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State of the Pharmacy 2021: Executives weigh in

Executives from leading pharmaceutical and technology and automation companies size up the pharmacy space as we move into the second year of the pandemic and pharmacies continue to play a crucial role in COVID-19 vaccinations.

“It was the best of times, it was the worst of times.” Charles Dickens’ opening line in A Tale of Two Cities could not be more apt to describe the state of pharmacy, as the industry stepped up amid the pandemic to play, perhaps, its most vital role yet to retail and consumers.

Pharmacies sprang into action amid the pandemic, filling a high volume of 30- and 90-day prescriptions, providing home delivery and curbside pickup of essential items like hand sanitizer, masks and toilet paper. Then came their involvement in COVID-19 testing and, more recently, they’ve taken on a huge role in the administration of COVID vaccines.

Indeed, as we enter the second year of the pandemic, there is light starting to emerge at the end of the tunnel. The role of the pharmacist and pharmacies is soaring to new heights, and pharmacy has become a destination for hope and survival.

DSN asked several company executives to weigh in on the state of the pharmacy business, how they are helping pharmacies and pharmacists during these turbulent times and what is needed in today’s environment to stay competitive, as well as how they view the future. Their answers shine a light on the optimism in the industry and its ability to respond to customers and patients.

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Eric Purcell, vice president of sales and marketing, Alembic

Drug Store News: How does your company help to meet the challenges of pharmacy?Eric Purcell: Alembic is focused on providing pharmacies with excellent supply service levels. Alembic supply is built on a foundation of vertical integration, and strong and flexible manufacturing capabilities. Adequate inventory levels and strong planning have been key pillars to its ability to meet ever-changing market conditions. Alembic has invested significantly in pipeline and manufacturing capabilities, and now has dedicated facilities for solid oral dose, dermatology, ophthalmic, injectables and oncology injectables, as well as facilities for API.

DSN: How has COVID-19 impacted the way you helped your customers?
COVID impacted many pharmaceutical supply chains and, as a result, many patients in the United States found it more challenging to access and afford medications. Alembic worked diligently to ensure a good supply of products during this challenging period. In addition, Alembic has worked with entities who provide assistance to patients to access more affordable medications.

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John Dillaway, executive vice president, Ascend Labs

DSN: What is needed in today’s environment to stay competitive?
John Dillaway:
With the advent of COVID, much has changed in today’s market, most notably within the area of customer interaction. With no direct customer visits for over a year, along with no in-person trade events, the industry has fast-tracked to a virtual environment, and the speed to which things revert to what we used to call “normal” remains to be seen. Companies that nimbly react to what will almost certainly be a slow to back to normal process — and even a hybrid of what was — going forward will find the most success. Companies will need to find ways to engage customers safely, productively and in a manner that holds their interest. This will be especially important for interaction with customers that retain some of the current COVID environment workplace changes.

DSN: How is your company improving patient care and pharmacy efficiency?
Ascend is always considering the patient experience and what it can do to improve things that contribute to that, including safety and compliance. Being part of a global company, Ascend has the benefit of its parent Alkem Laboratories’ experience and standing in other parts of the globe. Part of this experience includes the packaging and stability of many items in blister-pack format. Blisters offer many advantages, notably keeping each dose safe and, in many cases, numbered to remind patients when to take. There can also be downsides in that the blisters can be hard to open for some seniors, so consultation with pharmacies and the benefit of global experience is important. The companies that have an open attitude toward change and innovation in order to help patients will certainly have an upper hand in the market.

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William Sieber, president, Bavis Drive-Thru

DSN: How is your company improving patient care and pharmacy efficiency?
William Sieber:
Bavis Drive-Thru specializes in ways of supporting patient care. To help customer care, we are putting a great deal of emphasis on audio communications quality at the drive-thru. Our latest audio system provides the highest-quality communications between pharmacy staff and patients, reducing frustration from misunderstandings. Our drive-thru delivery equipment provides the appropriate large capacity and easy access to prescriptions.

