An Interview With Medicine-On-Time’s John Kalvelage

By ComputerTalk Editor Maggie Lockwood

For 25 years Medicine-On-Time has offered solutions to improve patient medication adherence and revenue to the pharmacy. Here, John Kalvelage shares how the company continues to evolve.

CT: What has been the secret to your 25-year longevity?
John Kalvelage: Well, a lot of sweat and a little luck. Twenty-five years ago we were pioneers, way ahead of our time. Most pharmacists practicing at that time were quite sure — erroneously so — that the comingling of oral solids in the dispensing of prescription drugs was illegal. So we were the lone missionaries spreading the gospel of compliance-enhancing prescription packaging, as well as promoting the business benefits of doing so. And with hard work and a little luck, we found a large enough audience of progressive community pharmacists who built successful adherence programs with Medicine-On-Time. Many of those pharmacists are still our customers to this day, some 20-plus years later. In short, we’re successful because our pharmacy customers are successful.

CT: What challenges do you face today?
Today the challenges we face are quite different. Virtually every pharmacist accepts the concept of multidosing as legitimate, and in fact most pharmacists would agree that adherence packaging is superior to, or preferable to, traditional vial dispensing for patients wrestling with complex drug therapies. So in that regard our job has become easier. But Medicine-On-time is still largely misunderstood by pharmacy at large. Most pharmacists believe that Medicine-On-Time is just a package. Rather, it’s a system driven by robust workflow software with advanced communication utilities that can communicate with prescribers and caregivers, and even send text alerts to patients. The system includes tools for organization and efficiency. Oh, and yes, it also includes patient-friendly packaging that comports to USP standards, is legal in all 50 states, and can be easily opened by the frail and elderly. Medicine-On-Time is a business opportunity, not just a package.
No pharmacy earns an extra dime for putting pills in a vial. But many pharmacies earn additional fees for putting pills in Medicine-On-Time packaging.CT: What is newsworthy in Medicine-On-Time’s 25th year?
These past 12 months have been arguably the most productive time in our company’s history. In terms of product refinement, we have recently partnered with Epson to produce high-quality graphic printing on our roll label stock. This development alone is a milestone. It means quiet, lightning-fast barcodes and photo images on Medicine-On-Time labels. We have been working on these goals for the better part of a decade. And now it’s a reality, in beta-testing.

In terms of system workflow and efficiency, we are so proud of our new strategic partnership with Pharmacy Automation Systems. We have incorporated their Versi-Fill 2 into the Medicine-On-Time workflow process and have achieved increased efficiencies that have surprised even us — almost a 300% increase, six techs down to two, and days ahead in production. And the “Versi” in Versi-Fill 2 stands for versatile. In addition to filling Medicine-On-Time packaging, it can also fill vials and a wide variety of punchcards — for less than half the cost of competitive products. With this machine we are bringing real value to our pharmacies at a price that makes economic sense.

CT: What would you like our readers to know about Medicine-On-Time today?
Every day, at kitchen tables all across this country, the adult children of elderly parents struggle to sort and organize eight, 10, or 12 prescriptions — all in virtually identical pill bottles — into pill boxes or organizers that they hope will give their loved ones a fighting chance to get it right. The process is tedious and stressful, and not always successful. And with Medicine-On-Time you can be their hero. You can fix it for them, and maybe generate some fees for doing so. No pharmacy earns an extra dime for putting pills in a vial. But many pharmacies earn additional fees for putting pills in Medicine-On-Time packaging. 

And the consumer customers for Medicine-On-Time are already customers of your pharmacy. Yes, Medicine-On-Time can be used to garner all sorts of other business: assisted living, community-based mental health. But I would like to remind every pharmacist that Medicine-On-Time is a retail package, designed to be dispensed over your counter to your retail ambulatory patients.

CT: What does the future hold for Medicine-On-Time?
In a world where health outcomes matter, we fit right in. Medicine-On-Time has the advantage of proven efficacy. A long-term study conducted by the University of South Carolina School of Public Health, and funded in part by CMS, found that on a population of Medicaid patients living at home and deemed at-risk of nursing home admission, an adherence intervention with Medicine-On-Time reduced the likelihood of nursing home admission by a whopping 66%. That alone is impressive. But the dollars and cents in the study hold even more good news for pharmacists and Medicine-On-Time. During the study the pharmacists got paid $20 to $25 per patient per month, separate and apart from drug reimbursement. During the intervention, South Carolina Medicaid saved $89.91 per patient per month. And CMS saved exactly $210 per patient per month.

The world is definitely changing. And I’m sure that I don’t have any magic crystal ball. But I think in that study we caught a glimpse of one possible future for pharmacy and Medicine-On-Time. CT

Two Vintage Photos from Medicine-On-Time’s Archives

John Kalvelage ready to hit the road and promote Medicine-On-Time.

The Medicine-On-Time team, including John Kalvelage, second from left, and Ian Salditch, fourth from left.