All of the pharmacies visited are different in ownership, size, and markets served, and in the products and services they offer. But like pharmacy owners everywhere, the owners of these pharmacies all face stiff chain and mail-order competition, deal with inadequate third-party reimbursement, and struggle to hire and retain good employees. What follows are four elements of success that emerged from this trip.
Bruce’s other trips include:
April 2008 – The Coast to Coast: Point Pleasant, N.J., to San Francisco; sponsored by Good Neighbor Pharmacies.
May 2010 – The Frontier: South Dakota, North Dakota, Montana, and Wyoming; sponsored by QS/1.
April 2012 – Route 66: Chicago to Los Angeles; sponsored by Epicor.
April 2013 – The Great Northwest: Washington, Oregon, and Idaho; sponsored by the Independent Pharmacy Cooperative (IPC).
May 2016 – Mid-America: Arkansas, Colorado, Illinois, Indiana, Kansas, Missouri, Nebraska, and Texas; sponsored by the Independent Pharmacy Cooperative (IPC).
The Front End Can Be a Healthcare Department, Too
Justin Ruffridge, Pharm.D., is the manager of Soldotna Professional Pharmacy in Soldotna. Coming in at 6,000 square feet, Soldotna Pharmacy is reported to be the largest independent pharmacy in Alaska.
Soldotna’s home healthcare department stands out as noteworthy. To help ensure that the right amount of inventory is on hand, and the items are priced to meet the delicate balance between competitive pricing and profit, Ruffridge relies on his Retail Management Solutions (RMS) point-of-sale system.
Ruffridge says the home medical equipment department helps strengthen the pharmacy’s image as a healthcare provider. The key to success, according to Ruffridge, is having enough items to make a statement. Then, he says, you need to train staff members on how the products work so they can explain them to patients and caregivers. One major plus, he says, is that most items are sold for cash so he has no third-party issues. And, he says, working with his suppliers who help promote the products to local physicians is also a real plus.
Stan Watts, R.Ph., owns Ron’s Apothecary Shoppe in Juneau. While prescriptions and compounding are the heart of his practice, he has also discovered the benefits of making the front end a healthcare department.
As a compounder, he has crafted a line of over-the-counter (OTC) compounds. They are displayed on a shelf next to a window that allows patients to see into the compounding lab. Carefully packaged and labeled, the products are formulated to relieve migraines, diaper rash, bug bites (they have a lot of mosquitoes in Alaska), and a dozen other ailments.
Ron’s Apothecary also measures and fits compression hose and sells homeopathic products and essential oils. To maximize the benefit of all this, Watts has implemented a customer loyalty program. Using the Retail Management Solutions (RMS) point-of-sale system, the pharmacy tracks all pharmacy purchases and provides points that can be redeemed on front-end purchases. “This,” according to Watts, “really helps tie the pharmacy and the front end together and boosts sales of both departments.”
Pharmacy Can Be Much More than Pills
Great Land Infusion Pharmacy in Anchorage is an impressive example of making patient care the focus of the pharmacy. Doug Noaeill, R.Ph., opened this pharmacy from scratch in 2006 and takes pride in providing home infusion, oncology, hospice, HIV, sterile compounding, and other clinical services.
Noaeill says the most critical success factor for his practice is developing relationships with providers. “But,” he says, “that doesn’t just mean doctor detailing.” He says the key to winning over prescribers is taking care of patients. That means providing exceptional pharmacy services as well as being able to work with payers to get these services covered. To help with that he trains his staff to go above and beyond by taking rejected cases over the head of first-line customer service agents and by carefully getting physicians and health advocates involved in making the case to the insurance company.
Bruce and Barry Christensen, both registered pharmacists, are a father-and-son team that owns Island Pharmacy in Ketchikan. The pharmacy is one of the oldest continuously operating pharmacies in Alaska. It started in a trailer in 1974, but is now housed in a modern building on the main street of this tourist town.
The Christensens are excited by the success they are having in specialty pharmacy. Barry, the son, says that serving patients on very expensive medications like Enbrel, Humira, and Risperdal requires extra attention to purchasing, handling, patient care, and prescriber relations. He finds this aspect of his practice rewarding and profitable. Barry adds that having doctors know they can help with these kinds of medications generates referrals for traditional dispensing, which is still the backbone of the pharmacy.
Watts, of Ron’s Apothecary, is also experimenting with a new type of service. He has enrolled in a program by the American Academy of Anti-Aging Medicine to provide metabolic and nutritional medicine. He says this is another way to differentiate his pharmacy from the chains by helping people get the precise nutritional support they need based on their age and physical condition. Eventually, he envisions turning this into a fee-based consultative practice that will enhance his role as a healthcare professional.
