Aug 23, 2014
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Looking for a Pharm.D to join a boot-strapped New York based on-demand digital pharmacy startup as a co-founder. Starting March 27th of next year, New York will become the first state to make electronic prescribing mandatory. The new e-prescribing rule was to take effect this year but physicians asked for a 1 year delay. This presents a unique opportunity to create an on-demand service for prescription medications much like AmazonFresh did for groceries, Uber did for cabs or Washio did for laundry, etc. Must be located or willing to relocate to NYC. Get in touch if interested.

Thanks!
 
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Ackj

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What exactly is a "digital pharmacy" and how is that different from mail order?
 
OP
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Aug 23, 2014
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What exactly is a "digital pharmacy" and how is that different from mail order?
It's different than mail order in a few ways.

Patients would not have to wait for their meds to arrive in the mail. Same day delivery would be available in a matter of hours.

Mail order pharmacies leave medications at the door, possibly compromising patients privacy or causing lost medications. Our on-demand pharmacy will hand deliver the medications in-person.

An on-demand pharmacy would also improve adherence by making it easy for a patient to get their medications.
 

BMBiology

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It's different than mail order in a few ways.

Patients would not have to wait for their meds to arrive in the mail. Same day delivery would be available in a matter of hours.

Mail order pharmacies leave medications at the door, possibly compromising patients privacy or causing lost medications. Our on-demand pharmacy will hand deliver the medications in-person.

An on-demand pharmacy would also improve adherence by making it easy for a patient to get their medications.
So the difference is you guys offer same day, in-person delivery. What else?

This also assumes you have the drugs in stock and there is no insurance problems.

How is this different from independent pharmacies? I am sure they can also get these electronic prescriptions and offer same day delivery.

I hope you don't think medications are like grocery. Just because prescriptions are sent electronically, nothing new by the way, doesn't mean the prescribers are not going to make any mistakes and the pharmacists don't need to check it and it doesn't mean insurance companies will pay for it.
 

Gombrich12

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I could see this maybe working if you decided to do it on a cash only basis and people were paying for the convenience of the service. A person gets prescribed lexapro, they load up your app and it shows you'll sell them 30 pills for $15 and have it delivered by the end of the next day. There is definitely a market for something like that. The problem is no technology exists for a person to control their e-prescription, it is sent from doctor to pharmacy not given from doctor to patient. You will have pharmacists and techs on the phone all day transferring and talking to offices due to the current technology.
 

stoichiometrist

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Ackj

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It's different than mail order in a few ways.

Patients would not have to wait for their meds to arrive in the mail. Same day delivery would be available in a matter of hours.

Mail order pharmacies leave medications at the door, possibly compromising patients privacy or causing lost medications. Our on-demand pharmacy will hand deliver the medications in-person.

An on-demand pharmacy would also improve adherence by making it easy for a patient to get their medications.
So it's the same as an independent that offers local delivery?
 

owlegrad

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So it's the same as an independent that offers local delivery?
Apparently the concept is they will only accept escripts and you cannot pickup or dropoff in person. Personally I like the idea, although I am not certain the public will go for it. If they can't come in person to complain about the long lines what is the point?

Also expecting the patients to be home to receive the meds is optimistic at best. We offer delivery and our delivery person is constantly bringing back meds that the patient wasn't home to receive in spite of being called before she leaves the store! So have fun with that.
 
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OP
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Aug 23, 2014
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So the difference is you guys offer same day, in-person delivery. What else?

This also assumes you have the drugs in stock and there is no insurance problems.

How is this different from independent pharmacies? I am sure they can also get these electronic prescriptions and offer same day delivery.

I hope you don't think medications are like grocery. Just because prescriptions are sent electronically, nothing new by the way, doesn't mean the prescribers are not going to make any mistakes and the pharmacists don't need to check it and it doesn't mean insurance companies will pay for it.
So yes the main difference is that we offer same day in person delivery. Numerous studies suggest that as high as 83% of consumers oppose mail order. If given a choice, 92% of patients that are currently on mail order would leave their mail order pharmacy.

We are not that different from an independent pharmacy. A patient would be able to call, email or chat with our pharmacist at anytime. They can add otc items to their prescription order thru the app. They would be able to add their credit card to make payment thru the app or pay cash at-delivery. The patient would receive push notifications thru the app and sms to alert them of any insurance or physician delays. They would be able to follow a status bar on the app until delivery.

I'm under no illusion that medications are like groceries. I grew up working at my parents independent pharmacy which they owned before I was even born. Electronic prescribing is nothing new but starting next year, it will become mandatory in NY and that is new. it's easy to see why that would be great for our business model.

The on-demand economy is booming because consumers are clamoring for it.
 
