Pharmacy Aquisition

[MountainPharmD]

How many of you have been slaving away at Walgreens or CVS wondering if there isn't something better out there? If plodding through a 12 or 14 hour shift cranking out 400 scripts without a single break is NOT your idea of good community pharmacy practice there is a better way...

Here is a hypothetical scenario based on real numbers. Your situation and geographic location may be different with respect to rent and utilities. This example is based on a rural location in the midwest. You want to open a store on times square in New York these numbers won't work.

A quick overview:

Average gross RX margin nationwide: $12.50

Sell 100 RXs a day x $12.50 x 5 days a week x only 50 weeks ( figure days lost due to being closed on holidays — a perk that you can enjoy as an owner) is $312,000 of gross margin ( that’s your profit over your drug cost).

That $312k is what you use to pay your overhead…. It’s a rather simplistic view but with some personal curiosity and a will to learn, one can make independent pharmacy a viable business model.

Lets say you fill 100 rxs per day:

$312k/12 months= $26,000 per month gross profit

-RPH: $10K
-Tech 1= $2600
-Tech 2/clerk= $2100
=$14,700 in monthly salary

other monthly expenses:
- Rent: $2000
- Rx processing system: $600
- Electric: $600
- Phone: $250
- IVR/telemanager: $45
- Alarm: $50
- Insurance check reconciliation service: $200
- Water: $50
- Advertising: $250
- Supplies: $250

TOTAL: $4295

So: $4295+ $14,700= $18,995 in total overhead expenses per month

GROSS PROFIT PER MONTH = $26,000- overhead expenses per month of $18,995= $7005 NET PROFIT per month

$7005/ month x 12 months= $84,060 as the owner

You’d make $120K as the working RPh and another ~ $80K as the owner for $200K per year—that’s on only 100 rxs per day.

Ask yourself this question: HOW MANY RXS ARE YOU FILLING PER SHIFT AT WALGREENS, WALMART, CVS, ETC.? AND HOW MANY TIMES DOES MANAGEMENT TELL YOU THAT YOU NEED TO CUT YOUR STAFFING? It’s not for economic reasons, that’s for sure.

Above you see the economic TRUTH of community pharmacy. Empowering yourself is empowering our profession. It can be done...you just have to be smart about it and manage you costs closely.

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[zelman]

You're ignoring the cost of having drugs on hand. Isn't that a big issue?

Also, isn't 100 RX per day high for a rural independent?

Asking genuinely. Not my area of expertise.

 

[HouTX]

You're ignoring the cost of having drugs on hand. Isn't that a big issue?

Also, isn't 100 RX per day high for a rural independent?

Asking genuinely. Not my area of expertise.

a big misconception is that rural equates to low script counts. in rural areas, there is less competition. I have personally worked at a CVS in a small town of 12,000 people. They only have another independent as a competitor and they do 500-600 on a daily basis.

 

[farmadiazepine]

This is why I want to open up my own store. I work on my week off at an independent that does ~400 scripts/day including a lot of HIV's, cancer meds, psychiatric meds, and compounding. Doing ~400/day is way less than my busy 4,300/week chain job. And I always wondered why the independent has more people? We have about 8 techs on a day, 2 delivery drivers, a security guard, and as many hours as you want to work.

This is why CVS is the devil. They are so money hungry. They are so greedy. Just give me some time and I'm gonna open up shop.

The problem is.. It's hard work! To get to 100 scripts/day you really have to push yourself and put yourself out there. To all those stores doing 100+ per day, the people working there are extremely hard workers. I need to get to that level instead of just whoring myself to everyone around me.

 

[BenJammin]

You're ignoring the cost of having drugs on hand. Isn't that a big issue?

Also, isn't 100 RX per day high for a rural independent?

Asking genuinely. Not my area of expertise.

I did a rotation in Oklahoma at an independent pharmacy in a town of 1800 and they did about ~200 a day.

 

[pezdispenser]

What about these expenses:

Payroll taxes on the salaries: 6.2% Social Security and 1.45% Medicare
Health insurance
Liability insurance
Licensing fees and DEA license
An accountant and lawyer
If you borrow money to buy the pharmacy or the inventory, the interest on the loan and any principal repayments

 

[BMBiology]

120 k base salary plus benefits = about 150 k

Some independents also cheat. They pay doctors for scripts, waive copayment on federal sponsored plans...all illegal. If you are not willing to do the same thing then you are at a disadvantage.

Also expect to be working 12 hours a day M-F and 6 hours on Sat in addition to working when you get home on business related matters.

