Pharmacy Challenges and Opportunities in 2020

pharmacy challenges solutions opportunitiesA new year is upon us and the pharmacy profession faces numerous issues, challenges and opportunities that are more abundant and at the same time more complex than perhaps they have ever been before in the history of the practice of our profession. New and fast paced pharmacy technological advancements and extremely rapid changes in disease treatments lead the way, but constantly changing laws and legislation, insurance issues, plus the explosion of specialty pharmacies have made change the norm in the past decade. One can only forecast that this trend of rapid change will continue and perhaps even accelerate over the next few years starting with 2020.

What Do these Changes in the Practice of Pharmacy Really Mean?

The explosion of “real time” media attention that now exists, plus a more educated and informed patient population have both certainly resulted in one major significant change: the roles that pharmacists play as part of the Healthcare Team are both expanding and becoming more demanding on our skills. The result is that pharmacists are being challenged now more than ever to be at the “center” regarding total patient care. Our traditional role and focus  is no longer centered only on our expertise regarding a patient’s medications and prescriptions, but perhaps has shifted to the pharmacist being the central player in ensuring a patient’s well being. This means both increased involvement with all other Healthcare professionals, as well as increased communication with physicians, nurses, ancillary healthcare staff, caretakers, insurance companies and of course, the patients themselves and their families.

The Pharmacist MUST Communicate and Educate

The vitally important role that we here at Healthcare Consultants can clearly see the pharmacist now filling (and the role ever growing and increasing in the future) is one of being both the “communicator” and the “educator”. One of the reasons this is taking place is that if you drew a diagram of all the healthcare roles and functions that are involved in ensuring the best possible patient care, the pharmacist is in most cases and scenarios at the very center. It is the pharmacist who must ensure that there is always an accurate flow of information taking place between all of then numerous healthcare team members to ensure the best outcomes and results for their patients. Keep in mind that the R. Ph. who often times is the one communicating directly with the patient and their family members. This not only relates to medications and making sure that factors such as accuracy of dosages, appropriate choice of medication for individual patients, correct administration instructions, checking for adverse drug interactions, adequate counseling and of course compliance all take place. The real focus has become education. After all, who is the real expert on drugs and medications? Once again the most recent Gallup poll shows that Pharmacists are at the top of the list for the most trusted professionals (see Gallup Poll). The public respects a Pharmacist’s knowledge, ethics, expertise and opinions. Add to this that studies have shown that patients are “more likely to be honest when talking to their pharmacist versus their doctor”. This was related to the fact that most patients interacted with their community druggist much more often than with their physicians or with any other healthcare providers on a “routine basis”. One example cited was a patient who had a total of 11 different physicians! Additionally, the point can be made that the specialization of physician care has led the public to view doctors as “only focusing on their piece of the overall picture” and leaves the pharmacist as the “overseer” who manages the entire patient care. This can be especially true when settings such as clinics and large multi-staff physician practices are involved.

What’s the “Bottom Line” Regarding the Change Taking Place?

The point is that a pharmacist’s role is no longer viewed as it previously was in the past as simply being a “pill counter, placing a label on the bottle and then being a cashier”. As a profession we are now responsible legally for counseling our patients, plus must initiate the increased communication with an expanding number of other healthcare team members to ensure our patients’ receive the best possible treatment available. This direction is a “must’ for each of us to understand and undertake in order to ensure increased patient medication compliance and provide the best healthcare available. This means expanding our own skills and education to perform tasks that perhaps many of us never did before (Pharmacogenetic testing is a great example as discussed in one of our posts several years ago – Pharmacogenetic Testing in Community Pharmacies. Physicians, related healthcare practitioners, insurance providers and especially our patients are demanding this of us. It is interesting to note that of the 10 “Top Read Health-System Articles” on Pharmacy Times , over half were about patient and/or physician counseling and communication regarding specific diseases and the pharmacists role as a “team member”.

The real “bottom line” is that 2020 is perhaps one of the most exciting times ever to be practicing pharmacy! The opportunities for us as both individuals and as professionals are almost limitless. Plus they are increasing at a rate never seen before. It is our choice to each participate and play a major role in this “revolution” in US healthcare, or to “sit on the sidelines” as an observer. I hope we all choose wisely.

About HealthCare Consultants

As always, HCC is here to help you in any way that we can. Contact us online or call us today at 800-642-1652 to discuss how we can help you (or just if you’d like to talk about any idea that you may have regarding Pharmacy!). Healthcare Consultants is a nationally renowned full service Pharmacy staffing and consulting firm that has been in business for over 30+ years. Owned, managed and staffed by full-time in-house Pharmacists, HCC offers a full range of Pharmacy Staffing & Placement, plus is noted for our Pharmacy Consulting Services that other firms simply cannot offer.

From major hospitals and healthcare systems to individual community retail and specialty pharmacies, HCC has been the nationally renowned pharmacy consulting firm of choice for over 30+ years now. We work with businesses of every size – from the corner drug store to national corporations and organizations – with only one goal in mind: to improve your pharmacy’s business operations. We can assist with expert advice in any area of your pharmacy business or practice.

HealthCare Consultants is additionally the leader in pharmacy startups! No other firm has opened and started up as many pharmacies throughout the nation as HCC. Plus, these new pharmacies run efficiently and profitably. Our in-house consulting experts can make sure that you do it right… every step of the way!

We urge you to contact us today to see how our Pharmacy Consulting services can help you improve your business now, plus be ready for the future. With a full-time staff of in-house Pharmacy Consultant specialists, HCC can answer any questions that you may have in all pharmacy settings. Contact us online or call us today at 800-642-1652 for a free consultation.

 


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Managing A Pharmacy

Managing A PharmacyManaging a pharmacy is an important part of almost every pharmacy owner’s responsibilities. The day-to-day management of just the pharmacy’s personnel, inventory, customers, vendors and store maintenance issues always seem to take up a majority of an owner’s day… and the list sometimes seems endless. Then add in such critical functions as ensuring that your pharmacy’s policy and procedure manual is kept up to date, that your drugstore is ready for any compliance or regulatory audits or inspections, that your employees are properly trained, and it sometimes seems that an owner never has the time to spend on what is perhaps the most important thing he or she needs to do: how to make sure that your drugstore is profitable. Plus spending the time on making your business even more profitable!

With the diminishing number of independent local community pharmacies operating throughout the United States, it’s sad to see over a ten percent reduction in the total over the past two decades. According to data supplied by NCPA (National Community Pharmacists Association), nearly 22,000 independent pharmacies are currently in business in the US. This represents a 12% decline since 2001, when the association reported that there were over 25,000 independent pharmacy businesses in operation nationally. Perhaps better management of those pharmacies that have been closed or shut down over the past seventeen years could have resulted in more profitable businesses and less pharmacies closing across the nation.

The Challenge of Managing a Pharmacy

Most independent pharmacy owners that were surveyed recently about the challenges they faced in managing their businesses cited two major areas of concern that they found challenging:
– Lack of time and resources
– Lack of business and management training

As discussed in the opening paragraph, most pharmacy owners simply don’t have the time to spend on what’s perhaps the really most important issues that face any business owner in any type of industry: increasing both efficiency and profitability. Delegating was often times mentioned as one possible solution, but this also had its drawbacks. Delegating was seen as “hiring additional staff” and this additional drain on the pharmacy’s limited resources often times offset any capital gains that resulted. Additionally, many pointed out that there simply was no objectivity from their internal staff. There was a “fear” that no one internally could look at the pharmacy’s operation and evaluate the business with the impartiality and detachment required to properly make unbiased recommendations and adjustments.

The second major area of concern that drugstore owners saw as challenging was the lack of both business and management training that they actually had. Very few had actually taken any courses in business or management since graduating from college. And how many pharmacy students have actually received this type of training while in school? Although many colleges and universities have now added business training into their curriculum, the fact remains that earning your diploma to graduate and pass the Board exam is the primary focus for most students. Most owners agreed that they had to learn the business side of owning and operating a pharmacy “on the fly” and made business mistakes that could have been avoided with more training.

