2017 NCPA Digest: A roadmap for independent community pharmacies

“If you can’t measure it, you can’t manage it,” goes the old business axiom.

With that in mind, the National Community Pharmacists Association and Cardinal Health published the 2017 NCPA Digest.

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The Digest helps community pharmacy owners manage their businesses better by providing facts, figures, and profiles — essential data that describes the impact community pharmacies have on patients and the communities they serve. It’s in these communities that independent pharmacies have their greatest effect, not only economically, but through civic contributions that help make their communities better places to live.

For more than eight decades, the Digest has provided the most comprehensive report available on the state of independent community pharmacy, allowing pharmacy owners to make prudent business decisions and equipping elected officials with the information they need to craft sound policy. The health care landscape has changed dramatically since the very first Digest. Through it all, the devotion and care independent pharmacists show to their patients and their community has remained a steadfast anchor.

Publishing the Digest requires countless hours over many months, and significant expense. It would not be possible without the sponsorship of Cardinal Health, for which NCPA is very grateful.

The Digest is essentially a compilation of data provided by independent community pharmacy owners across the country who respond to NCPA’s annual survey. We greatly appreciate the time these NCPA members take to share information that can help advance their profession.

NCPA members got early access to the Digest at the NCPA Annual Convention in October. NCPA members can access a copy at www.ncpanet.org/digest using their NCPA ID and password.

The 2017 NCPA Digest is a comprehensive overview of independent community pharmacy in the 2016 calendar year focusing on three major areas: 1. marketplace scope; 2. health care services offered; and 3. community involvement of local pharmacy owners and staff.

Independent community pharmacies remain a major segment of pharmacy – an $80 billion marketplace. These pharmacies represent 36 percent of U.S. retail pharmacies. In total, they number 22,041, including single and multiple store pharmacies, family-run regional chain pharmacies, and individually owned and operated franchisees.

Twenty-nine 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 1.96.

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 92 percent of total sales revenue.

It’s noteworthy how many independent community pharmacies care for underserved populations. Eighty-one percent of independent community pharmacies are situated in population areas of 50,000 or less.

• Prescription volume decreased from 60,493 prescriptions annually in 2016 to 59,746 in 2017, likely due in part to 90-day refill requirements, patients being steered to PBM-owned mail order pharmacies, and exclusionary pharmacy network arrangements.
• Generic drugs comprise 84 percent of all prescriptions dispensed.
• Fifty-two percent of total prescriptions are covered by the Medicare Part D and Medicaid programs.
• Ninety percent of community pharmacies are offering some type of medication adherence program.
• Below-cost reimbursements, exacerbated by DIR fees in Medicare Part D, contribute to gross margins falling by 5 percent over the past five years.

Independent community pharmacies are easily accessible providers of prescription drugs, medication counseling and other important health care services. The 2017 NCPA Digest captures the types of services they typically offer.

Independent community pharmacists play an important role in caring for the nation’s 46.2 million seniors. They provide pharmacist care for seniors in nursing homes, assisted living facilities, hospice, and home-based care. They also provide many specialty services for seniors, such as nutrition assessment and support, intravenous therapy, durable medical equipment, ostomy supplies, and pain management. By thinking innovatively, independent community pharmacists provide needed services and improve their business financially. In 2016, 44 percent of independent community pharmacists provided long-term care services to the residents of LTC facilities.

Costs associated with chronic illness are a major driver of rising health care costs in America. For most of these chronic illnesses, medications are the most cost-effective course of treatment, yet many patients don’t take their medication. To help combat the $290 billion medication non-adherence problem in the U.S. and improve patient health, 90 percent of independent community pharmacies have deployed comprehensive adherence programs, with nearly 77 percent offering medication synchronization services to their patients. The med sync or appointment-based model is the process of aligning all of a patient’s medications to refill on the same day of each month, coupled with an appointment with the pharmacist. Ninety-four percent of independent community pharmacies offering med sync services report synchronizing all chronic medications to a single monthly pick-up date, and 58 percent report calling patients 4-10 days in advance of the monthly pick-up date.

Independent community pharmacy is playing a major role in the rapidly growing specialty pharmacy market. Thirty-nine percent of independent community pharmacies dispense specialty medications. The top disease state specialty medications dispensed by these pharmacies include rheumatoid arthritis (85 percent), HIV (55 percent) and hepatitis C (45 percent). These pharmacies provide high-touch care to the patients in their local communities who need these medications.