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ELEMENTS PRIME NOW A look at Bartell Drugs’ delivery service through Amazon Prime

BALANCING ACT The dangers of using your bank account as your pharmacy’s accounting system

Choosing a Wholesaler How independent pharmacies can make the most of their primary wholesaler relationship


Professional supplements bring profits to professional pharmacies. Learn more at wellnessworks.com, or contact Director of Wellness Works Nutrition John Preckshot, RPh, CCN, FAARM at jpreckshot@wellnessworks.com today.



The business magazine for independent pharmacy

STAFF & CONTACTS Matthew Shamet – Publisher and Editorial Director Kirsten Hudson – Editor Paige Fisher – Graphic Designer Torrie Wright – Contributing Writer Greyson Honaker – Contributing Writer INTERESTED IN ADVERTISING? elements@pbahealth.com

Contents Departments 20 SPOTLIGHT:


Patients Feeling Sick? Check Their Smartwatch. Wearable technology may be able to pinpoint when people are about to get sick.

Nutrition & Wellness An independent pharmacy finds its niche beyond traditional pharmacy. 24 MONEY:


Meter Features How to help patients choose the right blood glucose meter and test strips.

Balancing Act The dangers of using your bank account as your pharmacy’s accounting system. 29 OUTLOOK:


Prime Now A look at Bartell Drugs’ delivery service through Amazon Prime. 11 SOLUTIONS:

Transferring Prescriptions The Tennessee Board of Pharmacy recently banned incentives for transferring prescriptions, bringing the issue into the limelight.


Human Interaction Improving how you interact with your patients is the real revenue-builder. 34 NOTES:

Digital Refills How promoting digital refills can save your pharmacy time and improve patient outcomes.

Feature: Choosing a Wholesaler


How independent pharmacies can make the most of their primary wholesaler relationship.

Find more strategies, tips and expert advice to improve your business at pbahealth.com/elements.

10 Big Negotiating Mistakes Pharmacies Should Avoid

Pharmacy school didn’t teach you the skills of an expert negotiator. But that doesn’t mean you can’t negotiate well. Avoid these common negotiating mistakes to up your game. Read more at http://bit.ly/2njCZrk.

Elements magazine is published quarterly by PBA Health. Copyright© 2017 PBA Health. All rights reserved. Neither this publication nor any part of it may be reproduced without written permission by PBA Health.


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Patients Feeling Sick? Check Their Smartwatch.

Wearable technology may be able to pinpoint when people are about to get sick The smartwatch on Mrs. Smith’s wrist could detect when she’s coming down with a cold. At least that’s what a recent study published in PLOS Biology found. “We can tell when people get sick, at the earliest possible times, probably even before they realize it,” said the study’s lead author Michael Snyder, a professor and chair of the department of genetics at Stanford University. “These smartwatches pick that up.” Wearables that continuously monitor body functions like heart rate, skin temperature, blood oxygen levels and physical activity produce reliable data that can establish a person’s physiological baseline and make it easy to detect changes. “Your car has 400 sensors on it and is always monitoring how it’s performing, and the average human has zero,” Snyder said. But that’s changing. Instead of using the general population to define a person’s healthy baseline, wearables establish a baseline specific to each person’s body. “That really is what personalized medicine is all about,” Snyder said. “We all have different resting heart rates, blood oxygen levels and skin temperatures. You have to first define that for each individual when they’re healthy.”

PUTTING IT ALL TOGETHER With a steady baseline and continuous monitoring, wearables can immediately detect deviations—and potential illnesses. For example, a severe elevated heart rate over a period of time can indicate an inflammatory disease, as it did for Snyder (who provided samples for the study) when he contracted Lyme disease during the study. The devices can even detect if someone is at risk for type 2 diabetes. “It’s the ultimate personalized medicine,” Snyder said. “What was sort of a toy can now become a mainstream health monitor.” Snyder said the study opens the door for detecting even more diseases, including neurological diseases and Parkinson’s. “I think we’ll wind up using them as measures of illness in a number of different contexts,” he said. IMPLICATIONS FOR PHARMACIES What wearables will mean for patient care and pharmacies depends on the technology itself, its integration with physicians, and the changing regulatory environment. Wearables may enable pharmacists to better understand the effects of a prescription on a patient in the future. “It’s going to give you instant feedback on your physiology,” Snyder said. “So you’ll know right away if your medication is working.” They could also potentially improve adherence by alerting patients when they get off sync or miss a day. And, wearables could drive more over-the-counter (OTC) sales as people who suspect an oncoming cold purchase OTC remedies to combat it. As pharmacists fight for provider status, it’s possible they could eventually monitor patients’ health remotely, or directly download the data at the pharmacy. “Information can go in your smartphone,” Snyder said, “so in principle you can share the information with all the relevant people.” Most importantly, the technology puts patients in better control of their health. “I don’t think any doctor can understand you the way you understand you,” Snyder said. “It’s a good thing to empower people to take charge of their health.”

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Meter Features How to help patients choose the right blood glucose meter and test strips

Testing blood glucose only requires a meter and test strips. But the market is saturated with options, from basic models that simply read blood glucose levels to versions that offer advanced features like memory for storing information. How are patients newly-diagnosed with diabetes supposed to know what to choose? “Diabetes can be extremely overwhelming when you’re newly diagnosed,” said Juliana DeMarici, channel marketing manager, U.S. Division at ACON Laboratories, a company that provides medical diagnostic and health care products. “There are tons of meters and it can be complicated to pick the right one.” That’s when patients turn to your independent community pharmacy. And, if you provide patients with the guidance and products they need to confidently test their blood glucose levels and successfully manage their diabetes, they’ll become loyal customers instead of turning to big box pharmacies. “Patients diagnosed with diabetes are a unique population because they’re the ones that return to the store,” DeMarici said. They’ll need to return to the pharmacy again and again to purchase test strips and manage their disease, often for the rest of their lives.


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THE MOST IMPORTANT FEATURES Blood glucose meters offer a myriad of features. Pharmacists should research the meters and strips they’re selling to their patients in order to make the best recommendations. DeMarici suggests reading consumer reviews and talking to Certified Diabetes Educators (CDE), who can familiarize pharmacists with the various options. Pharmacists also need to consider what stage patients are at. Not all features are important for newly-diagnosed patients. “Start with the basics,” DeMarici said. “The features get more complicated as you go along and learn.” Once patients get more comfortable with testing, they can use meal marker features before and after meals, for example. Every blood glucose meter sold in a pharmacy must pass strict requirements for accuracy and precision by the U.S. Food and Drug Administration (FDA). So, any meter will give your patients a general reading they can trust. What differentiates meters is their quality. And, true quality, DeMarici said, comes from the manufacturer. “What separates a good, high quality manufacturer and a low quality one is the partnership they form with pharmacies,” she said.