How To Get Business and Management Help

Most large corporations and companies actually have entire departments dedicated to managing, monitoring and evaluating their business operations. Most small and medium sized pharmacy businesses simply cannot afford hiring full-time employees to perform these critical tasks, nor can they afford to train their existing staff to objectively carry out these essential business roles. Many owners are finding that outsourcing to an experienced and qualified pharmacy consulting company best suits their needs for strategic planning and management. They find that outsourcing can be the most practical and economically feasible way to achieve large company effectiveness without the large company price tag.

Suggestions to Make a Pharmacy Profitable

Here are just a few examples of areas that most pharmacy owners tend to overlook, yet can result in increased operating efficiency, cost reductions and enhanced profitability.

Quarterly Business Reviews

Pharmacies should conduct quarterly business reviews to accurately assess their strategic position, direction and practices, and to ensure they continue to align with market shifts, competition, profitability and regulatory compliance. To be objective, perhaps the pharmacy owner should consider including a qualified third party who is able to provide an in-depth analyses and report on the actual state of the business. One who is able to evaluate the operation objectively in regards to the efficiency and opportunities that exist to gain a larger market share. This information can be invaluable in helping managers make the right decisions at exactly the right times to ensure your business always runs as efficiently and effectively as possible.

Cost Containment Strategies

Pharmacy owners can also benefit from an expert consultant on cost containment strategies. When cash flow is an issue, an owner really only has two choices: increase sales and volume, or reduce costs. Increasing sales is obviously an objective that every owner wants, but for immediate results cost containment is the fastest way to increase profits. Yet many managers simply don’t see some of the “hidden” costs that can be addressed immediately. An in-depth analysis of where the money goes can also sometimes reveal “hidden” costs that can be either reduced or eliminated.

Industry Niche Identification

Industry niche identification is also a great way to generate more revenue and be more profitable. Are there certain areas and services that the pharmacy can quickly ramp up and take advantage of? A great example is the sudden explosion of IV infusion therapy pharmacies that we discussed in detail in one of our previous blog posts just last week. The projected increase to approximately $28 billion dollars by 2021, plus the estimate that the market would expand by a compound annual growth rate (CAGR) of over ten percent by 2022, makes IV infusion and compounding a lucrative idea to consider.

Technology Evaluation

Technology evaluation has also become a critical area of pharmacy operations that many need outside help on. After all, keeping up with all the new medications coming onto the market and the ever changing regulatory and compliance requirements keeps every pharmacist pretty busy. Although pharmacists have always been considered “early adapters” when it comes to embracing new technologies, everyone can agree that the pace at which technology changes makes keeping up with the latest software, hardware and systems an almost impossible task. Why not rely on a technology expert to evaluate what you currently have and advise you regarding what’s coming or available? Perhaps new technology exists that offers a cost reduction, increases efficiency and leads to greater profits.

About HCC

Healthcare Consultants has been the nationally renowned pharmacy consulting firm of choice for over 30+ years now. Contact us today to see how our Pharmacy Consulting services can help you improve your business right now, plus be ready for the future. With a full-time staff of in-house Pharmacy Consultants and specialists, HCC can answer any questions that you may have in all areas of your business. Just a few of the services that we offer include:
– Business planning
– Business problem resolution and turnaround
– Cost containment & financial projection analysis
– Management consultation & operations evaluation
– Policy & Procedure review & Custom P & P Manuals
*Including Policies and Procedures customized for 503A and 503B operations
– Process design and evaluation
– Quality control and improvement
– Regulatory compliance and Gap analysis
– Workflow management

Contact us online now or call us today at 800-642-1652 for a free consultation.


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Pharmacy Job Tips

Pharmacy Job Tips for Switching JobsMany pharmacists have switched jobs recently and many are considering a change to a new work direction or setting as the profession of pharmacy evolves and changes. With New Year’s resolutions about to be on everyone’s minds, changing jobs as a pharmacist can be very tempting. It has been almost five years since the AACP (American Association of Colleges of Pharmacy) first released it’s National Pharmacist Workforce Study back in 2014, but the results are basically the same in 2019. The trends that the study documented all still continue to be accurate today:
– Women (female) pharmacists outnumber men (male) pharmacists.
Over 57% of actively licensed practicing pharmacists in the United States are now women. It is interesting to note though that ownership of pharmacies is still predominantly dominated by men, with over 70% of all the independent retail community pharmacies owned by a male pharmacist.
– Pharmacy graduates are outpacing the creation of new jobs.
In 1987 a total of 72 pharmacy schools existed in the US. In 2014, according to the AACP there were 130 accredited pharmacy colleges. As of July of 2019, there are now 143 US based colleges and schools of pharmacy with accredited (full or candidate status) professional degree programs, plus one 1 school with precandidate status, for a total of 144 colleges and schools. The Accreditation Council for Pharmacy Education (ACPE) is the national agency recognized by both the Council on Higher Education Accreditation and the US Department of Education, and it is ultimately the agency responsible for accrediting the pharmacy programs.
– Pharmacy positions are becoming much more specialized and diversified.
In 2014 the total number of practicing pharmacists throughout the nation actually working in retail positions fell below 50% for the first time ever to around 44%. The move away from retail pharmacy jobs showed an astonishing increase in pharmacists now working in hospitals (30%) and other practice areas and specialties (25%). Although the newest 2019 numbers released this past July now show a reversal of this pattern with retail pharmacy jobs now comprising an estimated 58%, pharmacists as a profession are constantly assuming greater responsibility in patient care, and more pharmacists are continuing to step outside of their old traditional practice settings by switching jobs.

What is the Actual Pharmacist Job Turnover Average Annually?

Although the only actual number that could be found regarding pharmacist job turnover is perhaps outdated (the study took place from 1983 through 1997), the national average was 11% per year. Perhaps equally important to note was that the pharmacists who left and switched jobs primarily made the change in less than three years. The primary reason for leaving a pharmacy position was attributed to stress and perhaps surprisingly, citing salary for the reason for “job switching” was number four down on the list (following stress, career advancement opportunities, geography and finally salary).

We should also quickly mention the Millennials. Named by Gallup as “The Job-Hopping Generation”, these younger professionals exhibit a tendency never before seen in the history of pharmacy (or other professions for that matter). A 2016 study on LinkedIn showed that Millennials average a change in jobs four times in their first decade out of college. That’s nearly double the rate of the Gen-Xers before them (graduating college between 1985 – 1992) who averaged about two job changes in their first 10 years of work.
Although the past recession may have contributed to this phenomena of “job hopping”, causing many pharmacy graduates into accepting jobs they perhaps were not excited about, the primary motivation according to CNN is that the “Millennials want to move up the ranks quickly. One of the fastest ways to do that is to change jobs. A new role often comes with a more elevated title and a substantial pay raise (15% or more versus 1 to 3% by someone staying in their current role)”.