Technology Opens New Doors
The first licensed telepharmacy in Alaska, Alaska Family Pharmacy Healy Telepharmacy, opened in June. Healy is a town of about 2,000 halfway between Anchorage and Fairbanks and is 100 miles from the nearest pharmacy. The telepharmacy is owned by Leif Holm, Pharm.D., who also owns three pharmacies in the Fairbanks area.
To support the telepharmacy, Holm purchased a system from TelePharm that is connected to the Computer-Rx system in Holm’s Prescription Center Pharmacy in Fairbanks. The telepharmacy is staffed by a pharmacy technician who greets customers and then fills and labels prescriptions in the remote location. All the technician’s actions are monitored over a secure and encrypted link to the host pharmacy. When patients present for their prescriptions, they are video linked to the pharmacist, who counsels them and then double-checks all the relevant actions of the technician.
In his three traditional pharmacies, Holm says, they use PrescribeWellness’s happy birthday outbound call program. And he uses PrescribeWellness software to monitor and contact people to remind them to request or pick up their prescriptions. Holm says his staff is often delighted when a patient comes in to say thanks for the extra attention.
One overlooked area for technology is in the will-call bin. Bernie’s Pharmacy, owned by Terri Hall-Klouda, has done something noteworthy. The pharmacy, located on the second floor of a three-story medical office building, has installed a large, custom-built, and impressive-looking will-call bin.
The bin has 162 slots, organized by number. When a prescription is filled, the pharmacy’s PioneerRx dispensing system and embedded point of sale assigns the prescription to a randomly generated open slot. Then when a patient comes in to pick up the prescription, the clerk types in the person’s name and the system points the clerk to the correct bin. The clerk then scans the item and doubles-checks the medication. Hall-Klouda says the system eliminates the need for storing items in alphabetical order and speeds up the process. And, she says, the impressive-looking will-call bin is often a topic of conversation and seems to give people a reason to tell their friends about Bernie’s Pharmacy.
These Pharmacy Owners Find Ways to Work Effectively with Their Trading Partners
With three pharmacies in the Fairbanks area, Holm’s competes with major chains such as CVS and Fred Meyer, a large Walmart-type chain in the Northwest. One tactic that works for him is using the Good Neighbor Pharmacy (GNP) Prescription Savings Club. This program is supported by AmerisourceBergen’s pharmacy services administrative organization (PSAO), Elevate Provider Network, and provides patients with the opportunity to get generic medications at prices that compare favorably with the large chain programs.
Another modest but meaningful GNP program Holm mentions is GNP’s Healthy Kids Free Vitamin Program. Holm says they work the program aggressively in the store and get out into the community to share its benefits with clinics, day care centers, and schools.
Dirk and Trish White, both registered pharmacists, own Harry Race Pharmacy and White’s Pharmacy in Sitka. They say one of the patient care services they provide is medication synchronization. To support this service they use the PrescribeWellness StarWellness module. Trish White says medsync has helped improve patient compliance while at the same time helping them better manage their time and inventory.
Soldotna’s Ruffridge says he has had some positive experience with PrescribeWellness, too. By closely monitoring the company’s performance dashboard and taking action on carefully identified patients, he has improved his star ratings by nearly one point. The system has also allowed him to make changes that have reduced direct and indirect remuneration (DIR) fees by several thousand dollars a quarter.
One final example of working with trading partners is mentioned by James Manners, general manager of Bernie’s Pharmacy. Manners says he finds attending his wholesaler trade show to be a profit builder. At last year’s AmerisourceBergen ThoughtSpot show, he says, he benefited in three ways.
First, he says, he got to meet managers for various technology solutions he was interested in purchasing. Indeed, he purchased a new PioneerRx pharmacy system at the show in 2016. Second, he gets to take advantage of deals on generics and OTC items that he says provide savings far in excess of the cost of attending the show. Finally, he feels that meeting with other pharmacy owners and managers and attending the educational session has been a major help to his career. His advice: “If at all possible I’d encourage every pharmacy owner to find a way to get to a major pharmacy event at least once a year.”
So there you have it: A brief overview of what pharmacy owners in Alaska are doing to be successful — all current examples that it is possible for a well-managed community pharmacy to succeed. Hopefully, you will find something here you think will benefit your pharmacy. CT
Bruce Kneeland is a semi-retired pharmacy industry consultant living in Prescott, Ariz. He visits dozens of community pharmacies each year and delivers CE programs intended to help pharmacy owners be more successful. He can be reached at firstname.lastname@example.org.