The partnership needs to involve more than transactions. “It should be an extension of your service,” DeMarici said. “Work with a vertically integrated manufacturer, someone who has their hands on every step of the process, who doesn’t outsource anything. Someone who can do care plans and rewards or bonus programs. There’s a lot that manufacturers should be providing to independent pharmacies.” THE BIG PICTURE Getting patients started with a meter and strips is only the beginning of the relationship. The ultimate goal is to help patients manage their diabetes and consistently test

their blood glucose as directed by their doctor. “The cornerstone of any good diabetes management program is adherence and compliance,” DeMarici said. “A unique diabetes management plan starts with picking good meters and getting patients to come back in, repurchase and be compliant.” Ultimately, if patients are satisfied with the overall service from their pharmacist, they’ll become loyal to the pharmacy and committed to compliance. “Having that patient leave the pharmacy with a good experience is going to help with compliance and keep them coming back,” DeMarici said.

What to Look For Patients probably look at price first when browsing blood glucose meters. But pharmacists should consider other factors when making a recommendation. “Affordability doesn’t always equal great quality, so telling them to go for the lowest price usually isn’t the best,” said Juliana DeMarici, channel marketing manager, U.S. division at ACON Laboratories. Consider these other important features. Cost Cost is always important to patients, and calculating it includes more than looking at the price tag. Also take into consideration budget, insurance coverage and copays. Data management A good meter records data that patients can download and share with health care providers and caregivers. This type of feature enables others to remotely monitor the glucose test results through a call-based

system, providing an added element of support, DeMarici said. Ease of use “Just like any consumer product, if it’s complicated to use they’re probably not going to stick with it,” DeMarici said. Convenient features, like if the meter turns on automatically when you insert a test strip or if it’s easy to set up, will help patients keep up with testing. Tech support Look for meters that offer tech support 24 hours a day, seven days a week. “If the patient needs help late at night and the pharmacy isn’t open, this is a great help,” DeMarici said. Type of enzymes Testing strips use various enzymes to react to the blood glucose, and the type of enzyme affects the meter’s reading. Pharmacists should know what enzymes the test strips use before making recommendations to patients. They can uniquely advise patients on this feature because of their knowledge of patients’ medications.

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Prime Now A look at Bartell Drugs’ delivery service through Amazon Prime When Bartell Drugs, a family-owned independent community pharmacy chain based in Seattle, became the first pharmacy to team up with Amazon Prime, the pharmacy differentiated itself in a big way. In November of last year, Bartell Drugs partnered with Amazon Prime to launch the delivery service, Prime Now. Prime Now allows Amazon Prime members to shop thousands of products from Bartell Drugs. Customers’ purchases are then delivered to their door—for free— within two hours. “As a regional retailer, it has helped propel our brand through our core service area to audiences that might be more inclined to shop online than in our physical stores,” said Brent Beebe, senior vice president of merchandising at Bartell Drugs. With more customers looking for convenient ways to shop, Bartell Drugs knew it needed to break into the online space. Partnering with Amazon Prime to create a delivery service was the perfect opportunity. “We had not previously been in the online space and knew that it was important to have that presence,” Beebe said. “The partnership with Prime Now allowed us to create that market without the expensive and timeconsuming need to develop an entire infrastructure for online sales of our own.” HOW IT WORKS Prime Now provides Bartell Drugs customers with a new online shopping experience. Amazon Prime customers access their accounts through Bartell Drugs’ website or directly through the Prime Now portal. Customers can also use the Prime


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Now app to easily log in and make purchases. Once logged in, customers simply browse Bartell Drugs’ assortment of products, select the items they want to purchase and submit the order. Bartell Drugs’ employees then package the products, and an Amazon Prime delivery driver delivers the order to the customer in one or two hours. The delivery service is available to Prime Now customers seven days a week (from 8 a.m. to 10 p.m. Monday through Friday and 10 a.m. to 10 p.m. Saturday and Sunday.) The convenient hours attract customers who don’t have the time or means to make it to the pharmacy on a given day. Ninety percent of the retail products sold in Bartell Drugs stores are available through Prime Now, including health, beauty, grocery, snacks and local products. Currently, Bartell Drugs’ prescriptions are not available for delivery. Right now the delivery service is available to customers in select zip codes, but the service is expanding rapidly to reach more customers in the Pacific


Northwest. Customers can look up their zip code on Bartell Drugs’ website to see if the delivery service is available in their area. SERVING THE COMMUNITY Prime Now enables Bartell Drugs to better serve its community because it can meet even more customers’ needs. The pharmacy recognizes that some customers find it difficult to visit its brick and mortar stores when the need arises. “Prime Now presents an unparalleled opportunity for our western Washington customers seeking convenience, a unique product assortment and a high level of service,” Beebe said. “It’s perfect for customers with busy lifestyles, as well as for people with small children or those who might have mobility issues.” Beebe said some of the most popular items sold through Prime Now include snacks, beverages and overthe-counter (OTC) medicines. The delivery service launched during cold and flu season, which enabled the pharmacy to better serve

customers who needed a more convenient way to find relief for their symptoms. According to Beebe, sales from cold and flu medications, along with personal care items, have been significant. “Bartell Drugs’ customers are loving the convenience of getting the products they need delivered right to their door with free two-hour delivery,” he said. EMBRACING INNOVATION It’s not always easy to be an innovator. As the first pharmacy to offer a delivery service through Amazon Prime, Bartell Drugs saw both risks and rewards. But because Bartell Drugs continuously looks for new ways to differentiate its stores from the competition, Prime Now was a welcomed opportunity. “As the first drugstore to be on Prime Now, it has been an iterative process,” Beebe said. “We continue to refine and curate our catalog of products as we better pinpoint the needs of our online customers.” Learn more about Prime Now at bartelldrugs.com/ primenow.

