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Total Pharmacy Solutions Summit: Extending Care, Expanding Revenue

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Drug Topics Journal, Drug Topics December 2022, Volume 166, Issue 12

The Fall 2022 summit tackled adding new revenue streams, upcoming legislation, and the expansion of pharmacy.

On October 22, 2022, community and independent pharmacists all over the United States virtually met to learn from a packed slate of speakers to discuss nonpharmacy benefit manager revenue, point of sale functional testing, the upcoming Drug Supply Chain Security Act, the role of technology, and 2 continuing education sessions.

Keynote Address

The morning opened with a keynote speech from Kevin Walker, PharmD, RPh, chief strategy officerat RPhAlly.During his presentation, Walker noted how often community pharmacists are left out—like with a recent $59 million grant in California that left pharmacists out in the cold, even though study after study has shown that pharmacists are helpful in the management of chronic diseases.

“Sometimes we are pushed away from community pharmacy because of thoughts of it not being clinical. But I’m here to tell you that I truly feel that patient care and clinical care happens in these locations,” Walker said.“It doesn’t only happen there, but I [also] feel like it is the most impactful location for it to occur. Prevention is everything. Having a holistic partner in your care is everything. Having someone that has time for you is everything. And that’s what we’re providing.”

However, it’s not all gloom and doom for community pharmacy. Walker cited a promising development in Idaho, where the state government has pushed out the pharmacy benefit manager (PBM) that had been administering benefits to state employees. In its place is a transparent pricing proposal that favors independent pharmacy with preferred decreased co-pays.

Going Beyond PBMs for Revenue

The days of depending on the revenue generated from prescription fills are gone, even as they remain the abiding image of pharmacy. The time to diversify is now, according to Lisa Faast, PharmD, CEO of DiversifyRx, in her session “Top 3 Non-PBM Revenue Opportunities in 2023.” Although they are ubiquitous and a face of life, PBMs can lead to anxiety, uncertainty, and poor cash flow if they are relied on as a major revenue source for a pharmacy.

Point-of-care testing is top of mind, thanks to COVID-19, but there are so many more seasonal concerns,from influenza to sexually transmitted diseases. Plus, pharmacy efficiency can often get results to patients faster than traditional labs. Pharmacogenomics can offer information on how a person’s biology will affect a drug’s metabolism, allowing for more personalized medicine. Cash prescriptions offer more flexibility to patients and can be offered alongside insurance options. Faast offered recommendations on how to get started and pitfalls to watch out for.

Offering these services can be a powerful way to fend off online pharmacies that advertise convenience, because “we’re a real brick and mortar, in real life pharmacy. [Patients]still like to get real health care from real [providers],not from the mailman. And when you can offer the exact same price—or sometimes even better pricing, frankly—than some of the big guys, [patients]will choose you. They like that personal connection, especially when it comes to health care,”Faast said.

Technology in the Pharmacy

Not all pharmacists are technophiles, but the time has come to embrace technology in the pharmacy, according to Paige Clark, RPh, vice president of pharmacy programs and policy at Prescryptive Health. Many pharmacists are spending more and more time reviewing drug pricing, often because of concerns about consistent pricing. With artificial intelligence completingthe price reviews, pharmacists have more time for patient interactions, allowing for confidence in pricing.

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When choosing a company to partner with, Clark said it’s important to be careful. “We are experts in patient care. We are experts in running our pharmacies. We are experts in a lot of things, but as pharmacists, we are not necessarily experts in technology. We might even be a bit of a technophobe. I would say that certainly was true of me. We [must] understand how to ask the right questions of our technology partners about data security,”she said.

Advanced Point of Sale Functional Testing

In the session, “Advanced Point of Sale Functional Testing,” Hillary Howell, PharmD, FACA, CCN,set out to help participants learn about the different types of available testing to patients and the regulations, the different types of advanced point of sale functional testing, when to use the various types of advanced point of sale functional testing, which types of training are recommended to offer advanced point of sale functional testing, and to examine the potential benefits to the patient and the practice. 

Howell covered topics such as direct-to-consumer testing vs point-of-care testing and the importance of having CLIA waivers in the pharmacy. She discussed the differences between allopathic and functional medicine models, where her experience in the subject was clear. Several specific types of testing, such as urine, breath, and stool, were discussed in-depth. There are several benefits to including point-of-care testing in the pharmacy,such as improved patient outcomes, increased pharmacy revenue, and expanded scope of pharmacist and pharmacy technician roles.

Howell’s presentation is an in-depth look at the ins and outs of point-of-care testing. “It helps me serve the purpose of not just mandating and giving [patients]prescriptions and sending them off [without getting] better,” Howell said.

Drug Supply Chain Security Act: Now and in November 2023

Josh Potter, director of compliance services at PRS Pharmacy Services, and Jim Shaver, director of operations at Advasur, closed out the day of community and pharmacy insights with a look at the Drug Supply Chain Security Act. Although the legislation is set to go into effect on November 27, 2023,when PRS asked a sample of pharmacies, 95% didn’t fully understand the act and only 8% were actively preparing for next November.

Potter broke down what drugs are affected by the legislation and how processes will differ from how they’re done now in key areas such as authorized trading partners, product identification, product tracing, product verification, detection and response, notification, wholesaler licensing, and interoperability.

For pharmacists who haven’t started getting ready for the legislation, “it will be very important that pharmacies, especially independent pharmacies, are attending webinars like this or listening to their buying group, their wholesalers, their compliance consultants, and so forth to make sure they do understand what requirements are coming down the line, and [to]make sure they’re compliant with today’s requirements,” Shaver said.

Click here to watch the Total Pharmacy Solutions Summit on demand.


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