A “Quick Tip List” to Consider Before Changing Pharmacy Jobs

Today, as the expansion of patient focused healthcare services has changed the entire landscape of the workplace, many new pharmacy job opportunities and career paths are available to a pharmacist to consider and evaluate than ever existed in the past. Retail, hospital, specialty, clinical, mail-order, compounding, nuclear….. the list of possibilities for pharmacy career paths has become almost endless. So here is some “free advice” from pharmacy staffing experts who have been dealing with pharmacists switching positions for over 30+ years now.
1. Take your time. The decision to change jobs or career paths is a major decision. Take the time to explore all the possibilities that are available to you.
2. Start by taking a personal self-audit and consider the following questions:
– What are my short term and long range goals?
– What pharmacy setting appeals to me and is my personality a good fit for that setting?
– What pharmacy sector fits in with my lifestyle?
– What professional and personal growth opportunities are available?
3. The next step is to talk with some pharmacists who practice in the areas of your interest. Who better to ask questions regarding professional development and opportunities than with the pharmacists that are actually practicing in those areas? In today’s world of social media, blogging and online engagement, access to individual professionals has become fast and easy! Take some time and communicate with several individuals who can share their experience and are willing to help fellow members of the pharmacy community on the exciting and changing career paths now available.
4. Lastly, consider trying several different pharmacy job types before actually making the commitment to a specific pharmacy setting. This is where Healthcare Consultants Pharmacy Staffing can help you. At HCC we have been finding that many pharmacists would rather initially “try out” several career path options before deciding on a permanent practice setting. This allows the individual to get actual experience in several different clinical &/or retail settings to see which opportunities fit best with their goals, personality and lifestyles.

Who Can Help You With Switching Jobs?

If you are seriously considering making a change, HCC can help you to “boost” your chances for success. Healthcare Consultants Pharmacy Staffing has been known nationally as a full service Pharmacy staffing agency since 1989. With all the services that we provide to both pharmacies and pharmacists, it is sometimes easy to overlook the fact the we are one of the most successful and respected pharmacy staffing and placement firms in the country. Pharmacy staffing and job placement are our primary business now for over 30+ years. If you are a pharmacist looking for a new position or considering a career change, we urge you to talk with us. With placement positions immediately available, contact us today online or call us at 800-642-1652 to explore how we can help you in your choice of a new pharmacy career path.


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IV Infusion Pharmacies

IV PharmacyIV and infusion pharmacy startups are always at the top of the list when you may be considering opening up a new pharmacy business or an expansion of your existing pharmacy operation. The IV and infusion pharmacies were the primary catalyst to the emergence of both the compounding and specialty pharmacy booms that have been dominating the pharmacy start up marketplace for the past several decades. IV and infusion pharmacies compound medications that are typically administered intravenously, but also provide for drugs to be administered as intramuscular injections and for epidural use.

What Needs Consideration for an Infusion Specialty Pharmacy Startup

The major consideration in opening up an IV and infusion pharmacy is that sterile compounding is a highly regulated area of the specialty pharmacy business and industry. Ever since the terrible meningitis outbreak in 2012 that was linked to the New England Compounding Center (NECC) and resulted in the deaths of 64 patients, IV and infusion pharmacies are under strict guidelines and the scrutiny of numerous federal and state agencies. Formalized IV and infusion preparation training (based on USP 797) is required now for all pharmacists and pharmacy technicians who are involved in the preparation and compounding of all sterile medications such as those produced in an IV infusion specialty pharmacy practice.

The IV and infusion pharmacy primarily compounds sterile medications for patient use in their homes or in a long-term care facility (LCF). Most frequently the patient has a fenestrated catheter inserted and the infusion via the catheter is delivered by one of three methods:
1. Electronic Pumps – typically the medications are pre-mixed from vials and delivered via IV infusion bags using an electronic pump.
2. Elastomeric Pump – these devices deliver the medications stored in a “balloon like reservoir” that is unclamped for delivery of the patient’s IV dosage.
3. Pre-Filled Infusion Therapy – one of latest technologies that delivers a preset (metered) unit dose from a pre-filled IV container.

Additional Statutes and Guidelines Required for Preparing Infusion Meds

Along with all the usual considerations involved in the planning and execution of a pharmacy startup operation to become a successful business venture, an IV and infusion pharmacy must also adhere to numerous additional statutes and guidelines. These include:
503B FDA facility requirements established in the Quality Compounding Act of 2013
USP 797 compliance guidelines
ASHP Guidelines on Home Infusion Pharmacy Services
– The Medicare Home Infusion Therapy Coverage Act (S. 1203 and H.R. 2195)
Additional equipment, supplies, logs and records are necessary. Sterile compounding equipment is a must (such as Laminar Flow Hoods), plus storage and handling requirements pertaining to both the ingredients and the IV drugs prepared must be strictly adhered to. IV and infusion pharmacies additionally must be in compliance with all of these federal and state agencies:
– United States Pharmacopeia (USP)
– HIPAA (The Health Insurance Portability and Accountability Act)
– Federal Food and Drug Administration (FDA)
– Occupational Safety and Health Administration (OSHA)
– Drug Enforcement Administration (DEA)
– The Centers for Medicare and Medicaid Services (CMS)
– National Institute for Occupational Safety and Health (NIOSH)
– Environmental Protection Agency (EPA)

Add into the mix the fact that an IV and infusion specialty pharmacy must also be in compliance with all local, state and federal laws, rules and regulations and the task of starting up a new pharmacy becomes exponentially more complicated, regulated and difficult. It is important to note that there are frequent changes, modifications and additions to both the laws and regulations by these various agencies, yet strict compliance and adherence is a must.

A customized Policy & Procedures manual is a necessity for every IV and infusion compounding pharmacy! As everyone is aware, each pharmacy business is required to have a policy and procedure manual. Every state and most PBMs have specific policy requirements that the pharmacy is expected to incorporate into their manuals. More importantly, the infusion pharmacy is expected to adhere to their own policies and procedures. These must be kept up-to-date and must clearly document that the operation is strictly adhering to all requirements. Merely possessing a generic P & P manual is not enough. This manual must contain the required policies and reflect the actual procedures established to properly and safely operate the specialty pharmacy.

Additional Professional and Accreditation Organizations for Infusion Compounding

Additionally, there are various ancillary professional organizations and accreditation bodies that set the guidelines and best practice standards to ensure the delivery of high quality patient care in regards to IV medication preparation and delivery.
These include:
– JCAHO (the Joint Commission)
– ASPEN (American Society for Parenteral and Enteral Nutrition)
– Medicare
– ACHC (Accreditation Commission for Healthcare)
– PCAB (Pharmacy Compounding Accreditation Board)
– HQAA (Healthcare Quality Association on Accreditation)
– IDSA (Infectious Diseases Society of America)
– CHAP (Community Health Accreditation Program)

Is Additional Training Required?

An additional point that must be taken into consideration is that IV training is now a requirement for all pharmacists and pharmacy technicians who are involved in preparing sterile IV and infusion medications. In fact, according to the directives based on USP 797, formalized training is required for all pharmacists and pharmacy technicians involved in any type of sterile compounding. Many states also now require special licensure for a pharmacist for preparing sterile preparations (and many see this special licensure requirement being the next change on a national level).
Lastly, special permits are also required for the operation of this type of specialty pharmacy practice. One specific application for a permit requires a detailed written response to a list of 21 clinical and operational questions which are based on your Policies and Procedures manual.

How and Where Do You Start?

As with any pharmacy operation, there are numerous factors to consider in the planning, execution and long term success of opening and maintaining a new IV and infusion pharmacy pharmacy business. Planning and proper execution are really the keys to a smooth pharmacy operation being opened and then becoming a successful and profitable business venture. Just a few of the considerations and tasks that are required for any successful pharmacy start-up operation include:
– The creation and review of a business plan
– Guidance regarding type of corporation to form – Limited Liability or LLC, C-Corporation, S-Corporation, Sole Proprietorship or a General partnership
– Startup cost estimates
– Obtaining financing
– Work flow design
– Assistance and guidance with the DEA & State Board of Pharmacy application process
– Creating Policy and Procedure manuals and Continuance Quality Improvement (CQI) manual
– Purchasing the equipment and supplies
– Obtaining legal support
– Staffing (not only the pharmacist, but technicians and ancillary support staff personnel)

As always, please contact us here at Healthcare Consultants if you have any questions regarding establishing or running an IV and infusion specialty pharmacy. With over 30+ years in the pharmacy consulting business, HCC can assist with expert advice in any area of your pharmacy operation or practice. We urge you to contact us today to see how our Pharmacy Consulting services can help YOU. With a full-time staff of in-house pharmacy consulting specialists, HCC can answer any questions that you may have in all areas of your business. Contact us online now or call us at 800-642-1652.


