Out From Behind the Counter

Retailers that recognize the pharmacist’s changing role can benefit from satisfied pharmacy customers and increased sales. Pharmacies face many challenges, including meeting regulations, adapting to technology, and finding the right staff levels. Grocery pharmacies have the added pressure of making sure the patients are happy, because these patients are also shoppers of the rest of the store. The U.S. is aging, and many of these pharmacy users are becoming more frequent visitors. Industry observers say supermarket pharmacies that maintain a high level of customer service can help boost sales in the rest of the store. Retailers are using everything from automation to signage to new drugs to help pharmacy departments compete in a changing environment. The J.D. Power 2015 U.S. Pharmacy study, which measures customer satisfaction on a 1,000-point scale, noted that in 2015 satisfaction with supermarket pharmacies improved to 851, up from 843 in 2014. Part of this satisfaction stemmed from the interactions with pharmacists and pharmacy staff. The study noted that the simple step of asking customers if they would like to speak with a pharmacist caused overall satisfaction to improve by 54 points. Talking to a pharmacist was not the only factor that improved customer satisfaction. It also helps to offer health screenings and wellness services. The study noted that 60 percent of customers who use these services buy other, nonprescription merchandise at the pharmacy, compared to 37 percent of customers who do not use health services. Of course, sometimes consumers simply want to fill a prescription. In some stores that small task can be daunting, says Christopher Thomsen, vice president of business development for pharmacy automation provider Kirby Lester, based in Lake Forest, Ill.“You go to the grocery store, you drop off your prescription at the pharmacy, and you do your shopping for twenty minutes,” he says. “You come back to the pharmacy and they say, ‘It will be another half-hour.’” Part of the problem is staffing. Thomsen says the role of the pharmacist is changing, and technology such as automation can help. “It comes down to utilizing the professionals in your staff behind the counter appropriately,” he says. “Don’t put that pharmacist behind the counter counting tablets. That professional is wasted.” Instead the pharmacist should be consulting with patients; pharmacy technicians can count pills and prepare labels. Robotics can help, as automated systems can fill prescriptions involving hundreds of different medications and can prepare the labels and bottles more efficiently than the old spatula and tray method. Newer, tabletop versions take up a smaller footprint and are suitable for supermarkets that have lower volumes than drugstore pharmacies. Thomsen notes the robots not only offer labor savings but also cut down on mistakes. “There are financial benefits and patient safety benefits to filling the prescription faster and more accurately,” he says. “The patient won’t say you gave me the wrong drug or shorted me.” Technology can also help pharmacies remind patients when to refill their prescriptions. L. Preston Hale, national manager, strategic accounts for pharmacy software management company QS/1, says the issue on everyone’s mind right now is medication adherence and the Centers for Medicare & Medicaid Services (CMS) Five Star Quality Rating System. “Third parties are being evaluated on how they are keeping patients adherent,” he says. “Keeping patients out of the hospital is a way to save healthcare dollars.” QS/1, based in Spartanburg, S.C., offers software that can identify patients that have disease states such as cholesterol, diabetes or high blood pressure. The software can show which patients have not come in to refill their maintenance prescriptions. The pharmacist can then contact the customer and invite them in for a consultation to see if the person is taking the incorrect dosage, if they received samples at the doctor’s office or if they cannot afford the medication. “You can see if they understand the importance of the medications and find out why they are not taking them,” says Hale. The pharmacist can also educate the consumer on the importance of maintenance. “Then, with a compliant patient you are on track, they are taking their medications and everybody is happy. The patient is going to feel better no doubt, and there will be no emergency room visit.” There are customer service benefits too. The software can identify which patients are due to refill prescriptions in the near future. Pharmacy staff can contact the person and set up a time for them to pick up these medications, or synchronize all the patient’s monthly prescriptions to be picked up on the same day each month. That convenience can help reframe the pharmacy as more than a stop on a list of errands. “Grocery is trying to position itself as the community focus point,” says Hale. “You go into the grocery store in the morning and get coffee and groceries because some have a place for breakfast. You have banks and eyeglasses in grocery. The pharmacy is going to wind up being a central focus point with wellness.” After all, says Hale, many grocery chains have clinics, and many offer educational services such as nutrition-related events. There are also flu shots, and some are offering other immunizations, such as for shingles. Pharmacists can use QS/1 software to identify which pharmacy customers are over the age of 65, Hale says, and contact them about coming in for a shingles vaccine. That personal service can help the grocery pharmacy compete with big box stores. “That’s the total wellness that pharmacy can bring,” says Hale. “It is happening today and it will be commonplace that you make appointments with pharmacists to coordinate healthcare.” Creating a bond Pharmacists can