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Transferring Prescriptions The Tennessee Board of Pharmacy recently banned incentives for transferring prescriptions, bringing the issue into the limelight

Does your state prohibit incentives for transferring prescriptions? A recent ruling in Tennessee significantly alters the pharmacy landscape in the state and has brought to light regulations you may not be aware of in your state. The Tennessee Board of Pharmacy recently enacted a rule to prohibit pharmacies from offering incentives to patients for transferring their prescriptions. Effective February 20, the rule states that a pharmacist “shall not incent or induce the transfer of a prescription absent the exercise of professional judgment.” So, if you own a pharmacy in Tennessee and you offer rewards points, gift cards or cash to patients for transferring their prescription to your pharmacy, you’ll now need to find other ways to gain new patients—or risk losing your license or paying a $1,000 civil penalty. The Tennessee Board of Pharmacy said transfer incentives have an overall negative effect on the safe delivery of pharmacy services across the state. “Constant transfer of prescriptions for the purpose of obtaining ‘gas points’ or in-store discounts on nonpharmacy items complicates care delivery and hampers the formation of strong pharmacist-doctor-patient relationships,” the ruling stated.

As patients get prescriptions from more sources, the risk of dangerous interactions rises. “The pharmacist is responsible for drug utilization review for the patient and can catch possible serious or even lifethreatening interactions,” said Reginald Dilliard, D.Ph., executive director of the Tennessee Board of Pharmacy. “Encouraging patients to transfer their prescriptions with financial incentives is counterproductive to this vital piece of patient care and a risk to their safety.” A LOOK AT FEDERAL LAWS Certain financial incentives for transferring prescriptions have been prohibited nationwide for Medicare and Medicaid beneficiaries since the introduction of the Health Insurance Portability and Accountability Act (HIPAA) in 1996. The Act forbids any “remuneration,” defined as “waivers of copayments and deductible amounts (or any part thereof) and transfers of items or services for free or for other than fair market value.” The law permits “coupons, rebates, or other rewards,” as well as inexpensive gifts. The Office of Inspector General (OIG), which is responsible for enforcing the law, allows non-cash or non-cash-equivalent gifts below $15

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Does Your State Prohibit Prescription Transfer Incentives? How do you know if your state board of pharmacy prohibits incentives for transferring prescriptions?

The National Association of Boards of Pharmacy (NABP) doesn’t keep a record of this information. But other states have passed similar laws. The wording in the rules vary by state and some states’ rules are stricter than others. Contact your state board of pharmacy to find out the specific restrictions in your state.

per item and $75 annually per person. Violating the law can result in a fine of up to $10,000 for each wrongful act. In a 2002 special advisory bulletin, the OIG said incentives unfairly benefit large pharmacies over smaller pharmacies because of their greater financial resources. And incentives carry the danger of lower quality or unnecessary services as pharmacies attempt to offset the costs they lose with their gifts. The Tennessee Board of Pharmacy has gone a step further than the federal law, prohibiting all types of incentives to all patients regardless of Medicare or Medicaid status. TRANSFER INCENTIVES: GOOD OR BAD? Should incentives for transferring prescriptions be banned? It depends on who you ask. The debate focuses on the perception of what’s best for patients. Proponents of banning incentives argue that they result in inconsistent patient care, decreased customer loyalty and increased risk of prescription errors. More importantly, they say, it also devalues the role of pharmacists and commoditizes prescription drugs, detracting from the dedicated patient care that’s essential to adherence and proper drug use. Opponents argue that prohibition increases patients’ financial burden and diminishes business competition. Incentives mean more money in the patient’s pocket through discounts, credits and rewards. And when one


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These states prohibit some form of incentives for prescription transfers: • • • • • • • •

Alabama Arkansas Mississippi New Hampshire New Jersey New York Oregon Tennessee

Source: USA Today

business offers incentives, another business will offer better incentives to compete, resulting in lower health care costs for patients. Prominent organizations like the American Pharmacists Association (APhA) and the National Community Pharmacists Association (NCPA) discourage the use of financial incentives for transferring prescriptions. The National Association of Boards of Pharmacy (NABP) does not have an official stance on the issue. WHAT YOU CAN DO Whether you’re for or against prescription transfer incentives, you have other options to encourage patients to come to your pharmacy. “Pharmacies can inform patients about the services offered and their areas of expertise,” said Carmen Catizone, M.S., R.Ph., D.Ph., executive director of NABP. And, the Tennessee Board of Pharmacy notes that pharmacies can promote themselves within the confines of the law. “The Board of Pharmacy by statute protects patient safety and pharmacies may promote themselves in any fashion that does not compromise that safety or is any way unprofessional,” Dilliard said. It’s possible that Tennessee’s ruling will spur more state pharmacy boards and state legislatures to consider adopting similar prohibitions. Keep an eye out for any changes to your state board of pharmacy’s laws to prevent a surprise fine you can’t afford.

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Choosing a Wholesaler How independent pharmacies can make the most of their primary wholesaler relationship

As the source for purchasing and receiving the prescription drugs your pharmacy runs on, you can’t underestimate the importance of choosing the right wholesaler. And the right contract. Clark Balcom, Senior Vice President and COO of PBA Health, a pharmacy services organization based in Kansas City, Mo., that serves independent community pharmacies with group purchasing services, expert contract negotiations, distribution services and more, said the relationship between a pharmacy and its primary wholesaler is misunderstood. “Pharmacies generally believe wholesalers are trying to take advantage of them or are trying to attain egregious profits from them. And, wholesalers generally believe pharmacies are doing well enough that they don’t need better pricing,” he said. But in reality, the relationship is symbiotic. “The wholesaler needs the pharmacy—its entire business model is sustained by its relationship with the pharmacy—and the pharmacy absolutely needs the services and supply of a wholesaler,” Balcom said. Your primary wholesaler relationship directly affects your pharmacy’s profitability. “It also impacts positively or negatively your ability as a community pharmacist to service your patients,” said Rob Meriweather, Corporate Vice President of Sales at H. D. Smith, a national wholesaler headquartered in Springfield, Ill. And in today’s ever-changing healthcare marketplace, the relationship—and contract—you have with your primary wholesaler could make or break your business. Increased competition from national chain pharmacies and thin margins due to declining reimbursements create challenges for independent pharmacies. Brian Nightengale, R.Ph., Ph.D., President of Good

