Publication Date 01/07/2014         Volume. 6 No. 6   
Information to Pharmacists


From the desk of the editor

Welcome to the July 2014 homepage edition of i2P (Information to Pharmacists) E-Magazine.
At the commencement of 2014 i2P focused on the need for the entire profession of pharmacy and its associated industry supports to undergo a renewal and regeneration.
We are now half-way through this year and it is quite apparent that pharmacy leaders do not yet have a cohesive and clear sense of direction.
Maybe the new initiative by Woolworths to deliver clinical service through young pharmacists and nurses may sharpen their focus.
If not, community pharmacy can look forward to losing a substantial and profitable market share of the clinical services market.
Who would you blame when that happens?
But I have to admit there is some effort, even though the results are but meagre.
In this edition of i2P we focus on the need for research about community pharmacy, the lack of activity from practicing pharmacists and when some research is delivered, a disconnect appears in its interpretation and implementation.

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We Want To Own ‘Well’

Peter Sayers

articles by this author...

Peter Sayers is vitally concerned about pharmacy professional practice - its innovation, its research and development, and its delivery to create an ongoing revenue stream. Delivery of healthcare is increasingly involved with Information Technology systems. All perspectives in IT must be considered for the impact on pharmacy practice and its viability.

Walgreens, the giant US retail pharmacy chain, is evolving its image into a “retail health and daily living store”.
It wants to own all things in the marketplace of “well”.
Australia is slowly moving towards this ideal, but current offerings need more research and investment to match the Walgreen vision.
Australian pharmacies have yet to realise that health is being rapidly commoditised.
Even hospitals have been moving towards a reimbursement system that quantifies a service and the detailed quality expected outcomes for a price( a package that eliminates inefficiencies).

This forms the basis of a catalogue of services – a health supermarket.

CEO Greg Wasson explained: “As patients gain more access to healthcare information and they become more responsible for making their own healthcare decisions, patients are indeed becoming more shoppers of health care,” Wasson said. “And, frankly, that trend is good for us.”

In addition to the important work the company is doing to position itself as the “new healthcare provider,” leveraging its 8,000 points of care and the health professionals in them — including 26,000 certified immunizing pharmacists, a major focus for the company as it seeks to redefine the role of the community pharmacists in the national delivery of health care — Walgreens is equally focused on transforming its stores to be more than just another drug store on the corner.

Hence, the emphasis on a “daily living store.”

“We now have 30 million more Americans who are going to gain coverage, and that is certainly going to challenge the system; we have an aging population ... 1-in-3 Americans in the next 10 years will turn 65; we have a higher incidence of chronic and complex diseases as people age; and, to top that off, we have a shortage of primary care physicians, so there are threats and opportunities in health care,” Wasson said. “The threats are the fact that all of us in health care have to have a relentless focus on cost reduction, and I can assure you that we do. The opportunities, though, that arise are more focused on the prevention and management of chronic disease, and that’s where we are headed.”

Walgreens will "step up investments in services to help Americans manage chronic diseases," Wasson announced, because "the company wants to capitalize on what he called the 'retailisation' of the nation's health care system."

The pharmacy giant "increasingly has been lobbying to give pharmacists a greater role in medical care such as providing immunizations in its stores as well as establishing retail health clinics staffed by nurse practitioners."
Walgreens' health professionals could help "provide certain primary medical care service amid a national shortage of primary care doctors" and assist patients in managing chronic conditions like diabetes, hypertension, and high cholesterol, the company's CEO said

What this means is that patients will see a continued expansion of scope of services to ensure that the company’s providers are viewed as a critical link in the screening and prevention of chronic conditions. “What we have and what we are building is an integrated network of healthcare providers, and that is built on the foundation of our 26,000 retail pharmacists, who we like to refer to as the new healthcare provider,” Wasson said.

Wasson also provided an update on the company’s three core strategies: Leveraging its store network, enhancing the customer experience, and reducing costs and boosting productivity.
Among the milestones mentioned:

* Walgreens slowed the pace of new store openings from 9% growth in 2008 to 4.2% in 2010. Going forward, the company expected growth of between 2.5% and 3% in fiscal 2011;

* Over the last two years, the company has acquired more drug stores than any other time in the company’s history. As a result, Walgreens now is No. 1 or No. 2 in 226 markets;

* Since launching its Customer Centric Retailing initiative in 2008, the company will have converted more than 2,000 stores to the format by the end of 2010 and plans to finish the rollout of 5,500 stores by the end of 2011; and

* Walgreens is expanding its infusion pharmacy services as evidenced by the September announcement to acquire substantially all of the assets of Omnicare’s home infusion business.

“We are going to skate to where that puck will be, and that’s more prevention and management of chronic disease,” Wasson said. “And we want to own the strategic category of ‘well.’”

It is obvious that Australian health services will follow the US trend because cost is such a major factor, and the only way to reduce cost is to create efficient delivery.

This further means intensive patient education and guidance so that patients can self-select their treatments with health professionals acting as a guide.

And because this is so similar to a supermarket model, guess what organisations are really going to take over health with a vengeance.

This will be a major departure for the average health professional, but unless they are willing to become “health guides” and “health mentors”, consumers will leave them behind.

An investment in patient education will be returned with interest through consumer/patient respect and a willingness to increase their personal health learning. 

Existing health services as we know them, will come under strong competitive pressure. In the UK we are already seeing the concept of “any willing provider” introduced into GP Consortia (Medicare Locals in Australia) and being able to step up and bid for any service, if they can demonstrate competence.

With the added competition, prices will head south under the pressure and that means cost efficiencies must be found across the entire spectrum of business or health practice.
This applies to pharmacy and its dispensing. To make a profit it will need automation and who is to say that today's nurse practitioner will not be tomorrow's dispenser. It happens in remote areas anyhow.
When dispensing becomes uneconomical to the small player, who will want it?
And what will today's pharmacist become?

On the other hand, if pharmacy can prove that it can provide vaccination clinics cheaper than nurses or GP’s then so be it.
If pharmacies have to stock specific foods, fresh or packaged, as part of a wellness or nutritional support program, then the space and expertise to do this must be found.

It is fast becoming a brave new health world, and the balance of control must tilt towards the consumer…or else!

Both the major pharmacy leader bodies (PGA and PSA) have not even plugged into the trend, let alone having forward plans in their back pockets!

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