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Cancer Specialty Pharmacy Startups

cancer pharmacyCancer and oncology pharmacies have become a major factor in the rise of specialty pharmacy startups nationwide. Because cancer and chemotherapy medications are typically extremely expensive and complex to both manufacture and compound, it is easy to see why oncology pharmacies have become a cornerstone in the specialty pharmacy industry. Oncology drugs necessitate special storage, handling and administration procedures that must be taken into consideration when starting up a specialty pharmacy or expanding an existing pharmacy operation. Additionally, out of all the specialty pharmacy models, oncology start-ups must consider that this type of specialty pharmacy requires the most clinical communication and interaction with other healthcare professionals, patients and insurance providers. However, the opportunities to create a successful startup pharmacy operation in this specialty pharmacy area are in place and there are numerous success stories. A survey by Zitter Health Insights showed that around 31% of oncology and cancer IV therapies were fulfilled in 2013 by cancer specialty pharmacies. Additionally it was reported that almost 28% of oncology medications were distributed to physicians’ offices or directly to patients to bring to their clinic by oncology specialty pharmacies in 2015.

The Onset of the Cancer Specialty Pharmacy

Historically the oncology medication treatments were administered to cancer patients in a hospital, but this changed dramatically in the early 1990’s. Cancer treatments increasingly moved to the clinic or physician’s office settings, with an estimated 80 – 90% of patients receiving their oncology drugs intravenously outside of the traditional hospital setting. This resulted in thousands of cancer clinics being set up across the nation who were being supplied by several major drug suppliers. The primary oncology drug suppliers were divisions of major wholesalers who dominated the marketplace. The largest of these providers that eventually became known in the industry as Specialty Distributors (SD) included:
– McKesson Specialty Care Solutions
– Cardinal Specialty Pharmaceutical Distribution
– Oncology Supply (owned and operated by the Amerisource Bergen Corporation)
– CuraScript (a division of ExpressScripts)
Then arrived “the age” of oral oncology medications. With the dramatic explosion in the number of oral cancer medications available for oncology treatment during the first decade of the new millennia, oral drugs accounted for a little over 35% of the marketplace by 2011 as reported in Pharmacy Times.
Physicians were focused on their patients who received intravenous medications and oncolytics at their offices and clinics, thus sending patients to their local pharmacies who were really unprepared to dispense the oral cancer medicines. Not only did the retail chains and independent community pharmacies not wish to stock the expensive medications, but there was a definite lack of patient counseling and education regarding the dispensing of these prescriptions. Specialty cancer and oncology pharmacies quickly emerged in the marketplace as a viable solution.

Additional Challenges for Oncology and Cancer Specialty Pharmacy Startups

Along with all the usual considerations involved in the planning and execution of a pharmacy startup operation to become a successful business, an oncology or cancer pharmacy has two additional challenges that must be taken into consideration. The first is the counseling and education involved with the dispensing of these medications. In many instances the specialty pharmacist is at the communication center and the key to a patient’s treatment regimen being a success. In the instance of “brown bagging” (where the cancer specialty pharmacy ships the medications directly to the patient), many pharmacists admitted that they underestimated the amount of time required to counsel and educate patients. It definitely requires the right personality and a pharmacist who is patient and enjoys extensive patient interaction. For “white bagging” (where the cancer specialty pharmacy ships the medications directly to the physician or clinic for the patient’s treatment when they arrive), the same is true. The physician or clinic’s staff members depend on frequent communication with the specialty pharmacist and once again the time required for this essentially vital task being performed well is significantly underestimated in many situations. The cancer regimens presented a challenge to all the healthcare professionals involved in the patient’s oncology treatment by the necessity of the ongoing clinical support that the specialty pharmacist now fills the role of providing.

The second additional challenge faced by the specialty pharmacy business owner that must be considered is the reimbursement from third-party providers. Many third-party providers embraced the cancer specialty pharmacies as a means to controlling costs, while the drug companies saw them as a good way to manage the expensive inventories associated with their products. However, the issues surrounding reimbursement have become extremely complex. It is important to keep in mind that about half of all specialty drug spending falls under the patients’ medical benefit coverage. Add into the scenario the Federal 340B Drug Pricing Program which requires that the drug manufacturers provide the medications at significantly reduced prices and you can start to see the complicated landscape and the “cloudy” issues involved. The drug manufactures embrace the specialty pharmacies, as they have proven effective as an additional outlet to dispense and ship their products to patients and providers. The manufacturers realize that the traditional channel strategy of wholesale distribution of their products will lead to a diminished return on investment for them. The distributor channels obviously are opposed to the cancer specialty pharmacies. They see a significant decrease in their distribution volume, plus decreased profits. If they can get the specialty pharmacy to order through them, then they get to keep the volume, but earn far less profit.
Faced with the dilemma of extremely expensive drugs used for a small proportion of patients, payers have attempted various new strategies designed to control costs. To participate, the specialty cancer pharmacy is faced with the complexity of the reimbursement system. These attempts at controlling costs include such strategies as:
– Formulary specialty tiers.
– “Split-Fill” programs.
In this scenario only half of the first 30 days of a patient’s therapy is covered for payer reimbursement until the patient is proven to be tolerating the drug and positively responding to the drug before treatment can be continued.
– Prior authorization requirements.
– Mandated use of designated specialty pharmacy providers.
To become a designated specialty pharmacy provider in many instances requires certification by the manufacturer of the pharmacy, the pharmacists and the technicians involved in the drug’s storage, handling, compounding and shipping. It must also be noted that trying to become accepted by a manufacturer into their distribution network usually requires a “tremendous” amount of data generation, collection and storage.

The Upside to Opening a New Cancer/Oncology Pharmacy

The upside of these challenges is the fact that in 2018 approximately 85% of Managed Care Plans (MCP’s) had entered into contracting with specialty pharmacy providers in regards to the supply of their oncology drugs. Although as noted above it can be a difficult task, the manufacturers also are embracing the specialty pharmacy business to help increase their market share. The fact that 51.4% of the Managed Care Plans reported using a single, preferred specialty provider is a challenging fact, but many organizations are now taking a very close look at this. One such group known as The Community Oncology Alliance (COA) is a forerunner whose mission “is to ensure that cancer patients receive quality, affordable, and accessible cancer care in their own communities”. They have become a major voice in being “dedicated to advocating for community oncology practices and, most importantly, the patients they serve”.

Find an Experienced and Reputable Pharmacy Consulting Firm to Partner With 

The cancer specialty pharmacy startup is a business and needs to make a profit. Yet the complex challenges discussed present risks that can affect the bottom line (plus result in a cash flow problem that is known in the entrepreneurial world as “the killer of new business enterprises”). Since the oncology specialty pharmacy usually takes on the assignment of benefits from their patients, they bear the burden of obtaining reimbursement by billing the payer. Thus the specialty pharmacy is at risk for incurring the pharmacy costs, and when dealing with such expensive drugs cannot afford to make mistakes or miss opportunities. The point is that as with any pharmacy operation, there are numerous factors to consider in the planning, execution and long term success of starting up, opening and maintaining a new oncology or cancer specialty pharmacy business. The planning and execution are key to a smooth pharmacy operation being opened and becoming a successful business. Just a few of the considerations and tasks that are required for any successful pharmacy start-up operation include:
– The creation and review of a business plan
– Guidance regarding type of corporation to form – Limited Liability or LLC, C-Corporation, S-Corporation, Sole Proprietorship or a General partnership
– Startup cost estimates
– Obtaining financing
– Work flow design
– Assistance and guidance with the DEA & State Board of Pharmacy application process
– Creating Policy and Procedure manuals and Continuance Quality Improvement (CQI) manual
– Purchasing the equipment and supplies
– Obtaining legal support
Staffing (not only the pharmacist, but technicians and ancillary support staff personnel)
As always, please contact us here at HCC if you have questions regarding establishing or running an oncology or cancer specialty pharmacy. With over 30+ years in the Pharmacy Consulting business, HCC can assist your business with expert advice in any area of your pharmacy operation or practice. We urge you to contact us today to see how our Pharmacy Consulting services can help. With a full-time staff of in-house Pharmacy Consultant specialists, HCC can answer any questions that you may have in all areas of your business. Contact us online or call us at 800-642-1652.