 

[Muse600]

how about tax advantages?

I figure having your own business, you can maximize how much you keep in your hand...

more from millionaire next door...

WORKING FOR THE TAX MAN
Assume for a few moments that you are Mr. Bob Stern, a scholar
who works for the IRS. One morning your manager, Mr. John
Young, calls you into his office. He gives you an assignment: to
enhance his understanding of the relationship between income and
wealth.
Mr. Young: Bob, I keep reading reports about the growth of
the millionaire population.
Mr. Stern: Yes. I have a pile of articles and clippings on the
same topic in my desk.
Mr. Young: Well, here is the problem. The number of
wealthy people keeps rapidly increasing. But our income tax
revenue for a lot of these people is not keeping pace.
Mr. Stern: I read somewhere that the wealthiest 3.5 percent
of the households in this country account for more than half
of the personal wealth. But these same folks account for less
than 30 percent of the income.
Mr. Young: I wish Congress would wake up. What this
country needs is a tax on wealth. Even in biblical times the
rich had to pay 10 percent of their wealth each year in taxes.
Now that's what I call the ultimate tax reform.
Mr. Stern: I know what you mean. But sooner or later we
will get 'em. Remember, it's inevitable-death and taxes.
Mr. Young: The estate tax area is not your specialty, Bob.
You are a little naive on this issue. You are thinking that we
will eventually take a big bite out of all the millionaires in
this country by taxing their estates.
Mr. Stern: The Grim Reaper is on our side.
Mr. Young: Not so fast, Bob. Just think of all the millionaires
in this country. Most of them own some kind of a business,
and a whole bunch own stocks. What do these folks do
with their money? They sit on it, or they plow it back into
their business. They hold on to all those stocks that keep
appreciating.
Mr. Stern: But what about the Grim Reaper?
Mr. Young: Look at it this way, Bob. We have often looked
at estate returns in the $1-million-and-above level. Last year
there were only about 25,000. But, Bob, at the same time
there were 3.5 million millionaires alive and kicking. That
means that 0.7 percent were picked up by the Reaper. This
number should be twice as high. But you know what a lot of
millionaires do? Before the Reaper shows up, they transform
themselves. It's like magic.
Mr. Stern: How do they do it? They can't just vanish. Do
they move offshore before the Reaper shows up?
Mr. Young: Offshore is not a significant factor. But I would
not be surprised if we found that half of the millionaires
transform themselves into nonmillionaires BR.
Mr. Stern: What do you mean by BR?
Mr. Young: It's an insider term. BR means "Before the Reaper,"
or prior to death, as opposed to AR, or "After the Reaper."
Look at this case study. Here's a woman, Lucy L., who had $7
million just a year before she died. She lived on her pension
money. Never in her life sold a share of stock out of her portfolio.
Her wealth doubled in just the six years between her seventieth
and seventy-sixth birthdays. But what did we get out of
it? In terms of income tax, nearly zip. She essentially had no
realized income from her portfolio. I hate unrealized income.
Mr. Stern: You're right. It is a clever enemy. But the Reaper
-he got her, right? Death and taxes.
Mr. Young: Wrong, Bob. She died last year. And do you
know what her net worth was at the time the Reaper finally
showed up? Less than $200,000. No estate taxes. Another
former millionaire mov~s on without leaving a taxable
estate. Some days I wish I were in another line of work. The . . .
enemy IS wInnIng.
Mr. Stern: But where did all her money go?
Mr. Young: She gave it to her church, two colleges, and a
dozen or more charitable organizations. She also gave
$10,000 to everyone of her children, grandchildren, and
nieces and nephews. She's real country-loaded with relatives,
like a lot of mountain people.
Mr. Stern: And what did we finally end up with?
Mr. Young: You're not listening, Bob. We, the government,
got zippo! Can you believe it? Her own government. There's
just no justice in America. We need a wealth tax.
Mr. Stern: Well, she sounds like a pretty nice person to give
so much money to a church, colleges, and charities.
Mr. Young: Bob, shame on you. She and her ilk are the
enemy. America needs their wealth to keep our government
operating. We need her money to payoff the federal debt.
We need to fund all our social programs.
Mr. Stern: Perhaps she feels that her church, the colleges,
and the charities also have needs.
Mr. Young: Bob, you are so naive. This woman is an amateur.
What type of experience does she have doling out her
wealth? We are her government. We're experts in redistributing
wealth. We should decide where and how wealth is
distributed. We are the pros. We have to start taxing wealth
before all the millionaires transform themselves into nonmillionaires.
Mr. Stern: What about all those famous people we read
about in the newspaper? The ones who have very high
incomes?
Mr. Young: God bless them, Bob. They are our best customers.
I love people who are big earners. Realized income
is our salvation. I want you to study these types. But I also
want you to find out how these other types can exist without
realizing a lot of income. Some of them must live like
monks. What's wrong with these people? Why don't they sell
a few million dollars' worth of stock and buy a mansion?
Mr. Stem: Is that why you have all those pictures of America's
highest-paid celebrities on the walls of your den at home?
Mr. Young: You bet. I love those people. They've got a real
bad case of the "spends." And to spend they have to have
realized income. Look at it this way. When a ball player buys
a $2 "million boat, we become his partner. He will need to
realize $4 million to pay $2 million for his boat. We are his
partner.
Mr. Stern: Ball players? Are they good role models for our
youth?
Mr. Young: Absolutely. They are high-income spenders.
They tell our youth to earn and spend. It's realized income
that our youth need to learn about. These spender types are
true patriots. That's why I keep Webster's definition of patriot
on my wall. Why don't you read it to me, Bob?
Mr. Stern: Patriot: one who loves his country and zealously
supports its authority and interests.
Mr. Young: Yes, Bob-zealously supports its authority and
interests. You know, Bob, the real patriots out there are people
who earn big incomes-$100,000, $200,000, and $1
million or more a year-and spend it all. Congress should
mint a new medal for this type of patriotism, Bob. It would
be called the Congressional Medal of Taxation and Consumption.
And as long as these patriots keep training their
kids to be medal winners, we are in good shape. Bob, do you
think we should start sending out holiday greeting cards to
all those companies that promote luxury cars, yachts, million-
dollar homes, and expensive clothes and accessories?
These people are really patriots in their own way. They
encourage spending. They are keeping us in business. Well,
Bob, it's getting late. You have your assignment. I want to
know more about the medal winners. But I also want you to
study the ways of those who don't spend their money.

