NCPA Digest: A roadmap for independent community pharmacies

In towns and cities across America, independent community pharmacies treat patients like family, promote safe and effective medication use, and actively participate in community life.

But these are challenging times for community pharmacy. Declining prescription drug reimbursements along with stagnant prescription volume reflects a changing marketplace that is forcing pharmacy owners to adjust their business model. Now more than ever, community pharmacy owners must consider options to diversify revenue while continuing to focus on evaluating the economics of third-party reimbursements. Their participation and value to their communities continues to be essential while they are looking to their peers and others to find new and better ways to manage their businesses.

With that in mind, the National Community Pharmacists Association and Cardinal Health recently published the 2019 version of the NCPA Digest, quantifying and profiling what makes community pharmacies successful and distinctive.

The Digest is designed to help community pharmacy owners better manage their businesses by providing facts, figures and profiles — essential data that describes the impact that community pharmacies have on patients and the places they serve.

For more than 80 years, the Digest has provided the most comprehensive report available on the state of the independent community pharmacy, allowing pharmacy owners to make prudent business decisions as well as equipping elected officials with the information they need to craft sound policy.

One of the innovations in the industry is that many community pharmacists have formed clinically integrated networks of pharmacy providers – known as CPESN® networks – to forge even stronger relationships with patients and their physicians. CPESN network pharmacies provide the integrated care and enhanced services that improve overall patient care, especially those with complex, chronic illnesses.

While NCPA members received early access to the Digest at the NCPA Annual Convention in October, all NCPA members can now access a copy at www.ncpanet.org/digest using their NCPA membership ID and password.

What the data says

The 2019 NCPA Digest  sponsored by Cardinal Health is a comprehensive overview of independent community pharmacy in the 2018 calendar year. It focuses on three major areas: Marketplace scope, health care services offered, and community involvement of local pharmacy owners and staff. A quick summary of those findings:

Independent community pharmacies remain a major segment of the overall pharmacy market – a $75.8 billion marketplace. They represent 35 percent of U.S. retail pharmacies. In total, they number 21,767, including single and multiple store pharmacies, family-run regional chain pharmacies and individually owned and operated franchisees.

Thirty-two percent of independent community pharmacy owners have ownership in two or more pharmacies, and the average number of pharmacies in which each independent owner has ownership is two.

More than 250,000 individuals are employed on a full- or part-time basis by these pharmacies, bolstering state and local economies and tax revenue. Prescription drugs are their focal point, representing 93 percent of total sales revenue.

Independent community pharmacists continue to be vital health care providers to patients and are involved, dynamic leaders in communities of all sizes, including both metropolitan and rural areas. In fact, 74 percent of independent community pharmacies are located in population areas of 50,000 or less.

• Prescription volume was virtually flat going from 59,137 in 2017 to 58,823 (189 per day) in 2018.
• 54 percent of total prescriptions are covered by the Medicare Part D and Medicaid programs.
• 91 percent of community pharmacies are offering some type of medication adherence program.
• 16 percent of independent pharmacies offer patient education classes for multiple patients at one time.

• Independent community pharmacists play an important role in caring for the nation’s 47 million seniors. They provide pharmacist care for seniors in nursing homes, assisted living facilities, hospice and those living at home. They also provide many specialty services for seniors, including nutrition assessment and support, intravenous therapy, durable medical equipment and ostomy supplies. In 2018, 43 percent of independent community pharmacists provided services to the residents of long-term care facilities.

• Costs associated with chronic illness are a major driver of rising health care costs in the U.S. For most of the patients with chronic illnesses, medications are the most cost-effective course of treatment, yet many patients don’t take their medicine as directed. To help combat non-adherence problem in the U.S. and improve patient health, 91 percent of independent community pharmacies have deployed comprehensive adherence programs. Nearly 79 percent offer medication synchronization services to their patients, which is the process of aligning all of a patient’s medications to refill on the same day of each month, in addition to an appointment with the pharmacist.
• 94 percent of independent community pharmacies offering med sync services synchronize all chronic medications to a single monthly pick-up date. In addition, 60 percent report calling patients 4-10 days in advance of the monthly pick-up date.

• Independent community pharmacies are playing a major role in the rapidly growing specialty pharmacy market. Thirty-nine percent of independent community pharmacies report dispensing specialty medications. The top disease-state specialty medications dispensed by these pharmacies include rheumatoid arthritis (83 percent), HIV (54 percent) and multiple sclerosis (40 percent). These pharmacies provide high-touch care to the patients in their local communities who need these very specific customized medications.

• As the emphasis on preventative care continues to grow, many states are expanding the role of pharmacists in providing point-of-care-testing. Offering these services provides opportunity for pharmacies far beyond the revenue that is generated from this service. Pharmacy-based point-of-care testing helps build a relationship based on trust between the patient and the pharmacist. The top four point-of care services provided are Influenza (13 percent), rapid strep (12 percent), cholesterol screening (10 percent), and hemoglobin A1C (6 percent).

Independent pharmacies are often revered as pillars of their local communities, and the 2019 NCPA Digest sponsored by Cardinal Health supports that perception. Sixty-five percent of all community pharmacy owners donated to at least five local organizations, with 32 percent donating to 10 or more local organizations. These small businesses impact their local economy not only through creating jobs, but also by contributing their time and treasure to their communities. Pharmacy owners and their team members donate their time as volunteers, coaches and leaders, demonstrating their roles as active, involved and caring members of their communities.

What makes a successful community pharmacy? The answer goes far beyond just the ability to dispense medications.

Being a successful community pharmacy means having roots in a community and being a part of the civic, social and economic fabric of a place. It includes having a compassionate, relationship-oriented team whose members are trusted advisers to pharmacy patients who are also their friends and neighbors. Now more than ever, it means offering vital patient services that fill a health care void in communities across our nation.