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Mail-Order Pharmacy Startups

Mail-Order Pharmacy Startup Consulting Opening Up New Mail Order Pharmacy The startup of mail order pharmacies is on the rise and the opening up of a mail-order pharmacy is becoming an extremely lucrative business model and investment. This specific market segment of the specialty pharmacy “arena” is undergoing rapid growth, rapid expansion, and equally rapid change. Independent mail-order pharmacies are now thriving by specializing in a specific niche or focusing on a particular disease. This means that the the large mail-order pharmacy operations can no longer dominate the marketplace.

The major mail-order pharmacies are associated with various large insurance providers and large retail chains such as Walgreens, Humana, Aetna and Caremark. The three largest are Express Scripts (Cigna), OptumRx (UnitedHealthcare) and CVS Health (CVS Caremark). Historically the majority of specialty pharmacies have contracts with Pharmacy Benefit Managers (PBM), but the number of independent mail order pharmacies specializing in specific niches or diseases is increasing at a rapid pace and thus these independent pharmacies are exponentially increasing in both volume and market share.

What’s Causing the Rise of the Mail-order Pharmacy?

To answer this question, let’s step back a moment first and cite some statistics from our most recent blog post earlier last week regarding the economic forecasts for specialty pharmacies. As was discussed, with a projected annual growth rate of about 20% per year according to the AMCP (American Society of Managed Care), many industry experts state that the specialty Rx industry is still in its infancy.  Spending on specialty pharmacy and services was almost $87 billion in 2012. However, Drug Channels estimated that in 2014 alone, “retail, mail, and specialty pharmacies dispensed about $78 billion in specialty pharmaceuticals.”

To then better focus in on the cause for this spike in the startups of independent mail-order pharmacies across the USA, one will first need to take a quick look at the topics of both Pharmacy Benefit Managers and the repackaging of medications.

Pharmacy Benefit Managers(PBM)

Pharmacy Benefit Managers (PBM) are third party administrators (TPA) of prescription drug programs for commercial health plans, self-insured employer plans, Medicare Part D plans, the Federal Employees Health Benefits Program, and state government employee plans. According to the American Pharmacists Association (APhA), “PBMs are primarily responsible for developing and maintaining the formulary, contracting with pharmacies, negotiating discounts and rebates with drug manufacturers, and processing and paying prescription drug claims”. Their role is to work with government programs and self-insured companies to help reduce drug costs and pharmacy expenses covered by the insurance plan. The problem that has arisen regarding Pharmacy Benefit Managers is that many feel that the PBMs prevent competition. As noted by the National Community Pharmacists Association (NCPA), the pharmacy benefit managers actually have multiple incentives and monetary reasons to prevent their mail-order pharmacy operations from having to compete with the local community pharmacies. As stated in a recent NCPA publication, “pharmacy benefit managers are the only companies that are allowed to process transactions for their rivals, set prices for their rivals, and determine how their rivals will compete”. It is clear that because the pharmacy benefit managers are able to establish both the billing rates and the copayment rates that the retail pharmacies charge their patients, the PBM is able to manipulate the contracts to direct the prescriptions to their own mail-order pharmacy operations for fulfillment. This puts the community pharmacy at a distinct disadvantage.

REPACKAGING OF MEDICATIONS

The repackaging of medications therefore has become a key factor in the emergence of independent mail-order pharmacies. To better understand this, one must note that by repackaging drugs the mail-order pharmacy operation can basically set up their own pricing. This is based on the following facts:
–  Private insurance plans most often use AWP (Average Wholesale Price) for establishing the payment rates.
– The AWP is determined and associated with an NDC (National Dispensing Code) and there typically are multiple AWPs for every drug and medication.
– By repackaging drugs and medications the mail-order pharmacy can create new NDC numbers and then select any AWP they want to use when it comes to billing.

One other factor to consider is that the PBMs control the formulary and the Maximum Allowable Cost (MAC) lists for the health plan provider. The MAC list is basically the pricing ceiling for a drug, or the maximum that a pharmacy can get reimbursed for. The PBMs commonly establish MAC lists for the community pharmacies for generic prescription drugs, but rarely use a MAC list at their own mail -order pharmacies. Once again the community pharmacy must operate at a clear competitive disadvantage and competition is stifled.

So How Does an Independent Mail Order Pharmacy Win?

Many independent mail-order pharmacies have now turned these factors to their advantage and are thriving. Many have become extremely profitable business enterprises by specializing in a specific niche or disease. Examples include cystic fibrosis, hospice, nuclear, COPD and respiratory medications, plus oncology and cancer medications. This specialization has led to increased efficiency, decreased waste, improvements in production and shipping, and ultimately increases in profitability and market share. Additionally, many independent mail-order pharmacies have embraced customer service, thus leading to significant customer satisfaction and patient loyalty. Medication Therapy Management (MTM) programs have also been embraced by many independent mail-order pharmacies to help patients improve in regards to their drug compliance, which obviously results in better medication outcomes.

Who Can Help Me Start Up a Specialty Pharmacy?

All agree that the mail-order pharmacy business model has become a lucrative business venture for many entrepreneurs. Yet there are numerous extremely complex challenges and issues that must be addressed. As with any new pharmacy start-up, the planning and execution are the absolute key to a smooth pharmacy operation being opened and becoming a successful business. Just a few of the considerations and tasks that are required for any successful pharmacy start-up operation include:
– The creation and review of a business plan
– Guidance regarding type of corporation to form – Limited Liability or LLC, C-Corporation, S-Corporation, Sole Proprietorship or a General partnership
– Startup cost estimates
– Obtaining financing
– Work flow design
– Assistance and guidance with the DEA & State Board of Pharmacy application process
– Creating Policy and Procedure manuals and Continuance Quality Improvement (CQI) manual
– Purchasing the equipment and supplies
– Obtaining legal support
Staffing (not only the pharmacist, but technicians and ancillary support staff personnel)
As always, please contact us here at HCC if you have questions regarding establishing or running a mail-order pharmacy. With over 30+ years in the Pharmacy Consulting business, HCC can assist with expert advice in any area of your pharmacy business or practice. We urge you to contact us today to see how our Pharmacy Consulting services can help YOU. With a full-time staff of in-house Pharmacy Consultant specialists, HCC can answer any questions that you may have in all areas of your business. Contact us online now or call us today at 800-642-1652.


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Specialty Pharmacies

Specialty Pharmacy Consultation specialty pharmacy startupSpecialty pharmacies have been designated by numerous industry experts as the fastest growing segment of the pharmacy industry. This is based on the number of new specialty pharmacies opening up nationally, plus the rise in the number of existing pharmacies expanding their operations via the addition of specialty pharmacy services. With a projected annual growth rate of about 20% per year according to the AMCP (American Society of Managed Care), many entrepreneurs are investing in the continued success of specialty pharmacies as a lucrative business model. Yet the industry is still in its infancy according to several experts. Spending on specialty pharmacy and services was almost $87 billion in 2012. However, Drug Channels estimated that in 2014 alone, “retail, mail, and specialty pharmacies dispensed about $78 billion in specialty pharmaceuticals.”