 

[Wheresmyaricept]

120 k base salary plus benefits = about 150 k

Some independents also cheat. They pay doctors for scripts, waive copayment on federal sponsored plans...all illegal. If you are not willing to do the same thing then you are at a disadvantage.

Also expect to be working 12 hours a day M-F and 6 hours on Sat in addition to working when you get home on business related matters.

This. Most pharmacists walk out of work and don't have to worry about anything until their next shift. If you own an independent, you're on call 24/7.

I met an independent owner who has his cell phone number on the door to the pharmacy just in case there's an emergency at midnight and someone can't wait for their scripts after getting out of the ER. He's the only pharmacy in a small town and does 300 a day, but literally his whole family is involved. His wife makes trips to the bank and is a tech when needed. His brother is the accountant. His mom helps with paperwork. He said he is always working, even on his days off he's doing paperwork at home. He said his wife hates it.

You don't get that as much with chains.

 

[BenJammin]

This. Most pharmacists walk out of work and don't have to worry about anything until their next shift. If you own an independent, you're on call 24/7.

I met an independent owner who has his cell phone number on the door to the pharmacy just in case there's an emergency at midnight and someone can't wait for their scripts after getting out of the ER. He's the only pharmacy in a small town and does 300 a day, but literally his whole family is involved. His wife makes trips to the bank and is a tech when needed. His brother is the accountant. His mom helps with paperwork. He said he is always working, even on his days off he's doing paperwork at home. He said his wife hates it.

You don't get that as much with chains.

Isn't that the nature of the beast? You don't jump into a pool and gripe about getting wet. Independent businesses are lots of work but it's worth the trade off in most cases. No district managers to answer to, no store managers griping about your choice of dress shirt, no more refill binders, no more patients threatening to call corporate because you won't refill their xanax 29 days early, and you get to choose the employees. How much is that worth to you?

 

[opinionfree]

I didn't run your numbers, but it looks like some figures must be missing.

What about store build out (walls, shelves, fixtures, flooring, lighting, bathrooms, exterior signage, etc,). HUGE expense. Construction costs for COMMERCIAL applications are big.
Pharmacies use and store Hazardous Chemicals. I can't imagine what government fees are associated acquiring the necessary permits.
Trash. Can't throw our trash away with the regular refuse.
Interior liability insurance. Customer slips and gets booboo.
I'm not seeing anything about taxes.
Average gross RX margin nationwide: $12.50 (When I started at CVS, so it is most assuredly biased, they said reimbursement rates were pennies per script.) Not sure where $12.50/script is realistic.
Interior decoration and design/Advertisement/Cash registers.
Vials/bottles/bags.
Inventory. (lots of tied up, dead money).
Being in a rural area, you could twist the local government for opening business financial incentives. This is a plus.

