Community pharmacy fills gaps in access and
Transcription
Community pharmacy fills gaps in access and
2014 Community pharmacy fills gaps in access and affordability for patients, payers A special report by Drug Store News Group A LEBHAR-FRIEDMAN® PUBLICATION 425 Park Ave., New York, NY 10022 (212) 756-5220 Fax (212) 756-5270 Subscription Services: (813) 627-6707 President/Group Publisher John Kenlon (212) 756-5238, [email protected] Publisher Wayne Bennett (212) 756-5157, [email protected] Editor in Chief Rob Eder (212) 756-5160, [email protected] Executive Editor Teresa Dombach (212) 756-5015, [email protected] Senior Editor/OTC & Natural Health Michael Johnsen (717) 820-4652, [email protected] Senior Editor/Beauty Care Antoinette Alexander (212) 756-5246, [email protected] Desk Editor Rebecca Haughey (212) 756-5093, [email protected] Desk Editor Sierra McCleary-Harris (212) 756-5208, [email protected] Online News Editor Ryan Chavis (212) 756-5178, [email protected] Contributing Editors Jim Frederick, Barbara White-Sax, Alaric DeArment NACDS members operate pharmacies in every state and Congressional district. Have you toured one in yours? NACDS invites members of the 113th Congress to experience first-hand the patientcare power of community pharmacies. Through an NACDS RxIMPACT Pharmacy Tour, you will see what your constituents see and take away insights about how: • Pharmacies help patients use medicines safely and stay healthy • Innovative pharmacy services do even more to improve patient health and quality of life • Widely trusted and accessible, pharmacists are extremely valued by those in greatest need • Pharmacy services improve healthcare affordability. Please contact NACDS’ Heidi Ecker at (703) 837-4121 or [email protected]. NATIONAL ASSOCIATION OF nacds.org CHAIN DRUG STORES Director of Continuing Education and Clinical Content Suzanne Feeney (630) 240-2838, [email protected] REGIONAL SALES OFFICES NEW YORK 425 Park Ave. New York, NY 10022 Associate Publisher Eric Savitch (856) 489-3336, [email protected] Area Manager Alex Tomas (212) 756-5155, [email protected] MIDWEST 444 N. Michigan Ave. Chicago, IL 60611 Central Regional Manager Catherine Stephany (312) 645-5081, [email protected] WEST Western Regional Manager Mary Fagnano (818) 386-8709, [email protected] Custom MEDIA Creative Director Darren Ursino [email protected] Client Services Account Manager Jamie Travis [email protected] Marketing Coordinator Mackenzie Degen [email protected] Associate Creative Director Michael Iafrate [email protected] Designer Calvin Anthony [email protected] President J. Roger Friedman PERMISSIONS Materials may not be reproduced without written permission. Requests should be directed to John Kenlon, President/Retail Group Publisher, Drug Store News, 425 Park Ave., New York, NY 10022. DrugStoreNews.com Prescribing healthcare savings One of America’s most intractable challenges is the staggering cost of health care. One vital but underutilized resource that could help break the cost cycle is the nation’s nearly 62,000 community pharmacies. Editor in Chief Rob Eder Pharmacists provide a wealth of patient care services beyond prescription dispensing and basic counseling. They prevent health conditions from spiraling out of control, they catch dangerous diseases in their early stages and they help patients manage chronic diseases and complex medication regimens. Pharmacists increasingly are providing immunizations and vaccinations — a role most could not fill five to six years ago. According to one study, immunization programs conducted in a pharmacy setting versus a physician’s office save an average of about $31 per patient. Each year, the United States spends about $300 billion due to patients not taking their medications as prescribed. Research from CVS Caremark has shown that patients with chronic conditions who take their medications correctly save about $7,800 per patient. Yet about half of these patients will stop taking their medications within a year. Medication therapy management — where pharmacists work closely with patients to ensure they take their medications correctly — is returning about $12 in savings for every $1 invested in it. It’s not just about reducing the cost of drugs, it’s the role the community pharmacist can play in helping reduce total healthcare spending. This report offers a close-up look at the health contributions provided by nearly 40 pharmacy companies across the United States, and the solutions that are possible when pharmacists are empowered to practice at the top of the profession. Editor’s note: In addition to the companies that appear in this report, Drug Store News would like to acknowledge the following companies for participating in NACDS RxImpact Day 2014, including: Astrup Drug, Kinney Drugs, Marsh Supermarkets, Navarro Discount Pharmacies, Red Cross Pharmacy and Ritzman Pharmacies. INSIDE Pharmacy Profiles Ahold USA������������������������������������� Page 4 Albertsons ������������������������������������ Page 4 Bartell Drugs �������������������������������� Page 5 Bi-Lo/Winn-Dixie��������������������������� Page 5 Cardinal Health ����������������������������� Page 6 Costco ������������������������������������������ Page 6 CVS Caremark������������������������������� Page 7 Delhaize America �������������������������� Page 7 Discount Drug Mart ���������������������� Page 8 Fruth Pharmacy ���������������������������� Page 8 Genoa Healthcare ������������������������� Page 9 Good Neighbor Pharmacy�������������� Page 9 Hartig Drug ���������������������������������� Page 10 H-E-B������������������������������������������� Page 10 Hi-School Pharmacy Services������ Page 11 HomeTown Pharmacy������������������� Page 11 Hy-Vee ����������������������������������������� Page 12 Klingensmith’s Drug Stores���������� Page 12 Lovelace Retail Pharmacy������������� Page 13 Meijer ������������������������������������������ Page 13 NuCara����������������������������������������� Page 14 Shopko����������������������������������������� Page 14 Rite Aid ���������������������������������������� Page 15 Quick Check �������������������������������� Page 15 Supervalu ������������������������������������ Page 16 Thrifty White Drug ������������������������ Page 16 Thriftway/Zitomer Pharmacy �������� Page 17 Wakefern Food/ShopRite ������������� Page 17 Walgreens������������������������������������ Page 18 Walmart ��������������������������������������� Page 18 Wegmans������������������������������������� Page 19 Weis Markets ������������������������������� Page 19 Wilkinson Pharmacy �������������������� Page 20 March 2014 • 3 Ahold dietitians capture intersection of grocery, Rx For Dutch-based Royal Ahold’s U.S. retail banners — which include Stop & Shop in the Northeast, Giant Food Stores of Carlisle, Pa., and Giant Food of Landover, Md. — the pharmacy and the health-and-wellness services its pharmacists provide are a prime focus of the company’s total retail offering and a key to Ahold’s reputation for high-service, one-stop shopping. Ahold’s more than 565 food-drug combo stores promote Ahold emphasizes the intersection of food and pharmacy by staffing dietitians who provide nutritional counseling in its stores. the critically important intersection of healthy food and pharmacy. The company has been effective at exploring the links between pharmacist counseling and medicines in the prescription department, and the nutritional counseling and healthy eating offerings provided in the food aisles, along with the dietitians who staff some of its stores. Both, say its leaders, are key to good health. Nutritionists are encouraged to refer customers to the store pharmacist for advice, and vice versa. Increasingly, pharmacists at Stop & Shop and other Ahold outlets also are encouraged to step out from behind the counter to help customers find the right OTC product or to meet with the store’s dietitian, if available. The company also has allied with Unilever to sponsor in-store clinic programs and with Quaker Oats to promote oatmeal as a way to lower cholesterol. Last year, Ahold launched a new campaign to promote stronger relationships between pharmacists and their patients. The program, called “ACT” for “Acknowledge, Coach and Thank,” is