May 20, 2002

Consumers weigh in on how they choose a pharmacy and how they think their R.Ph. can better serve them




Consumers weigh in on how they choose a pharmacy and how they think their R.Ph. can better serve them

If you never thought to ask your customers, in the words of former New York City mayor Ed Koch, "How am I doin'?" we did. We found that most consumers have a favorable impression of their pharmacist. But they are receiving counseling from their pharmacist less often.

These are some conclusions from a consumer survey Drug Topics just completed. This report is the second in a two-part series examining the role of pharmacists. The first part of the series (Drug Topics, May 5) queried pharmacists directly about their responsibilities and authority within the healthcare profession. This second part evaluates patients' views of pharmacists' responsibilities and authority.

Drug Topics polled consumers about the types of pharmacies they patronize, what factors they consider to be of importance when choosing a pharmacy, what services their pharmacist offers, what services they would like their pharmacy to offer, and several other topics.

A three-page questionnaire was mailed to 1,000 nationally representative households. A total of 710 consumers responded. Of the survey respondents, 19% were men and 81% were women. Average age of the respondents was 51, and the average household income was $49,724. All community settings were represented, with more than half (51%) of the respondents residing in a suburban environment, 30% residing in a rural environment, and 19% residing in an urban environment. Each geographic area in the United States was represented as well, with 36% respondents living in the South, 23% in the Midwest, 21% in the East, and 20% in the West.

Choosing a pharmacy

Approximately nine out of 10 (88%) consumers said they had obtained prescription drugs at a pharmacy. Most persons patronized one pharmacy. Almost half (46%) of the survey respondents reported filling the majority of their prescriptions at a chain pharmacy. Another 19% filled their scripts at in-dependent pharmacies, 16% at supermarket pharmacies, 15% at mass- merchandiser pharmacies, and 4% at other types of pharmacies.

Chain pharmacies were particularly popular among consumers in the East (60%), compared with the South (47%), Midwest (41%), and West (35%). Mass-merchandiser pharmacies were frequented more often by respondents in the Midwest (25%), compared with 15% of respondents in the West, 14% in the South, and just 6% of respondents in the East. Consumers under age 40 patronized mass merchants more often than did those 60 or older (19% versus 12%). Respondents whose household income was less than $25,000 relied more on independent stores than did higher-income respondents (27% versus 11%-17%).

According to 32% of respondents, "health insurance plan requirement" was the most important factor when selecting a pharmacy, followed by convenient location (27%). Good prices (16%), helpful pharmacist (15%), and convenient hours (11%) were of less importance (see Figure 1). Those who usually patronize mass merchants are more likely to cite "good prices" as the most important factor when choosing a pharmacy, compared with those who patronize other types of pharmacies (30% versus 10%-12%). Those who frequent independent pharmacies were more likely to choose "helpful pharmacist" as the most important factor in selecting a pharmacy, compared with patrons of other types of pharmacies (31% versus 9%-12%).



Seeking counsel

Most respondents reported at least some interaction with their pharmacist when they visit a pharmacy. On their last visit to fill a new prescription, 59% of respondents said they recalled having a conversation with the pharmacist. Those in the West were more likely to have discussed a new medication with the pharmacist, compared with those in other geographic regions—81% versus 63% of consumers in the Midwest, 54% in the South, and 42% in the East.

Consumers age 60 or older were more likely than those who were younger to recall having such a discussion—66% versus 53% of respondents under age 40 and 55% of those age 40 to 59. Those patronizing independent pharmacies were more likely to have discussed a new prescription with the pharmacist (73%), compared with those frequenting mass-merchandisers (57%) or chains (50%).

Pharmacists seem to be providing counseling less and less frequently over the past few years, however. Respondents to a consumer survey conducted by Drug Topics in 1997 reported that their pharmacist discussed new medications with them 68% of the time. This percentage dropped to 66% in a 1998 Drug Topics consumer survey and to 60% in a 2000 survey.

Pharmacists initiate counseling more frequently, though, which is a good thing. According to the 1998 poll, pharmacists initiated counseling only 71% of the time, but this year pharmacists initiated these discussions 93% of the time.

Going over the counter

More than seven out of 10 respondents reported that they had purchased over-the-counter products at their pharmacy. Those frequenting chain pharmacies (78%) and mass-merchandiser pharmacies (74%) purchased OTC products at the pharmacy most often, compared with those patronizing other types of pharmacies. Of the respondents purchasing these products, 42% sometimes or always sought the pharmacist's advice about their purchases. Those patronizing independents were significantly more likely to have sought the pharmacist's advice (70% versus 33%-40%).

The neighborhood pharmacist

Consumers believe that their pharmacist has completed six years of higher education (beyond high school). The pharmacist was described as friendly and knowledgeable by 78% and 77% of respondents to our survey, respectively (see Figure 2).



Consumers who patronize independent pharmacies held the most favorable opinion of their pharmacist. They were significantly more likely to describe their pharmacist as friendly and trustworthy. Independent pharmacists were also more likely to be described as cooperative and knowledgeable than were chain and mass-merchandiser pharmacists. Pharmacists were distinguishable from their assistants to 82% of respondents.