Neighbor Pharmacy, a part of AmerisourceBergen, a national wholesaler headquartered in Chesterbrook, Pa., said these pressures all point to the need for independent pharmacies to evolve. “These challenges present some great opportunities for those who are willing to innovate, invest in change and take some bold chances,” he said. “An effective and strategic relationship between the pharmacy and wholesaler can certainly facilitate this evolution and increase the likelihood of future success.” So, how do you choose the right wholesaler for your independent pharmacy? And, how do you capitalize on that business relationship? First, pharmacy owners need to know what to look for in a primary wholesale partner. Then, they can choose a wholesaler that meets their specific needs and establish a relationship that will increase their profitability and improve their success. CHOOSE THE RIGHT PARTNER Most pharmacies know they need to look for the basics in a wholesaler: a high-quality line of products to meet their needs at a reliable price point. “We exist in a third-party payment model. What a pharmacy can charge is capped. So, they need a reliable price point to sustain their business,” Balcom said. “They don’t get to choose their sell price, so they have to have a good buy price.” But many pharmacies don’t understand the complex enterprise of the wholesaler pricing model, Balcom said. “Pharmacies think they get a brand cost of goods and a generic price, but behind the curtain is a whole lot of other stuff they never see or never have the capacity to truly understand,” he said. “But it’s what they don’t know that they need to know when choosing a wholesaler.”

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And, Balcom said, it’s important for pharmacies to look for a reliable contract structure that works for both them and the wholesaler. “It has to be fair, it has to be balanced and it has to be something both parties can rely on,” he said. But choosing a wholesaler isn’t all about getting better pricing. “Cost of goods will only get you through to tomorrow,” said Perry Anderson, Vice President of Independent National Accounts at McKesson, a national wholesaler headquartered in San Francisco. “Independent pharmacy owners need far more from a good wholesale partner than a competitive cost of goods to be successful today.” Nightengale said pharmacies need to look for a wholesaler with the same priorities as them, such as focusing on positive patient outcomes, a great customer experience and a healthy business. “A good wholesaler’s entire philosophy should be driven by patient-focused product access, which gives pharmacists the confidence that product will be available when they need it,” he said. Meriweather shares a similar outlook. “It’s vitally important for independent pharmacy owners to find a wholesaler with shared interests,” he said. “You have to look beyond the sales pitch to find what’s truly driving the wholesale partner you’re considering.” It’s about finding synergy. “Pharmacy owners need to find a wholesaler that acts like a partner—not just a supplier—and that can provide them with the programs, resources and tools to compete and survive in today’s marketplace,” Anderson said. Seek a wholesaler partner that cares about its customers like you care about your patients. “What’s


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made retail independents really good at what they do is they know their customers, their customers trust them and they truly care about what they’re doing,” said Jeff Brannon, Vice President of Retail Independent Buying Groups at Cardinal Health, a national wholesaler headquartered in Dublin, Ohio. “I look at our business through the same lens. You have to know your customer, you have to care about what you’re doing and build a relationship on trust that’s mutually beneficial.” Balcom said the biggest challenge for pharmacies when choosing a wholesaler today is they have to be willing to break down all the elements of that business relationship. “You have to know what they are and that they exist, so you know what to ask,” he said. And, pharmacies need to make sure what they negotiated up front is what they’re getting after the fact. “What happens after the negotiation or after you make the decision is what matters most,” Balcom said. “You can have a wonderful promise and no fulfillment, and with that you really have nothing.” ESTABLISH A LASTING RELATIONSHIP The relationship between a pharmacy and its primary wholesaler only works with trust and transparency, Meriweather said. “Until you have transparency, you may not be getting what it is you think you’re getting,” he said. Similarly, Nightengale believes in building the relationship on a foundation of mutual trust and respect. “This is enabled by alignment of the pharmacy’s goals and aspirations, a mutual understanding of the specific market in which the pharmacy operates, and open and honest communication,” he said.

Brannon shares a similar outlook. He said it comes down to confidence and trust in the wholesaler’s team. When you think of the wholesaler as a trusted advisor, he said, it can help pharmacy owners improve gross margin, income and cash flow, as well as grow their business. But Balcom stressed that pharmacies should assess what’s at the heart of the relationship: a contract that’s designed around trust. “When you have a balanced contract, it usually leads to transparency, appropriate sharing of data, and a trusted business relationship where you can sit down and improve and advance it,” he said. “When you have an improperly structured contract, it leads to an adversarial-type interaction, causing a break down—and potentially a loss of—that relationship.” GET A BETTER COST OF GOODS When it comes to a primary wholesaler contract, pulling a number of levers can get a better cost of goods, but the number one way is for a pharmacy to maximize its generic purchases from its primary wholesaler, said Chris Lanctot, Vice President of Independent Sales at Cardinal Health. Meriweather also noted the importance of compliance. “The more compliant you are to the wholesaler source program, the more profit you drive to the wholesaler and the more profit they have to share back to you in terms of discounts,” he said. Nightengale said pharmacies should have confidence that being loyal to their purchasing agreement will maximize their discounts, and he recommends taking full advantage of the rebates in their contract. “The best partnership between an independent pharmacy and their wholesaler will drive the highest profitability for the pharmacy,” he said. Additionally, Meriweather said while volume itself isn’t a driving factor, volume per site matters because wholesalers will consider their cost to serve. “If I’m paying the same cost to deliver to your pharmacy whether you’re buying $50,000 or $500,000, my cost to serve you goes down as your volume goes up,” he said. “If I can reduce the overhead burden I have servicing your business, I have more margin to share back with you.” Pharmacies also need to be conscious of their payment terms. Lanctot said if pharmacies can commit to shorter payment terms and pay their invoices on time, the wholesaler can provide them with a better cost of inventory. It’s a win-win. “If you have a true wholesaler partner,

Questions to Ask Choosing a primary wholesaler is a big decision for your independent community pharmacy. Here are the top questions you need to ask. Is the wholesaler equipped to provide all of my product needs? Does the wholesaler understand my business goals and objectives? Does the wholesaler share my commitment to my patients, their health and their experience? How can the wholesaler help me maintain margins and grow my business? What can the wholesaler do to help my pharmacy compete and thrive in today’s marketplace besides providing better pricing? What does the wholesaler see for the future of retail pharmacy? What is it investing in to help advance that cause? How will I know what the wholesaler promised me is what I’m getting? Does the wholesaler have any conflicts of interest that would make it difficult to service my business or provide what was promised?