designed to encourage pharmacists to “take a more active, deliberate role in communicating with our patients” and “adopt an ownership mentality and make each customer feel important and appreciated,” said Andrew Markievich, manager of pharmacy clinical programs for Ahold USA. Reunited Albertsons expands wellness offerings Albertsons is back. The storied supermarket banner is flying over a reunited retail network that stretches across the western and southwestern United States and throughout Florida in the Southeast. Combined with its sister company, New Albertson’s, Inc., the two companies command a retail grocery and drug store empire that extends across much of the Midwest and into the Northeast and New England states. Besides Albertsons, that network includes respected supermarket and pharmacy brands like Jewel-Osco supermarkets and Osco drug stores in the Midwest, Shaw’s and Star Market in New England, and Acme Markets in Pennsylvania, New Jersey, Delaware and Maryland. All those divisions operate within New Albertson’s, acquired last year from Supervalu by Cerberus Capital Management, which had already purchased much of the Albertsons empire. The subsequent re-integration of the remaining Albertsons stores that also came with last year’s deal with Supervalu continued to expand and reinvigorate one of the nation’s largest and most innovative pharmacy providers. “New Albertson’s Inc., which operates pharmacies in Jewel-Osco, Acme Markets and Shaw’s/Star Markets, and Albertson’s LLC, which operates Albertson’s LLC and New Albertson’s Inc. run a retail grocery and drug store empire that extends across much of the United states. Albertsons-Osco and Albertsons-Sav-On pharmacies, together operate a total of 811 pharmacies across the country. Both companies have worked with local partners to also offer 16 in-store clinics,” said spokeswoman Christine Wilcox. Those pharmacies “offer a full menu of health-and-wellness services,” Wilcox said, through “both group programs [and] private one-on-one appointments. We also have a core of specially trained Wellness Pharmacists to offer a comprehensive menu of services … to help patients better manage their chronic conditions, such as diabetes, high blood pressure, high cholesterol, asthma and more.” Continued on page 20 4 • March 2014 DrugStoreNews.com Bartell Drugs provides affordable lab tests With the influx of new patients under the Affordable Care Act, an important function of retail pharmacies will be to provide some of the services that patients traditionally associate with primary care physicians in order to alleviate the pressure on doctors and on hospital emergency rooms. One area in which Seattle-based Bartell Drugs is helping is cholesterol and blood-sugar testing. Bartell director of pharmacy operations and clinical services Billy Chow told DSN that lab testing can cost up to $125, but in a retail pharmacy setting, that price can dip to between $15 and $20. The main barrier, he said, is letting patients know. “One of the challenges is visibility,” Chow said. “People don’t realize they can go to a community pharmacy.” For that reason, the chain has embarked on training its pharmacists in cholesterol, A1C and blood-glucose testing. Bartell also has recently launched a retail clinic program under a partnership with Group Health Cooperative. Under the program, dubbed CareClinic and launched in December, Group Health nurse practitioners provide treat- Bartell Drugs offers affordably priced testing for cholesterol and blood sugar. ments for such minor ailments as cuts and bruises, pinkeye and sore throat. Currently, there is one clinic at a store in Seattle’s University Village shopping center and another in the neighboring city of Bellevue, Wash. Chow told DSN that a third clinic is planned to launch on March 7 in Seattle’s Ballard neighborhood. Bi-Lo/Winn-Dixie make health convenient in Southeast Ask consumers in the Southeast to name their grocery outlet, and two supermarket brands are sure to come up: Bi-Lo and Winn-Dixie. Many of those consumers also will cite either chain as their source for prescriptions, preventive health services and nutritional advice. Both Bi-Lo and Winn-Dixie are owned by Greenville, S.C.-based Bi-Lo Holdings. Together, they comprise the nation’s ninth-largest supermarket chain by sales volume, with 684 stores in Alabama, Florida, Georgia, Louisiana, Mississippi, North Carolina, South Carolina and Tennessee. But Bi-Lo also fields 482 full-service pharmacies in Bi-Lo and Winn-Dixie stores. Bi-Lo allows online prescription ordering and offers a pharmacy mobile app. DrugStoreNews.com Bi-Lo Pharmacy is serious about health and wellness. Its service menu includes free screenings for blood glucose and cholesterol levels by appointment, and immunizations for influenza, pneumonia, tetanus, Hepatitis B, shingles, HPV and other conditions. Patients can schedule both screenings and vaccinations online. They also can save money through a $4 generic discount program and the Bi-Lo Prescription Drug Plan, which offers “access to the lowest prices on common prescriptions.” Bi-Lo also has joined the mobile health revolution, with online prescription ordering and a pharmacy smartphone app for customers on the go. The chain continues to expand its commitment to health and convenience. In January, Bi-Lo like several other pharmacy chains temporarily suspended the up-front cost of a 30-day supply of most prescription drugs for patients newly enrolled in an insurance plan through the Affordable Care Act who hadn’t yet received their membership cards. The goal: “To help make their transition to the Public Health Insurance Marketplace a little easier,” said VP pharmacy John Fegan. In February, Bi-Lo took a big step toward boosting patients’ adherence to their medication regimens with the launch of “Refill Sync,” an opt-in program that synchronizes customers’ maintenance medication prescriptions so that all scripts Continued on page 20 March 2014 • 5 Cardinal brings ‘coordination, efficiency’ to health care In a sweeping transformation, drug wholesale and health services giant Cardinal Health is aligning its massive distribution and service network to meet the needs of a shifting healthcare system desperately in need of new solutions. “This is an extraordinary time in health care,” said Cardinal chairman and CEO George Barrett. “We see care becoming more coordinated, delivered in more cost-effective settings and driven by incentives increasingly linked to outcomes, rather than activities.” What’s more, he said, “we are in the early stages of an unprecedented demographic wave, which is bringing nearly 10,000 people per day to eligibility age for Medicare.” Cardinal, he said, “will use our scale, our broad reach across the system and our portfolio of services and products to help bring coordination and efficiency” to the nation’s changing health system. As a healthcare entity, Cardinal operates on a massive scale. The company provides pharmaceuticals and medical products and services to more than 100,000 locations every day, including nearly 8,000 independent retail pharmacies and roughly 10,000 chain pharmacies, as well as thousands of hospital and clinic CVS’ hybrid structure creates unique patient care solutions With its unique hybrid structure and its ability to leverage the three core parts of its business — part big retail pharmacy chain, part big pharmacy benefit manager, part big retail clinic operator — CVS Caremark is using behavioral economics and predictive analytics to create an innovative array of programs and services that align effectively with the long-term trends in health care. Indeed, one area in which the company remains laserfocused is improving medication adherence. The cost of people not taking their medications as they are prescribed Cardinal Health’s purchase of AssuraMed makes the company the leading distributor of direct-to-home medical supplies. pharmacies across the United States. With its $2 billion purchase last year of AssuraMed, a leading provider of medical supplies and home infusion therapy, Cardinal is now also the industry-leading distributor of directContinued on page 21 CVS’ Pharmacy Advisor program aims to improve medication adherence. Preventive