Although I love you putting this together. If it even remotely factored out the way you set it up, I think many pharmacists would team up and be building independent pharmacies all over the place.

 

[BenJammin]

Or maybe the chains have brainwashed them?

 

[Sparda29]

This. Most pharmacists walk out of work and don't have to worry about anything until their next shift. If you own an independent, you're on call 24/7.

I met an independent owner who has his cell phone number on the door to the pharmacy just in case there's an emergency at midnight and someone can't wait for their scripts after getting out of the ER. He's the only pharmacy in a small town and does 300 a day, but literally his whole family is involved. His wife makes trips to the bank and is a tech when needed. His brother is the accountant. His mom helps with paperwork. He said he is always working, even on his days off he's doing paperwork at home. He said his wife hates it.

You don't get that as much with chains.

More work yes. But YOU are the BOSS. In the end, all profits go to you.

 

[accordman83]

You're ignoring the cost of having drugs on hand. Isn't that a big issue?

Also, isn't 100 RX per day high for a rural independent?

Asking genuinely. Not my area of expertise.

My first job out of school was at a Walmart in a town of 3100, and my first day on the job we filled 916 scripts. And Walmart was not the only game in town either.

 

[tammoraf81]

Your title say " pharmacy acquisition" now with that said ,you will have to consider the loan debt too in your calculations . I don't think 100 Rx a day will be enough to pay you reasonable salary and sustain the debt in the same time
Now with start up "I'm not a big fan" it will be hard to get to 100 a day but with a much smaller loan

 

[npage148]

You underestimate how much people like their time off. Sure I may fill 300-350 in 14 hours but on my day off I won't be dealing with pharmacy stuff unless my boss coming knocking on my front door to talk to me.

 

[MountainPharmD]

You underestimate how much people like their time off. Sure I may fill 300-350 in 14 hours but on my day off I won't be dealing with pharmacy stuff unless my boss coming knocking on my front door to talk to me.

In addition to your one or two days off a week I guess you like not making any more then your yearly salary no matter how hard you work. I guess you like being the employee of a company that could give a **** less about you and would fire you in a second to save a buck. I guess you like not building wealth and equity in an asset. In the end your slaving away for the benefit of a multibillion dollar a year corporation that could terminate your employment at anytime leaving you with nothing. If that makes you happy keep punching the time clock at CVS.

 

[BMBiology]

In addition to your one or two days off a week I guess you like not making any more then your yearly salary no matter how hard you work. I guess you like being the employee of a company that could give a **** less about you and would fire you in a second to save a buck. I guess you like not building wealth and equity in an asset. In the end your slaving away for the benefit of a multibillion dollar a year corporation that could terminate your employment at anytime leaving you with nothing. If that makes you happy keep punching the time clock at CVS.

You make it sounds like it is always better to own a business than to work for someone's else. That is not always the case. Not every business is successful and the numbers you posted are based on assumptions. Yes there are rewards to owning a business but at the same time you shouldn't avoid discussing the risk and challenges.

 

[HouTX]

big risk, big reward. I'm with you mountain

 

[MountainPharmD]

As I said above this was a very simply example to stimulate discussion. We are brain washed by our schools and the big chains against pharmacy ownership. Employees are much easier to manage and control. It took a successful independent owner months to finally break though and make me understand that this is actually a viable option. Sure it's harder than ever before to be in the pharmacy business. It's not impossible as many would lead us to believe.

The above example would be for a pharmacy doing approximately $1.4 million in annual sales on 25,000. You should be able to acquire this business for about $210,000 plus inventory of approximately $120K. The debt service on an SBA loan with a 10% down payment would give a month payment of $3,700 or $44,400 a year.

Again a very simple example. A complete financial analysis would need to be done and many factors weighed to determine if this hypothetical scenario would be a viable opportunity. If this were a pharmacy under the same owner for 40 years who's running a gross profit margin in the 16% to 19% range this would be a dream opportunity. The nationwide average gross profit is 24%. If you join the right buying group you could start off from day one with a better acquisition cost on drugs and instantly get a bump in margin up to 20% to 22%.

