Using Adherence Packaging to Grow Your Independent Pharmacy Profits
Here at PDS, we take pride in highlighting some of our incredible solutions partners. We know these companies have the potential to revolutionize pharmacies just like yours through their products and services. We’re excited to introduce RxSafe’s blog post about adherence packaging services.
Independent pharmacy owners can no longer sit on the sidelines when it comes to evolving and growing their services to compete with companies like Amazon, CVS and Walgreens. While there are many opportunities for you to grow your business and profitability, developing an adherence packaging program should be at the top of your list. 
At the 2019 PDS Super-Conference, RxSafe assembled five independent pharmacy owners, with a collective 37 years of experience in adherence packaging, and asked them to share what they have learned. These pharmacists have tried all manners of adherence modalities before arriving at what really works.
Through a series of questions and answers in this blog, they’re going to give you their hard-won advice and insight.
The following people featured at the breakfast session:
- Amjad Abukwaik, Sheefa Pharmacy in Paterson, NJ
- Bruce Kocian, Gibson Pharmacy in Athens TX
- Kyle Lomax, Southern Pharmacy in Jonesboro, AR
- Ben McNabb, Love Oak Pharmacy in Eastland, TX
- Neil Patolia, AUM Pharmacy in Anaheim, CA
- Todd Eury (Moderator), publisher, Pharmacy Podcast Network
Q: [Todd Eury] What is patient awareness? Has Amazon talked about adherence and is PillPack being more aggressive towards your patients? Or has it been pretty much the same as it’s always been with Amazon?
A: [Ben McNabb] I’m seeing quite a bit more advertising in our area. I think they’re still acclimating themselves to the pharmacy industry. So, I think we’re only kind of seeing the tip of the iceberg here and what Amazon’s able to do with how they’re going to market it and how they’re going to push it out. I would probably say that they haven’t pushed it extensively, so I think there’s still a window of opportunity to try to be first in your marketplace. Try to get to your providers quickly, maybe you start advertising in your local area through social media and other means of advertising, to try to be first in line when someone sees a PillPack ad on TV, or through Google ad networks, and other things.
Q. [Todd Eury] Have you had experience with strip packaging and adherence packaging before purchasing the RxSafe RapidPakRx? If so, discuss that experience and tell us about what you’ve done and how you’ve managed it.
A. [Bruce Kocian] We do have a competing company’s automation for strip packaging. Before the strip packaging, you name it, we’ve probably done it: Medicine on Time, Doc-u-Dose, OPUS, cassettes. The experience as far as the automation goes was not a good one at first. With the previous machine, we had varied time and a lot of time constraints on the pharmacists themselves. We put a hold on our adherence packaging system until the RapidPakRx came out. I will tell you that the look on my techicians’ face when we say we have a new customer that’s going to the packaging as opposed to what it was before is completely different. I would want everybody to really do your due diligence on the automation as well as the company that you’re going to be in business with when you step down this path.
Q. [Todd Eury] How are you introducing adherence to your patient base and what’s their reaction? Is this being followed up with counseling and/or spending more time with your patients?
A. [Ben McNabb] Our marketing plan is very significant. I know many owners that have bought a packager and it just gets put in a corner and it’s not used. The packager doesn’t do the work. You still have to sell the service. So that’s extremely important. We started out with a lot of video and social media advertising. We got picked up by local news stations. That really got us out there very well in my area. I had people that have trouble remembering, and they’ve been mistaking their medications for years. Now the patients just tell me it’s life-changing in many ways.
Q. [PDS Audience Member] To fill, let’s say 11 prescriptions for that patient, how long does that take?
A. [Amjad Abukwaik] With the RapidPakRx, it just takes about 10 minutes per patient. The verification for a pharmacist is a minute or less. You don’t have to open the box, I just look at the screen where I actually see every single pouch. Usually, there’s no error, but if there is any you can see it right there on the screen.
A. [Neil Patolia] For us, it’s faster than it was. Before, it was around an hour to half an hour because the checking alone takes so much time with the [competitor system]. With the [competing system], you can buy a camera system, but the camera system costs thousand dollars more instead of a technician just manually checking it. So now it’s half an hour to 20 minutes. Not even that now.
Q. [Todd Eury] How many technicians are required for your packaging program and do you run the packaging system every day?
A. [Bruce Kocian] Currently there is one technician that runs the packaging program. She has help from the other technicians. We use RxSafe so obviously, the fill technicians on the RxSafe are pulling the SKUs out of the safe that go into the RapidPakRx. But it’s a single technician. We have about 150 people in the RapidPakRx. She runs that probably Monday, Tuesday, Wednesday. By Thursday, Friday she’s working on the people for the next week, not actually running the packer. I see her easily being able to do 30-plus people a day by herself on the packer. It’s that efficient.
Q. [PDS Audience Member] With the non-adherents that we all have that just refuse to be adherent, have you had much luck putting those patients in the program and then just accepting it? Because those are the ones that, even if you’re in a sync program, they won’t pick up.