services make Costco health destination Warehouse club store giant Costco Wholesale has exploded in size and reach to become the nation’s fourth-largest retailer. But along with its growth as a club store powerhouse, Costco has steadily expanded patient care services and become a health-and-wellness destination for millions of Americans. The company’s reach as a one-stop destination for health products and services — some of them free and most of the rest priced at steep discounts in keeping with the company’s legendary low-price mission — can hardly be overstated. In the Costco, known for its low prices, offers free and steeply discounted health products and services. fiscal year ended Aug. 31, 2013, Costco operated 565 in-store pharmacies, employing some 2,000 pharmacists — up from 544 the previous year — as well as 614 optical centers and 469 hearing aid centers within its huge warehouse stores. Serving a membership base that now comprises 40 million households and more than 72 million cardholders, Costco pharmacists filled 38 million prescriptions last year and provided an expanding battery of preventive care services. Among them: an adult immunization program, delivered by pharmacists on a walk-in basis, with flu shots going for just $14.99. Costco pharmacists also offer free periodic health screenings for a variety of conditions, including bone disease, diabetes and chronic obstructive pulmonary disease. “Our osteoporosis screening uses ultrasound technology to assess one’s risk for this condition,” the company reported. “Our healthy heart screenings offer a risk assessment for heart disease, a lipid-stick profile test and a blood-pressure check. Our lung health screening uses a spirometer to identify those at risk of COPD at the pre-symptomatic stage.” On its pharmacy website, Costco provides guidance on the changes wrought by the Affordable Care Act for patients looking for health coverage. Indeed, the company offers a trove of Continued on page 21 6 • March 2014 DrugStoreNews.com is a $300 billion drain on the U.S. healthcare system. Enter Pharmacy Advisor. The flagship program is driven by the fact that face-to-face counseling between pharmacists and patients can be two to three times more effective as other forms of communication in driving adherence to prescription drug regimens. The condition-based program, which was first introduced in 2011 for diabetes only, alerts pharmacists when patients are not adherent to their medications or when there is a gap in care — for instance, when a patient has missed a critical biometric screening that could impact their drug therapy — and enables them to communicate and intervene with patients in real time. Since then, Pharmacy Advisor has been expanded to nine other chronic diseases, including high blood pressure, high cholesterol, coronary artery disease, congestive heart failure, asthma, breast cancer, chronic obstructive pulmonary disease, depression and osteoporosis. In 2013, CVS Caremark had 16 million patient lives on Pharmacy Advisor. The program has been shown to increase adherence rates up to 3.9%, with a return of $3 in savings for every $1 Continued on page 21 Consumer health ‘a vital responsibility’ for Delhaize Any pharmacist working for one of Delhaize America’s supermarket chains from Maine to Florida knows that good health depends not only on the medication therapy and clinical services they provide in the pharmacy, but also on the nutritional advice and healthy eating choices their patients make in the food aisles. Delhaize employs more than 107,000 associates and operates 1,514 supermarkets in 16 eastern and southern states under several regional banners. The largest are Salisbury, N.C.-based Food Lion, which operates more than 1,100 supermarkets and 39 instore pharmacies; and Hannaford, based in Scarborough, Maine, which serves New England and New York state with 180 stores, some 140 of which include pharmacies. Those pharmacies are aligned with the company’s holistic approach to its customers’ overall health through such programs as Guiding Stars, a nutrition navigation system that helps customers find healthier foods throughout the store. “Health across all our markets is a vital element of our responsibility,” the company reported. “Our skilled pharmacists do more than just fill prescriptions. They counsel patients on the proper use of medication and provide information on maintaining a healthy lifestyle.” Delhaize encourages its pharmacists to work in partnership with its staff of nutritionists and dietitians to boost customers’ DrugStoreNews.com Hannaford pharmacies provide holistic options to customers. healthy eating habits. Pharmacists in the company’s Hannaford stores exemplify that approach. “Because they’re located within a supermarket, Hannaford pharmacies have a unique advantage when it comes to offering help in managing your health conditions,” the company tells customers. “Our pharmacists not only help you with prescription and over-the-counter medications, they also can help put you in touch with our staff of nutritionists and registered dietitians.” “Together, they can provide nutrition information that may effect medications you’re taking, and give helpful advice on vitaContinued on page 21 March 2014 • 7 Discount Drug Mart: Loyalty via service, convenience In many parts of Ohio, a trip to Discount Drug Mart — most of its fiercely loyal customers just call it “Drug Mart” — is a shopping ritual that takes place like clockwork several times a month. Drug Mart’s 72 stores — and the pharmacists, pharmacy technicians and other employees who staff them — are as firmly fixed in the life of their communities as the local youth league baseball diamonds. Not bad for a chain that opened its first store just 45 years ago. Medina, Ohio-based Drug Mart is a tribute to one-stop shopping — its drug stores are packed with everything from medicines to Discount Drug Mart trusted pharmacists draw generations of Ohioans. hardware. But Buckeye State residents are as likely to seek out the wellness counseling of the stores’ pharmacists as they are to stock up on hammers, laundry detergent or fresh fruits and vegetables. Indeed, the company owes its success and legendary ability to draw generations of Ohio customers as much to its role as a trusted local health provider as to its one-stop convenience and competitive prices. Signaling the company’s determination to remain at its core a community health resource, pharmacist, founder and CEO Parviz Boodjeh continued for years to serve patients one day each week at one of the pharmacies so he wouldn’t lose touch with patients or medication issues. Drug Mart now fills more than 4.5 million prescriptions a year. Its pharmacists provide a wide range of services to make it easier for patients to stay well and adhere to their medication therapy. Among those services: immunizations for several conditions; a new “Sync Your Meds” program that allows patients to refill all their prescriptions at the same time each month; automatic prescription refills; and generic prescriptions for as little as $1.99. Also popular with Ohioans are such programs as Senior Savings Day each Wednesday, the company’s “Health Buzz” newsletter featuring the latest health research and medical insights, and a free $5 gift card for uninsured patients who sign up for a flu shot. Founder’s ‘down-home touch’ shapes culture at Fruth In the early days of Fruth Pharmacy, at its first store in Point Pleasant, W.Va., pharmacist and company founder Jack Fruth used to post a sign on the door after closing time: “In case of emergency, call Jack Fruth at home.” The founder’s “desire to serve the community,” noted Fruth emphasizes a commitment to community with services like prescription delivery to patients’ homes. a company report, “was evident not only in his willingness to come out in the middle of the night, but also with his involvement with local projects like the founding of Pleasant Valley Hospital.” Indeed, Fruth’s level of commitment to the care of his neighbors distinguished the company he established as an above-and-beyond drug store retailer, and it continues to shape the culture of this formidable regional pharmacy chain. Since 1952, Point Pleasant, W.Va.