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Immunization Inroads

It's been just over a decade since supermarkets were first identified as a natural source of whole-health products and services for an emerging consumer base focused on their health and well-being. At the time, pharmacy was viewed as a main driver in branding a company as a health and wellness retailer. Ukrop's Super Markets was an early advocate in the whole-health movement. In the pursuing years,

It's been just over a decade since supermarkets were first identified as a natural source of whole-health products and services for an emerging consumer base focused on their health and well-being. At the time, pharmacy was viewed as a main driver in branding a company as a health and wellness retailer.

Ukrop's Super Markets was an early advocate in the whole-health movement. In the pursuing years, the Richmond, Va.-based regional chain has used the pharmacy as the launching pad for integrating health-related services throughout the store. Wellness centers, adjacent to the pharmacy, provide shoppers nutritional counseling, disease-state education, health screenings and immunizations. The pharmacy works closely with several registered dietitians on staff who make sure shoppers are well informed about healthy food choices. All regularly participate in community outreach health programs. The retailer has won acclaim as a whole health leader, including the first recipient of the SN Whole Health Enterprise Award.

Despite progress made on this concept that has been evolutionary, John Beckner, Ukrop's director of pharmacy and health services, who has been a whole-health advocate since the beginning of his 16-year tenure there, says the food industry has yet to fully harness the whole-health opportunity. Some obstacles he cites are the time and labor required to execute various health outreach programs, difficulty in getting reimbursed for disease-state management and gaining the full support from other store departments in promoting the supermarket as a destination for health and wellness.

“Early on, everyone thought pharmacy had to be the driver of health and wellness in the store. I am not sure that has happened,” Beckner told SN.

But it is the pharmacy with its connection to disease states and medication management that makes it the perfect pivotal point for supermarkets to brand themselves as a wellness enterprise. “Pharmacy is the magnet that draws people into the store for health and wellness. The supermarket is unique in that it brings together everything for a healthy lifestyle.”

While Ukrop's has run several disease-state programs over the years, the pharmacy threw its full support behind diabetes, the seventh-leading cause of death in the United States. Beckner estimates that about 5% of Ukrop's customers have the disease.

“We've tried to make ourselves a destination for diabetes,” said Beckner. Ukrop's diabetes program has evolved from a series of classes to in-store seminars and nutritional store tours. According a Ukrop's website, the retailer offers 15-20-minute individual sessions conducted by a Ukrop's pharmacist by appointment for a $25 fee.

Ukrop's had hoped disease-state management programs such as diabetes would warrant reimbursement from third-party payors. But Beckner said reimbursement for such programs has been inconsistent. “It never took hold like we thought it would,” he said.

“Our biggest opportunity may be to work with self-insured employer groups. That is a big opportunity because the employer is the ultimate payor and they see their health care costs in regard to these particular conditions.”

MOVE TO VACCINATE

Ukrop's also has turned its attention to immunization, which has become a growing and year-round program. Ukrop's began its program in 1998. It has since administered nearly 300,000 seasonal flu vaccinations as part of its annual immunization program. The retailer gives out approximately 35,000 flu vaccines every year. Shots are free for customers with Medicare Part B. For customers not using health insurance, the influenza shot costs $25 with a Ukrop's Valued Customer Card, a $14 savings.

Ukrop's also offers routine adult vaccines including hepatitis A, hepatitis B, tetanus, MMR, chicken pox, meningococcal, human papilloma virus and shingles vaccines. According to reports, many of these vaccines are underutilized in the adult community and contacting these diseases risk serious health complications especially when combined with the flu. The retailer also offers pre-travel counseling services that advise on vaccines and mediations prior to and during a trip.

This year, Ukrop's like many other retailers around the country ran out of the seasonal flu vaccine due to the early start of the season and manufacturers switching production to the H1N1 vaccine.

Beckner anticipated a huge demand for the H1N1 vaccine. “It is scary. It is the lead story on the national and local news. There has been so much focus on H1N1. It has prompted more people to get seasonal flu shots. I think H1N1 is over-hyped. Not that it isn't important and serious, but seasonal vaccine kills 36,000 to 40,000 people every year. We don't know how many people swine flu is going to kill.”

Like Ukrop's, United Supermarkets, Lubbock, Texas, is promoting its image as a whole-health provider through its growing immunization program. The chain recently relaunched its “Free to Feel Better” program and in doing so it joined other supermarket chains around the country in offering free antibiotics and prenatal vitamins at no cost with a physician's prescription.

Free antibiotic programs started to spread as a reaction to Wal-Mart Stores' $4 generic prescription drug program introduced in 2006. But the programs haven't been without controversy with the growth of antibiotic-resistent infections.

Tim Purser, business director of pharmacy for United Supermarkets, is well aware of the controversy. “For us it is about affordable access to health care,” he said. United is the only grocery chain offering such a program in the West Texas market through its Market Street-banner stores. Purser noted the free antibiotics/prenatal vitamins are distributed only with a prescription. In a depressed economy such programs are welcomed by customers living in the rural West Texas communities that United serves, he said.

“From a guest relations perspective it is probably the best we've launched. The communities we serve have been overwhelmingly complimentary on how great the service has been.” The program covers 60 of the most prescribed generic antibiotics and up to a year's worth of prenatal vitamins.

Immunization is viewed as an expanding fee-for-service growth segment. “From an ancillary service delivery of a product other than pharmaceuticals, the immunization program is probably the most recognized,” said Purser in explaining why these programs are a focus for supermarket pharmacy.

United has 50 stores and 44 pharmacies. Purser said 95% of its 120 full-time pharmacists are certified to give out immunization shots. Besides in-store immunizations, United has made a concerted effort to offer clinics at schools and businesses. “We get mobile and go to many locations as an outreach program to provide the seasonal flu vaccine to our communities.”

The immunization program “does increase foot traffic and provides a synergistic relationship with the store that allows us to provide a total solution whether it be through the nutritionist, pharmacy and Living Well ExpressCare clinics all in one location. It rounds out the whole wellness experience.