Pharmacy services

Providing printed materials (91%), filling Rxs quickly (90%), and explaining side effects and being available to freely answer questions (each 88%) were cited by respondents as the most important services offered by pharmacists (see Figure 3). Offering to recontact the consumer to make sure the medication is working correctly was rated as the least important service offered (22%).



For consumers frequenting independent pharmacies, getting counseling about medications is important. These patrons are significantly more likely than others to cite as important that the pharmacist explains how the medication should work and offers advice on OTC drugs.

Almost all of the respondents reported their pharmacists provide printed materials (95%) and fill prescriptions quickly (94%). Only 73% of respondents, however, reported that their pharmacists always or sometimes explained possible side effects (see Figure 4). Since consumers feel that this service is very important, pharmacists would be wise to take more time to explain possible medication side effects. No change in this area has occurred since 1997, when the Drug Topics consumer survey found that just 72% of consumers received counseling from their pharmacist about medication side effects, yet 86% said that this service was important.



Those using independent pharmacies (and to a lesser degree, supermarket pharmacies) were more likely to report that their pharmacists always fill prescriptions quickly (75% for independent pharmacies and 62% for supermarket pharmacies, versus 49% for chain pharmacies and 41% for mass-merchandiser pharmacies). More consumers reported that independent pharmacists always told them about side effects (60% versus 38%-47%) and were available to answer questions (76% versus 47%-58%) than pharmacists in other types of settings.

Despite consumer perception of these services as important, only 35% of respondents would consider switching pharmacies if these services were not available. Only a few (4%) would consider paying a nominal fee (for example, $10 per consultation) for any of these services.

Of those who received printed information with their prescriptions, 75% claimed they always read this information. Women were more likely than men to report reading the information provided to them by their pharmacist (77% versus 66%). Some 59% of consumers said they read all of the information, compared with most of the information (33%) or some of the information (8%). It is interesting to note that respondents in lower-income households (under $50,000) were more likely to read all of the information, compared with those in higher-income households (68% versus 48%). Printed materials were considered easy to understand by the majority of consumers (94%).

An ounce of prevention

Approximately one-third of consumers said their pharmacy offers immunizations, and 55% of respondents indicated that their pharmacy offers blood pressure screening (see Figure 5). Other tests available on a more limited basis were cholesterol screening (offered by 17% of respondents' pharmacies), blood glucose screening (13%), and osteoporosis screening (11%).



Of those services that were unavailable at their pharmacy, 55% of respondents said they would be interested in receiving cholesterol screening, and 49% said they would be interested in receiving blood pressure screening. As evidence of interest in certain pharmacy-based screening programs, 48% of respondents would be willing to pay a nominal fee (again, approximately $10) for cholesterol screening and 70% would be willing to pay a nominal fee for immunizations. Consumers in the Midwest were significantly less willing to pay for immunizations than were those in other regions of the country (55% versus 69%-81%).

Just 17% of consumers reported participating in immunization programs offered at their pharmacy. Of all respondents, 13% received immunizations against influenza, 8% received immunizations against pneumonia, and 1% received immunizations against hepatitis.

Disease management programs

Only 6% of the respondents believed that a disease management program was available at their pharmacy. Just six consumers (19% of respondents to the question) had participated in these activities, most often in diabetes management. These six respondents took part in their respective programs at no cost to them. For three persons, the program was complimentary, and the others reported the program was paid for by their private insurer or the government.

Drug substitution

More than six out of 10 pharmacists said their pharmacist has substituted a different medication for the drug prescribed by their physician. Substitution of a generic drug was reported by 60% of consumers, and substitution of a brand-name drug was reported by 12% of consumers. Only 12 respondents (2%) reported having the pharmacist prescribe a drug for them. Of these 12 persons, six said that the pharmacist prescribed a painkiller, four said the pharmacist prescribed an antibiotic, one said the pharmacist prescribed treatment for lice, one said the pharmacist prescribed emergency contraception, and five said "other." All of the respondents were satisfied with this experience.

Logging on

Use of on-line pharmacies by patients appears to be up from 2000, when just 13 respondents to our consumer survey said that they had used an e-pharmacy. In this year's survey, 7% (39) of respondents said they have tried this form of shopping. Among respondents in the $50,000-$99,999 income group, reported use of on-line pharmacies was 12%. It is interesting to note that twice as many respondents age 40 years and older reported using e-pharmacies than those younger than 40 (3.8% of those under 40, 7.6% of those between the ages of 40 and 59, and 7.8% of those age 60 or older).

Prescription discount cards

Prescription discount cards were used by 39% of respondents. Consumers in the South were most likely to have used these cards (46%), and those in the West were least likely to have used them (25%). The most common sponsors of the cards were private insurers (77%), followed by "other" (15%), drug chains (5%), and drug manufacturers (2%).

Those with income above $25,000 were more likely to have prescription discount cards sponsored by private insurers. Respondents with income under $25,000 were more likely to have cards provided by a sponsor designated as "other." Satisfaction with the cards was moderate, with only 40% of consumers reporting that they were extremely satisfied with their cards.

Charlotte LoBuono



Drug Topics