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the faster you pay, the bigger discount they’re willing to give you,” Meriweather said. CONSIDER INDUSTRY TRENDS Today’s market is increasingly focused on the level of competitiveness of generic pricing. “As a result of that, we’re seeing an increase in the volume of purchases that independent pharmacies are seeking to make through secondary suppliers,” Balcom said. But the challenge with secondary suppliers is their cost structure, which many pharmacy owners don’t completely understand. “If you’re having to go outside to purchase products, you’re increasing your operational costs, your frustration and your opportunity costs because you’re taking value away from your primary contract, and with some of the secondary supply markets you may be increasing the risk to your patients,” Balcom said. “As long as you have a well-negotiated pricing structure with your primary wholesaler, you shouldn’t have to overutilize secondary supply.” Nightengale agrees. “What many independent pharmacies may not realize is that splitting purchases between multiple suppliers may actually be harming their bottom line,” he said. “Focusing solely on the sticker price of a product, and not considering compliance incentives that a primary wholesaler can offer, can cause pharmacies to leave a lot of value on the table when they purchase from a secondary supplier. Secondary purchasing also takes valuable time away from interacting with patients and operating the business more efficiently.” Anderson said that while some cases exist where secondary supplier sources are needed, aligning with a good wholesale partner should eliminate this need. “Owners need to consider the time and resources it takes to successfully manage multiple suppliers,” he said. “At the end of the day, it can oftentimes end up costing you more.” Pharmacies will access the secondary market to try to relieve some of the pressure, Meriweather said, when they can relieve it by simply maximizing the primary agreement they already have. WEIGH YOUR OPTIONS Because choosing a wholesaler is so important, pharmacies need to do their homework and select the right partner for their business.


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Carefully consider what each wholesaler has to offer and how that fits into your pharmacy’s business structure and objectives. Brannon said a team approach sets Cardinal Health apart. “We have a well-trained team to support our customers, maximize receivables and impact cash flow, manage inventory, and provide front-end and patientfacing solutions, as well as business operations solutions to help reduce expenses,” he said. Lanctot added, “We care about the success of community pharmacy and believe communities are much better off where there are retail independents.” Nightengale said AmerisourceBergen’s focus is on forming a long-lasting and strategic relationship with its independent customers, built on trust, innovation and a holistic understanding of their customers’ goals and aspirations. He said a unique way the company accomplishes this is through its Good Neighbor Pharmacy program. “Many wholesalers offer a broad range of services including prescription claims, reimbursement and payment, and front-end retailing support,” he said. “We take it a step further by providing store-specific data coupled with localized expertise to help our independents make the most appropriate, data-driven decisions for their business and practice.” For McKesson, its franchise network of independent pharmacies known as Health Mart, differentiates the company. “Health Mart is an independent pharmacy owner’s one-stop shop to access many operational, marketing, regulatory and clinical resource tools needed to compete and be successful in pharmacy,” Anderson said. “This saves owners time and money while managing their business profitably.” Meriweather said because wholesaling is commoditized, H. D. Smith separates itself with the service it provides. “It’s less important what we do, and it’s more important the way we do it,” he said. While H. D. Smith offers everything you’d expect from a primary wholesaler, it also provides pharmacies with the tools and resources necessary to improve the operational side of their businesses, achieve sustained relevance and drive quality outcomes. “The future of our health is likely going to be driven by providers that can understand and effectively address the needs of the patients they care for,” he said. “The independent community-based pharmacist is that provider.”

A Better Contract How ProfitGuard, a wholesaler contract negotiation service, helps independent pharmacies buy better Independent community pharmacies want to offset reimbursement pressures and maximize profitability. This starts with the primary wholesaler contract. “Pharmacies have to generate margin through their supplier relationship,” said Clark Balcom, Senior Vice President and COO of PBA Health. “It’s one of the few things they can still influence today.” But most pharmacy owners don’t have the time or experience to ensure they receive the best deal on their contract. PBA Health offers a primary wholesaler contract negotiation service, called ProfitGuard, to secure independent pharmacies with the best overall margins and operations possible. The service also includes dynamic data analytics tools to help pharmacies monitor and improve their purchasing. Balcom said ProfitGuard complements the pharmacy’s wholesaler relationship. “Everything we do in our negotiations is designed to get the maximum volume to the primary wholesaler at the best possible overall price for the pharmacy,” he said.

is going to be monitored and managed on the backside.” Business owners often let pride get in the way of getting a good contract. “They sometimes fail to recognize that they need help and that others are equipped and available to help them make better decisions. And, that others have much-needed expertise and experience that they don’t,” Balcom said. He compares the importance of primary wholesaler contract negotiations to surgery. “If you needed surgery, wouldn’t you want to make sure you have a professional expert? Wouldn’t you want to know that it will be successful and not lead to any bad side effects?” he said. “If you’re willing to have a bad negotiation, experience negative side effects and lose money, then do it yourself. But if you want to have a good surgery—or contract—ask an expert.” Balcom said ProfitGuard’s goal isn’t to cut pharmacies out of the process; it’s to help them make an informed decision. “We elevate their understanding and visibility into all of the various pieces that have to be managed to drive the economic benefit,” he said.

BENEFITTING BOTH PARTIES ProfitGuard forms regional groups of pharmacies to create buying power and enables up to five national wholesalers to competitively bid on the group’s business. “We amass volume, which is healthy for our wholesalers and better for our pharmacies,” Balcom said. The service presents a balanced economic benefit to both ProfitGuard members and wholesalers. It helps pharmacies negotiate to get a better cost of inventory, and it provides a reliable book of business to wholesalers—one they know will be delivered. But the benefits go beyond economics. Pharmacy owners get the security of experts negotiating on their behalf. “You’re substantially dependent on your wholesale supplier in your business,” Balcom said. “You want to know that every particular element has been evaluated, is carefully contracted and

THE BOTTOM LINE ProfitGuard is not like a normal buying group. “Most buying groups won’t help pharmacies negotiate with multiple wholesalers the way they normally would in a competitive market. They won’t bring their members to the negotiating table, give guidance, offer advice on where to go next, or resourcefully use the experience of prior negotiations,” Balcom said. “We do all of this for ProfitGuard members.” And, other organizations don’t offer pharmacies dynamic tools to manage their purchasing after they sign a contract. “We give them the tools they need to get the best price on every item they order,” Balcom said. “That’s how we drive gross margin improvement. I’m not aware of any other organization that can do that.” Learn more at pbahealth.com/profitguard.

