REMEDIES FOR FUTURE SURVIVAL

MICHAEL SLEZAK

SAN FRANCISCO -- Supermarket pharmacies must do more than merely dispense prescriptions to survive in the coming decade. They also need to have innovative promotional and professional activities, cutting-edge technology, incentive programs, community outreach programs, and perhaps the capacity for mail-order, warehousing and repackaging as well.

This was the message delivered by pharmacy executives from two large supermarket chains in a joint presentation at the FMI Supermarket Pharmacy Conference held here last month. The executives were Robert Coopman, vice president of pharmacy at H-E-B Grocery, San Antonio, with 103 pharmacies, and Bob Storch, vice president of professional services for Dominick's Finer Foods, Northlake, Ill., which operates 60 pharmacies.

"We will be getting into the business of disease state monitoring this year," Coopman announced. "That's going to put pharmacists in a critical role, inside the stores and outside of the pharmacy, making appointments with patients."

Coopman also suggested that pharmacists can get more involved in therapeutic interchange, marketing of over-the-counter medications and adopting more efficient work practices. H-E-B, for example, has reduced its costs with a new pharmacy layout based on industrial engineering practices to create a work flow with fixed work stations.

Coopman said H-E-B encourages pharmacists to participate in community programs by giving cash bonuses.

"We've had thousands of presentations and events where our pharmacists got involved with the community," Coopman explained. "From our standpoint, that is a strategic advantage when we talk to health maintenance organizations that we've positioned ourselves as part of their market and community."

Coopman said H-E-B gives its pharmacists flexibility to design their own outreach programs. "If you let the pharmacists build the programs themselves, there's more power in it," he said. "We provide support for getting tools, making contacts and printing literature."

Coopman said the chain bought several kits of a canned puppet show presentation that enabled H-E-B pharmacists to teach second, third and fourth graders about drugs. If pharmacies cannot prove their merits to the public and to HMOs, through community involvement and other means, they risk extinction, Coopman said.

"I don't know how long our society will be willing to pay pharmacists $50,000 to $80,000 a year to count five, 10, 15, 20," he said, citing the possibility of unit-dose distribution and the growth of mail-order as key issues facing supermarket pharmacists.

"Five or six years ago, there were no Phar-Mors in central and south Texas. Then there were 10, and now they're gone. Two years ago, there were 14 Krogers in San Antonio, now they're gone," said Coopman, illustrating the volatile state of pharmacy retailing, at least in Texas.

H-E-B is positioning itself for the future by investing in ancillary businesses as well as pharmacy, said Coopman. These include a mail-order operation, warehousing and repackaging.

"We will create a central database by August," said Coopman, which will help the company "proceed with its mail order business.

"We warehouse our pharmaceuticals and it's a key advantage," said Coopman. "Food stores already know how to handle tonnage and have the systems, so we're further along than drug chains."

H-E-B also repackages "about 74 items," Coopman said. "It's not a big investment to do it and the payback is substantial." He added that after the first 30 days of repackaging, H-E-B had covered its setup costs. Coopman added that it is more advantageous because H-E-B gains significantly by doing its own repackaging compared to purchasing repackaged products.

A pharmacy operation needs to have "world-class computer technology to survive in this industry," said Storch of Dominick's Finer Foods.

The chain recently installed E-mail in its pharmacies "and it's been a tremendous help," said Storch. With the computer programs that are available, "Pharmacists can be doing six things at once," he said. "They love it."

Dominick's central data base is also helping the retail chain develop its mail-order pharmacy business, said Storch.

"Does mail order have a place at a 60-pharmacy chain like ours? It sure does," said Storch. The central data base, he said, enables customers anywhere in the United States to receive their prescriptions overnight or by mail, by calling an 800-number.

"We're looking at a system right now," said Storch, "where people can access the refilling of their prescription over the telephone and leave that message 24 hours a day.

"I believe the time will come when prescriptions can be filled over cable and phone lines," Storch added.

Within the store, Storch has encouraged Dominick's pharmacists to make the most of synergy with the food departments.

"We challenge our pharmacists to say that the whole supermarket is a shopping basket for better health," said Storch. "Our relationship with our produce brothers and sisters, as we call them, is so important. There's a great deal of respect for what we both do. Fresh produce drives the traffic in our store and I respect that. "Plus they're selling a healthful product my pharmacists can interface with on a Saturday or Sunday when the pharmacy is not as busy," said Storch. "They can be out there having a 'Meet the Pharmacist' session and interacting with produce customers. That's a synergy we play on."

One promotion tied in the pharmacy department with potatoes while also heightening public awareness about the chain's contracts with several third-party plans. A radio ad named employers whose health plan members could have their prescriptions filled at Dominick's. The radio ad concluded, "That's no small potatoes."

"Then, when they came in to fill the prescription, we gave them a 10-pound bag of potatoes," recalled Storch.

Sometimes promotional events develop quite by accident. For example, Storch had arranged for visiting nurses to come into Dominick's to administer flu shots. Simultaneously, several Dominick's stores were selling durable medical equipment. The idea occurred to Storch to have the nurses provide free delivery and in-home demonstrations of the equipment. The partnering between the two groups has worked well, he said.

Dominick's pharmacists are also on an incentive program to promote their community involvement, which pays bonuses based on the number of interactions that pharmacists have with customers.