The retail chain pharmacy market is highly competitive and getting more so each day. What can your chain pharmacy do to maintain its competitive edge?
In this edition of Pharmacist to Pharmacist, we spoke to Nancy Gallo, a pharmacist and senior director of sales support for McKesson Pharmacy Systems. She told us about the shared challenges she’s hearing from her chain pharmacy customers. She also outlined some strategies your chain pharmacy can use to stay ahead of the market.
What does your role involve?
Gallo: I manage the team that helps our sales reps with product demos. Our main product is EnterpriseRx. It’s a centralized pharmacy management system (PMS) for chain pharmacies. As a pharmacist, I can set up our demo environments to reflect real-life scenarios. We can show the clinical and business value that our products can bring to a pharmacy’s operation.
What kind of challenges are your customers facing?
Gallo: The first challenge for chain pharmacies is finding more time to spend with patients and improving their health outcomes. It’s the clinical side of the business. The second challenge is operational efficiency. Chain pharmacies must still fill prescriptions. But they need to be more efficient, effective and accurate. The third challenge is simply the business of running a chain pharmacy. I’m talking about revenue, costs, inventory, staffing and compliance. They’re three separate issues, but they’re all connected.
Why are those issues becoming more challenging for chain pharmacies?
Gallo: For prescriptions, it’s volume. Baby boomers are older and sicker. They need prescriptions. And there’s a drug for everything. On the business side, it’s benefits. It’s more difficult to get health plans to approve a prescription. It’s more complicated to send in a drug claim for payment. Adherence is making the clinical piece more challenging. You can’t get the best outcomes if patients don’t take their pills.
How can chain pharmacies get more efficient?
Gallo: Chain pharmacies can use technology to automate a lot of manual functions. They can move to a central fill or central fill as a service model. A central facility fills the prescriptions and delivers them to the pharmacy sites to dispense to patients. Or they can move to a unit-dose packaging model. A distributor can prepackage drugs in a single package for one course of treatment. Both models end the need for your pharmacists to count out pills from behind the pharmacy counter. This also frees up their time to focus on patient care. In general, centralization helps maximize efficiencies, including workload balancing, staffing, expertise in certain functions, and more.
What business strategies for chain pharmacies do you recommend?
Gallo: Technology can help there, too. You can use technology to automate prior authorization. You can use it to verify benefits and see if patients are eligible for financial aid. You can use technology to send claims and improve revenue recovery. You can use it to make sure you’re following all state and federal dispensing rules. Staff training, education and awareness are critical. That must be constant. Everything is changing all the time. Our customers tell us they’ve seen more changes in pharmacy in the past 18 months than they have in the past 18 years.
What clinical strategies for chain pharmacies do you recommend?
Gallo: It comes back to spending more time with patients. If you’re a chain pharmacy and you get the operational and business parts right, you should have more time to spend with patients. Spending time with patients improves adherence. Adherence improves outcomes. What could you do with that time? You could review patients’ medication histories. You could do medication therapy. You could ask them why they’re not taking their drugs. If convenience is an issue, you could enroll them in your medication synchronization program. If they’re adherent but not reaching their health goals, you could offer disease management services like nutritional counseling for diabetic patients.
How can technology help chain pharmacies’ clinical strategies?
Gallo: Chain pharmacies can offer health screenings to patients. Screenings are most useful if they’re connected to a chain’s PMS. A blood pressure kiosk is a good example. A patient takes his or her blood pressure. If that reading goes to the pharmacist, the pharmacist can see whether it’s high. If it’s high, the pharmacist can see if the patient has been picking up their blood pressure drug. If not, the pharmacist can intervene and try to correct the situation. If your chain pharmacy offers health screenings or other types of point-of-care testing, those devices should be interoperable with your PMS.
You’re describing the transition of the pharmacist into a provider. What are your thoughts on that?
Gallo: I’m an advocate of the transition. When pharmacists are proactive in prevention and wellness, patients have better health outcomes. Vaccine programs are a perfect example of a provider service pharmacists can offer patients. We need state licensing changes that let us do things like perform simple diagnostic tests, make a diagnosis based on the results and then prescribe the right drug. One thing that doesn’t need to change is trust. There’s an inherent trust between patients and their pharmacists because they spend so much time together. We just need to take it to the next level.
Are there other trends chain pharmacies should watch and stay on top of?
Gallo: On the clinical side, it’s knowing what drug trends are happening in your community. Your chain pharmacy can use the clinical applications in your PMS to check if the right patients are getting the right drugs in the right amounts for the right diagnoses. On the business side, you need to stay on top of drug formulary changes by health plans. You want to dispense the most effective drug. But you also want to stay in formulary to avoid any prior authorization or billing problems that can cost you time and money.
What will the daily life of a retail pharmacist be like five years from now?
Gallo: They will be out from behind the counter or the glass partition and be with patients in another room. It will be less about getting that prescription filled and more about, “Hey, let’s talk about that prescription.” It will be a much more interactive relationship between pharmacist and patient. I believe pharmacists are trying to do that now. But as we move from billing for prescriptions to billing for services, pharmacists will be taking an even bigger interactive role with patients.
What do you like most about being a pharmacist?
Gallo: It really is about taking care of people. I want to be the person patients talk to about their health issues. I want to make a difference by solving their problems. Now I think of our customers as my patients. I want to solve their problems. And if I do my job right, my chain pharmacy customers can make a difference in the lives of their patients.