Tyler Woods, PharmD, was joined by Ajay Mehra, chief financial officer and cofounder of UGO Rx, and Scott Cady, PharmD, during the Total Pharmacy Solutions Summit Fall 2023 to discuss how pharmacists can maximize opportunities to improve their stores.
“Let’s take back pharmacy” might be a generic saying, but it’s one that’s crucial to the success of any independent pharmacy owner’s business. “I don’t have to tell anyone here [about] the hurdles and obstacles we face, but that doesn’t mean that there aren’t options and opportunities for us within [those obstacles],” Tyler Woods, PharmD, said during the Total Pharmacy Solutions Summit on October 28
For the final session of the day, Woods, district manager at VMC Pharmacy Program, was joined by Ajay Mehra, chief financial officer and cofounder of UGO Rx, and Scott Cady, PharmD, pharmacist and owner of Chillicothe Family Pharmacy. Together, they discussed how pharmacists can maximize opportunities to improve their stores.
“This is a profession where we know there are a lot of opportunities; there are a lot of pharmacists out there with incredible clinical knowledge,” Woods said. “But we’ve heard over and over that we have to get better at business.”
The current pharmacy benefit management model is not, according to Woods—and many others in the pharmacy space—an even playing field for independent pharmacies. To combat that, pharmacists need to be able to make choices that answer this question: How can we make better, educated decisions on our business health?
There are 3 maxims that independent pharmacists and pharmacy owners should keep in mind when attempting to answer that question, Woods said. These maxims are to work smarter, not harder; maximize opportunities; and change the assessment of “what is good business.”
“The hardest part is [saying], ‘OK, we’ve identified where we want to go; how do we get there?’” Woods noted. Recognizing opportunities and mapping out how to capitalize on them is crucial for independent pharmacy owners looking to move their business forward.
In 2017, Mehra and his business partner had the difficult conversation that no pharmacy owner wants to have. “[We] looked at each other and said, ‘I think we have to shut it down.’ It was like swallowing an Alka-Seltzer pill. It was the craziest thing that we were about to lose everything that we had spent the past 5 or 6 years prior to that building,” Mehra said.
That difficult conversation between Mehra and his business partner led to the creation of UGO Rx, a cloud-based platform for pharmacy owners that allows them to visualize pharmacy performance, compare metrics, and identify areas where profitability can be improved. Within the platform, users can conduct a community search to identify processed medications and find new drugs and optimal national drug codes, search the entire Medicare Part D and Medicaid formulary to bypass formulary restrictions, and compare and analyze pharmacy performance vs the wider UGO Rx community to quickly identify profit opportunities.
Like most pharmacy owners, neither Mehra nor his business partner went to business school. “We just knew that we weren’t working smart,” he explained. According to Mehra, as pharmacy owners, “we sometimes forget that we’re a pharmacy by function but we’re a business by operation, and the 2 [things] get blurred.”
During the development process, Mehra and his business partner interviewed their pharmacy employees, asking what processes could be done better and what tasks took the most time. One of the biggest issues was Medicare prior authorizations (PAs). When a PA or rejection would come through, staff would reach out to the prescriber’s office, where they were frequently met with a request for the list of medications that were covered by the patient’s insurance. “The 2 people in charge of the patient’s care—the doctor and the pharmacy—are the 2 people left completely out of the loop when it comes to drug coverage and treating the patient,” Mehra explained.
Three years later, UGO’s Medicare Part D search tool went live, taking the entire Medicare Part D formulary for every plan across all 50 states and making it searchable. Users can enter information about the drug and the insurance plan, and UGO will show all covered alternatives within the health care plan for that specific drug as well as average reimbursements per the Centers for Medicare & Medicaid Services.
Having this information about alternative medications at the fingertips of pharmacy staff allows pharmacists, technicians, and owners to make educated decisions based on reimbursement and capitalize on an opportunity to improve the pharmacy’s bottom line. “Having the ability to do the search makes things so much easier,” Cady said. “You’re not taking 10 to 15 minutes to find that magic bullet, the product that’s covered and reimburses the best. I’ve got a tool, I can make a couple of clicks, and I know on average what my reimbursement could be and what is the best product for my patient. It’s a win for me, and it’s a win for my pharmacy.”
“Over and over, we hear these comments: ‘I went to school to be a pharmacist, not to be a business owner or run a business,’” Woods said. “I think the perfect scenario is when we can blend those 2 things together. So often we submit a PA or send a fax to a physician’s office, but that’s not necessarily taking care of the patient. This is the opportunity for you to put that clinical hat on and dig in. It’s moving that needle; it gives you more power over your operations, and the result is taking care of your patients in a better way.”