build relationships. “There is a great opportunity for pharmacists to strengthen the bond with customers,” says Mike Coughlin, founder and CEO of the pharmacy automation company ScriptPro, based in Mission, Kan. “The pharmacy customer is a very loyal customer because they’ve committed themselves to the store. They’ve got prescriptions there on file and it’s a major undertaking to move them. You want the customer to feel they are getting the undivided attention of the staff.” Coughlin says to do this the pharmacy needs efficient systems and efficient staffing. Robotics can help the pharmacy staff save time and can also contribute to improving the experience for repeat customers. “The patients that come in with routine refills can get bogged down in line behind someone who has an issue,” he says. “They are calling the insurance company, they can’t afford all the drugs so they want to take some out.” If the staff can see this frequent customer stuck in a lengthening line, they might direct the person to the counter and take care of them quickly. Of course other departments in the store know they need to make the shopper’s experience a positive one, but the pharmacy is more complex. “Meat and bakery have complexities, but in the pharmacy they are dealing with life and death issues,” says Coughlin. “Grocery store general managers are saying we don’t understand, we worked in other departments.” He adds that technology is a big investment that pays off in not only better customer service but also in improved employee morale, especially among professionals who worked hard to earn a doctor of pharmacy degree. “Pharmacists will be happier if they do the things they were trained to do,” says Coughlin. “They did not take a course on pill counting.” In fact, he says, in one large grocery pharmacy chain that invested in ScriptPro’s automation, the pharmacists began to dress more professionally because they were coming out from behind the counter and talking with patients. Lost and found Another obstacle to some pharmacies’ success is that consumers sometimes cannot even find the department, especially in today’s one-stop-shopping emporiums. “When you walk in the door if you are a new customer you can’t see the pharmacy or even see if they have one,” says Ron Mackert, vice president of the store fixture manufacturer Uniweb, based in Corona, Calif. To drive more sales to pharmacy, the stores should do two things, says Mackert. They should display signage showing where the pharmacy is. That could include a banner over the pharmacy, signs over gondolas and even a color-coded path on the floor. The store should also put up a sign in the entrance—and not just during flu season. The other tactic, Mackert says, is to include pharmacy-specific ads in the weekly flier. “They can get a dedicated page talking about the professionalism they offer and consultations they offer,” he says. “Everybody has their favorite pharmacy, so the challenge is to get them to switch from other pharmacies.” The simple fact is pharmacy is a profit center, and grocery can capitalize on this. “Pharmacy is still a growth industry and always will be, regardless of the economy,” Mackert says. “I think if they understand they have to put their message in front of potential customers they will increase their business.” One issue that pharmacies must handle is the abuse of drugs, including over the counter drugs that can be used to produce methamphetamine. Acura Pharmaceuticals, a specialty pharmaceutical company based in Palatine, Ill., develops abuse deterrent products such as Nexafed, tamper-resistant pseudoephedrine for sinus and nasal congestion relief. “With Nexafed you would get exactly the same relief, but if a meth cook tried to use Nexafed they would be stymied,” says Brad Rivet, vice president, marketing for Acura Pharmaceuticals. “The meth would be totally worthless.” Nexafed is made of the same ingredients as products such as Sudafed, so regulations that require the consumer to visit the pharmacy, show an ID and place their name in a database still apply. Some pharmacies that offer Nexafed are seeing a decrease in meth-related problems, Rivet says. “They don’t lose customers they want to keep,” he says. “They are losing the ones that steal lithium batteries or nail polish remover on the way out and make their young clerks nervous at night. This makes the store a safer environment.” Filling for the future Pharmacy revenues continue to grow and industry observers estimate total spending on U.S. medicines increased about 10 percent to nearly $375 billion in 2014 as the year saw a record volume of about 4.3 billion prescriptions filled. Doug Long, vice president, industry relations for Parsippany, N.J.-based IMS Institute for Healthcare Informatics, spoke about trends at this year’s National Association of Chain Drug Stores Total Store Expo in Denver. The three largest categories for drug sales, he said, were hepatitis, diabetes and oncology. Hepatitis C leads because of Harvoni, an approximately $1,000-a-day therapy from Gilead Sciences. “It is the number one product,” Long said at his Pharmaceutical Trends, Issues and Forecasts presentation. “It cures hepatitis in eight weeks. Previous products are off the market, and that’s unheard of.” Overall, Long said, 83 percent of prescriptions filled are for generic drugs, 70 percent are for chronic conditions and 65 percent are for patients 50 and older. The trends to watch, he said, will include mergers, such as the recent announcement of CVS buying Target pharmacies, the expiry of some drug patents and resulting launches for generic versions of Nexium for gastroesophageal reflux disease and Abilify for mental illness, and the launch of biosimilars, which are FDA approved medications that are made of biological organisms, and are highly similar to previously approved biologic drugs.