A. [Ben McNabb] That’s what I’ve found tremendous. Even with sync, some of these patients, they just will not take the medications appropriately or there are anecdotal issues with the physician telling them only take a half or whatever these issues are. When you’re reconciling the meds every single month, once a month, you’re forcing them to take it according to how the package is listed. If they miss a dose, they potentially put it to the side, and they continue trying to remain adherent on the dates and times. Over the long run, it trains them. It’s going to keep your scores moving forward the way it needs to go.
Q. [PDS Audience Member] I want to know what percentage of your patients are you having as a pharmacist to relook at because of potential errors when it checks it? How does the adherence system match if you need to fill 15 of one NDC and 15 of another? Does that confuse the system?
A. [Bruce Kocian] With the RapidPakRx, it’s minimal to none because of the technology. The RapidPakRx will not drop a pill to be packed if it does not recognize it. Before it ever drops the pill to be sealed, if it doesn’t recognize the medication, it alerts you on it. So it’s very, very minimal on the repacks.
Q. [PDS Audience Member] If the patient takes the 11 prescriptions per month, you probably can get compliance back. What is the net profit per patient?
A. [Ben McNabb] We use PDS RxAnalytics, but when we determined what we were getting, we were getting approximately $180 of gross margin before rebate per patient per month. You should consider it as a subscription-based model. I think that’s how Amazon considers this. This is a subscription that they’re paying their Amazon Prime fee for. They’re getting all of this included service. Don’t forget the tax benefits of bringing in this technology. Some of these tax breaks help pay off these technologies and really reduce how many patients you need to bring on to break even on the technology.
A. [Amjad Abukwaik] I’m sure all of you do marketing. Let’s say you let staff go out of their own pharmacy and out from behind the bench to go to doctors, adult daycare, and so on. If you bring in five to seven patients a month on this system, new patients, do the math. You give an average patient eight or 10 prescriptions, and hopefully, you’re making $10 per prescription. Let’s say 10 patients per month, new patients, brand-new patients, that’s 10, probably times 10- I mean, do the math. It’s almost like four or five thousand dollars extra income coming in. That would pay for your machine.
A. [Bruce Kocian] As compared to the competing company’s machine, when you do have 200-250 canisters, if you’re going to load that machine completely, you’re talking about a significant increase in your inventory. With the RapidPakRx, you have no increase in inventory other than your increase in patient volume.
Q. [Todd Eury] How are you marketing adherence technology to your customer base?
A. [Ben McNabb] I’ve been really impressed with the impact of social media. Especially, if you can get this social media presence out there as personalized as possible, you already have a well-built advantage. You can really get that message out there. Make sure you’re doing your research on effective social media advertising. Facebook typically doesn’t like the mass-produced or stock-image type of advertisement. It really wants it to come down to that local level. It wants it to come down to that relationship that exists between you and the customer, that’s a sincere relationship. So, if you can get that across, Facebook’s algorithms could really pick that up, see that it’s engaging content, and you can boost the heck out of it in your geographic area and really make a good go at it.
A. [Amjad Abukwaik] One of my stores packs all of their sync program patients on Monday and Wednesday. On the other days, they’re out seeing doctors and speaking about the sync program. They’re also talking about adherence packaging, and how that’s beneficial for their patients and their practice.
Q. [Todd Eury] Does offering adherence really grow your service area?
A. [Ben McNabb] Because of packaging, we’re able to service a much larger geographic area than what we have in the past. We went from a potential population reach of about 18,000 to 125,000 when you start looking at the map.
Q. [Todd Eury] How do you partner with other health providers?
A. [Amjad Abukwaik] Partner with your PBM. You have a lot of Medicare Part D plans, you know, reps, and they knock on your door. They ask about switching patients from plan A to plan B. Find a good one that is beneficial for you. They will be your best friend and will bring you tons of patients.
A. [Neil Patolia] We’re in a medical building, and next door, what they did was they had all the brokers come in. And whenever I talk to brokers, I’m like, “Okay, so you’re a broker, there are other brokers just like you. So, in order to differentiate yourself, why don’t you work with a pharmacy that has a packaging system?” It’s a win-win for you because you get the extra value that the other brokers can’t bring in.
A. [Bruce Kocian] Hospital readmissions is another venue. Go there if you have a hospital close to you locally. Their readmission rate greatly affects the reimbursement with Medicare now. We also have a nurse in the county that works for one of the insurance companies that refers patients to her. She’s not a home health nurse, she doesn’t work for the local home health agency, she works for one of the insurance companies. And she calls us on a regular basis with her high-med, difficult patients, to put them in our packaging system.
The above statements are simply excerpts from a larger discussion panel. To see the entire adherence breakfast session and hear even more from these independent pharmacy owners who are having success with their compliance and adherence programs, click here.
To learn more about the RapidPakRx and PakMyMeds, visit rxsafe.com/pds.
Using Adherence Packaging to Grow Your Independent Pharmacy Profits
