- Joined
- Feb 27, 2006
- Messages
- 2,243
- Reaction score
- 229
Illinois got rid of the triplicate requirement quite a while ago.
Update on our store!
- Thread starter Doctor M
- Start date
- Joined
- May 25, 2009
- Messages
- 175
- Reaction score
- 0
.
Last edited:
We are using Rx30 as our computer vendor...Rx30 is pretty simple to use and is windows based...It was also within our budget when we were looking at systems...we bought the system outright, cash...This is important cause we just leased an RMS cash registrar system...Pretty nice system...lets us take FSA cards which will attract many more patients to us, especially the school system employees in the area! QS1 was way too expensive, up in the range of $24000! Rx30 was around $8000.
what are you using now?
I work at CVS nowbut am in the first stages of opening a new independent. It's VERY overwhelming!
Yes it is...When my business partner and I started the process, it was daunting...we first renovated the whole building...then I started on the paperwork..Oh my god...I spent every minute that i wasnt at CVS working on the licenses, State and DEA, and on the INS companies. Medicaid was a nightmare...Fingerprints, Background checks, sign here, sign there, date here, date there...Jeez...We signed our lives away!
You should look at Rx30...good system good price!
OH HELL YES!!! I cannot even begin to tell you how much better is...I wish I could teach a class on how to start your own independent...Then we could take the profession back from the chains...hmmm...thats not a bad idea...
I still remember the first claim I ran when we opened...paid claim for albuterol neb! How exciting!
all I can say is that its a great learning experience...you're gonna make mistakes and it will cost you money...but it's all part of the learning experience!
Thanks!!
- Joined
- May 16, 2009
- Messages
- 1,449
- Reaction score
- 1,233
Great work Doctor M!
Apologies if this was already answered in this thread, but how many hours a week would you say you put into your business? What responsibilities do you have when your not the dispensing Pharmacist?
Apologies if this was already answered in this thread, but how many hours a week would you say you put into your business? What responsibilities do you have when your not the dispensing Pharmacist?
We work everyday...We are still in the "probationary" period...What this means that although we are stable, we are not out of the woods yet...Since we picked up the ALF account, we spent a lot of money on the new drugs (psychiatric drugs). As soon as the Ins companies catch up, we will be 110% ok. See, although we are doing great, filling 80-100 daily, we need to be careful because the ins companies dont pay quickly...If you're not careful, your cash flow can be severely diminished...if your cash isnt flowing in and the drug bill comes in, well, then you have a slight problem...The first 6 months was crucial...nerve racking...nail biting...but we survived...
Why do we work everyday? Because we want to know what is going on with our business...Are we making money...are we losing money on any claims? Where do a lot of price comparing with CVS and Walgreens; that takes time! We are also in the process of medicare accreditation and that is very time consuming! Also, we had to do a little renovation since we picked up the ALF account...We had to make room for the new drugs and blister packs! Let me very clear that i dont consider this work...compared to working for the chains, im not nearly as tired as I was working for CVS...We get to sit down and eat lunch...We have a grill in the back...we grill steaks from time to time...This past week, I put in many hours, but i know that in 2 years, all this work im putting in will pay off...
- Joined
- Sep 18, 2004
- Messages
- 254
- Reaction score
- 2
UM, it's not just the independents.... not sure why the chains would be any "MORE" honorable about filling any number of C2s, esp if it means a sale of $2000 CASH in today's till....
- Joined
- Apr 27, 2005
- Messages
- 604
- Reaction score
- 6
If you work at a chain where the pharmacists fill these rxs then it is the pharmacists who obviously don't care about dispensing fake rxs. They are gonna get paid the same whether they fill them or not, an independent gets to keep the money in their pockets. The chains of course want you to fill them to make money but if I turn them away it doesn't affect my salary. Also the ones I turn away aren't going to complain because their doing something illegal.
First, it is in the best interest of the independents to not fill "fake" rx's and know about it...You will be cut off so quickly by the wholesaler you have no drugs coming in. The wholesaler will hold your order when you are ordering too many bottles of oxycodone...Its called "held pending DEA regulatory review"...We have no vested interest in filling "iffy rxs" cause we are in this business for the long term...