-based Fruth Pharmacy has meant “hometown family pharmacy,” by its own description, to generations of Americans in West Virginia and Ohio. Over those decades, the company has expanded to 26 stores. But Fruth remains, “first and foremost, a family business,” according to a spokesperson, “a full-service pharmacy and retail store with a down-home touch.” That “touch” extends to services like prescription delivery from all stores to patients’ homes, drug compounding and pharmacists who go to extra lengths to counsel their patients. 8 • March 2014 DrugStoreNews.com Genoa programs enforce medication adherence Compliance is an important pharmacy issue for all patients, but for patients in the mental health and addictions community, compliance is critical. “A one day lapse in medication can be a crisis for these patients,” said Dale Masten, director of government affairs at Genoa Healthcare. “That’s why it’s so important for us to be on-site as part of the healthcare team. Patients can have transportation issues, so having access to their mental health provider and pharmacist in the same location can improve outcomes.” Unlike traditional retail pharmacies, the Mercer Island, Tukwila-based company’s 122 pharmacies in 27 states and the District of Columbia are “closed door” pharmacies located on-site at partner behavioral health clinics and open to the clinics’ patients. “We strive to have a medication possession rate as close to 1% as possible, meaning patients are taking their medications as prescribed,” Masten said. “We work hard to ensure that patients always have access to their medication since a one-day lapse can increase the risk of hospitalization. We’re committed to helping consumers stay on their medication by providing the support necessary to make that happen.” Refill reminder calls are always made by a person who can respond to patient questions and help if patients aren’t following their medication schedule. “If it’s time for a patient’s refill and the patient has 12 pills left, we know something’s wrong, and we can walk down the hall and speak to the patient’s physician,” Masten said. Genoa developed a specialized perforated, color-coded, multimedication adherence packaging system for individuals living with severe and persistent mental illness. One pack represents a seven day medication supply and lists each medication and when it should be taken. The company offers a variety of other packaging to help optimize ease-of-use and increase the rate of compliance, along with many other services focused on improving adherence and outcomes for patients. Good Neighbor wins customers’ loyalty Once again in 2013, Good Neighbor Pharmacy ranked highest in overall customer satisfaction among chain drug stores in the annual J.D. Power U.S. National Pharmacy Study. That makes the third time the big national pharmacy network proved tops in customer loyalty since J.D. Power launched the consumer survey — GNP was previously awarded the honor in 2010 and tied for the recognition in 2011. Clearly, Americans embrace the kind of personalized, professional care and attention they get from the more than 3,200 independent pharmacy owner-operators who carry the Good Neighbor logo. Backed by the support of GNP’s parent company, wholesale pharmaceutical and health services giant AmerisourceBergen, independent pharmacists “play a vital role in their patients’ health care,” said Scott Robinson, group VP of Good Neighbor Pharmacy. “We are proud to support them in providing an unmatched level of personalized care through our valuable services, such as our immunization program and Prescription Savings Club.” Longtime Good Neighbor Pharmacy member Roger Accardi, owner of Accardi Clinical Pharmacy in Orange City, Fla., explained his store’s appeal this way: “We know our patients by name; they’re not just a number. We are good neighbors, and we, as community pharmacists, practice pharmacy the way it was meant to be.” GNP’s 3,200-plus member drug stores serve thousands of communities coast to coast, providing “a variety of patient care services, ranging from flu shots and immunizations, including a travel health program; a respiratory therapy program for chronic DrugStoreNews.com Good Neighbor Pharmacy services range from immunizations to its Diabetes Shoppe. obstructive pulmonary disease, or COPD, and asthma patients; Diabetes Shoppe; and home healthcare products and services,” said Chrissy Lane, director of brand management for the chain. More health-and-wellness initiatives are on the way. “In 2014, Good Neighbor Pharmacy is developing a new wellness platform that will incorporate all of our existing patient care services,” Lane said, “along with some new initiatives that will be important pharmacy measures based on changes in health care, such as the Affordable Care Act, Star Ratings (i.e., a health quality improvement initiative and rating system from the Centers for Medicare and Medicaid Services) and a movement toward outcomesbased pharmacy. We also are putting medication adherence at the forefront of our program as one of the most important priorities that is current in health care today.” March 2014 • 9 Hartig thrives on community care, personal service “It is still possible to thrive among a world of giant chain drug stores, grocery and mass merchants.” So says Richard Hartig, the third-generation pharmacist and owner of venerable Midwestern drug store operator Hartig Drug. His company’s success springs from a combination of powerful ingredients that allow small-scale local retailers to withstand the gale-force winds of national chain competition — ingredients like a deeply rooted reputation for personalized service, a strong grasp of local community health needs and shopping patterns, an energetic role in local civic affairs and the ability of its pharmacists to establish first-name-basis relationships with customers. Add to that picture Hartig’s strong focus on preventive health services and on “neat, clean stores, which carry a traditional drug store mix at exceptional prices,” and you have the makings of success over more than a century of service. Hartig prides itself “as America’s second-oldest continuously operated family drug chain,” in business since 1904. The Dubuque, Iowa-based firm operates 16 traditional pharmacies and two long-term care pharmacies in Iowa, Illinois and Wisconsin. “To us, customer service is more than lip service; it’s a culture,” the company said. “The men and women of Hartig Drug welcome our customers into our places of business as if they were family.” Hartig’s primary role, said its top manager is “providing affordable, accessible health care and vital medicines to members of the community. But we also believe that it is our responsibility to contribute more than simply access to a pharmacy or healthcare service.” That responsibility extends to civic life, Hartig said. “Whether it’s the Chamber of Commerce, Main Street, the local schools or any number of excellent community organizations, Hartig Drug is … supporting our community with volunteers, financial resources and most of all, a community conscience,” he said. In line with that commitment, Hartig became “one of the first retail chains in the country to implement prescription vial recycling” in 2013, the company reported. “This program will allow patients and customers to safely and confidentially recycle empty prescription medication vials.” That includes “any empty prescription container from any pharmacy,” Hartig noted. H-E-B offers Texas-sized wellness platform “We want to be known as the premier healthcare provider in Texas, recognizing H-E-B as a total wellness destination,” said Craig Norman, senior VP pharmacy for San Antonio-based supermarket and pharmacy powerhouse H-E-B. That statement sums up the company’s determination to be the Lone Star State’s go-to resource both for accessible front-line health services and nutritional advice. Norman said that determination “encompasses pharmacy and the rest of the store,” including counseling on healthy food choices by dietitians and nutritionists, along with “education we provide online, and of course a lot of programs in pharmacy.” With 235 supermarket pharmacies across Texas, H-E-B is known almost as much