DSN: Reducing costs is crucial in today’s competitive environment. What is your company doing to reduce costs for retailers/pharmacies?
Bavis Drive-Thru continues the development of new equipment to meet the needs of the industry. We focus on providing the best experience for the drive-thru customer, the efficiency of pharmacy personnel and lowering costs. Because the first two of these occur with each transaction, making improvements in the everyday transaction offers a significant multiplier and yields the highest savings. We always want to reduce first costs where possible and do so at every turn. Our goal, however, is to provide the best overall cost reduction in every change we make.

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Sandra Canally, founder and CEO, The Compliance Team

DSN: What is needed in today’s environment to stay competitive?
Sandra Canally:
The most important way you stay competitive is to assess what your customer needs within the market and factoring in what impacts the services you offer, how you offer them and the environment you offer them.

The best example is the pandemic and how we all have had to alter our business models to continue to deliver our services. Change also then acts as a catalyst to generate new ways of getting the job done. In doing so, getting feedback from your customer on your “new model” is key.

DSN: How does your program offering for accreditation impact patient safety and pharmacy efficiency?
The Compliance Team’s accreditation programs look at the pharmacy’s processes and standard operating procedures from the front door to the back door. Our team focuses in on utilizing operations-driven quality standards to identify, benchmark and improve day-to-day practices, with a net goal of increased efficiency.

Whether on site or virtually, we verify and validate how they meet the standards by review of patient and personnel records, observation of actual process and interview of staff, and identifying if the organizational process matches the written policies. In evaluating a chain, it is even more important to look at how those practices align across all locations, establishing a pattern of areas in need of improvement.

Ron Cerminaro, director of commercial strategy and operations, Camber Pharmaceuticals

DSN: How would you describe the current state of pharmacy?
Heroic! The profession of pharmacy, as well as many other healthcare professions, has evolved in the past year at a previously unimagined rate.

In support of all healthcare providers to fulfill their mission in the “new normal,” Camber Pharmaceuticals rapidly developed innovative protocols to keep essential distribution employees safe and ensure continuous distribution of our pharmaceutical products required to maintain quality of life for patients.

DSN: What is needed in today’s environment to stay competitive?
I believe competitive success is the product of doing more than your average competitor believes is necessary. While the base requirements for competing pharmaceutical companies are offering high-quality products, consistent supply and competitive pricing, there is so much more that a pharmaceutical company can do in the strategic and operational implementation of sound supply chain fulfillment to provide value to the limited pool of customers in our industry.

Using operations experience in retail, wholesale and commercialization, Camber designs capabilities to dovetail with our customers’ operations that will minimize labor impact, reduce expense, eliminate cost, expedite processes, improve efficiencies and help them achieve their corporate goals.

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John Webster, co-owner and principal, Crocus Medical

DSN: What is the greatest challenge for pharmacies and pharmacists?
John Webster:
We have a major disconnect in the funding system. Pharmacists are currently paid to process a prescription or, more accurately, for the logistics of filling and delivering a prescription to the client. What we should be paying them for is health counselling to that client with respect to medication usage. So, unfortunately, we pay them to deliver product, but what we want as clients — and in most cases the healthcare funding bodies as well — is personal consultation to ensure proper medication usage.

The end result is the pharmacist, under the current business model, is driven to increase their Rx volume because that is what we pay them to do. Until we start funding the service and consultation model, we will never reap the benefits of their clinical expertise or enjoy the significant cost savings they can provide to the health system.

DSN: How does your company help to meet the challenges of pharmacy?
It’s not realistic that a pharmacist can have a personal relationship with each and every client in a busy pharmacy, but pharmacists still have to be accessible and available to meet with clients if they have questions or concerns. Anyone can get medications quickly and easily from a mail order provider, but developing the trust to share your personal health issues with a healthcare professional is not the task of the moment

To address this, we believe pharmacists should automate what dispensing functions they can, designate more responsibility to their support staff and use that “newly found” time to provide the listening, education and support their clients want from them. That establishes a relationship with the client that is more difficult to dislodge. Our Crocus Medical product portfolio allows the pharmacy to streamline the preparation of the prescriptions so they can be delivered faster, more efficiently and, in some cases, more conveniently, which benefits both the pharmacist and their customers.