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Nutrition & Wellness An independent pharmacy finds its niche beyond traditional pharmacy


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At Coastal Pharmacy & Wellness, an independent community pharmacy in Portland, Maine, patient health is about more than prescriptions. The pharmacy stocks high-quality nutritional products from more than 150 vendors, and it aims to help patients find the right vitamins and supplements for their mind, body and lifestyle. Many patients visit Coastal Pharmacy & Wellness solely for its nutritional products and wellness expertise, and practitioners regularly recommend the pharmacy to their patients. “It’s not just a small part of our business,” said Kim Crabb, marketing director at Coastal Pharmacy & Wellness. “It’s one of the cornerstones.” Coastal Pharmacy & Wellness opened under new ownership in early 2016, but it had provided these services for more than eight years under previous ownership. Five wellness specialists on staff curate the vitamins and supplements offered in the pharmacy after thorough


Products to Stock research to ensure effectiveness and quality. “Our wellness specialists know about the companies as well as what goes into their products and confidently stand behind them,” Crabb said. Additionally, the pharmacy stocks practitioner supplement lines that support and address certain medical concerns. For example, the pharmacy carries CandiBactin-AR® and CandiBactin-BR® by Metagenics, herbal formulas with anti-microbial properties indicated for Small Intestine Bacterial Overgrowth (SIBO). The pharmacy also stocks Homocysteine Factors by Pure Encapsulations, a nutrient blend formulated to improve homocysteine levels in patients at high risk of cardiovascular disease. Crabb said these products aren’t commonly offered by other pharmacies or supplement stores. GUIDANCE FROM THE EXPERTS Vitamin and supplement options overwhelm many patients who lack knowledge about how they work and how they interact with prescriptions. Coastal Pharmacy & Wellness does more than explain the differences between fish oil and flax oil. The pharmacy offers patients integrated guidance on nutritional products and prescription medications from experts on both sides of the counter. “Our pharmacists are sometimes the first to be asked about nutritional or supplement information,” Crabb said. “While they also help educate and recommend supplements, they often bring our wellness specialists into the conversation.” With more than 40 years of combined nutritional and wellness experience, including sports nutrition, medicinal interaction and nutrient depletion, the wellness specialists help patients navigate the products and make the best decisions for their health. “When nutritional and pharmaceutical concerns converge, it’s a collaborative effort between our pharmacists and wellness specialists to help patients get what they need,” Crabb said. “Our customers find great value in the highly-personalized service we offer. They also

Want to offer nutritional supplements in your pharmacy? Here’s a list of the products Coastal Pharmacy & Wellness, an independent community pharmacy in Portland, Maine, offers to give you an idea of where to start. • High-quality supplements • Nutraceuticals • Homeopathic remedies • Herbal remedies • Essential oils • Natural skin care and beauty products • Sports supplements

appreciate that we aren’t just selling them a product.” The wellness specialists steer patients toward the right products and away from ones they don’t need. “Their primary focus is on increasing wellness, not sales,” Crabb said. “Customers know when you’re being disingenuous.” Consultations are on a walk-in basis, so staff members can spend as much time as necessary with each patient. Coastal Pharmacy & Wellness will soon offer information cards to go with medications known to deplete nutrient levels. The cards will list food and supplement sources for the depleted nutrient and will include a discount for the applicable supplement. “At the top of our list is offering probiotics with antibiotics,” Crabb said. EDUCATING PATIENTS The supplement industry is largely unregulated and its credibility hotly contested. Confronted with so many contradictory voices, patients often struggle to understand what’s true. Many patients wonder if supplements are even important. Coastal Pharmacy & Wellness believes they’re vital. “No matter who you are, unless you closely monitor everything you eat, you are most likely deficient

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Quick Tips for Promoting Nutrition

Are you planning to offer vitamins and supplements at your pharmacy? Kim Crabb, marketing director at Coastal Pharmacy & Wellness, offers advice for other independent pharmacies. Have a knowledgeable team “You need to be able to educate as well as help patients find appropriate products,” Crabb said. “It’s what sets you apart and establishes your store as a valuable resource.” Carry quality brands “Make sure your brands are dedicated to strict quality control standards and use high-quality ingredients,” Crabb said. “Research them and pick the ones you can trust and stand behind. Don’t offer many different options just for the sake of having choices.” Identify and cater to your demographic “If you don’t have a lot of patients with young children, then don’t offer a lot of children’s products,” Crabb said. She suggests surveying your patients to gauge interest and to pinpoint their concerns and pain points. Believe in it “To be truly successful in a business like this, your team needs to believe in what they do and what they offer to your patients,” Crabb said. “If you’re adding supplements to your pharmacy in the sole interest of adding to your bottom line, customers will pick up on that.”


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in something,” Crabb said. “We believe, in addition to a healthy diet and exercise, they are an essential part of the whole wellness picture.” To other patients, all supplements seem the same. They see five products touting real OMEGA-3 and wonder what could be the difference. So, they snatch the cheapest supplement off the shelf. Crabb said that’s a mistake. “Searching for the cheapest option without regard for what goes into it or how it’s made can result in wasted time and money on products that aren’t as effective, have contaminants or have unnecessary inert ingredients that can cause issues,” she said. Because Coastal Pharmacy & Wellness wants to educate patients on health and wellness, the pharmacy provides regular health education through in-store events, Facebook posts and its monthly newsletter. The pharmacy also enlists local practitioners and its own staff to educate the community and provide resources on topics like mental health, diet and exercise, functional medicine, Lyme disease, herbal remedies and acupuncture. “It’s important that the information we share isn’t just on supplements that will pull in revenue for us,” Crabb said. GETTING INTO SPORTS NUTRITION Coastal Pharmacy & Wellness offers a specialization you’d be hard-pressed to find in another pharmacy: sports nutrition products. The staff sports nutrition specialist, Dan Baker, conducts walk-in consultations with patients on Mondays and Tuesdays. During the consultation, he asks about patients’ activities, lifestyle, diet and health concerns to provide in-depth recommendations. He also educates them on how supplements work in their bodies on a systemic level. “It’s not just about telling them what product they need; it’s also about the why,” Crabb said. Dan also hosts regular demonstrations at area fitness facilities. For Coastal Pharmacy & Wellness, it’s all about improving health for patients through trusted relationships and holistic services. “We are truly committed to this part of our business and invest the necessary time and effort to make it a success,” Crabb said.



