Here at PDS, we take pride in highlighting some of our incredible exhibitors. We know these companies have the potential to revolutionize pharmacies just like yours through their products and services. We’re excited to work with Drug Topics. Read on for their sponsored blog post about the business landscape after COVID within pharmacies and 5 objectives for focusing on growth again, written by Ollin Sykes, CPA, CITP and Scotty Sykes, CPA, CFP.

5 Objectives for Boosting Rx Business and Cash Clinical Services

Coming out of the sudden, severe lockdowns from the coronavirus disease 2019 (COVID-19), pharmacies are adjusting to a new way of serving patients and providing services. To build some positive momentum, here are 5 ways that current pharmacy owners are adapting their businesses to serve people. 

#1. Crisis-Based Services 

During a crisis, helping your patients and community can also lead to new services. Out of COVID-19, pharmacies have the opportunity to provide items like hand sanitizer, cleaners, safety garments, infrared thermometers, and more. By packaging and pricing a variety of products for the size of company or organization, you help customers quickly get the supplies they need from a local source. 

#2. Managing DIR and GER Challenges

Direct and indirect remuneration (DIR) fees are typically the third largest expense in a pharmacy behind inventory and payroll costs. You can mitigate higher DIR fees by monitoring your Star Ratings, but also by exploring med syncing and compliance packaging. If you can reduce DIR fees by 1 to 2 percentage points through this investment, it’s easy to calculate how such technologies can pay for themselves and more — plus result in happier patients and families. 

As for generic effective rate (GER) challenges and potential clawbacks, which are not influenced by performance measures, make sure that you know which contracts, if any, include GERs or “effective rate guarantees” in the contract language. You can work with your PSAO on contract terms, and also consider a separate inventory for plans with GERs. The separate inventory could be sourced differently with a higher average wholesale price to lessen a potential clawback.

#3. Offering Cash Clinical Services

This is a pioneering area where pharmacists can identify ways to keep their patients healthier and prevent or manage larger health problems. It may include phlebotomy and clinical testing to identify and consult on the root cause of ailments that can be treated prior to or beyond medications. Whether that results in non-interactive private label nutritional supplements or food sensitivity solutions, you should explore cash clinical services that make sense for your pharmacy. 

Explore a few private label providers before you move forward with patient testing and consulting. Build relationships with a few trusted vendors, and educate your team first so that you feel confident promoting probiotics or other supplements to patients. 

#4. Building Community Relations

Who are your target patients and customers? Take a look at who they are, the prescriptions they use, their family members, and common health care services. How can your pharmacy add value to their treatment experience and act as a resource? 

For example, Nicolette Mathey, PharmD, a Florida-based pharmacist and a consultant to pharmacists through her company, Atrium24, identified elective surgeries as a trend in her community. So she developed a branded surgical treatment kit for cosmetic surgery clinics. The kits inform patients about surgery preparation and after-care. Often, the patients end up working with Mathey’s pharmacy on any medications or products related to their surgeries. 

Another idea is to join — or have one of your team members join — public social media groups in the community. Interact with parents, coaches, or seniors on healthy living topics. Provide guidance if community members express a need that your pharmacy can solve. 

#5. Enhancing Quality of Life

What happens when your pharmacy becomes a resource in your community during challenging times? You are viewed as a health care provider and a friend, building a network of healthier, informed community members and patients who rely on your business. As a trusted resource, you gradually diversify your services and revenues, which improves your bottom line margins, profits and quality of life. 

Coming out of COVID, make sure that your pharmacy is a part of the larger community and health care conversation. You matter. 

Need additional information?

To learn more about how independent pharmacies are adapting their operations to best serve their patients through COVID, get a sneak peek of the latest PDS member town hall.

About

Here at PDS, we take pride in highlighting some of our incredible media partners. We know these companies have the potential to revolutionize pharmacies just like yours through their products and services. We’re excited to work with Pharmacy Times. Read on for their sponsored blog post about the importance of immunization programs, written by PDS member, Travis Wolff, PharmD and Emma Leffler, PharmD. Travis is the manager and co-owner of Med-World Pharmacy in Sapulpa, Oklahom and Emma is a PGY1 community pharmacy resident.

There are many areas of patient care where pharmacists can have a direct impact, yet a number of them do not have the confidence or understand the potential magnitude of that impact.  

Moving the Independent Pharmacy Forward with Immunizations

If pharmacists want to continue to move the profession forward, seeking provider opportunities, they must gain that confidence and help stakeholders understand the important roles they play. These include conducting diabetes or point-of-care testing, but it is immunizations that provide the clearest snapshot.  

Let’s go back to the years when pharmacists first saw immunization-friendly legislation being enacted from state to state. The National Association of Chain Drug Stores compared influenza vaccine rates from 2003 to 2013 to cover this period of pro-pharmacist legislation.