Second, when i worked for CVS, script count was extremely important to them...We filled what we believed to be legal rx's to patients...Technology nowadays allows for fakes to get around and they look sooooo real...Its nearly impossible to police them and the last thing i wanna do is deny someone pain medication when they were duly entitled to it...It disgusts me when pharmacists will lie to a legitimate patient about having in stock medication...Drug dealers can go to hell and i will not service them...
SUCOP in Louisville, KY has professional Fridays. I bet this is something that administration would like to have lectured to their students one day.
Very interested with your ownership posts. I have seen a bunch of pharmacies close, med. shoppes and a bunch of independents. I also know of pharms that were going to buy the stores from existing owners. the banks would not loan them the money based on tax returns etc of the stores. also, accountants would not recommend buying them. these were stores doing 700 to 1200 rxs per week. Perhaps these owners were just tired of it. Perhaps they didn't manage things well and paid themselves a bit to much. Perhaps Doctor M and his partner will start a rebirth of independent pharmacies. One can only hope.
- Joined
- Oct 28, 2008
- Messages
- 2,569
- Reaction score
- 40
I'm sure that Prof. Fiebelkorn would love to have you do that in his management class...he's adding a second semester starting next year.
yes, ive heard...i am very interested to see how it turns out! It will be a great class...
- Joined
- Oct 21, 2006
- Messages
- 142
- Reaction score
- 0
Not all things can be taught in a classroom, and starting a business is one of them. I believe you either have a "natural" business oriented mind, or you don't.
Most of the most successful business owners I know only have just high school education, started very small and building their empires over time. Conglats to Dr. M, very inspirational. Moreso for being a UB alumni!
- Joined
- Mar 20, 2010
- Messages
- 12
- Reaction score
- 0
Dr M, this is the post I am looking for. Thank you for taking the time to combat the doom and gloom that persists on this forum. I was hoping we would see more stories like this since my first week of pharmacy school when they told us that the slowed growth rate of the chains is putting downward pressure on job prospects. Funny that 20 years ago, accelerated growth was a "concern" now slowed growth causes dread. These people cannot be pleased! Our profession is fundamentally sound. I think this "surplus" (although I've never heard of a pharmacists sitting at home unemployed) will in fact re concrete the independant pharmacist in communities throughout this country. I am a 2nd generation pharmacist (my mother is a UB graduate incidentally!) She would jump at the chance to go into partnership with her son--I hope to see this turn into a reality. Are you strictly a dispensing pharmacy!? If so these numbers are even more exciting. I cannot imagine the furthered growth potential you could realize by tapping into compounding, MTM, DM management, etc. Dr M you are an inspiration to all bewildered PharmD students!
I do have a few questions for you, in the last year or so I have been researching some of the franchise/wholesaler partnerships out there. Med Shoppe seems a little outdated and less than desirable. Good Neighbor seems decent since you don't have to explicitly be a Good Neighbor pharmacy you can just reap the benefits of being associated with them. However, HealthMart (not crazy about the name and how much the marketing feels pseudo-chain) seems really lucrative. You pay a flat fee/mo and there is a 90 day back out clause, that seems appealing. As a newly minted independent pharmacist, what do you think of these companies?
Sorry for the drawn out post.
Respectfully,
MDJPharmD
I do have a few questions for you, in the last year or so I have been researching some of the franchise/wholesaler partnerships out there. Med Shoppe seems a little outdated and less than desirable. Good Neighbor seems decent since you don't have to explicitly be a Good Neighbor pharmacy you can just reap the benefits of being associated with them. However, HealthMart (not crazy about the name and how much the marketing feels pseudo-chain) seems really lucrative. You pay a flat fee/mo and there is a 90 day back out clause, that seems appealing. As a newly minted independent pharmacist, what do you think of these companies?
Sorry for the drawn out post.
Respectfully,
MDJPharmD
Ok, so the month of March was a big month! We were asked by the home healthcare nurse of the ALF if we would like to be marketed at other ALF's for the "terrific"job we are doing there...Although we were flattered, we politely declined for now...Although we are financially stable, another huge acct would may set us back to far...We asked them to wait a few months before they consider a move to us...I for see a few more accts in the coming months! This month we are on pace for a 10-15% increase in volume/sales...we are on pace to fill around 2600-2700 rx's for the month...Our average Gross Margin for rx sales is 25%, with a generic utilization of 76%. I think we are doing ok
Ok, so the month of March was a big month! We were asked by the home healthcare nurse of the ALF if we would like to be marketed at other ALF's for the "terrific"job we are doing there...Although we were flattered, we politely declined for now...Although we are financially stable, another huge acct would may set us back to far...We asked them to wait a few months before they consider a move to us...I for see a few more accts in the coming months! This month we are on pace for a 10-15% increase in volume/sales...we are on pace to fill around 2600-2700 rx's for the month...Our average Gross Margin for rx sales is 25%, with a generic utilization of 76%. I think we are doing ok
Doctor M - I love reading this thread, keep up the good work man. I am happy to read that things are continuing to be on the up and up for you and your partner.
