Developing and expanding clinical services at your retail pharmacy can help prevent sweeping healthcare industry changes from challenging your financial sustainability. In this edition of Pharmacist to Pharmacist, Matt Horton, director of product and vendor management for vaccines at McKesson Pharmaceutical Solutions and Services, explains how your pharmacy can use its seasonal flu vaccination program as a springboard for better financial and clinical outcomes.

What are you responsible for in your role at McKesson?

Horton: I lead a team that’s responsible for buying and selling all of the vaccines that McKesson distributes to pharmacies of all kinds. On the front end, that means working with suppliers on the types and amounts of vaccines that our pharmacies need. In the middle, we work with our distribution centers to make sure those vaccine products get to our pharmacies. And at the end, we work with our pharmacies to develop their vaccination programs.

When you talk to your retail pharmacy customers, what do they say is keeping them up at night?

Horton: The pace of change pharmacies are facing is incredible. There are just a ton of headwinds out there for them. But by far the most common one I hear about is reimbursement pressure. It’s payment rates not keeping up with the cost of drugs. They take some comfort in knowing that everyone is dealing with the same thing. But that only goes so far. Ultimately, you have to do something about it.

What is the “something” that you recommend that retail pharmacies do?

Horton: You need to diversify your revenue and profit streams. It’s really something pharmacies have been doing for years. Think about it. Back in the day, a soda fountain added a pharmacy to diversify its revenue and profit streams. Then a pharmacy added front-end, over-the-counter items to diversify its revenue and profit streams. Now, it’s time for you to do that again, but this time with clinical services. That’s where my team comes in and works with you to develop your immunization program.

How should retail pharmacies start their vaccination programs?

Horton: That’s actually the biggest challenge for pharmacies—knowing where you should start. There are a lot of operational issues that you have to address first before you give your first shot to a patient.

What’s the first operational issue that retail pharmacies need to address?

Horton: The first is state certification. Every state has different laws. You need to know what vaccines and vaccine-related products your state allows pharmacists to administer. You need to know what types of patients your state allows pharmacists to administer vaccines to—adults, children or both. You need to know if your state lets you administer vaccines without the approval of the patient’s doctor. Once you know all that, you can incorporate into a Collaborative Practice Agreement that your state will accept.

What supply chain issues do retail pharmacies face before starting an immunization program?

Horton: All vaccines are different. Some need to be refrigerated or frozen, and some should be kept at room temperature. You have to understand the storage requirements of each vaccine and be able to meet all those requirements at your pharmacy. You also need to know how much of each type of vaccine you need to buy and store onsite at the right time. Are you doing seasonal flu vaccines only? Are you doing age-based maintenance or prevention vaccines? Are you doing travel vaccines? You should be able to estimate the amount of each that you’ll need based on your patient population. You can also talk to your peers about how much they buy and keep onsite. It’s usually better to buy a little less than you think you’ll need than too much. You will be able to receive more the day after re-order.

What quality and safety issues do retail pharmacies need to address regarding vaccinations?

Horton: Your pharmacists must be certified immunizers, and there are a lot of training courses that they can take. Ideally, you’d have a separate, private room where you could give your vaccines. Each vaccine comes with its own post-vaccination waiting time to see if there’s any adverse reaction to the drug. And you must have the proper protocols in place in case there is a reaction.

How can retail pharmacies convert flu shots into better business and clinical results year round?

Horton: You should see your flu immunization program as an opportunity to expand your business. First, you’re attracting new patients to your pharmacy. Those new patients can turn into loyal customers for years. They’re not just coming in once a year. They’re coming in all the time to get all their prescriptions filled and to buy other things at your store. Second, you’re creating new possibilities with existing patients. In the few minutes it takes you to give a shot, you can have a conversation with your patient about their health and about other clinical services at your pharmacy that can help them maintain or improve their health. You could offer them medication therapy management, a different vaccine, or other reimbursable care. They could start getting all their maintenance vaccines from you. Flu shots are a springboard to a year-round immunization program and other clinical services.

What other benefits accrue to retail pharmacies that take this approach?

Horton: Well, there are the business benefits. You’re diversifying your revenue and profit streams like I mentioned earlier. You’re also taking another big step in playing a larger role in patient care—making that transition from pharmacist to provider. We’ve made amazing progress, but we still have a long way to go. Five years from now I see us moving away from solely reimbursement for the drugs we dispense to reimbursement for clinical services and patient outcomes.

What do you like most working with retail pharmacies on their immunization and clinical programs?

Horton: Like I said earlier, retail pharmacies are facing a lot of challenges. But they also have more opportunities right now. As a pharmacist, I love seeing our profession change. It’s changing right before our eyes as we take on a bigger role in patient care. I meet with pharmacists around the country, and I see some truly spectacular business and clinical ideas that I’m able to share with others that have the same vision for the future.

Editor’s note: If you have a question for one of our pharmacists, please leave a comment and let us know. We’ll be sure to cover it in a future edition of Pharmacist to Pharmacist.

Related: Learn more about McKesson’s vaccine supply, purchasing and distribution services for retail pharmacies

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McKesson editorial staff is committed to sharing innovative approaches and insights so our customers can get the most out of their business solutions and identify areas for operational improvement and revenue growth.

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