During that time:

• 5.1 million vaccinations could be attributed to the new legislation.
• The American Pharmacists Association (APhA) Foundation conducted a pilot study that looked at immunizations across 8 community pharmacies in Washington State.
• The study results showed that vaccine administration rates had increased by 41.4% over 6 months.
• In addition, for every influenza vaccine walk-in, 1.45 other vaccinations were identified as being due. Of those unmet patient immunization needs, 95% were administered by the pharmacist at the point of care.

Understanding the impact pharmacists have had after receiving immunization privileges greatly boosts the case that they should be given additional responsibilities. After we shared these two studies with our federal and local representatives, they asked us about the local community we served. This led us to dive into our own initiatives.  

Immunization Facts

We will start by laying out some important facts. Immunization is one of the most cost-effective means of preventing disease. Individuals can defend themselves against several diseases by staying up-to-date on all recommended immunizations. Additionally, as more individuals become protected from particular diseases, communities gain a collective immunity that aids in reducing complications, deaths, and hospitalizations. Community pharmacists can reach out to and educate patients in their communities, and administer these preventive immunizations to them.  

Some challenges that providers face are:

• Consistent accessibility to the adult patient population
• Identifying patient vaccine eligibility
• Supplying and administering all recommended immunizations in the office

Patient challenges range from access to reliable information, knowing which immunizations are recommended based on age or comorbidities, and remembering when to receive follow-up doses. By creating pharmacist-led immunization programs, community pharmacies can improve patient outreach, immunization rates, and follow-up doses.  

From the most current data up to 2016, overall immunization rates for hepatitis A (23.7%), human papillomavirus (8.6%), influenza (70.4%), pneumococcal disease (66.9%), shingles (37.4%), and tetanus, diphtheria, and pertussis (26.6%) have increased slightly. Pharmacists have the optimal opportunity to increase these rates around the nation. Our pharmacy targeted 1 specific immunization in 2019, the shingles vaccine Shingrix.  

Seeing it in Action

In 2019, we promoted Shingrix immunizations on our Facebook page and flyers, and through individual discussions with the patients we identified as being eligible to receive them. The determination of eligibility stemmed from our Sync+ program, which analyzes patient profiles to determine chronic disease medication adherence, immunization eligibility, and preventive screening opportunities. Patients aged 50 years or older were identified as eligible for the Shingrix vaccination. Our Sync+ patients were sorted through, alphabetizing by last name. This allowed for a staggered informing of eligibility versus a bombardment of vaccinations on a single day or week. When the program identified a patient as being eligible, we communicated a message through a written note in the patient’s Sync+ basket, as well as a typed note in the patient’s electronic profile. Pharmacy team members could then counsel patients at pick-up time about benefits, eligibility, and what to expect.  

Because of the advertisements and 1-on-1 counseling, our pharmacy, Med-World, more than doubled its Shingrix vaccination rates in 7 months versus the rate in 2018. Of the 447 patients we have analyzed thus far through Sync+, 74% are eligible for Shingrix immunization, 26% of whom have received it. Numerous patients identified have yet to receive their 1-on-1 counseling, because of when their pharmacy system sync day falls during the month.  

Many patients had questions about whether Shingrix is still given if they have already received the Zostavax immunization, and whether it is inactive or live. Patients who previously received Zostavax are still eligible, and we encourage them to receive the new shingles immunization. Although 

Zostavax is a live immunization and carries increased contraindications and precautions, Shingrix is an inactive immunization, which means greater availability to more people. Additionally, Shingrix is 97% effective at preventing shingles in people aged 50 years or older, whereas Zostavax is only 50% to 64% effective at preventing shingles in that age group.

Once patients receive their first immunization, we document the date of their next follow-up dose on their comprehensive immunization spreadsheet and computerized profile note. Each month, a staff member calls patients within the 2- to 6-month period to inform them that it is time for the last dose of Shingrix. When patients have received both doses, the staff make the appropriate documentation. In 2019, our program completed 3.5 times as many follow-up doses versus 2018.  

Conclusion: Independent Pharmacies Impact Immunization Rates

Based on our findings, community pharmacist immunization programs can have an extensive impact on immunization rates, especially regarding follow-up dose rates. Barriers to patient immunization initiation included the ability to contact patients, patients receiving the immunization at a different facility, and cost. Additional research and time are needed to determine the longterm impact that pharmacist-led programs have on immunization rates and follow-up doses. We plan to expand our immunization program to include other immunizations, such as hepatitis B, Pneumovax 23, and Prevnar 13B.  

We hope that community pharmacists across the nation will gain confidence and better understand how to communicate their value to stakeholders.  

If we can have this kind of impact on immunizations, what would the impact be across other point-of-care health services if pharmacists were entrusted with them?  

Next Steps:

Join the PDS Innovate in a Day event on February 11 where we will be talking more about immunizations and other strategies you can implement in your pharmacy now to propel your business forward in 2021.

References