 

[MountainPharmD]

I had a friend in the Army whose line of reasoning before we did something really dangerous and stupid was "No risk, no fun". I've modified that slightly for the business world, "No risk, no reward."

Spare me the whole "I work for corporate chain X and when I'm off, I'm off". You've obviously never been a PIC or pharmacy manager. As a PIC at Kroger I averaged at least 50 hours a week while getting paid a salary based on 40 hours a week. There was no possible way in a 40 hour work week I could do all the BS management/metrics crap the company wanted me to do and be a 40 hour a week pharmacist filling my share of 300 to 400 rxs a day. In the end I got no credit for when things went well and all the blame when they went bad. I never made one single dime more than my salary no matter how hard I worked or many hours a week I put in.

If your only argument is I'm off when I'm off...go be a PIC for a few years and then tell me about being off when your off.

 

[MountainPharmD]

You make it sounds like it is always better to own a business than to work for someone's else. That is not always the case. Not every business is successful and the numbers you posted are based on assumptions. Yes there are rewards to owning a business but at the same time you shouldn't avoid discussing the risk and challenges.

I'm not avoiding discussing anything. There are risks associated with everything. I never said owning an independant is a guaranteed success. Just like I wont say being an employee of a big chain is a guarenteed success. An independent could fail and your big corporate chain could decide tomorrow they don't need you and fire you. There are risks everywhere.

 

[npage148]

In addition to your one or two days off a week I guess you like not making any more then your yearly salary no matter how hard you work. I guess you like being the employee of a company that could give a **** less about you and would fire you in a second to save a buck. I guess you like not building wealth and equity in an asset. In the end your slaving away for the benefit of a multibillion dollar a year corporation that could terminate your employment at anytime leaving you with nothing. If that makes you happy keep punching the time clock at CVS.

Well I get 3-4 days off a week during a 42 hour week. But if working non-stop for your business that is more than likely going to fail (based on historical rates) floats your boat go for it.

If you die tomorrow your family isn't going to care you worked tirelessly to build a successful business. They will care they never got to spent time with you beacuse you were always at work.

 

[PharmEcon]

Obviously differences in preferences, risk aversion, what one wants out of a career, etc. There is no right answer because it depends on the person.

As for more than likely to fail- it really depends on the homework you do plus a bit of luck, but you can definitely swing the chances in your favor and the payout can possibly be very big. Build up the business after a while and you can hire someone as a staff pharmacist and cut back your own hours too.

 

[HouTX]

Obviously differences in preferences, risk aversion, what one wants out of a career, etc. There is no right answer because it depends on the person.

As for more than likely to fail- it really depends on the homework you do plus a bit of luck, but you can definitely swing the chances in your favor and the payout can possibly be very big. Build up the business after a while and you can hire someone as a staff pharmacist and cut back your own hours too.

uhh that's not possible. for the nay-sayers, owning your own pharmacy means working 24/7 and no time for family /sarcasm

 

[BMBiology]

This thread isn't about starting a pharmacy. It is just a rant about retail pharmacy. I never think it is a good idea to start a business just because you don't like the alternative.

I sense something happened to mountain recently. If something did, I would take a step back and not rush into things. It is always better to underestimate things than based your assumptions on lofty numbers.

 

[Aznfarmerboi]

I am a big advocate of taking risks and opening up businesses...

but 150 prescriptions is the break even point.

............. with that said, there was never a better time..., and a worst time..., to open up an independent.

The biggest expense is labor. You can get away with hiring new graduates or retirees for a lot less. Up to 30 percent less (30 to 40 dollars). You can also offer good technicians a lot less. Contrary to other posts, a good lead tech should not cost you more than 15 dollars, and a tech.. 9-10.

Next... a lot of drugs are going generic. You don't have to worry about huge inventory costs. That bottle of Zyprexa isn't going to kill you anymore.

Also, retail space costs less because of the economy. There are a lot of big chains closing down (Blockbuster, Borders, etc). Banks are not building every where and paying what ever prices landlords were asking for.



Now the bad... the absolute reason why I would not invest in a pharmacy now is because of insurances. They force mail order on a lot of drugs now. Back then, I would dispense gazillion lipitors, singulairs, etc. I still do but not to what I was seeing back then. They also want to do creams, doxy, ibuprofen, etc... If they are not taking business away from mail order, they are forcing people to go to preferred pharmacies like CVS or Wags.

On top of that, they are cutting reimbursement for lots of drugs that sometimes you are forced to take a loss.

And..., what finally kills it is that most plans are government funded plans like medicare, which hurts you even more so.