for its preventive health and nutritional efforts as for its role as the state’s leading supermarket. What’s more, the chain is a leading innovator at tying its pharmacy care efforts together with its healthy eating educational programs. H-E-B’s famed Second Saturdays program exemplifies its ability to integrate food and pharmacy. “We provide screenings to the public in every pharmacy, the second Saturday of every month,” Norman said, with free testing for blood pressure and glucose levels, and additional screenings offered for a full lipid profile and other tests for a fee. Hi-School caters to rural community needs Hi-School Pharmacy Services is dedicated to providing pharmacy services in small, rural communities in Washington and Oregon. “In many of the locations in which we operate, we are the only pharmacy provider for the community,” said Jack Holt, president of Hi-School Pharmacy Services. The chain currently operates 31 stores and considers an additional seven stores as affiliates. “We anticipate growth this coming year between five and 10 additional stores, either through new store openings and/or additional affiliate stores joining our organization,” Holt said. Holt said the chain is always looking for ways to improve the pharmacy experience for its customers. This year, HiSchool will remodel between four and five stores to upgrade existing counseling areas. The chain also will test new store design concepts. Sometimes that means integrating other retail categories into A ‘HomeTown’ resource for Michigan health care A “whole” that’s more than the sum of its parts. That could describe Newaygo, Mich.-based HomeTown Pharmacy, a closely allied network of 36 independently owned drug stores in Michigan that combines the buying clout and sophisticated data management of a retail chain with the deep “hometown” roots of a mom-and-pop pharmacy. The goal: to “bring together the personalized service of independently owned … pharmacies with the bargaining power and efficiencies of a larger corporation,” the company said. “Our pharmacies offer compounding, prescription services, medication counseling, blood-pressure checks, flu clinics, shingles vaccinations, flu shots, pneumonia vaccinations, prescription delivery and durable medical equipment.” It’s no accident that HomeTown blends small-town per- H-E-B offers free blood-pressure and glucose tests on the second Saturday of every month. “That’s our big consumer outreach,” Norman said. “And the Second Saturday screenings have become more of a total store event on those days … [with] healthy product demonstrations and other activities in the store to promote health and wellness … during those events.” In its pharmacies, Norman said, “the cornerstone of our professional service offerings is our immunization program,” Continued on page 20 10 • March 2014 DrugStoreNews.com its stores to better serve their communities. “In several of our locations, we have combined the pharmacy/variety store we operate with an ACE Hardware component to make us more of a one-stop shopping experience,” Holt said. Hi-School firmly focuses on pharmacy. “We worked well with our state pharmacy organizations in Oregon in getting PBM legislation enacted in 2013,” Holt said. “As similar measures are being considered in 2014 for the state of Washington, we want to assist in getting those laws passed also. These are key legislative issues that will help maintain our survival in a tough pharmacy environment.” To better serve customers, the chain is working toward integrating medication therapy management and med synchronization into its existing pharmacy software system. “These will be important initiatives at our small regional chain this year,” Holt said. HomeTown is part of a pilot project to evaluate rapid diagnostic testing in community pharmacies. DrugStoreNews.com sonal service and big-chain operating expertise. Founders Tim and Fred Grice began their pharmacy careers working for a national drug store chain before launching HomeTown in 1996. Says a company report, “Both brothers came to realize the necessity of growth for future survival and the importance of patient-driven community pharmacy.” The concept took firm root in Michigan and attracted a stillgrowing network of independent owner-operators that now spans the entire state. The wide range of preventive care services offered by HomeTown pharmacists also has spawned new community health initiatives and collaborative care agreements as patients and health systems seek alternate-site care solutions in the face of a growing shortage of primary care physicians. Among them: a pilot project to determine the costeffectiveness and patient acceptance of rapid diagnostic testing in community pharmacies. Participating HomeTown pharmacists were certified by the University of Nebraska Medical Center College of Pharmacy and Ferris State University to provide free influenza and strep throat diagnosis and treatment to eligible patients, under physiciandeveloped protocols. Jeff Stull, HomeTown’s pharmacy development manager, said, “We are not trying to compete with physicianbased practices, as we are still referring the sickest of patients to their local physicians, but we do feel that our pharmacists can provide quality care that is accessible and more convenient.” March 2014 • 11 Hy-Vee builds loyalty with high-touch care To Midwesterners, Hy-Vee means more than groceries. The chain is familiar both as one of the region’s premier supermarket operators, and as a center for health services ranging from prescription counseling to high-touch clinical care. West Des Moines, Iowa-based Hy-Vee employs more than 900 pharmacists and operates 245 in-store and standalone pharmacies — two more will open in April — in eight contiguous states. That total includes a specialty pharmacy, a compounding center, a high-volume centralfill prescription facility and 16 health clinic pharmacies. Its pharmacists and clinicians provide health-andwellness services, including medication therapy management, on-site screenings, immunizations, medication reviews and Hy-Vee pharmacists and clinicians provide a range of health-and-wellness services, including immunizations and medication reviews. counseling by certified diabetes educators and nutritionists. Those efforts have generated stellar customer satisfaction levels. Surveys suggest 92% of Hy-Vee’s pharmacy customers are “satisfied or very satisfied,” which it calls “the highest pharmacy satisfaction rate in the Midwest.” The chain’s commitment to wellness extends beyond the pharmacy. Hy-Vee employs more than 200 dietitians — making it the nation’s third-largest employer of nutritionists — who help guide consumers through the food choices in its supermarkets, both through educational store tours and personalized nutrition counseling. “Hy-Vee dietitians … develop personal nutrition plans to combat heart disease, diabetes and other health issues,” the company reported. Hy-Vee also contracts with local employers to provide biometric screenings, medical nutrition therapy in coordination with other clinicians, a healthy lifestyle management program and other services for their employees. The company’s leap into specialty and biotech pharmacy came through acquiring specialty provider Amber Pharmacy in February. “We were seeing customers … with specialty prescriptions that our pharmacies … didn’t have the staffing or depth of knowledge to administer,” said VP pharmacy Bob Egeland. Now, he said, “we tell every customer we can help with their specialty needs.” The goal is “to help reduce the stress associated with chronic illnesses and ensure the focus remains on the patient’s well-being … with condition-specific programs and resources that promote greater adherence to prescribed therapies, improved health and faster recovery.” Med sync boosts patient outreach at Klingensmith’s In June 2013, a team from Klingensmith’s Drug Stores traveled from the chain’s rural western Pennsylvania base to Minnesota to learn from another mostly rural chain, Thrifty White Pharmacy, about a service that has grown in importance for retail pharmacies everywhere: medication synchronization. Medication synchronization is when patients sign up with pharmacies to have all of their