OP
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Aug 23, 2014
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Apparently the concept is they will only accept escripts and you cannot pickup or dropoff in person. Personally I like the idea, although I am not certain the public will go for it. If they can't come in person to complain about the long lines what is the point?

Also expecting the patients to be home to receive the meds is optimistic at best. We offer delivery and our delivery person is constantly bringing back meds that the patient wasn't home to receive in spite of being called before she leaves the store! So have fun with that.

Most patients aren't looking forward to long lines. If they can avoid them, most will. You do make a good point about patients not being home. That will be part of the struggle.
 
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Aug 23, 2014
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I could see this maybe working if you decided to do it on a cash only basis and people were paying for the convenience of the service. A person gets prescribed lexapro, they load up your app and it shows you'll sell them 30 pills for $15 and have it delivered by the end of the next day. There is definitely a market for something like that. The problem is no technology exists for a person to control their e-prescription, it is sent from doctor to pharmacy not given from doctor to patient. You will have pharmacists and techs on the phone all day transferring and talking to offices due to the current technology.

Yes a patient's doctor would e-prescribe the scripts to us. The patient would then download our app, enter a few details including scanning their insurance card to start the process. For refills, they'll simply scan their prescription bottles.
 
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BMBiology

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^ profit margin is already razor thin. How are you going to be able to offer all of these free services?
 

BMBiology

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Another problem - the vast majority of patients on chronic medications are 50 years and older. They are not into apps as the younger generation.
 
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^ profit margin is already razor thin. How are you going to be able to offer all of these free services?
Some pharmacies already offer free delivery and are able to survive. The problem is that we will be offering free delivery through out the city. This will definitely affect us at the start but we hope to make up for it once our volume increases. It's going to be tough but as they say... no risk, no reward.
 
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Another problem - the vast majority of patients on chronic medications are 50 years and older. They are not into apps as the younger generation.

We've also thought about this. So using the app, a user would be able to create multiple profiles... say for their mother, sister, children etc. This would enable a user that's more tech savvy to place an order for family members. Caretakers would also be able to place orders for their clients.
 

Ackj

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So why not just have this as an add-on to a traditional independent pharmacy? Is there some major savings by eliminating the retail side? NY will still make you register an address and they require certain square feet for a pharmacy, so it's not like you'll have a big real estate/rent savings. It seems like you're essentially going to be an independent pharmacy that doesn't let customers visit in person, so maybe you'll save on needing a cashier.
 

Muse600

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good idea! haven't heard of anything like this before, but anytime the gov't mandates something, it's good to get on board early and create your own niche

NY relocation is a deal breaker for me...I love the socal sun!
 
OP
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Aug 23, 2014
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So why not just have this as an add-on to a traditional independent pharmacy? Is there some major savings by eliminating the retail side? NY will still make you register an address and they require certain square feet for a pharmacy, so it's not like you'll have a big real estate/rent savings. It seems like you're essentially going to be an independent pharmacy that doesn't let customers visit in person, so maybe you'll save on needing a cashier.

That's exactly what we intend to do... establish as an add-on to a traditional independent pharmacy. That's why we need a pharmacist to join our team.
 
OP
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Aug 23, 2014
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good idea! haven't heard of anything like this before, but anytime the gov't mandates something, it's good to get on board early and create your own niche

NY relocation is a deal breaker for me...I love the socal sun!
Thanks for seeing the vision. If all goes well, we maybe coming to your city soon. Hehe
 

BMBiology

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I would seriously crunch the numbers. The cost of the app including maintenance + same day delivery. Same day delivery is also an issue because they have to be at home. Major inconvenience. To me it sounds like you guys are just an independent pharmacy + an app.

Yes, people like convenience but there is now virtually a pharmacy at every corner. I am sure Walgreens and CVS also have their own app. Adding same day delivery is not a game changer. People don't need to get their Lipitor in 30 mins. Food? Yes. A ride? Yes. Groceries? Maybe. Viagra? Maybe. Lipitor? No
 
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Aug 23, 2014
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We've already crunched the numbers. The app is being built now and is almost finished. Customers not being home after placing an order is something that every on-demand service has to deal with. I'm sure some people order a cab thru Uber and are not there when the cab get there. I'm sure some people get their clothes dry cleaned by Washio and are not home during delivery. I'm sure some people order groceries thru Fresh Direct and are not home during delivery.

Dry cleaners, grocery stores and cabs are even more rampant than pharmacies but yet, these on-demand services are thriving. We don't expect everyone to use the service but if you can place your prescription order from your couch in the comfort of your home, would you not? Consider that talking to a pharmacist will only require a tap from the app.

I would imagine the big chains will get into this space soon once paper scripts are done away with. Hopefully we'll have the advantage of being first to market.
 