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Marc Kikuchi, CEO of North America generics, Dr. Reddy’s Labs

DSN: How has COVID-19 impacted the way your company helps your customers?
Marc Kikuchi:
The pharma industry in general, and generics manufacturers in particular, face an array of unprecedented challenges in the wake of the COVID-19 pandemic. One of the most problematic is the push by governments throughout the world to onshore API production and finished-goods manufacturing. This global phenomenon, fueled by the rise of nationalism, will present unique challenges that generic pharma manufacturers — due to the sheer volume of product we produce — will be grappling with for many years to come. Maintaining high quality standards for API and finished drug forms in an ever-evolving supply chain landscape is underpinned by the requirement for environmental preservation, resource availability and urgent need to deliver sustainable manufacturing. Because of this, I predict that sustaining the environment will become the No. 1 challenge for manufacturers and supply chain participants in the pharma industry over the next 10 to 20 years and beyond.

DSN: How are you helping to meet the challenges of the pharmacies?
Additionally, there are two important ways that Dr. Reddy’s can best help pharmacies in 2021. First, maintaining a strong pipeline to facilitate the launch of new products will continue to be important to all Dr. Reddy’s stakeholders. A continuous stream of new product launches will provide customers and patients with more affordable options and enhance access to products and services that they need.

Secondly, Dr. Reddy’s is focused and committed to ensuring adequate supply by increasing the safety stock levels in the U.S. to minimize any potential disruptions. During the pandemic, Dr. Reddy’s doubled down on its commitment to customers and patients to deliver affordable medicines when they needed it most. Going forward, we will continue to be guided by our deep-rooted philosophy that “Good Health Can’t Wait.” As a leader in the pharmaceutical industry, Dr. Reddy’s believes it now has the ethical and moral imperative to accelerate access to much-needed medicines for people around the world. Our philosophy of “Good Health Can’t Wait” is guidance for our current behavior and inspiration for our future actions.

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Trygve Anderson, vice president of commercial –pharmacy, Elsevier

DSN: How would you describe the current state of pharmacy?
Trygve Anderson:
Certainly, it is no secret that the pharmacy industry is experiencing a significant amount of change. The typical mom-and-pop pharmacy has gone by the wayside, giving rise to an enhanced pharmacy model that focuses on the total care of a patient through drug therapy management, active patient engagement and the ability to expand clinical services like administering vaccines, including the COVID-19 vaccine.

Enhanced pharmacy services play an important role in connecting patients to affordable and accessible services and resources to help them on their path to better health. They are paving the way for “clinical pharmacy” to be accepted as a key service provided to patients in pharmacies by providers to ensure that the patient’s chronic conditions are managed appropriately.

DSN: How have your customers’ expectations changed?
Our customers are voicing an ever-increasing demand for timely, evidence-based drug information to enable pharmacists to make important drug therapy decisions and keep the patient informed and engaged in their treatment plan.

Elsevier partners with customers to help pharmacists serve the needs of their patients throughout their health-and-wellness journey. We work closely with our customers to ensure they have evidence-based content and solutions needed to be confident, informed medication advisors.

To support and provide critical information to healthcare workers, pharmacists and other stakeholders, we launched the COVID-19 Healthcare Hub, the Pharmacy Toolkit and have expanded the hubs into obesity and cancer. Elsevier’s solutions help retail pharmacists build stronger relationships with patients while helping pharmacists maximize products and encourage discussions regarding their patients’ medication therapy.

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Danny Sanchez, vice president and general manager, EnlivenHealth, a division of Omnicell

DSN: How does your company help to meet the challenges
of pharmacy?
Danny Sanchez:
EnlivenHealth’s proven digital solutions help pharmacies streamline traditionally inefficient and manual workflow processes, allowing pharmacists to save time and focus more on providing revenue-generating, value-based services, such as vaccinations and point-of-care testing. EnlivenHealth’s solutions enable pharmacies to increase script volume by an average of 2.3% over their current growth performance.