prescriptions dispensed at once, rather than at different times. According to a recent study by Thrifty White, two-thirds to more than three-quarters of patients enrolled in synchronization programs took their drugs as prescribed, compared with slightly more than one-third to less than half of those not enrolled. The improved adherence stems not just from more convenient filling, but from an active effort on the part of the pharmacy to reach out to patients to determine if there have been changes in therapy, hospital visits or new prescriptions. While the full effect of the programs can take a year to materialize, the company already has seen improvements, Klingensmith’s president David Cippel told DSN. Since the program was rolled out in September, it has taken on about 700 patients, a number that Cippel said he hopes to grow to 1,000 in the next couple of months. “We see a lot of good ideas out there, and we have to pick and choose from the good ideas where we see opportunity,” Cippel said. In addition to its popularity with patients, the program has won the favor of physicians because for them, it means fewer calls from the pharmacies requesting refills and thus less time spent on clerical work. 12 • March 2014 DrugStoreNews.com Lovelace expands the web of care in New Mexico For generations of New Mexico residents, comprehensive health care has meant Lovelace Health System. The big hospital and pharmacy network provides state-of-the-art care through six major health centers, including its Albuquerque, N.M.-based flagship, Lovelace Medical Center Heart Hospital of New Mexico, and the state’s only hospital dedicated to women’s health. But Lovelace also reaches patients through 13 outpatient pharmacies in and around Albuquerque, Rio Rancho and Santa Fe, as well as a specialty pharmacy to serve patients with serious chronic conditions. The care provided by those pharmacies is closely coordinated with Lovelace network hospitals and physicians. “Our pharmacists focus on empowering health outcomes for our patients and working closely with providers in helping patients with their medication needs,” explained Lovelace Pharmacy CEO Brad Trom. This year, Lovelace pharmacies will fill more than 800,000 prescriptions. Some of its stores also provide drug compounding and a free prescription delivery service. In addition to in-store flu shots and on-site employee vaccinations, Lovelace pharmacists also provide shingles, hepatitis, tetanus and pneumonia vaccinations. Lovelace pharmacists also offer Ask the Pharmacist sessions for seniors. In 2014, Lovelace Pharmacy anticipates continuing its Med- Lovelace pharmacists provide free medication assessments and a number of vaccinations, as well as offer informational events for seniors. ication Reconciliation Program and increasing the availability of immunization services to more private organizations around the Albuquerque and Santa Fe area. Lovelace also will add two additional pharmacy locations this year at new Lovelace Medical Group primary care clinics. Pharmacist clinicians will be part of the health care team for the patient-centered medical home that will be offered at these locations. Continued on page 21 Meijer continues to offer more patient-focused practice With 204 stores, Grand Rapids, Mich.-based Meijer has a history of punching above its weight when it comes to finding new ways to provide care through its in-store pharmacies. In a recent interview with DSN, Meijer VP pharmacy retail operations Karen Mankowski summed it up best: “We’ve been focusing on switching from a product-based practice to more of a patient-focused practice.” One of the most recent examples is its in-store cholesterol testing. That program, which had been available in a handful of stores, was rolled last year into all its stores, available Monday through Friday. In January, Meijer announced it would participate in a study with Ferris State University and the University of Nebraska Medical Center College of Pharmacy to test the effectiveness of rapid diagnostic testing and dispensing of medicines to patients with influenza and strep throat. If patients turn out to have either illness, the pharmacist can dispense drugs for it under a special pharmacist-physician protocol. This year, the chain will begin offering a medicationsynchronization program that allows patients to fill all their prescriptions on the same day each month. The program will DrugStoreNews.com Meijer transitioned from a product-based practice to a more patient-focused practice. allow pickups to be scheduled during off-peak hours in order to give pharmacists a chance to consult with patients. A diabetes counseling program also has been expanded. All of Meijer’s pharmacies have at least one specially trained diabetic care pharmacist, and Mankowski said the company has begun training pharmacists in motivational interviewing to determine what motivates patients to become compliant with drug regimens and lifestyle changes. March 2014 • 13 NuCara brings pharmacy innovation to rural areas Many of the developments in retail pharmacy that have attracted media attention have taken place in large, urban settings, but some of the most forward-thinking pharmacy retailers also can be found in rural areas. Conrad, Iowa-based NuCara operates 21 stores — mostly in Iowa, as well as a few in Minnesota, Illinois and Texas — and has helped expand access to care in some of the most sparsely populated places in the country by leveraging cutting-edge new modes of care. Last year, it began operating a telepharmacy service in Zearing, Iowa, a town with a population of 547. The service, which now includes about 700 patients, began in February 2013 as a pilot and has been based at a permanent location since July, managed from the nearby town of Nevada, Iowa. The service allows the company to have a presence 40 hours per week and bring in pharmacist-provided patient care services, durable medical equipment and compounding. Meanwhile, the Pleasant Hill, Iowa, store has a closeddoor specialty pharmacy that serves about 2,000 patients per month who have HIV, tuberculosis and sexually transmitted infections. That service began in October 2012, but the company is currently focused on expanding it. The company also plans to turn several of its stores into “Diabetes Centers,” and it has developed a program for physicians to refer patients to it for diabetes selfmanagement education. The goal is to help patients learn to manage their disease state for life and maintain control over their disease. Big-box Shopko maintains small-store pharmacy feel Would a big-box mass merchandise store call pharmacy service “the cornerstone of our business?” Green Bay, Wis.based Shopko does. The company is steeped in a highservice culture that actively promotes preventive health care and patient convenience at more than 300 in-store pharmacies and dozens of walk-in clinics operated by an independent health provider under the FastCare brand. Shopko has always had a strong connection with pharmacy. Indeed, the company was founded by pharmacist James Ruben, who opened the first Shopko store in Green Bay, Wis., in 1962. “He saw the opportunity to combine healthcare services with a large discount store, and in 1971 Shopko became one of the first mass retailers to feature a pharmacy in its stores,” the company reported. Shopko offers in-store and worksite immunizations, prescription delivery via mail, diabetic care, and mobile and online pharmacy apps. Since then, Shopko has grown to more than 330 stores across a variety of formats in 21 states throughout the Midwest, Mountain, North Central and Pacific Northwest regions. Its primary retail outlets include 134 Shopko stores, “providing quality name-brand merchandise, great values, pharmacy and optical services in small to mid-sized cities,” as well as 176 Shopko Hometown locations, which the company describes as “a smaller concept store developed to meet the needs of smaller communities.” In addition, the chain has opened five small-scale Shopko Express Rx stores and 18 full-scale Shopko Pharmacy locations. Despite its big-box format, size and reach, Shopko maintains a locally oriented, community-focused operating policy. Mike Zagelow, director of pharmacy business development, describes the company as “a smaller, familyoriented chain with an environment that … pharmacy staff can be comfortable with and thrive in,” with “a service experience that exceeds that of the larger chains.” Shopko’s pharmacy team reaches patients with a variety of wellness and convenience programs, including in-store and worksite immunizations, diabetic care, home delivery of prescriptions via mail, mobile and online pharmacy applications, and a full-service dispensing and patient counseling program for long-term-care facilities called Shopko RxCare. On its website, the company also offers customers a “Cold and Flu Forecaster” function to check the level and severity of cold and flu outbreaks in their local areas. 