Although we must all keep in mind that it is virtually impossible to come up with an exact number for pharmacies dispensing specialty medications, estimates project that this will quadruple by the end of next year (2020), with spending reaching around $400 billion (or slightly less than 10% of the US health spending in total). Add in the fact that of the 27 new drugs approved in 2013 by  alone by the FDA, 14 were specialty pharmaceutical medications, and just such statistics are reminding many of the famous California Gold Rush of 1848. Perhaps we should call it the “Specialty Pharmacy Gold Rush”? It is clear that the prospect of success regarding starting up a specialty pharmacy is there, but remember that it is directly proportional to the number of specialty pharmacies “panning for the gold” that is rapidly expanding.

Which Specialty Model Is a Lucrative Startup Now?

An analysis in 2012 by UnitedHealthcare reveals that about 51 percent of spending on specialty drugs is for cancer, rheumatoid arthritis, and multiple sclerosis. These are followed by HIV, hepatitis C, respiratory conditions, anticoagulants, growth deficiency, and transplants. Originally, the pharmacies that were classified with the “Specialty Pharmacy” designation were primarily dealing with the preparation of IV and injectable medications. This however rapidly expanded into many other types and models of specialty pharmacies that have proven to be successful business models. A quick look at several lucrative “winners” currently in the specialty pharmacy game are listed below for your review.

Compounding Pharmacies
Dermatologicals were a perfect prescription type for specialty pharmacies to embrace. Any pharmacist can tell you that each dermatologist has their own “secret sauce” that most chain drug stores always turned away. Add in the explosion of compounding opportunities (examples such as penile implant solutions, veterinary medications, the delivery of medications in alternative strengths, dosage forms and flavors for infants are just a few) and the number of compounding pharmacies has increased exponentially in the last decade alone. Compounding pharmacies additionally must meet the 503B FDA facility requirements established in the Quality Compounding Act of 2013, plus meet USP 797 compliance guidelines.

Mail-Order Pharmacies 
This market segment of specialty pharmacies is undergoing rapid growth and equally rapid change. Most of the specialty pharmacies have contracts with Pharmacy Benefit Managers (PBM), but some are independent mail order pharmacies specializing in a specific niche or disease such as cystic fibrosis, hospice, nuclear, COPD and respiratory medications, plus oncology and cancer. The major mail order pharmacies are associated with many insurance providers and large retail chains such as Walgreens, Humana, Aetna and Caremark. The three largest are Express Scripts, OptumRx (UnitedHealthcare) and CVS Health.

IV and Infusion Pharmacies –
Special permits are required for the operation of this type of specialty pharmacy practice. One specific application for a permit requires a detailed written response to a list of 21 clinical and operational questions which are based on your Policies and Procedures. Additional  equipment, supplies, logs and records are necessary. Sterile compounding equipment is a must (such as Laminar Flow Hoods), plus storage and handling requirements pertaining to both the ingredients and the specialty drugs prepared must be strictly adhered to.  As with other types of compounding pharmacies, IV and infusion pharmacies additionally must meet the 503B FDA facility requirements established in the Quality Compounding Act of 2013, plus meet USP 797 compliance guidelines.

Specialty pharmacy startups were again at the forefront of discussions earlier this year after the release of an article by HealthLeaders Magazine (a division of Simplify Compliance). The study stated that the commercial pharmacy spending rate in the USA had risen to a new high that greatly exceeded the previous five year average of a 14% increase. The spending rate increased by over 18%, far exceeding the already optimistic economic projections that analysts were expecting. What’s important to note from the study for our current discussion regarding a specialty pharmacy startup’s viability is the fact that oncology and immunotherapy drugs were cited in the report as the most significant drivers of the higher spending rate seen. One can then extrapolate that data to predict that investments made in the startup of a pharmacy dealing with both oncology and immunotherapy drugs will most likely yield a lucrative return or result. That’s obviously dependent in the end on how well the business startup is planned and executed, plus the proper management of the business and operation afterwards.

How Do I Start Up a Specialty Pharmacy?

Opening and starting up a specialty pharmacy requires both expertise and experience to result in a successful business operation. Yes, it is similar in many respects to starting up a “traditional” retail pharmacy. However, in addition to the list of steps followed in the planning and execution of more “traditional” pharmacies, there are numerous equipment, policies, procedures and operational considerations. How a business owner chooses to get into the specialty pharmacy market is an investment decision. While more and more pharmacies are entering the specialty pharmacy market, the market is not without its challenges. Let a nationally renowned pharmacy consulting firm like Healthcare Consultants help you get the most out of your investment and guide you through the entire process.

Who Can Help Me Start Up a Specialty Pharmacy?

If you’re considering opening or starting a Specialty Pharmacy, or perhaps expanding or turning a portion of your existing pharmacy business into a specialty pharmacy, then Healthcare Consultants can help you! HCC has helped plan and open more specialty pharmacies nationally than perhaps any other Pharmacy Consulting firm in the industry. Plus HCC offers the additional advantage of Pharmacy Staffing and Pharmacy Management, being in the pharmacy recruitment and staffing business for over 30+ years now, as well as being recognized as one of the premier Pharmacy Consulting agencies in the nation. With a proven track record and a history of success, HCC can plan and execute a strategy so you can win in the Specialty Pharmacy arena. Contact us online now or call us today at 800-642-1652 to discuss how we can help you startup, grow and/or expand your pharmacy business.

 


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Relief and Temp Pharmacists

Relief Pharmacists in FL, GA, AL, NC, SC, TXMany pharmacy owners occasionally need a relief pharmacist or temp pharmacist quickly. The issues that many pharmacy owners face finding the right temporary pharmacist are numerous. Perhaps the pharmacy owner is planning a vacation or simply has an emergency situation and needs some help. Or perhaps a staff member quits, has an emergency of their own or simply needs a break. Many of us have been faced with the question of who can help us, and sometimes, help us quickly! Finding a qualified pharmacist to fill in quickly during a crisis or emergency situation and work relief for you is just like buying insurance sometimes: Nobody wants it until they actually need it!

What Are the Issues of Finding Pharmacy Relief Services?

The issues involved that one should think about in the finding a relief pharmacist can be summed up quickly:

– What staffing agency should I call?
Many find that the pharmacy staffing agencies are either very small or very large when needing one. The smaller ones have very limited resources, while the larger ones are harder to do business with as a new client (as they are focused primarily on satisfying their existing regular and mostly larger clients first).

– Do they have experienced and dependable Pharmacists to send for relief services?
Many pharmacy staffing agencies have a very limited pool of candidates to choose from. Being limited geographically may mean that their available resources are already being utilized, or that the pharmacists that they can offer may not be dependable. What could be worse than expecting some peace of mind while dealing with a personal emergency situation and getting a call that the temporary pharmacist was a “no show” that day?

– Quality choices that meet your specific needs are a major concern.
If you are operating any type of specialty pharmacy (compounding, IV infusion, oncology, mail order, etc.) you may realize that not just any relief pharmacist can walk in and function in your environment. This may be true in many retail community pharmacy environments also. Even with experience, is the pharmacist of the quality and possess the required experience and skills that you (and your patients) expect?

– Pricing and costs are always a consideration!
A major factor in choosing a pharmacy staffing agency to meet your relief needs is obviously the cost. In certain instances the pricing may be a secondary issue, but let’s be realistic: Price is always an issue. When it comes to supply and demand, an agency with few available candidates will charge more. Travel charges may also be added on that will inflate the cost of the fill-in pharmacist. Also keep in mind that in the 1990’s the average salary for a pharmacist was about $50,000. Comparing that number to the average pharmacist’s salary of between $112,000 – $119,000 in 2016, one can easily draw the conclusion that perhaps the cost of a relief or temp pharmacist prohibits a pharmacy owner from ever going on a vacation or having an emergency!

– Seasonality is sometimes a major concern when getting pharmacy relief for your business.
In many cases seasonality will affect both the availability and the price. High demand during certain times of the year are a normal factor on both pharmacist selection and cost. Holidays are a great example. How many qualified pharmacists want to actually spend the major holidays working? Recent statistics show that fewer and fewer pharmacists will give up their precious “free time” than ever before.