The reimbursement for medicaid varies from state to state...For the most part,I believe in Florida, Brand name single source pays at around AWP - 17% + a $3.73 fee. Generics are a bit different...For a single source generic AWP-20% and for multi source generics AWP - 45% + a $3.73 fee...You make your money when a single source generic goes multi source...For example, Tamsulosin was a single source generic for 2 months or so...It went multi source like 3 weeks ago...Most Ins were still reimbursing at the single source rate and the wholesale price dropped drastically....
Medicare reimbursement depends on the PBM administering the plan...For the most part, Medicare and Medicaid pay decent...One certain INS company pays at WAC - 0.6% for brands, so you actually lose on brand name drugs...Realize however that most pharmacies buy at WAC - 2.75% to 4% after rebates depending on the wholesaler you purchase from...
We are still waiting to see what will happen to reimbursement when the new healthcare reform kicks in in 2014 and also the lawsuit with PAL's versus First Data Bank...AWP reimbursement will be gone and will depend on WAC...Scary...
Hope this helped a bit...
This month has been an ok month...We have picked up another ALF, a very small one of 22 beds, but not at full capacity...The ALF needs a lot of work in terms of medicine...The ther ALF we service recommended us and we were given the job no questions asked...We are on pace to fill around 2800-2850 rx's, a small increase from last month; we attribute this to many factors such as a few pts have passed or have moved away...We are looking into marketing ourselves a bit more in the ALF business...We stay away from Nursing homes because we do not have our consultant licenses' yet; once we do, we will hit the nursing homes...We are projecting 2850 rx's at a 25% GP...We do not expect a drop going into the summer because we do not have any snow birds...Once we get the pt in the door, they do not leave...More updates to come...
Awesome! Keep up! If you have a blog setup or anything I'd be interesting in reading about how you went about starting. I am considering evetually opening up a pharmacy but only if it's economically viable for me and most importantly if I can contribute something worthwhile/innovative to pharmacy (as in, not follow the CVS/Wallgreens model).
Doctor M: Thank you for your updates. I have a question. In California it used to be that you made about $10 a script. Average cost was around $50 and gross margins were 20-25% depending on your mix. With medicare and less cash prescriptions the average reimbursement has gone down.
I think it is about $8 a script now due to many factors. Lower reimbursement from insurance agencies, less cash Rx's, etc. How are you able to maintain such high $ per rx filled? Is it because you fill predominately psych and pain meds? Are other independents in Florida doing well also?
Have you considered adding compounding yet? The gross profit is very high!
I think it is about $8 a script now due to many factors. Lower reimbursement from insurance agencies, less cash Rx's, etc. How are you able to maintain such high $ per rx filled? Is it because you fill predominately psych and pain meds? Are other independents in Florida doing well also?
Have you considered adding compounding yet? The gross profit is very high!
$8 per script is extremely low...too low...you cannot survive on that unless you cut your labor next to nothing and use ceiling fans instead of central air! Even $10 per rx is low...The avg independent makes about $18 per rx; We are doing slightly better than that...I attribute that to the ALF (psyche meds) and also narcotics...Mind you, we do not fill a large amt of narcs; many of our patients have ins so the margin is lowered a bit; We also pick the narcs we fill simply for the reason that there are too many pill mill doctors in the Tampa area...We are only given a certain allotment or narcs per month so we save them for regular legitimate prescriptions from doctors we know...
We are doing well because of the 85 bed ALF and the 22 bed ALF we just picked up...We push generics when appropriate; we also have a few specialty biopharmaceutics that we dispense; although expensive, we make anywhere from 4-8 percent on those...If you can fork out the cash for those, 4 to 8% is not that bad. It doesnt help the gross margin, but it is still profit.
