Supermarket pharmacies navigate clinical roles through partnerships

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Supermarket pharmacies navigate clinical roles through partnerships

By Sandra Levy - 05/29/2019
Supermarket pharmacies are having a moment. Once relegated to obscured locations in the store, they now are no longer hidden from customers’ sight, nor thought of as merely an added convenience. Moving away from the staid count, pour, lick and stick role they once had, supermarket pharmacists increasingly play an important clinical role with a focus on patient outcomes.

Indeed, supermarket pharmacies and their pharmacists have taken their rightful place, alongside pharmacy chain behemoths in terms of volume and services, simultaneously fulfilling scores of prescriptions and providing a host of services that range from disease state management and immunizations to medication therapy management and home delivery.

What’s more, many supermarket pharmacies are managing the prior authorization process and are getting more involved with high touch specialty drugs, enabling clinical interventions and better patient outcomes.

In 2018, supermarkets with pharmacies accounted for 7.2% of U.S. prescription revenues and 12.4% of 30 day equivalent prescriptions dispensed, according to The 2019 Economic Report on U.S. Pharmacies and Pharmacy Benefit Managers. For 2018, the report estimated that prescription revenues at supermarkets declined by 4.4%, but 30-day prescriptions dispensed increased by 1.6%, said Adam Fein of Pembroke Consulting, an author of the report.

Yet, supermarket pharmacies also are facing the same headwinds that the entire pharmacy industry is. That means companies have to get smart about their offerings by finding partners whose solutions can help them handle increased prescription volume while expanding their clinical roles to boost outcomes and improve profitability.

Filling smarter
At the center of Johnson City, N.Y.-based Innovation’s pharmacy automation offerings is its PharmASSIST systems, which provides flexibility in fulfillment and higher levels of efficiency. The Model 4 is a self-calibrating dispenser, which allows immediate on-site auto calibration of medicines. The PharmASSIST RDSx is a robotic dispensing technology designed for high volume industrial applications and high throughput, as well as reliability. Each RDSx fills up to 300 prescriptions an hour.

“In fulfillment, our operators today are looking for ways to make the actual production of the prescriptions as safe and as efficient as possible,” Doyle Jensen, executive vice president at Innovation, said. “We’re seeing that accomplished through a shift to a highly evolved central fill model, where the most amount of technology can be deployed to drive the lowest product cost per prescription. It also gives them the flexibility from that same central fill as a point for home delivery or mail. We see people in the supermarket space adding both of those services into their models.”

Pharmacists spend between 80% and 90% of their time filling prescriptions, Jensen said. “By moving that production to a centralized automated facility creates the time for them to provide patient services,” he said.

Innovation central fill

One supermarket pharmacy that looks to Innovation to enable clinical interventions is Pittsburgh-based Giant Eagle, a $10 billion company with pharmacy representing some $1.4-to-$1.5 billion in sales. The chain operates 213 pharmacies across western Pennsylvania, Ohio, West Virginia, Maryland and Indiana. Each store averages more than 2,000 prescriptions a week, and roughly 40% of the chain’s volume is filled via Giant Eagle’s central fill facility.

“Innovation provides the technology for us to take the filling process out of the store and bring it into the robots in the central facility, and the communication to move that data back and forth, Jim Tsipakis, Giant Eagle’s senior vice president of pharmacy, said. “More importantly, it allows us to concentrate our valuable pharmacists’ and pharmacy technicians’ resources for services. The real value is the human interaction and the high touch that we want to be able to provide to our patients,” he said, noting that it also serves as a differentiator for the chain by ensuring a pharmacist is available to handle patients’ health-and-wellness needs.”

Schnuck Markets, which has 107 retail pharmacies located across Missouri, Illinois, Wisconsin and Iowa, also relies on central fill for enabling patient engagement.

“Central fill allows the majority of maintenance prescription refills to be processed off-site in order to allow our pharmacy teammates to spend more time with their patients at the store,” Brigid Elam, the chain’s director of retail pharmacy, said. “In addition to improving service levels, utilizing the central fill process decreases the cost to fill and helps optimize overall inventory levels. Also, our stores and patients are supported by a call center and central processing center.” Elam said that Schnucks is offering a plethora of clinical services that focus on a total health-and-wellness offering that also includes nutrition. “We have partnered with Strand platform to improve efficiencies with offering more clinical services, including diabetes self-management education, smoking cessation counseling and blood pressure checks within our current retail workflow,” she said. “This is in addition to the robust full-service immunization program we offer that includes travel health and our MTM programs,” she said.

McKesson High Volume Solutions, based in Malvern, Pa., is making headway with central fill services to free up pharmacists. HVS vice president Joe Tammaro said the company is seeing that supermarket pharmacies’ per-store prescription volume is typically higher than in the traditional drug store industry. “The needs for some solutions to take that volume away and free up pharmacists’ time to do value-added services is even more pronounced in the supermarket industry than in the traditional drug store industry,” he said, noting that HVS provides automation to supermarket pharmacies for centralized off-site prescription filling that can be purchased or offered as a service a per-prescription fee.

“One of the biggest advantages of HVS is that we are a systems integrator. We select the best technology from a number of other vendors, and integrate and implement that together so it’s the best of the best, not just one technology that we own and you have to use,” Tammaro said.

Robotics not only are used for central fill, though. Some supermarkets prefer to have in-store automation that can work alongside the staff to streamline the process of filling prescriptions. Kansas City, Mo.-based ScriptPro has a compact line of three robots — CRS 75, CRS 150 and CRS 225 — aimed at supermarket pharmacies. “The CRS 150 is the most popular among supermarket pharmacies. It can easily fit into a grocery store pharmacy, and 150 tends to be the sweet spot for the number of [drug] cells that you need in a grocery store,” ScriptPro CEO Mike Coughlin said.

In addition to filling the prescription, the robot labels the prescription and puts auxiliary messages on the label, such as certain foods patients should avoid or any issues regarding driving that might be affected by the medication.

“The robot will go to the drug cell and do some verification check. It will activate the drug cell to drop the pill into the bottle and then it will print and apply a label, and then bring it out on a conveyer,” Coughlin said “There are about 10 steps required to manually perform this process that are eliminated by the robot. The pharmacist then can interact with the patient and coordinate their other prescriptions that should be refiled at the same time.” Time-saving tools aren’t limited to robots, either. Such administrative tasks as prior authorization can be automated to make the patient’s experience bet