Fewer Pharmacist To Choose From?

Being in the pharmacy staffing industry for over 30+ years now, our experience is that there are far fewer pharmacists who choose to work extra jobs as relief. The same is true of those that choose to work only in temporary pharmacy staffing positions.

Based on a survey released by the AACP (American Association of Colleges of Pharmacy) in 2014 called the National Pharmacist Workforce Study, statistics revealed that only about 8% of all pharmacists nationally worked a second job as a relief pharmacist. Back in the 1990’s this number was estimated to be around 15%. Additionally, the average extra time worked by a pharmacist as relief was an estimated six hours weekly. This represents a significant decrease from the estimated 10 – 12 hours that pharmacists “moon lighted” back in the 1990’s. The study noted that a significant decrease regarding available pharmacists working part-time or as relief was seen every year since 2009. One can only see this trend continuing, leading to a smaller pool of pharmacists to choose from should you need them.

Being Prepared Versus Reactive

To avoid future problems when looking for a relief pharmacist and for available qualified pharmacists to meet any temporary needs you may have that arise, one must embrace the following adage that most major companies have learned over time: Hiring is an ongoing process not event. Another way of saying it is be prepared. Here at HCC Pharmacy Staffing we have been actively “preaching” to both clients and potential clients to be pro-active when it comes to the issue of getting a dependable and qualified relief pharmacist in place for when the need arises. Yet the reality is that the majority of pharmacy owners are reactive and not prepared when the time comes. The old cliche that has become HCC’s tagline over the past 30+ years is that “an ounce of prevention is worth a pound of cure”! This certainly applies to getting an experienced and dependable temporary pharmacist quickly when the situation requires one.

About Healthcare Consultants Pharmacy Staffing

At Healthcare Consultants Pharmacy Staffing we have been helping pharmacies throughout the Southeastern United States with temp and relief pharmacists for over 30+ years now. HCC centers its focus primarily on the following six states:
– Florida
– Georgia
– Texas
– South Carolina
– North Carolina
– Alabama

We encourage you to be pro-active in regards to the issue of getting dependable and qualified pharmacists for relief when the need arises for you. Healthcare Consultants Pharmacy Staffing has been a national leader in regards to temporary Pharmacist staffing and is known as a “full service” Pharmacy staffing company since 1989. With all the services that we provide to pharmacies, it is sometimes easy to overlook the fact the we are one of the most successful and respected pharmacy staffing firms in the nation. Our pool of qualified and dependable pharmacists available covers all aspects of job types: retail, hospital, clinical and specialty pharmacies.

Call us today at 800.642.1652, or contact us online to talk with our experienced staff to start a discussion on how we may be able to help you. That way when you do need a temporary or relief pharmacist, help is only a phone call away!


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Hospital Pharmacist Jobs

Hospital Pharmacist JobsHospital jobs and positions for pharmacists in clinical settings are becoming lucrative opportunities as a clearer job market future emerges in the pharmacy profession. As discussed previously, the 2018 pharmacist job statistics clearly indicated that there would be a shift over the next decade from retail to hospital employment opportunities for pharmacists, plus a significant surge in the demand for RPh’s in all hospital, clinical and institutional settings.

As documented by the latest US Department of Labor (Bureau of Labor Statistics), currently around fifty-eight percent (58%) of all pharmacists work in a retail job or community drug store environment. What’s truly important to note, however, is that this is well down from the 65.2% reported almost a decade ago back in 2010. Meanwhile approximately twenty-six percent (25.8%) of all US pharmacists now work in jobs that are located in a hospital, clinical or home health settings. Once again, what’s truly important to take note of is the fact that, while retail pharmacist jobs dropped, hospital pharmacists rose to almost twenty-six percent (25.8%) in 2018 as compared to around twenty-three percent (23.2%) that was seen back in 2010.

The predicted shift is being fueled by hospitals and Health Care Systems and major hospitals pursue the enormous and lucrative specialty pharmacy dispensing revenues. In 2018, a staggering twenty-percent (20%) of hospitals owned a specialty pharmacy. Compare that with the fact that only three years prior in 2016 less than nine percent (9%) of hospitals owned a specialty pharmacy.

What Do the Pharmacist Job Statistics Predict?

These US Department of Labor statistics clearly indicate that the current trends are not an anomaly and that outcome will continue to be towards an increasing percentage of new jobs for the hospital sector and its practitioners. The latest USDL statistics reported that there will be a very small or minimal increase in the expansion of retail pharmacy jobs seen over the next ten year period (estimated at less than 1%), and that the retail job market for pharmacists will become rather stagnant. On the “flip side” is the the prediction that there will be well over a ten percent (10%) expansion in the number of hospital jobs for pharmacists seen over the next decade. Several medical employment and staffing experts are even predicting that a thirteen to fifteen percent (13-15%) increase is not unrealistic.

Why Shift From Retail to Hospital Pharmacy Job?

Hospital pharmacists historically were paid salaries that were lower (sometimes significantly) when compared to the salaries for retail, community, independent and chain store pharmacy positions. Now the reverse of this is being seen. Factoring in various parameters such as the longevity of being in a position, the skills required for the position and the duties being performed by the pharmacist on staff, plus certain geographical considerations, hospital pharmacist salaries now surpass those of most retail pharmacist jobs. Plus, hospital pharmacies also offer a wide range of areas for both advancement and growth that simply cannot be found in the retail pharmacy business environment.

Basically it is simply a matter of the old economic rule of supply and demand. While the total supply of pharmacists is increasing, the demand is shifting to skilled hospital RPh’s and jobs in specialized positions. The increase in supply is due in part to both the increased number of students graduating with RPh degrees, plus the decreased number of active pharmacists retiring. The number of pharmacy graduates has significantly increased as the number of pharmacy schools has increased. In the late 1980’s there were a total of only 72 accredited pharmacy schools in the nation. As reported by the AACP (American Association of Colleges of Pharmacy) there now exists a total of 130 accredited pharmacy schools offering a B. S. in Pharmacy degree in the United States. Additionally, as the average age of retirement continues to increase (from previously about 62 years of age to over 70 years old now), fewer vacant job positions and openings are becoming available to be filled.

If YOU Are Considering Switching From Retail To Hospital Pharmacy

If you are currently thinking about your own future in the pharmacy profession and considering a switch or transition from a retail to a hospital setting, please take a moment to consider the following:

– In some states additional licensure requirements are required for certain hospital, clinical and nursing home positions. Using Florida as an example, to become the Director of Pharmacy in a hospital or work as a consulting pharmacist in a nursing home, a Consulting Pharmacist licence is additionally required. In Florida, as specified in Rule 64B16-26.301, an RPh must successfully pass an exam after taking an approved twelve hour course, plus then must work under a preceptor for three consecutive months to be evaluated and assessed (within one year of passing the exam). Additionally, the pharmacist must obtain a minimum of forty training hours, of which sixty percent (60%) must take place onsite at an institutional or hospital pharmacy holding a permit.
– The hospital pharmacy environment is not the “slow paced” job that many of us as pharmacists remember from the “good old days”. Perhaps it really never was. Today’s hospital pharmacy positions are conversely a fast paced work environment that require a high energy level and extended periods of concentration and focus.
– Hospital hours can be a major negative to many RPh’s lifestyles. This is especially true for new employees that are typically hired to work on the “graveyard shift” in order to get a position at a hospital (in order to get their “foot in the door”). Remember that a hospital never closes, even on major holidays (although this is also true for many large chain drug stores as well these days).
– Although you may think that switching from a retail pharmacy job means no longer having to deal with sick patients and difficult customers who are always in a hurry to get their prescriptions, keep in mind that doctors, nurses and other various members of the hospital’s health care team can also sometimes be extremely difficult to deal with.
– Certain hospital pharmacy activities (such as preparing IV solutions, infusions and other sterile medications in a Laminar-Flow Hood) can be very taxing on an individual. Pharmacists who have back pain or problems sometimes find that positions like this are extremely hard to work at for long periods of time.
– Keeping current is hard in clinical settings. Changes in hospital pharmacy occur more quickly than elsewhere. It is essential that the hospital pharmacist continuously read clinical journals, articles and continue getting education and training on a regular basis.