EnlivenHealth builds the industry’s most proven and trusted patient engagement and omnichannel communications solutions, which enable pharmacies to deliver the right therapy to the right patient, at the right time. Crucially, our solutions have proven to strengthen patient retention by an average of 14%. The EnlivenHealth Patient Engagement Platform — deployed at more than 30,000 pharmacies
nationwide — is the only comprehensive, fully integrated patient engagement solution in the industry.

EnlivenHealth’s pioneering medication synchronization solution is deployed at 23,000 pharmacies nationwide. This appointment-based solution has been proven to measurably improve patient adherence. The Journal of the American Pharmacists Association recently published a study which found that patients are three times as likely to be adherent if they are enrolled in appointment-based med sync programs like those powered by EnlivenHealth’s med sync solution.

DSN: What is needed in today’s environment to stay competitive?
Some must-haves include:

  • Providing value-based services that allow pharmacists to practice at the top of their license, drive script growth and improve patient retention;
  • Transforming the practice and business of pharmacy with an appointment-based workflow model that frees up the pharmacists’ time to focus on patients and enable the vital shift to value-based services;
  • Deploying digital, omnichannel communications technologies and tools that will help pharmacies to create a truly personalized and differentiated patient experience; and
  • Leveraging advanced clinical care and decision support technologies that strengthen patient engagement and retention, and measurably improve PDC scores and, ultimately, patient health outcomes.
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Cindy Fitton, director of marketing, Follett Products

DSN: How does your company help to meet the challenges
of pharmacy?
Cindy Fitton:
Follett, the market leader in high-performance pharmacy refrigeration and known for precise temperature control, has a full range of refrigerators and freezers available in the sizes and configurations to meet all medication and vaccine cold storage needs. Engineered with forced-air refrigeration and microprocessor controls for use in real-world healthcare applications, Follett purpose-built, medical-grade refrigerators and freezers feature quick recovery after door openings and uniform cabinet-wide temperatures. Heavy-duty components and full stainless steel construction provide exceptional reliability while continuous monitoring and a full suite of alarming features safeguard critical products.

DSN: How has COVID-19 impacted the way you help your customers?
The safe storage of vaccines is a crucial component of protecting patients against this virus. Vaccines require storage within a defined temperature range, and even slight departures from recommended storage temperatures will reduce potency, which could result in inadequate immune response. Each time a vaccine is exposed to excessive heat or cold, the potency deteriorates; and once potency is lost, it can never be restored. The worst case is that patients unknowingly receive a vaccine that provides no protection at all.

Follett has just completed the redesign and expansion of its upright refrigerator and freezer manufacturing to increase production of high-performance medical-grade refrigerators and freezers. This increase in supply allows us to support the surge in demand for refrigeration that delivers against the demanding criteria required to maximize the efficacy of the vaccines needed to conquer this pandemic

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Marvin Richardson, CEO, iA

DSN: What do you see is the greatest challenge for pharmacies and pharmacists?
Marvin Richardson:
Near-term, we think the well-being of pharmacists is our collective greatest challenge. As a pharmacist-led organization, we understand the immense stress that is put on the pharmacist and pharmacy staff largely due to time constraints from filling redundant prescriptions. We believe through centralized fulfillment and fulfillment automation that iA can help pharmacists get the time they need to focus on value-add work and their patients, helping alleviate the undue stresses they face daily. We know pharmacists want to provide quality patient care. The challenge is being able to support them with the time needed to take care of the patient and themselves.

DSN: What is needed in today’s environment to stay competitive?
Pharmacy fulfillment solutions from iA empower our pharmacy providers to not only stay competitive with their offerings, but to transform their pharmacy. By removing tasks from the retail environment and transferring them to central fill, this helps create time for pharmacies to engage in other activities, such as administering vaccinations, providing consultations and participating in medication therapy management. Providing additional services beyond filling prescriptions allows for pharmacy providers to offer a more holistic care experience for the patient, which can help pharmacies gain a competitive edge.