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Balancing Act The dangers of using your bank account as your pharmacy’s accounting system If you use your bank account as your accounting system, you’re jeopardizing your pharmacy business. Scott Sykes, CPA, of Sykes & Company, PA, an accounting firm focused on independent pharmacies, said a sufficient accounting system is imperative, especially considering the thin margins independent community pharmacies operate on today. “Your bank account doesn’t list how much cash is tied up in your other assets, such as inventory and receivables,” he said. “It doesn’t tell you what your gross margin is, what your gross revenues are or what your key ratios are.” When you check your bank account balance to see whether or not it increased from last month, you don’t get the full picture of your business. You don’t know what your margins are, for one. A bank account is misleading because it’s only one piece of a complex puzzle—and one piece doesn’t tell you much, Sykes said. “There are a lot of other moving parts, all of which need to be analyzed and taken into consideration together.” INACCURATE ACCOUNTING Many pharmacy owners don’t understand why using their bank account as their accounting system is a bad idea. “They don’t teach accounting or business in pharmacy schools, so not knowing how important fundamental accounting is can lead to this type of system,” Sykes said. But pharmacy owners need to take their accounting seriously. “Pharmacies require management and understanding to optimize performance, and the accounting system allows an owner to be productive and have a full understanding of the performance of that pharmacy.”


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“Integrity in your accounting process is paramount,” he said. “The knowledge and understanding you can gain from knowing the numbers you’re receiving are accurate is invaluable.” Pharmacies should use an accrual-based accounting system rather than a cash system. An accrual-based system recognizes income when



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earned and recognizes expenses when received. “Most pharmacy sales are third party sales, which are received many days after the prescription is filled or the revenue is earned,” Sykes said. “So, the accrual system gives you a more accurate picture of pharmacy performance.” And, the IRS requires most pharmacies to report on the full accrual accounting system. Sykes also stressed the dangers of using your bank account as your accounting system if your pharmacy is in growth mode. “First, how will you know you’re growing?” he said. “Second, cash flow is a major component of a growing pharmacy, so you have to be able to analyze all liabilities and assets when looking ahead. A bank account can’t do that.” OPERATING ON THIN MARGINS Because pharmacies today operate on thin margins, it’s vital for pharmacy owners to know what their margin is—and for it to be accurate. Pharmacies need to know what their margin is before and after the rebate, Sykes said. “Your margin on your tax return or financial statement is only as accurate as your inventory and third party receivable balance.” And, pharmacies need to understand why their margin is higher or lower than the industry average so they can make improvements. Better purchasing, revenue diversification, data mining and filling scripts that pay more are all areas that can—and will—increase a pharmacy’s margin, Sykes said. “These areas are what pharmacy owners should be spending a majority of their time on, as it will ultimately have the biggest bang for the buck.” Sykes said if pharmacy owners don’t understand what their margins are or where they stand, they can’t plan around them. “Not knowing what your margins are can hinder you from taking action to maximize those margins,” he said. IMPROVING YOUR ACCOUNTING For pharmacies with a non-existent accounting system, Sykes recommends finding a CPA and a


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model that works for them. “Today’s technology allows you to outsource your accounting to professionals who specialize in your industry,” he said. “Find someone who knows your business and can implement processes to maximize the value of an efficient accounting system.” Sykes & Company, PA, focuses on accounting specifically for independent community pharmacies, so they know and understand the complexity of the industry. The firm helps pharmacies with every aspect of pharmacy accounting, including tax and business advisory needs. “Being involved in only the pharmacy industry allows our professionals to speak your language and understand your business,” Sykes said. Learn more at sykes-cpa.com.

3 Keys to an Effective Accounting System

These three components make up an effective accounting system. Are you using all three? Daily accounting processes These processes include recording point-of-sale (POS) reports, reconciling bank accounts and recording payables. Balance sheet The balance sheet lists your bank account balance each month and additional accounts to analyze. Profit and loss statement (P&L) and cash flow statement These financial statements go handin-hand, and they’re only as accurate as your balance sheet accounts.

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Human Interaction Improving how you interact with your patients is the real revenue-builder You can’t easily measure the effects of human interaction, so it’s easy to overlook it as a way to boost revenue. Too much time socializing may even be viewed by some as a detriment to the bottom line. From a numbers perspective, meaningful interaction with patients steals precious time and energy from quantifiable revenue-building activities, like filling scripts and optimizing purchasing. “Your ROI is based on sales and numbers. How many scripts did you fill today? What are your profits? All of this is data-driven,” said Brittany Benson, manufacturer research specialist at Hamacher Resource Group (HRG), a leading partner in category management, business

“People go to independent pharmacies because of the relationship they have with the staff there.” strategy and marketing services focused on consumer health care at retail. “Sometimes those data-driven tasks end up driving decisions instead of other, more intangible, factors that are important to you and your patients.” For independent community pharmacies, great human interaction is a key ingredient to financial success. Human interaction builds relationships, which leads to loyalty

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3 Easy Ways to Improve Interaction

Making your patients feel cared for doesn’t require grand gestures. Give these three simple interactions a try. See patients, not customers Bringing human elements to human interaction begins with your perception, said Sean Grudzinski, product research and analysis manager at Hamacher Resource Group. It starts with simply seeing customers as patients. Ditch the counter “One of the best ways to improve human interaction is to get out from behind the counter,” Grudzinski said. “Talk to your patients whenever you can. Make it a priority and part of your daily routine.” Know your patients by name “Learn their names and recognize them by name,” he said. “That’s one of the first things to do. You should know almost everybody’s name coming into the pharmacy. That goes a long way to improving human interaction.”


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and retention. “People go to independent pharmacies because of the relationship they have with the staff there,” Benson said. “Independents get to know the customers better, build trust, and that’s what pulls those customers back.” Megan Moyer, senior marketing communications specialist at HRG, adds that human interaction not only leads to retention but also generates new customers and sales. “It could lead to great word-of-mouth, which means you’re going to expand your business,” she said. And, the financial benefits extend beyond current patients. “Think about the generational sales of their family,” said Sean Grudzinski, product research and analysis manager at HRG. “You’re talking about not just helping and providing solutions for that patient but also providing those same services and solutions for their kids and their kids. And that is definitely unique.” More than a boost to your bottom line, human interaction improves patients’ health by providing a support system they can count on. “The independent pharmacy could be the only place they’re receiving support in their health care journey. And it could be a blessing to them to have someone showing they care,” Benson said. And that interaction builds a more holistic brand for the pharmacy. “It’s that perception of the pharmacy as being the place where you go to be cared for,” Moyer said, “and that they’re a partner in wellness.” MAKING INTERACTIONS PERSONAL Great human interaction isn’t simply placing bodies on the pharmacy floor to direct patients to the right aisles or to the pharmacy counter. It’s behavior that treats patients as valuable people whose well-being matters. “It’s those human elements of what it means to think about another person and figure out how you can best serve them that day,” Benson said. Human elements like compassion, understanding, awareness, listening and observing are how you show patients respect. These manifest even in small ways. For example, showing respect to a patient by being honest and upfront about a wait time. “Even if the pharmacist can’t meet the patient’s need at the moment, they can offer them that human acknowledgment of, I see you, you’re important, and I’m sorry but it’s going to take this long before we can address your need,” Benson said.