How Can You Prepare to Switch From Retail to Hospital Pharmacy?

For a more in depth discussion of how to get yourself ready to switch from a retail to a hospital pharmacy career, please visit our previous post on Tips for Pharmacists Switching Jobs. Here are some of suggestions that you may want to consider trying:
1. Take or attend a Continuing Education class that covers information in the areas of hospital or clinical settings that may be of interest to you.
2. Attend a hospital pharmacy conference. There are numerous national and state hospital pharmacy organizations that offer annual conferences. Examples include the American Society of Health-System Pharmacists (ASHP), the American Society of Consultant Pharmacists (ASCP) and the American College of Clinical Pharmacy (ACCP).
3. Do some job “shadowing”. “Test drive” the job before you make a decision to actually switch. Find pharmacists in your area who practice in a hospital setting. See if job “shadowing” is allowed and perhaps spend some time at their place of work to experience what a typical day can look like at their job.
4. Read. Sometimes simply reading about a particular job setting or environment can help you get a better picture of what the job really is all about.

Who Can Help You Make A Switch?

If you are seriously considering making the change from retail or community pharmacy to hospital or institutional pharmacy, HCC can help you to “boost” your chances for success. Healthcare Consultants Pharmacy Staffing has been known as a full service pharmacy staffing company since 1989. With all the services that we provide to both pharmacies and pharmacists, it it sometimes easy to overlook the fact the we are one of the nation’s most successful and respected pharmacy staffing, pharmacist recruitment and direct hire firms in the pharmacy employment area. Pharmacy staffing and job placement have been our primary business now for over 30+ years. If you are a pharmacist looking to switch to a new position or area of practice, we urge you to talk with us. With positions immediately available, contact us today online or call us at 800-642-1652 to get started.


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Emergency Relief Pharmacists

relief pharmacists in FL, GA, AL, NC, SC, TXEmergency relief pharmacists are always in demand, but the recent announcement last week in California that over 1,400 Pharmacy Practice Exams were invalidated is already having a “ripple effect” regarding the profession’s ability to meet emergency needs. The students that were impacted make a valid point that many have lost job opportunities and money because of the exams being invalidated. Many students are facing repayment of their student loans coming due before they’re able to afford repaying them. Yet on the “flipside” of the story is the effect this situation has on numerous employers like pharmacy owners and managers. It’s important to always keep in mind that in situations such as these the end result can be a possible shortage of pharmacists available to do temporary and relief work in some emergency situations.

Temporary Relief Pharmacists in Emergencies

Needing temporary pharmacists during emergency situations can sometimes pose what seems like insurmountable obstacles to the pharmacy owner and manager. Last year in 2018 the hurricanes in both Texas and Florida had triggered discussions with several HCC clients regarding various scenarios and situations that can occur when an emergency relief pharmacist can be of critical importance to your drugstore even being open for business. Because a pharmacy can not legally be open for business without a registered pharmacist on duty, sometimes the pharmacy owner or store manager is faced with the dilemma of finding a pharmacist quickly or having to close the pharmacy’s doors and shut the business down until a pharmacist can be found.  Emergencies such as the severe weather that accompanies a hurricane can prevent a pharmacist scheduled to work a certain shift from returning safely from evacuation if it’s required. This also applies if the pharmacist was on vacation and severe weather leads to the closing of airports that will simply impede or delay his or her return to work.

Additionally, the death of a family member, personal illness, accidents and other unforeseen events can lead to emergency situations that can force a pharmacy to shut down. This not only results in lost business, but can cause severe stress and frustration to loyal customers and patients who rely on the pharmacy being open for their medications and health needs. This can be even more critical in rural communities and small towns where sometimes only one pharmacy is open and operates. With no pharmacists to rely on for “back-up”, emergencies from not having a registered pharmacist available can quickly turn into an escalating crisis for an entire community.

Why Use a Pharmacy Staffing Agency?

In the past it was often the case that a pharmacist’s co-workers would simply fill in when needed to. To cover for an illness, vacations and situations like a death in the family, all of the other pharmacists simply worked overtime or called their friends to fill in. Yet for several reasons this has shifted to the utilization of pharmacy staffing agencies and staffing firms over the past decade.

The first reason is that several recent studies have linked long shifts and hours worked by pharmacists to severe increases in medication errors. In one study published by the National Association of Pharmacy Regulatory Advisers (NAPRA) it was noted that “pharmacists who are overburdened and understaffed present a very real threat of harm to the patients who depend on them”. Another study performed at the Houston Methodist Hospital documented that an exponential relationship can be seen between a pharmacist’s workload and working long shifts to an alarming increase in medication dispensing errors. Some states are even considering legislation over the past several years regarding setting limits on how many hours per shift and hours a week that a pharmacist should be allowed to work.

The second reason cited for the shift to using pharmacy staffing agencies is that overworked pharmacists have been shown to “burn out” and to quickly develop a negative attitude toward their profession. A great article in Pharmacy Times noted that excessive overtime, long shifts and being on-call constantly, all contribute to the extremely high rate of “burn out” seen in the pharmacy profession. The result is that more and more pharmacists are choosing not to work part time jobs or do relief work any longer.

Lastly is the expense and cost. By using a pharmacy staffing agency for relief pharmacists, the pharmacy can save on all of the following:
– Hiring expenses and the time required
– HR expenses such as criminal background checks, license verification, drug screening and paperwork
– Payroll taxes
– Accounting expenses
– Insurance
– Overtime pay
Some accounting experts estimate that all of the above expenses can add up to an increase of over 60% per hour when compared to hiring a pharmacist on staff paid by the hour.

Choosing an Emergency Pharmacy Staffing Agency

As with all other vendors, choosing the right pharmacy staffing agency is critical. You want one that is not too small as to be geographically constrained and that has a limited number of viable pharmacists that meet your specific needs. You also want one that is not too large and therefor is not service oriented when dealing with a “smaller” clients immediate needs.

The perfect choice if you’re pharmacy is located in the Southeast is HealthCare Consultants Pharmacy Staffing. Our emergency pharmacist staffing service is available 24 hours a day, 365 days a year. HCC maintains one of the largest active pools of emergency pharmacists in the nation, thus allowing us to quickly locate available, qualified and reliable pharmacists in the following states: Florida, Georgia, Texas, North Carolina, South Carolina and Alabama. Our proprietary online system allows us to match your needs with the most qualified candidate to work relief during your emergency. HCC also ensures that all of our emergency pharmacists comply with all HIPAA requirements and maintain professional liability insurance. As always, with HealthCare Consultants Pharmacy Staffing, your satisfaction is guaranteed!

Please also note that HCC can fill all of your emergency relief staffing needs regarding pharmacy technicians (in Florida only). HCC has been the leading provider of qualified, registered, licensed and professional pharmacy technicians (CPhTs) in Florida since 1989. As with emergency pharmacists, satisfaction with our emergency pharmacy technician staffing is guaranteed!

We strongly urge you to be proactive regarding establishing a relation with us now (this way all required paperwork is completed before an emergency situation actually occurs). Then, when you require an emergency relief pharmacist, HCC will be ready to meet your needs so that you can relax and rest easy. Call us now at (800) 642-1652 or take a moment and Contact Us Online and an HCC in-house staffing consultant will contact you as soon as possible to discuss all of your emergency and staffing needs.

 


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