Staying Ahead in the Craziness That is Pharmacy Ownership

  • February 11, 2019
  • /   Andrew Fisher
  • /   Post Tags

By Andrew Fisher, Pharmacy Owner

Part of ORCHIDsocial

        Owning a pharmacy is not for the faint of heart. Pharmacy owners get to deal with all of the difficulties and hardships that are shared by most small businesses – plus, we have the additional pleasure of working under the thumbs of a massive government bureaucracy and multi-billion-dollar conglomerates that see little value in our existence.  The conglomerates, of course, are the pharmacy benefit managers (PBMs), and each year it seems to get harder and harder to work with them. Between the captive networks they are creating (the Caremark/Aetna, and ESI/Cigna mergers are perfect examples), the restrictions on the type of business you can do (RIP compounding pharmacies), and the declining reimbursements on seemingly every medication, it is not hard to understand why surviving as a community pharmacy is so difficult.


            Challenges often create opportunities, though, and there are many community pharmacies that are thriving. Why is that? It’s not always the same answer, but a big reason is that community pharmacies have a purpose. They fill an important role, and, as long as that is the case, there will be opportunities for success. Pharmacy owners just have to find them.


            In today’s rapidly changing environment, staying up-to-date on payer policies and reimbursement guidelines is more important than ever for success. Because the PBM’s manuals allow for them to change policies and reimbursements any time they want with no notification to the pharmacies, this can be extremely challenging. Add in effective rate contracts that make the adjudication information that is available when the claim is billed irrelevant, and it get evens more difficult. All of the information is there, we just need to look in the right places.


Pharmacies also need to find a way to engage more with the prescribers and other healthcare providers in their local community in non-traditional ways. Episodic payments, ACOs, and other developments in our healthcare system are creating new ways for pharmacies to grow new business. Many physicians are looking for good community pharmacies with whom to partner to take better care of their patients. The rapidly changing dynamics of drug reimbursement have made physicians’ lives very difficult when it comes to taking care of their patients. A pharmacy that works with prescribers to identify effective therapies, and then makes it easy for them to prescribe medications that will be effective for the patient, will find many new referral sources to help the business grow.


If you own a pharmacy, don’t lose hope. The industry has not left you behind. It has changed, and those changes are making it necessary to adjust how you have always done business, but there is still a tremendous need for independent community pharmacies and there always will be. Stay ahead of the changes, integrate even more within your local community, and your pharmacy will continue to thrive.


If you’d like to discuss more strategies to stay ahead, contact ORCHID. We’d love to work with you!