14 • March 2014 DrugStoreNews.com Wellness empowerment drives Rite Aid health strategy Wellness empowerment. Those two simple words more or less describe everything Rite Aid is focused on right now as a company, empowering its customers to take more control of their health and well-being. That theme of wellness empowerment is playing out in a number of critical initiatives for the company, including: • wellness+. Rite Aid’s loyalty card was the first such program built upon a health and wellness platform. The card, which now has about 25 million active members, rewards points based on select purchases throughout the store. Important, in addition to discounts on select items, the program also delivers special, wellness-related rewards, such as a free health screening, gym membership discounts, and subscriptions to health and fitness magazines. To encourage customers to keep their prescriptions in one pharmacy — using multiple pharmacies is one of the key reasons patients tend not to adhere to their medications as prescribed — the program, where states allow, awards more points on prescriptions filled at Rite Aid. Since introducing the program in 2010, Rite Aid has developed some niche, lifestyle-focused versions of the program, including wellness+ for Diabetes and wellness65+, which offer special consultations with Rite Aid pharmacists, among other exclusive offerings, such as special in-store health events for seniors on the first Wednesday of each month. • Wellness stores. About one-quarter of Rite Aid’s 4,600 stores have been converted to some variation of a new format it calls its Wellness concept store, which puts a much greater emphasis on pharmacy, creating an area for patient consultations and generally making the pharmacist more accessible to customers. The stores also include another important feature — the Rite Aid’s 1,900 Wellness Ambassadors serve as the bridge between customers and the pharmacy. Wellness Ambassador, which is a new position in the store, specially trained to help customers navigate health products in the store and generally act as a bridge between the customer and the pharmacy, encouraging conversation with a Rite Aid pharmacist where appropriate. Rite Aid has more than 1,900 of these Wellness Ambassadors working in its stores. • Expanded clinical services. In addition to providing immunizations — Rite Aid delivered 2.5 million flu shots in the last year — and medication therapy management (MTM) sessions, the company is also taking other important steps to train its pharmacists to play an even greater role in in patient care. The company recently began training its pharmacists on motivational interviewing techniques to help patients to change unhealthy behaviors and drive better Continued on page 20 Quick Chek brings convenience to patient compliance Increasing patient compliance is the top priority at Quick Chek. The Whitehouse Station, N.J.-based company operates 12 pharmacy stores as part of its chain of 138 retail locations throughout New Jersey and southern New York. Quick Chek pharmacy locations are a hybrid of a convenience and drug store format. While a typical convenience store has four linear feet of OTC and HBC products, Quick Chek’s pharmacy stores feature 160 linear feet of OTC/HBC in an expanded section near the pharmacy. The chain is adding pharmacy consultation rooms to remodeled locations. “We’re trying to improve patient compliance through a number of programs,” said Michael Wunder, director of pharmacy at the chain. “Our refill reminder program now alerts patients to refills through phone, text or email. We’re moving DrugStoreNews.com forward with a new med sync program that will allow patients who take three or more prescriptions to shift to a synchronized program where they can refill all their prescriptions in one visit once a month.” Quick Chek also provides patient consultation services; immunizations for flu, meningitis, HPV, pneumonia and shingles; and blood pressure screenings among other services. Wunder said that it’s really Quick Chek pharmacists who set the chain apart. “The average tenure of our pharmacists is 15 years or more,” he said. “One of our pharmacists has been in the same location since 1980, and we have six pharmacists who have 25 years of service. Those pharmacists have been familiar healthcare professionals for multiple generations in some families. That inspires trust.” March 2014 • 15 Supervalu boosts diabetic care, preventive health After selling 877 supermarkets and food/drug combo stores to an investment firm last year, including its Albertson’s, Jewel-Osco, Sav-on and other retail brands, Eden Prairie, Minn.based Supervalu is a leaner company. But the firm remains a major force in pharmacy retailing in the upper Midwest, the mid-Atlantic region and parts of the central United States through well-known store brands like Cub Foods, Shoppers Food & Pharmacy, Farm Fresh and Shop ‘n Save. Together, those regional supermarket chains operate more Some Supervalu pharmacists offer screenings for blood-glucose and hemogloban A1C levels. than 170 in-store pharmacies. And all put a heavy emphasis on preventive-health services and convenient, accessible pharmacist-delivered care in their stores. “Our pharmacists practice innovative and world-class patient care,” the company asserts. “The success of Supervalu pharmacies is the result of meaningful patient relationships, exceptional pharmacy teams and cutting-edge technology.” Among the health services now offered at some Supervalu locations around the United States: • “Eating Healthy with Diabetes,” a comprehensive educational and counseling program conducted jointly by specially trained pharmacists along with a registered dietitian. The purpose: to guide diabetic patients to better nutritional and lifestyle choices so they can continue to lead normal lives and reduce the risk of complications posed by diabetes. The program includes two-hour group tours of the store and pharmacy; most recently, Supervalu’s Shop ‘n Save division began offering the tours in February 2014; • Health screenings by appointment at some pharmacies for blood-glucose and hemoglobin A1C levels, as well as a full lipid panel test for cholesterol; • Adult immunizations by pharmacists for influenza, shingles, Continued on page 22 Thrifty White proves role of pharmacy in patient care Running a community pharmacy is about more than selling medicines and everyday necessities “on the corner of Fourth and Main,” said Bob Narveson, president and CEO of Plymouth, Minn.