Risks vs benefits... turn over is so low in retail because most pharmacists are aware that it is easier to make 120-200k working for chains (and even finding sweet spots), vs opening up a new store. In fact, I continue to see retail pharmacies selling out to chain. The truth is even if I wanted to open up a pharmacy, there are not that many good locations. It is either taken up by established independents, or the location is in a rural and suburban areas thats dying.

 

[Aznfarmerboi]

I'm not avoiding discussing anything. There are risks associated with everything. I never said owning an independant is a guaranteed success. Just like I wont say being an employee of a big chain is a guarenteed success. An independent could fail and your big corporate chain could decide tomorrow they don't need you and fire you. There are risks everywhere.

.... so are you planning on opening up your pharmacy? You have been bitter about chains for a while now. I thought you were still with CVS Caremark on the PBM side.

 

[PharmEcon]

but 150 prescriptions is the break even point.

This probably varies regionally a lot and on whether the owner is the only pharmacist working there. I know of several independents doing well with less volume than this.

 

[MountainPharmD]

Well I get 3-4 days off a week during a 42 hour week. But if working non-stop for your business that is more than likely going to fail (based on historical rates) floats your boat go for it.

If you die tomorrow your family isn't going to care you worked tirelessly to build a successful business. They will care they never got to spent time with you beacuse you were always at work.

Those are the exact reasons I quit working for a corporate retail chain.

If you think working for a corporate retail chain gives you some sort of job guarantee you are a fool.

 

[MountainPharmD]

.... so are you planning on opening up your pharmacy? You have been bitter about chains for a while now. I thought you were still with CVS Caremark on the PBM side.

I am in the process of acquiring an existing pharmacy. If all goes well I will be done with Caremark Feb. 15th and running my own pharmacy March 1st.

 

[MountainPharmD]

I am a big advocate of taking risks and opening up businesses...

The biggest expense is labor.

Not even close. The biggest expense is cost of goods sold which accounts for 75% or greater of your expenses. How profitable you are is entirely dependent on your COGS and how you manage it.

After that then yes, labor should be your next biggest expense. That's easy to manage.

Now the bad... the absolute reason why I would not invest in a pharmacy now is because of insurances. They force mail order on a lot of drugs now. Back then, I would dispense gazillion lipitors, singulairs, etc. I still do but not to what I was seeing back then. They also want to do creams, doxy, ibuprofen, etc... If they are not taking business away from mail order, they are forcing people to go to preferred pharmacies like CVS or Wags.

On top of that, they are cutting reimbursement for lots of drugs that sometimes you are forced to take a loss.

And..., what finally kills it is that most plans are government funded plans like medicare, which hurts you even more so.

There are big positive changes coming to insurance specifically Medicare D. The entire Med D program will be revamped for 2015. MAC pricing will be eliminated. The restricted networks and preferred pharmacies will be eliminated or at the very least any willing provider will be allowed to participate. Big changes...

 

[PharmEcon]

There are big positive changes coming to insurance specifically Medicare D. The entire Med D program will be revamped for 2015. MAC pricing will be eliminated. The restricted networks and preferred pharmacies will be eliminated or at the very least any willing provider will be allowed to participate. Big changes...

When the ACA's provisions on CMS spending kicks in, the FULs will push medicaid reimbursements down below current MACs in many cases. Not sure where you are getting that MACs are going away (would be interested in seeing what you are referring to). As for preferred networks, the recent CMS proposal which is still in the comment phase suggests changes to the preferred pharmacy model for Part D plans, but not eliminating them.

 

[opinionfree]

Well it sounds like congratulations are due on your soon to be ownership of a pharmacy. With all of me, I hope it is the success you envision it to be.

I take umbrage that you are arguing with people, that voice any opinions against what you consider to be the perfect undertaking. If you just want people to validate your plan to acquire a pharmacy, ask for it. But to post this elaborate hypothetical example of a pretend pharmacy acquisition, which in fact is your real plan, is indicative of questionable integrity. Then to argue against any sincere questioning of your actual plan, is just not nice.

I sincerely wish you well. However, your defensive nature and damned be all with opposing views mentality, doesn't exactly lead me to think you will be successful. When someone needs to argue, in an attempt to mask their underlying fears, it's never a good sign. Hopefully, you will prove me wrong.

 

[MountainPharmD]

When the ACA's provisions on CMS spending kicks in, the FULs will push medicaid reimbursements down below current MACs in many cases. Not sure where you are getting that MACs are going away (would be interested in seeing what you are referring to). As for preferred networks, the recent CMS proposal which is still in the comment phase suggests changes to the preferred pharmacy model for Part D plans, but not eliminating them.