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Ackj

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That's exactly what we intend to do... establish as an add-on to a traditional independent pharmacy. That's why we need a pharmacist to join our team.
Okay, I see. You/your team are tech guys, and you need an Rph to make it work. I think this would be great as an add-on. For a standalone app-only pharmacy, that sounds a little dicey, but that would be a great perk to have for an existing pharmacy. I know many customers like the email/text notifications when an Rx is received from doctor, ready for pickup, etc, so this would just take it a step further and allow for delivery as well.

I still think you need to have a physical pick up option available, because for urgent things that's still going to be the fastest way to get your pain med, antibiotic, etc. Sure you can have it at my doorstep this evening, but I don't want to wait that long, I'm sick and I need it right away.
 

Corpseman

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We've already crunched the numbers. The app is being built now and is almost finished. Customers not being home after placing an order is something that every on-demand service has to deal with. I'm sure some people order a cab thru Uber and is not there when the cab get there. I'm sure some people get their clothes dry cleaned by Washio and are not home during delivery. I'm sure some people order groceries thru Fresh Direct and are not home during delivery.

Dry cleaners, groceries and cabs are even more rampant than pharmacies but yet, these on-demand services are thriving. We don't expect everyone to use the service but if you can place your prescription order from your couch in the comfort of your home, would you not? Consider that talking to a pharmacist will only require a tap from the app.

I would imagine the big chains will get into this space soon once paper scripts are done away with. Hopefully we'll have the advantage of being first to market.
clothes, groceries, cabs =/= drugs....you have laws to deal with.

What space, I don't understand what you offer that you cannot get through other services already. You keep hounding the e-scipt thing, what does that change?

All you are talking about is a delivery service...cool story, but that has been around for awhile. It has been tried by numerous companies and doesn't really work.

How do you plan on transporting C-2s? other controls? What about your liability? How do you plan on counseling?

You do realize that you can manage your prescriptions with apps at most big retail pharmacies, right? and even they with their multi billion dollars can't get those things to work perfectly.
 
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Aug 23, 2014
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clothes, groceries, cabs =/= drugs....you have laws to deal with.

What space, I don't understand what you offer that you cannot get through other services already. You keep hounding the e-scipt thing, what does that change?

All you are talking about is a delivery service...cool story, but that has been around for awhile. It has been tried by numerous companies and doesn't really work.

How do you plan on transporting C-2s? other controls? What about your liability? How do you plan on counseling?

You do realize that you can manage your prescriptions with apps at most big retail pharmacies, right? and even they with their multi billion dollars can't get those things to work perfectly.


Glad you can join the conversation. I'll break it down for you.

You asked "what space?". It doesn't exist yet but we plan to be the first in the on-demand economy. The on-demand economy is defined as the economic activity created by technology companies that fulfill consumer demand via the immediate provisioning of goods and services. You can learn more on techcrunch, business insider, wall street journal etc. Example of companies that are part of this economy are uber, lyft, washio, amazonfresh, freshdirect, eaze(delivers medical marijuana), handy, instacart, cleanly, eat24, zipments and lots more. Venture capital funding in companies providing on-demand products and services have totaled over $1.5 billion since 2010.

Now consider this... the only difference between uber and the traditional cab company is that you can place your credit card on file and request a cab thru the app. This almost trivial difference has allowed them to grow to a $30 billion company in just 4 years. Consumers demand convenience.

It's not just about the money. An on-demand pharmacy stands to do lots of good. 20% of prescriptions never get picked up from the pharmacy. 4 out of 5 prescriptions are not refilled by patients as prescribed by their doctor. Hassle and procrastination are big factors that lead to this kind of non-adherence. Thru our model, we'll eliminate that average 45 minute wait time that's associated with filling a script in person and make it as easy as possible for patients to get the medications they need. That's a win for patients, savings for the healthcare industry and if we can turn a little profit, that's good too.


the 'escript thing' changes a lot. Without electronic prescriptions, on-demand delivery of medications will be almost impossible. State law across the US require that a pharmacy obtain an original hard copy rx before filling a prescription. So a patient scanning a copy of their rx thru the app wouldn't be acceptable.

I believe that in NYS, pharmacy employees are allowed to deliver cII. We will check more on this and if not, we'll exclude controls just like mail order pharmacies exclude controls. Obviously we will carry liability insurance which is mandated by state and federal law. Counseling will be done thru the phone or thru secure email.

Yes, with big chains, you can currently manage your existing scripts with apps but not request free delivery. Additionally, no chain currently allows you the ability to fill a new script thru an app.
 
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OP
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Aug 23, 2014
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Okay, I see. You/your team are tech guys, and you need an Rph to make it work. I think this would be great as an add-on. For a standalone app-only pharmacy, that sounds a little dicey, but that would be a great perk to have for an existing pharmacy. I know many customers like the email/text notifications when an Rx is received from doctor, ready for pickup, etc, so this would just take it a step further and allow for delivery as well.