Many independents here in the Tampa area we speculate will close in the next year or so due to the new legislation for pain management clinics...Those pharmacies filled 99% pain drugs (oxycodone and oxycontin) all day long...With the new legislation, the narcos will be forced to go into withdrawal or go see a real pain management specialist who will not give them 270 oxycodone 30mg tablets and 120 tablets of oxycontin 80mg tabs...They'll get vicodin or motrin 800...Many of those people were coming from other states simply for the purpose to obtain narcotic prescriptions from these clinics...The clinics never asked any questions...Our pharmacy does about 90% regular rx's and about 10% narcs...huge difference...Only that we will still be in business after all those pill mill clinics and pharmacies shut down...
As for compounding, yes, we are going to get into that...Actually we were about to and then the ALF came along so we had to post pone the compounding...We are going to start sterile compounding, which has a huge market with the eye institutes in the area...
Going back to the $8 per rx in Cali, where did you get those numbers? Because those numbers are too low...Im still flabbergasted at those numbers...We would have either shut down or cut our labor to just 2 of us!
- Joined
- Jul 11, 2007
- Messages
- 1,290
- Reaction score
- 211
Those numbers are not correct, Cali is one hell of an expensive place to run a business too. At $8/script the place would go under fast.
I use to work for a pharmaceutical co. and was under the impression the first company to file for generic had a 6 month exclusivity on the generic market? Is this not true?
I worked at Schwarz Pharma and they were the first to file the generic for omeprazole, we had 6 months of exclusivity and at one point 72% of the US market share. We had $180M worth of product sitting in our warehouse waiting for the day we received the okay with the generic. Astra hates SP because we got around their patent.
Yes 180 days...but i do know that the second generic came out pretty quick!
- Joined
- Jul 7, 2007
- Messages
- 795
- Reaction score
- 76
The short answer is: it depends. There are two big buckets - patent expirations and patent challenges, but each has its nuances.
- Joined
- May 15, 2010
- Messages
- 4,849
- Reaction score
- 165
The short answer is: it depends. There are two big buckets - patent expirations and patent challenges, but each has its nuances.
Our 1 year anniversary will be July 17th 2010. We started at 10-25 rx's per day.
- Joined
- Jul 7, 2007
- Messages
- 795
- Reaction score
- 76
That's great.Our 1 year anniversary will be July 17th 2010. We started at 10-25 rx's per day.
To do those numbers in the summer is no small achievement for any pharmacy.Are you going to do flu shots, come Fall? And pneumo shots? Florida has all the retirees who should be getting them... it feels like half New Jersey now drives with Florida plates, since all the old people came back for the summer a month ago.
- Joined
- Mar 25, 2008
- Messages
- 9,848
- Reaction score
- 1,836
Our 1 year anniversary will be July 17th 2010. We started at 10-25 rx's per day.
What are your hours of operation? And is the neighborhood where you keep your pharmacy an urban, rural, or suburban neighborhood?
Mon-Fri 8am - 7pm
Sat 9-5
Sun 10-4
Probably gonna make the store 8-8pm soon...
We are in St Petersburg Fl, like 2 miles from the city of st petersburg
That's great.
Are you going to do flu shots, come Fall? And pneumo shots? Florida has all the retirees who should be getting them... it feels like half New Jersey now drives with Florida plates, since all the old people came back for the summer a month ago.
Yes,
we are licensed to immunize...if we can get a hold of the flu shots that is...we are doing well...cant complain one bit! Where in upstate are you from? I am from Buffalo (grew up in Orchard Park)...
- Joined
- Jul 7, 2007
- Messages
- 795
- Reaction score
- 76
I have just moved to north Westchester County after three years in New Jersey, so it's not really that Upstate, but I think White Plains is technically the cut-off, and I am half an hour north of there.
It *feels* a lot more Upstate than NYC, the small towns and everyone knowing everyone's business. Just like when I disagreed with the GPS and took a very scenic detour on the way to the Niagara Falls and we ended up stopping for lunch at some one-street town good hour away from the Thruway, and got a grilling from the owner - where we were from, and how do we like it here, and why we were there anyway - along with a list of about a hundred places we should see on our way from there to Buffalo. 
Thanks for the insight and the inspiration. It is the stories like these that give me the desire to keep on pushing through the schooling so I can eventually have my own Pharmacy and be in the position that you are and will be in a few years time.
- Joined
- Jan 15, 2010
- Messages
- 75
- Reaction score
- 1
I just wanted to say congrats to you, on your success Doctor M.