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Luis Rodriguez, president, Keycentrix

DSN: Reducing costs is crucial in today’s competitive environment. What is your company doing to reduce costs for retailers/pharmacies?
Luis Rodriguez:
Keycentrix products reduce costs for pharmacies because they are built to increase efficiency. Our Newleaf pharmacy-
management software is a highly configurable solution that can adapt to fit each pharmacy’s unique processes, in a way that is intuitive and easy to learn. The ability to effectively communicate with prescribers and patients, incorporate business rule triggers, and have everything be easily accessible in one place means scripts can be filled faster with a high degree of accuracy. That translates into both operating costs savings, as well as the ability to recognize income sooner.

DSN: Do you think e-commerce is here to stay or do you think pent-up demand will drive customers back to stores?
Online options such as direct-to-consumer pharmacy and telehealth are absolutely here to stay. The pandemic has certainly accelerated these industry segments as patients have looked for alternatives to in-person care, but the reality is that online options have been around for many years, and consumers in all industries will continue to look for online options. Post-pandemic, we will see the ways in which these segments continue to evolve as patients show how they want to use them going forward. In-person care will never go away, since its benefits remain the same. The real key — and the developments we look forward to seeing — are the ways in which in person and online can increasingly work together or alongside each other to meet the needs of patients.

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Brian Sullivan, senior systems sales manager of healthcare solutions for USA and Canada, KNAPP

DSN: What technological innovations have had the greatest impact
on your business and your customers’ businesses?
Brian Sullivan:
The use of micro-fulfillment and nano-fulfillment solutions have rapidly emerged as top line considerations, delivering both strategic and tactical advantages, and complementing KNAPP’s larger central-fill pharmacy technology that has delivered supply chain efficiencies for the last 15-plus years.

Central-fill solutions continue to play a significant role in our customers’ goals of achieving cost reduction; right-sizing staffing; achieving track, trace and serialization compliance; and improvement of accuracy through automation. Our KiSoft One Pharmacy Suite is delivering actionable insights through the recent addition of KiSoft Analytics and KiSoft redPILOT, which helps companies leverage the benefits of predictive filling. By filling prescriptions based on real-time data, ahead of the actual Rx drop, KNAPP customers are able to further optimize the use of automation, thereby reducing costs and increasing the bottom line.

Now, micro- and nano-fulfillment solutions — similar to our offerings in grocery and retail that utilize hub and spoke solutions — are expanding operations capabilities to 24/7 operation and are meeting the emerging needs of pharmacy customers looking for same-day delivery at a lower overall cost, and with touchless service.

DSN: What is needed in today’s environment to stay competitive?
Today, more than ever, our customers realize the need to stay ahead of the curve, leveraging the latest approaches to automation and reducing the challenges of staffing shortages while providing the flexibility to serve their customers and patients’ various and differing needs. Emphasis is now moving toward a more comprehensive suite of needs that address the complete value chain and retail operations. Same-day delivery to the home, after hours pickup of prescriptions and OTC items, and digital ordering of both prescription and nonprescription products are now top of mind.

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Mehdi Maghsoodnia, CEO, 1health

DSN: How has COVID-19 impacted the way you help your customers?
Mehdi Maghsoodnia:
The pandemic introduced a whole new set of challenges for 1health customers, particularly in terms of testing for COVID-19 and, now that vaccines have been created, for the administration, reporting and verification of those immunized.

When COVID-19 arrived, 1health was the first organization to develop an FDA emergency use authorized RT-PCR saliva test that could be self-administered anywhere. We continue to support new types of testing from antibody to fast PCR as our partners need to keep up with the challenges of bringing their members and customers back to work safely.

Throughout the pandemic, 1health was and continues to be focused on providing testing as a service to organizations to help empower people to live healthier, longer lives by providing efficient precision testing at scale.

DSN: What advice do you have to offer for retailers and customers going forward?
It is important for retailers to have a comprehensive pandemic program available to their customers. Therefore, it’s critical for those businesses to have a trusted platform partner who can provide not only multiple types of testing, but also information systems around vaccination.

