What I learned week 9

What I learned week 9

Melissa Mattison told us about her daily operations as a retail pharmacist. I was not aware of all the duties that pharmacists partake in every day. Usually every morning there are trucks to drop off orders that she must be present for. Her job is to make sure what they were billed for was what they received. Simultaneously throughout the day she is looking through several queues. There are problem queues, which mainly consist of insurance rejects, direct physician queues, and personal queues. It’s the pharmacists job to clear out all queues and fix any issues sooner than later. She is also listening to voicemails, checking the DUR’s drug utilization review, and checking if the drug is appropriate for the patient when orders come in. In addition, there are call lists such as adherence calls, that the pharmacist must call the patient and ask if you’ve taken your medication and if you have any questions. Diving deeper into this, there are pros and cons: from the clinician side, the expertise health staff knows that the patient needs the medicine and it only works if you take it. In a sense they are looking out for your overall health and wellness, rather than just handing you the pills in hopes you’ll take them, it also creates a relationship between the pharmacist and patient. Others may argue that’s it’s an annoying pushy sales tactic; because if you don’t pick up your medication or refill, that’s a loss for the pharmacy. When we were discussing patient adherence calls I sparked a question, “Is it the physician who requires the pharmacy to make adherence calls, or can the patient request these calls be made themselves? Mattison acknowledge it is a company base system. In fact, the insurance companies are the ones that want these calls to be made because they’re the ones getting paid. Another interesting thing I learned was that immunization became a game changer for many retail pharmacies. Some pharmacists were apprehensive at first because they chose a career where they didn’t have to “touch” people. Immunizations are the #1 most profitable item at Walgreens; and only 12 years ago in the state of Massachusetts were they able to immunize at the age of 12, now the age has decreased to 9 years old. The convivence factor of immunizations through retail pharmacies is key. Nobody wants to go to a doctor, schedule some appointment three days in advance, come in on time, wait for an hour in a cold room, get the vaccine, and get herded out. You can walk into Walgreens or any other pharmacy at any time and be in and out in less than fifteen minutes.  We then got into Walgreens as retailer pharmacies and some of their functions. The district manager for Walgreens explained that retail in general, companies keep $0.3 off every dollar they make. Payroll is the number one cost to most all businesses. He demonstrated to us that normal consumers don’t understand how little companies keep in revenue and that their expenses can be very high. The average monthly rent for any Walgreens location with about 10,000 sq. feet is around $40,000. Retail stores must also deal with comprehensive lost: stealing, spoilage, etc.  This sparked another question, Question 2: Do you accept EBT? The Walgreens district manager advised yes, they took take EBT as well as WIC but they make little to no money on it. These programs are government funded and they take away any profit. Take for example formula, something so high cost, Walgreens makes little to no money off because for many individuals its funded for them, especially in inner cities; therefore, grocery stores for example stay away from cities because of things such as high rates of stealing, high rent cost, low revenue made off government funded programs, etc. He then got into the pharmacy side of things. 2/3 of the business is pharmacy driven. If the pharmacist isn’t in the pharmacy, they can’t even open the pharmacy. Something I thought was interesting what that the district manager said they would never ask a pharmacist to take the trash out because that would be a waste of payroll. There are things that only the pharmacist can do so they want to make sure the pharmacists are utilizing their time, because they get paid significantly more than a cashier; so, they would have the minimum wage cashier take out the trash instead. Also, relating to adherence calls, the pharmacy has three days to call you and remind you to refill, one day they’ll call at 9 am, if you don’t answer, then 12 pm the next day and if no answer, around dinner time the last day; this increases the likelihood of you answering.

Discussing retail pharmacies, I decided to research the future of retail pharmacies. I discovered that retail pharmacies face shrinking margins. Anemic reimbursements and industry consolidation are forcing retail pharmacy companies to look for new sources of revenue. Retail pharmacies are trying to redefine themselves; they have already come along way with introducing consumers to realize they do more than count pills. “Consumers have been quick to adopt retail pharmacies big and small as their neighborhood sources of flu shots, strep tests and ear checks, along with milk, mascara and even sushi rolls.” Research suggests consumers would embrace more services if they were offered. Immunization became a game changer, but now more than ever pharmacists are pushing to provide more services.

What emerged is a picture of an industry at a crossroads, but with three strategic opportunities: Become a health hub for consumers, deliver new value to traditional partners and new entrants and master the “last mile” to meet consumers where they are both virtually and physically. Ultimately the consumers are the ones driving this change. Consumer needs, preferences and engagement will rule the future of pharmacy, meaning speed, variety and convenience will reign. Tools that have classically been used in consumer facing industries, such as customer segmentation and targeting, and trade off analyses for experience design development, will need to be applied more liberally to a healthcare setting to determine what, why and how services are delivered.

References: https://www.pwc.com/us/en/health-industries/health-research-institute/publications/pharmacy-of-the-future.html