The whole reimbursement model will be changing... AWP, FUL, MAC all gone. The model will be based on actual acquisition cost.

Changing the preferred pharmacy networks to allow any willing provided along with the new reimbursement model essentially eliminates them.

 

[PharmEcon]

The whole reimbursement model will be changing... AWP, FUL, MAC all gone. The model will be based on actual acquisition cost.

Changing the preferred pharmacy networks to allow any willing provided along with the new reimbursement model essentially eliminates them.

FULs are not going away, they are just going to be recalculated and likely to the detriment of retail pharmacies http://www.drugchannels.net/2013/11/amp-final-rule-delayed-yet-again-to-may.html http://www.gao.gov/products/GAO-11-141R

The preferred pharmacy thing could end up [effectively] being true depending on what is implemented in the end, but it is still in the comment phase (or whatever the technical term for that phase is).

 

[MountainPharmD]

Well it sounds like congratulations are due on your soon to be ownership of a pharmacy. With all of me, I hope it is the success you envision it to be.

I take umbrage that you are arguing with people, that voice any opinions against what you consider to be the perfect undertaking. If you just want people to validate your plan to acquire a pharmacy, ask for it. But to post this elaborate hypothetical example of a pretend pharmacy acquisition, which in fact is your real plan, is indicative of questionable integrity. Then to argue against any sincere questioning of your actual plan, is just not nice.

What the hell are you talking about? It's a discussion...that's whats supposed to happen. Opinions and counter opinions are voiced back and forth.

I need no validation for my plan. I know what I'm doing and why I'm doing it. I give a damn what you or anyone else on here thinks. The scenario above is a hypothetical example based off some real world numbers. The point is to stimulate discussion and get people thinking about ownership. Truth be told I'm not the one who created it. The same scenario was presented to me many months ago which is what got the ball rolling for me. All I'm trying to do is pay it forward. Trust me, the example above is not elaborate at all. It's a very simplistic scenario meant to stimulate discussion and dispel some of the myths and misconceptions people have towards ownership.

Questionable integrity?!?!? Your a freaking idiot!

I sincerely wish you well. However, your defensive nature and damned be all with opposing views mentality, doesn't exactly lead me to think you will be successful. When someone needs to argue, in an attempt to mask their underlying fears, it's never a good sign. Hopefully, you will prove me wrong.

You can take sincerely and shove it up your ass.

The point of this thread was to stimulate discussion. So sorry your delicate little feelings got hurt. I take great umbrage to statements made by someone whose been a member of this forum for all of 5 minutes. Stick around for a while, keep your mouth shut and you might learn something.

 

[MountainPharmD]

FULs are not going away, they are just going to be recalculated and likely to the detriment of retail pharmacies http://www.drugchannels.net/2013/11/amp-final-rule-delayed-yet-again-to-may.html http://www.gao.gov/products/GAO-11-141R

The preferred pharmacy thing could end up [effectively] being true depending on what is implemented in the end, but it is still in the comment phase (or whatever the technical term for that phase is).

Oh yeah, its far from certain. However, there has been enough hell raised about it that there will be changes in one form or another.

 

[MountainPharmD]

Let me clarify...there are several members of this forum whose opinions I do value. I do care what they think. However, I would not solicit their opinion or advice through a public thread in the forums section.

For the sake of clarity...I don't care what anyone thinks about what I post in the public forums.

 

[owlegrad]

All right chill out with the name calling

 

[opinionfree]

The OP states that the impetus behind this whole undertaking is 'hypothetical' then by post 31 he admits, "I am in the process of acquiring an existing pharmacy. If all goes well I will be done with Caremark Feb. 15th and running my own pharmacy March 1st." Damn. if that's not an attempt to deceive, what is?

This is a public forum. I'll respond or post, to ANYTHING I want. Thank you.

Oh, and your pharmacy, WILL FAIL. You will be BANKRUPT and most assuredly under investigation for fraud, within 18 months. You haven't the intelligence or integrity to make it a success. HAHA!!!

 

[Silent Cool]

Here are some pharmacies for sale:

http://www.sunbeltnetwork.com/business-for-sale/search/Drug-Stores_Pharmacies

Why don't you buy one of these?

 

[BenJammin]

Mountain you operate in my neck of the woods I believe. I'd happily work relief for you.