I still think you need to have a physical pick up option available, because for urgent things that's still going to be the fastest way to get your pain med, antibiotic, etc. Sure you can have it at my doorstep this evening, but I don't want to wait that long, I'm sick and I need it right away.


Yes we do need an Rph to make it work. You have one in mind? Hehe
We will have a physical pick up option but I don't imagine that most of our customers will be using that option but when they do, it will be available for them.
 
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Corpseman

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"Glad you can join the conversation. I'll break it down for you.

You asked "what space?". It doesn't exist yet but we plan to be the first in the on-demand economy. The on-demand economy is defined as the economic activity created by technology companies that fulfill consumer demand via the immediate provisioning of goods and services. You can learn more on techcrunch, business insider, wall street journal etc. Example of companies that are part of this economy are uber, lyft, washio, amazonfresh, freshdirect, eaze(delivers medical marijuana), handy, instacart, cleanly, eat24, zipments and lots more. Venture capital funding in companies providing on-demand products and services have totaled over $1.5 billion since 2010.

My point is that on-demand delivery has been tried and only works in very small amounts, not the 150+ you need to turn every day in order to make any profit. Also, if this is in addition to an independent....again this has been done numerous times and is nothing new. However, again it is a small portion of their overall service. A stand alone will have a hard time doing this on its own and surviving.

Now consider this... the only difference between uber and the traditional cab company is that you can place your credit card on file and request a cab thru the app. This almost trivial difference has allowed them to grow to a $30 billion company in just 4 years. Consumers demand convenience.

It's not just about the money. An on-demand pharmacy stands to do lots of good. 20% of prescriptions never get picked up from the pharmacy. 4 out of 5 prescriptions are not refilled by patients as prescribed by their doctor. Hassle and procrastination are big factors that lead to this kind of non-adherence. Thru our model, we'll eliminate that average 45 minute wait time that's associated with filling a script in person and make it as easy as possible for patients to get the medications they need. That's a win for patients, savings for the healthcare industry and if we can turn a little profit, that's good too.

I don't know the exact number, but I would bet that 85% at least of prescriptions are not filled for people waiting inside the store. This gives them the convenience to pick it up at their choosing and not worrying about being home for a delivery.


the 'escript thing' changes a lot. Without electronic prescriptions, on-demand delivery of medications will be almost impossible. State law across the US require that a pharmacy obtain an original hard copy rx before filling a prescription. So a patient scanning a copy of their rx thru the app wouldn't be acceptable.

However, right now a script can be e-scribed to a pharmacy and filled without the patient having to be there. I still don't see how e-scribing sudenly changes the game in favor of your type of pharmacy. Is there some sort of weird NY law that doesn't allow e-scribing yet?

I believe that in NYS, pharmacy employees are allowed to deliver cII. We will check more on this and if not, we'll exclude controls just like mail order pharmacies exclude controls. Obviously we will carry liability insurance which is mandated by state and federal law. Counseling will be done thru the phone or thru secure email.

Mail order pharmacies can ship controls including C2s as far as I know and was taught in law class, granted some states may differ (please correct me if I am wrong).

Yes, with big chains, you can currently manage your existing scripts with apps but not request free delivery. No chain currently allows you to ability to fill a new script thru an app.

I don't see how you can turn a profit with free delivery, but more power to you. How would your app allow someone to be able to fill a new that has not gone to the pharmacy yet?"


I do appreciate people thinking outside the box, so I hope this works out for you. I just dont like taking the pharmacist out of the picture which would be my only complaint against this system.
 
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I do appreciate people thinking outside the box, so I hope this works out for you. I just dont like taking the pharmacist out of the picture which would be my only complaint against this system.

*Replies in the quote.

I have great respect for pharmacists. My late uncle was one and so is my father. Our intention is not to take the pharmacist out of the picture.
Obviously there will always be patients that would prefer face time with a pharmacist and those patients can always visit their neighborhood pharmacy.

But for those patients that can't make it, inconvenienced or hassled by trips to the pharmacy, our service will be there. Unlike mail order pharmacy usage which is mostly mandated by insurance plans, the choice of using our service will be entirely up to the patient.
 
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zelman

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...I'm sure some people order a cab thru Uber and are not there when the cab get there...
Doesn't happen because they track you via GPS on the app. You should do the same. "Rx's delivered, even if you try to ditch us."
 
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WVUPharm2007

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So...you are opening an independent pharmacy that only takes eScripts/Fax with same day delivery and internet ordering? I really don't want to burst your bubble, but that exists. A bunch of local independants do that. Some of them even come take your written Rx, take it back, fill it, then bring it back to you that day.