We encourage retailers to talk to testing companies and ask the following questions:

  • Do you have a broad national network of labs you work with?;
  • Is your platform a simple API that can be integrated into existing systems?;
  • Can you support my brand to provide a seamless customer experience?;
  • Can you provide a list of companies you work with that use your system?;
  • Can you provide us with multiple types of tests, including fast PCR, antibody and more?;
  • Can all the information be uploaded to a single system, including vaccination, test results and more?; and
  • Is the customer info available through API to integrate to my existing marketing systems?
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Chris Fitzmaurice, director of Industry data resources, ScriptPro

DSN: What technological innovations have had the greatest impact on your business and your customers’ business?
Chris Fitzmaurice:
As patients become more technologically savvy, they are also becoming more educated about their health. And while there are myriad sources of information available, pharmacists are becoming increasingly important as filters for verifiable facts about health care. Giving these pharmacists evidence-based tools to understand all the data and formulate reasonable recommendations will continue to be a focus for the industry. ScriptPro’s clinical documentation software, APCS, offers this evidence-based approach in a streamlined fashion to help pharmacists quickly gather information about their patients, then tailor their recommendations to the individual. As automation continues to help the profession evolve, pharmacies will look for ways to leverage the pharmacist’s role as an educator and, eventually, a provider.

Patients are also expecting a more tailored experience for the way they take their medication. Medication regimens are only growing more complex. The lives of patients are no different. This means that the old concept of one-size-fits-all no longer applies. Simplifying the basic conceit of taking medications is not only helping improve adherence but is also finally matching the flexibility of taking medications with the variances of everyday life. ScriptPro’s line of automated Medication Packaging machines are helping to provide this flexibility.

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Mike Popovich, CEO, STChealth

DSN: How has COVID-19 impacted your company and the way your company operates now?
Mike Popovich:
As a software vendor supporting pharmacies, we’ve invested in new tools and resources that help us better serve our pharmacy clients, including additional technology and staff to ensure immunization and disease surveillance data gets reported to the correct public health authorities without impacting the pharmacist’s workflow.

DSN: How has COVID-19 impacted the way you help your customers?
Sometimes tragedy has a way of facilitating change, and that’s certainly been true for the COVID pandemic. Prior to COVID, bidirectional immunization reporting was thought of as a luxury; the ability to query your state immunization information system, or IIS, for patient history was helpful, but not always required. Because of the pandemic, we’re now seeing requirements for bidirectional immunization reporting in all 50 states. This has pushed our pharmacy clients to establish electronic reporting connections with a state’s IIS and allows us to continue bridging the gap between public health and our pharmacy clients.

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Mike McBride, vice president of partner relations, Upsher-Smith Labs

DSN: How do you view the state of pharmacy going forward?
Mike McBride:
Pharmacists are among the most accessible healthcare professionals in the country and, as such, they are in a great position to expand their scope of practice. Thanks to technological innovations, pharmacists can now provide patients with care that goes beyond dispensing and adjudicating prescriptions to include services that help patients prevent disease, improve health and enhance well-being. This expanding capacity has never been more apparent than during the COVID-19 pandemic. In addition to offering home delivery and telepharmacy options, pharmacists also provided access to vaccinations — and local health expertise. We believe that the pandemic has reinforced and expanded pharmacy’s place at the wheel of new healthcare delivery models,and that this will continue once the pandemic has ended. Upsher-Smith is exploring ways to expand our relationship with pharmacists to include more collaborative interactions where pharmacy, prescribers and patients enjoy a more connected and patient-centric experience.

DSN: Reducing costs is crucial in today’s competitive environment. What is your company doing to reduce costs for retailers/pharmacies?
Upsher-Smith is committed to providing affordable medications to patients, and we continue to focus on controlling costs for both our generic and branded products. For example, we have invested in an optimized, state-of-the-art manufacturing facility at our headquarters in Maple Grove, Minn. This 300,000-sq.-ft. facility will enable us to consolidate our production into one location, even as we expand our capacity to produce additional dosage forms, as well as complex generics.

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