 

[BenJammin]

You underestimate how much people like their time off. Sure I may fill 300-350 in 14 hours but on my day off I won't be dealing with pharmacy stuff unless my boss coming knocking on my front door to talk to me.

Why can't you just accept that owning a pharmacy is not for you? You make it seem like it's bad for all. Lots of independent pharmacy owners get to spend time with their husbands/wives and children. Lots of independents aren't open 9-9 and you're sure as hell not tucking your kids into bed while slaving away at CVS during an 8-10 shift

 

[All4MyDaughter]

Mountain you operate in my neck of the woods I believe. I'd happily work relief for you.

Me too, though I'm not in the area. I wish you the best of luck, Mountain!

 

[MountainPharmD]

The OP states that the impetus behind this whole undertaking is 'hypothetical' then by post 31 he admits, "I am in the process of acquiring an existing pharmacy. If all goes well I will be done with Caremark Feb. 15th and running my own pharmacy March 1st." Damn. if that's not an attempt to deceive, what is?

This is a public forum. I'll respond or post, to ANYTHING I want. Thank you.

Oh, and your pharmacy, WILL FAIL. You will be BANKRUPT and most assuredly under investigation for fraud, within 18 months. You haven't the intelligence or integrity to make it a success. HAHA!!!

You got lost somewhere slick. Let me try and catch you up.

1.) The scenario I posted is entirely hypothetical however it's based on real numbers.

2.) I did not create the scenario. It was presented to me about 4 months ago by a very successful independent owner. It's what got me thinking about independent
ownership. I posted it on here to sort of pay it forward and hopefully get a young pharmacist or two thinking about independent ownership.

3.) I'm in the process of acquiring a pharmacy, never tried to deny or conceal it. I will not discuss the terms and conditions of the acquisition on a public internet
forum. I'll be glad to discuss general pharmacy acquisition and financial analysis questions.

Are you on the same page as everyone else now? Do I need to break out the Big Chief Tablet and crayons and draw you a picture? I know...the internet is hard. Keep practicing, you'll get it.

(Just for you owlegrad...no name calling!)

 

[Jibby321]

You got lost somewhere slick. Let me try and catch you up.

1.) The scenario I posted is entirely hypothetical however it's based on real numbers.

2.) I did not create the scenario. It was presented to me about 4 months ago by a very successful independent owner. It's what got me thinking about independent
ownership. I posted it on here to sort of pay it forward and hopefully get a young pharmacist or two thinking about independent ownership.

3.) I'm in the process of acquiring a pharmacy, never tried to deny or conceal it. I will not discuss the terms and conditions of the acquisition on a public internet
forum. I'll be glad to discuss general pharmacy acquisition and financial analysis questions.

Are you on the same page as everyone else now? Do I need to break out the Big Chief Tablet and crayons and draw you a picture? I know...the internet is hard. Keep practicing, you'll get it.

(Just for you owlegrad...no name calling!)

My family has been a small business over for 10+ years now. I have alot of respect for small business owners and support them whenever possible. Especially pharmacies. So I wish you luck mountain!

 

[npage148]

Why can't you just accept that owning a pharmacy is not for you? You make it seem like it's bad for all. Lots of independent pharmacy owners get to spend time with their husbands/wives and children. Lots of independents aren't open 9-9 and you're sure as hell not tucking your kids into bed while slaving away at CVS during an 8-10 shift

Well, the op made it seem like it was bad for all to NOT own a pharmacy so I might as well express the polar opposite view for the sake of it.

I also don't have kids but my dogs don't really mind when i get home. They are always happy to see me

 

[MountainPharmD]

Well, the op made it seem like it was bad for all to NOT own a pharmacy so I might as well express the polar opposite view for the sake of it.

I also don't have kids but my dogs don't really mind when i get home. They are always happy to see me

I simply countered the very weak arguments a few people expressed. I will never make a blanket statement concerning whats right and wrong for any one individual. Well...that's not true. There is an exception. Corporate retail pharmacy sucks and is bad for everyone.

 

[Unchained]

I give credit to Mountain for going out and fighting the good fight. Corporate retail pharmacy does suck and is bad for everyone. You can outsmart and outwork the next guy but what concerns me are the macro factors beyond our control. As gov't takes over more of our lives they are redistributing money to corporations and social programs. This trend has accelerated in the last 20 years and will continue. Pharmacy in particular being the end distributor has been seen as a cash cow by insurance companies,manufacturers and distributors. I feel that there are better ways to invest time and money than in a pharmacy.