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CREATING BETTER HUMAN INTERACTION It’s easy to talk about creating better human interaction, but practicing it is another thing. Engaging with people doesn’t always come naturally, and it’s often not top-of-mind. Benson said to start by making it a priority. Once human interaction is your pharmacy’s main focus, it becomes the lens through which you see every facet of your business and “something you’ll consider when making all your decisions.” Cohesion is another necessary element. “When you have a cohesive team, you have the support system in place and everyone can focus on their own strengths,” Benson said. “You can free the pharmacist to do what they’re great at and what they need to be doing for the patient.” But for the best human interaction, the team needs to be well-trained. A team with training in communication will have the ability and confidence to interact with any patient who comes into the pharmacy. They’ll be prepared for whatever situation a patient brings and can navigate sensitive issues. “Every employee’s interactions with a patient are a direct reflection of you and the store. Creating consistency through training will further enhance your brand,” Grudzinski said. NAVIGATING SENSITIVE TOPICS Health is a sensitive business. Some patients prefer privacy. Others want to speak but are too shy or embarrassed. Effective human interaction creates safe opportunities for patients to speak and respects the privacy of those who don’t. Much of the time, determining what the patient in front of you wants requires communication beyond speech— the nonverbal communication, Benson said. People’s expressions and body language can say a lot. But the only way to notice those details is by switching from task mode to patient mode. “You have to be able to care about the patient more than your own feelings,” Benson said. “Sometimes you have to switch your modes mentally from ‘I’m doing scripts’ to patient mode and think about what you need to do differently when interacting with a patient.”

Whether patients are shy or don’t want any interaction, taking the time to look at them and listen is key to meeting their needs. “Give them your full attention, look them in the eye, and provide them the opportunity to share,” Moyer said. Benson added, “It’s amazing what people start to share when you stop talking.” This works even for reserved patients because it fosters a welcoming and caring environment. “You can’t be everything to everyone,” Benson said, “but you can control the type of environment you want your pharmacy to have.” FINDING TIME FOR MORE In a pharmacy, busyness is the norm. When work responsibilities pile up, it’s easy to forget to prioritize human interaction. “Sometimes the stress of everything can build up,” Benson said. “If you’re mindful of how it’s affecting you or how it can be affecting your patients, you can figure out how to switch your focus back to your main priority for the day, which is offering great health care and great interactions with everyone who comes into your store.” Delegation may be the best cure for busyness. “Pharmacists should give ownership to others within their business to, say, manage their front end, their purchasing or their assortment,” Grudzinski said. “The reality is they can’t do it all, and when they try to, customer interaction may suffer.” Moyer suggests getting creative and fostering human interaction outside of normal business hours. For example, offer educational seminars on health and wellness topics. Or, host an open house where you walk people around the store and show them your unique products and services. “If they make a commitment to these types of events, where they’re focused on interaction with patients, it can make up for the inability to make those connections during a typical work day,” Moyer said. Ultimately, if the pharmacist prioritizes human interaction and creates a cohesive team, Benson said, the staff will naturally carve out time during the day for quality human interaction amidst other tasks.

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Digital Refills How promoting digital refills can save your pharmacy time and improve patient outcomes Think of everything you accomplish in a day. All of those activities take time. Time you don’t have if you’re manually inputting a refill request. Digital refills—prescriptions refilled through a digital channel such as a website or mobile app— streamline the refill process. So pharmacists can focus on patients. “Most patients see their pharmacist more than their primary physician these days,” said Susan Barrett, vice president of business development at Digital Pharmacist, a digital communication platform for independent pharmacies. “Digital refills allow the pharmacist to spend more time with patients on education, adherence and improving outcomes.” And, pharmacies that don’t offer digital refills may find it difficult to compete with national chain pharmacies and big box stores. “It’s about survival,” Barrett said. “If they’re not doing it, they will lose market share, revenue and patients to the chains.” A CONVENIENT SOLUTION Patients want convenience. With digital refills, patients can refill a prescription anytime, anywhere.


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Promoting Your Mobile App

It’s not enough to have a mobile app. Market your pharmacy’s mobile app to patients with these ideas. • Create a page on your website • Use bag stuffers • Offer an incentive • Hang posters in your store • Ask patients if they use the app

They can also manage their medications through medication reminders and management profiles on a mobile app. Digital refills also save pharmacies time. Pharmacists and technicians spend less time on the phone and more time assisting patients. “Our digital platform offers oneclick refills and integrates with 53 pharmacy management systems, which eliminates the need to sift through faxes and input refills manually,” Barrett said. “Instead, the refill shows up automatically in the queue.” This all adds up to big timesavings. “One of our pharmacies saved 30 hours a month as a result of digital refills,” Barrett said. IMPROVING OUTCOMES Digital refills make it easy for patients to keep track of their medications, which can improve outcomes. “A father can manage his whole family on a mobile app,” Barrett said. “It’s easy to manage medications, manage profiles and access health information.” Mobile apps offer medication reminders, refill reminders and education to help increase

adherence. “In most cases we see, if patients understand how a medication can help their conditions, they will be more apt to take their medication and experience the benefits,” she said. SPREADING THE WORD If patients don’t know they can refill their prescriptions on your mobile app or website, they won’t do it. “You can have the best product since sliced bread, but if you’re not effectively marketing it, you can’t grow a sustainable business,” Barrett said. Take advantage of available features. For example, Digital Pharmacist offers pharmacies a branded mobile app with a textto-download feature that the pharmacist or technician can use to send the patient a text message with a link to download the app. “It’s important to take advantage of promotional opportunities to drive new customers into the store, a service we provide for the independent pharmacy at Digital Pharmacist,” Barrett said. Learn more about Digital Pharmacist at digitalpharmacist.com.

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Elements Magazine - Vol.6 Iss.2 June 2017  

Elements Magazine - Vol.6 Iss.2 June 2017  

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