pharmacy is the largest impetus for advocates asking lawmakers to grant pharmacists provider status under Medicare Part B. In addition to codifying the pharmacist’s role in the healthcare system, it also would make pharmacies eligible for other reimbursement opportunities.

As they wait for a higher status within Medicare, pharmacies are looking to long-term care services as a way to show their worth to health insurers. Canally said that because payers look for independently approved programs, the Compliance Team offers LTC pharmacy accreditation.
“If pharmacists want to go to a payer and show the additional services they’re doing, they‘re going to stand a better chance of getting recognized by the payer if the pharmacy has been validated by a third-party accreditor,” she said. “The accreditation program is a way to validate the quality as it relates to these services.”

Finding the Time
As pharmacists are making big moves in patient care, they also are acutely aware of the fact that there are only so many hours in a day and only so much space behind the counter, where they must get more
done, faster.

“Retail is reluctant to relinquish any space to pharmacy,” Uniweb’s Mackert said. “Whether it’s in a grocery store or standalone, the line between retail and pharmacy is a hard line that does not get crossed. When the
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