i'd like to back peddle a little bit here from the negative view this thread has taken. I'll be the first to admit that our profession faces issues/problems that aren't being addressed- i.e. Too many schools, slow economic growth, pbm pressures, chain pressures on staff etc.
We are not the only profession with problems and our profession will change with time as will any profession. People are inherently afraid of change as evidenced so far in this thread/message board. Sure there are some scary issues we're facing, but at the end of the day, i think we discount our value and what we really do in the pharmacy. I've worked with great techs, but they will never replace me, unless they get a pharm.d. State boards of pharmacy's sole purpose is to protect the public. A lot of the crazy ideas being thrown around will never fly with the boards of pharmacy. They are an independent entity and not ran by any of the big 3 chains. Their sole concern is patient safety, end of story.
To address the project one and hyperlink in this thread, one should take away several things. First, this is outdated data and the wag ceo when this was written, is no longer with the company. Walgreens understands that the profession is changing and they must change their business model in order to survive. If they just stick back and have pharmacists count pills and do nothing else, then their business will inevitably fail. They stated 64% of their business was pharmacy. How are they going to continue to grow that business without pharmacists? We drive the business. I truly believe that wag is one of the only companies trying to advance the profession right now as evidenced by the following:
1. Opening of compounding centers promoting compounding services across the nation. These centers have specialized compounding equipment and meds not found in most "typical" pharmacies.
2. Immunization centers that now offer any and all cdc recommended vaccines to state legal age appropriate groups. These include flu, pneumo, zostavax, hepb/a, tdap, hpv, mmr etc.
3. Nurse practitioner established clinics in-house to enhance patient care and collaboration with pharmacists.
4. Mtm billable opportunities for interventions/recommendations/medication reviews.
5. Standing up to pbms - refusal to accept below standard reimbursement rates that would degrade/devalue our profession. Basically, the rates in which express scripts wants to pay ~$5 gross profit per rx is not worth a pharmacists time. If other chains would take a stand, pbms would have no choice, but to give us reasonable rates. Wag is also pushing 90 day at retail and wants to promote patient choice as to where they get their rx and not let the pbms dictate where the patient must go. Low pbm reimbursement is actually driving chains to get creative to control their costs and the #1 controllable cost for any company is payroll. So figuring out ways to decrease that makes sense. But if we continue to accept low rates, what will happen? Less tech help, less rphs etc. More people must stand up to pbms. Wag sold their pbm because they believe we can cut costs by cutting out the pbm and directly administering a rx benefit for a company without a "middle man." express scripts made nearly 3 billion gross profit in the trailing 12 months. That is a ridiculous amount of money for being a middle man that could be better spent by lowering healthcare costs.
6. Project one would put the pharmacist out from behind the counter and take away some of the mundane activities such as being the cashier, insurance billing, count pills etc. And would instead allow pharmacists to counsel patients, make otc recommendations and do more clinical activities.
7. Every store will be clia waived by the end of the year and will offer fee for service point of care testing for blood glucose, a1c, blood pressure, cholesterol and bone density screenings.
8. Collaborative partnership with johns hopkins promoting pharmacist centered care
http://news.walgreens.com/article_display.cfm?article_id=5430
there are tons of other activities, but tell me what other chain is making this kind of push?
Other factors that will influence demand positively will be lower unemployment (employed people have insurance that go to the doctor and get rxs filled), national healthcare mandating coverage for 30 million uninsured. Along with an improved economy, older rphs finally get to retire which is what most have been putting off because their 401k stinks right now, hopeful expansion in the scope of practice of a pharmacist, introduction of new blockbuster drugs going generic over the next few years will make medication copays more affordable. As for some people that think that brick and mortar buildings will go away... There are some things people just feel more comfortable doing in person. I wouldn't consult a doctor over the internet for treatment, buy a car without seeing it in person and most people prefer not to talk to automated 1-800 #'s nor wait weeks to get their medication that seems to get lost in the mail fairly frequently. I know i personally provide quality advice and service to my patients that can't be touched by a mail order pharmacist, but at the same time, i don't yield questions for rx meds that a patient doesn't get filled with my company.
Sorry for the long post, but i felt this post needed a devil's advocate.