-based Thrifty White Drug. It’s about being the most accessible health-and-wellness resource within the community and a springboard for innovative local health initiatives. “Community pharmacies have an integral role in driving shared savings and improving patient care” with adherence programs, immunizations, health screenings and other clinical efforts, in collaboration with accountable care organizations, said Narveson, who also serves as chairman of the National Association of Chain Drug Stores. Thrifty White embodies those concepts. The company’s 87 corporate-owned drug stores — along with roughly 80 affiliated independent drug stores — serve a sprawling swath of the upper and central Midwest, “providing health care to small towns and cities … that range from 1,000 to 90,000 in population.” The company also serves remote patients via telepharmacy. Thrifty White strives to be a springboard for innovative health initiatives. Thrifty White has become a top innovator in pharmacybased care. Its pharmacists, said Tim Weippert, EVP pharmacy, “are the frontline professionals that patients come to during times of change and need for advice and assistance” with issues like health reform, insurance eligibility, managing disease and maintaining a healthy lifestyle. It’s about engaging patients more effectively, Weippert Continued on page 22 16 • March 2014 DrugStoreNews.com Thriftway means small-town service for big-city dwellers Even busy, sophisticated urban consumers in one of the biggest cities in the world respond to friendly, personal service by pharmacists with longtime ties to their neighborhoods and the willingness to listen to their concerns and provide real counseling. That’s the basis for the continuing ability of Thriftway Pharmacy to thrive in the ultra-competitive arena of New York’s drug store market. In business since 1958, the Brooklyn-based chain operates more than a half-dozen stores in Brooklyn and Manhattan, and specializes in the personalized customer care and firstname-basis customer service found in small-town community pharmacies — including home delivery and in-depth counseling. Thriftway bills itself as “a friendly neighborhood drug store” with free blood pressure checks, a senior savers program and other conveniences. But its pharmacists care for a diverse patient population, including patients with HIV/AIDS and other serious conditions. The company also excels at caring for diabetic patients. The company’s specialty pharmacy, Thriftway Pharmacy Health Services, offers “support, advice and clinical expertise” to patients with HIV, hepatitis, diabetes and other conditions who are dependent on expensive, highmaintenance medication therapy. That therapy includes “a one-on-one personal relationship with a pharmacist to coordinate enrollment, billing, refills and renewals.” Patients enrolled in TPHS also gain “access to vitamins, nutritional supplements and a wide variety of other over-the-counter products at discounted prices,” the company said, as well as an informational welcome packet and, for HIV patients, “a complimentary pager to assist … with their medication adherence program.” What has been called the Thriftway chain’s crown jewel is Zitomer Pharmacy, a luxurious, three-floor combination drug store and upscale department store on Madison Avenue between 75th and 76th Streets. Established in 1950 as an upscale pharmacy to serve Manhattan’s chic Upper East Side, Zitomer’s pharmacy fills some 700 prescriptions a day while also offering everything from high-end jewelry and prestige fragrances to children’s clothing and women’s hats. ShopRite promotes health with ‘Live Right’ campaign When the people who manage a retail store also own the company, the motivation to please customers and keep them coming back is strong. Such is the case with Keasbey, N.J.-based ShopRite, the supermarket and pharmacy arm of Wakefern Food Corp. ShopRite is well known to millions of food store and pharmacy customers in the Northeast. The retailer-owned cooperative now operates more than 200 in-store pharmacies across its base of roughly 250 supermarkets spread throughout New Jersey, New York, Connecticut, Pennsylvania, Delaware and Maryland. “From a small, struggling cooperative with eight members — all owners of their own grocery stores — Wakefern Food Corp., the merchandising and distribution arm for ShopRite, has grown into the largest retailer-owned cooperative in the United States and the largest employer in New Jersey,” said the company in a statement. Under the tagline “Caring is Our Business,” ShopRite’s pharmacies extend both health services and cost-saving benefits to consumers in its market area. Diabetic patients, for instance, have access to free, 30-day supplies of several diabetic medicines, and many generic drugs are available for $3.99 per 30-day prescription. Also offered to expectant moms: free 30-day supplies of prenatal vitamins. Where regulations allow, ShopRite pharmacists provide both seasonal flu shots and pneumonia vaccinations. Meanwhile, DrugStoreNews.com a staff of more than 50 in-store registered dietitians work in partnership with pharmacists as a team to provide screenings and counseling on such health issues as diabetes and high cholesterol, and coach shoppers on proper nutrition and disease prevention under a program called “Live Right with ShopRite.” Beyond the stores, ShopRite is deeply embedded in the welfare of its communities. Among its civic endeavors: longtime participation in and support for the Community Food Bank of New Jersey and an innovative program called Supermarket Careers. Founded by ShopRite in 1989, the program provides “education and training of special needs students to prepare them for meaningful careers in the supermarket industry … and is now in place in 42 schools,” according to the company. ShopRite pharmacists and dietitians provide counseling on health issues like diabetes. March 2014 • 17 Walgreens transforms pharmacy, creates well experience The nation’s largest pharmacy provider has been in business since 1901, but Walgreens is firmly focused on the future of pharmacy-based patient care by providing costeffective, comprehensive solutions to the nation’s troubled health system. Walgreens is expanding diagnostic lab testing services and specialty care to include more personalized care for patients with such conditions as HIV. Walgreens is out to transform the way community pharmacy serves patients and the healthcare system as a whole. The chain, which now operates more than 8,200 pharmacies and more than 400 in-store health clinics, has expanded into virtually every facet of accessible community care. “Walgreens’ scope of pharmacy services includes retail, specialty, infusion, medical facility and mail service, along with respiratory services,” the company reported. “These services improve health outcomes and lower costs for payers including employers, managed care organizations, health systems, pharmacy benefit managers and the public sector.” Walgreens is out to “transform the role of community pharmacy and “create a well experience,” said president and CEO Greg Wasson. “An aging population demands more pharmacy services,” Wasson said. “Walgreens is becoming a key part of the community healthcare delivery team, supporting primary care physicians, health plans and health systems to address patient needs and gaps in care.” Continued on page 22 Wegmans advancing health, wellness with flair What do you call a supermarket and pharmacy chain that draws thousands of enthusiastic shoppers to its grand openings and elicits gushing, unsolicited praise on social media? In western New York state, eastern Pennsylvania and parts of New Jersey, Virginia, Maryland and Massachusetts, consumers call it “Wegmans.” Rochester, N.Y.-based Wegmans might be called the Cadillac of combo stores. The chain’s more than 80 stores — all of which contain full-service pharmacies — offer consumers a Wegmans’ pharmacists work with nutritionists on disease prevention and eating habits. vast array of products and in-store services in strikingly beautiful stores, staffed by motivated and empowered employees who continue to propel Wegman’s into Fortune magazine’s list of the best companies to work for each year. One blogger, Rachel Sanders of online content provider BuzzFeed, called shopping at Wegmans “essentially a journey through a small, beautifully maintained, self-sustaining city.” Another customer called the chain “the be-all and end-all of supermarkets.” Pharmacies have been an essential part of Wegmans’ one-stop appeal since 1972. Its pharmacists provide an expanding menu of services, including immunizations, steep discounts on generic medicines, an online ask-your-pharmacist service, free home prescription deliveries and a mobile app for prescription refills. Wegmans’ pharmacists can vaccinate customers without an appointment against a variety of potential health threats, including flu, hepatitis A and B, chicken pox, shingles, HPV and meningitis. What’s more, each store’s pharmacists work in tandem with Wegmans nutritionists, who provide advice, both in stores and online, on healthier eating habits and disease prevention. Continued on page 22 Walmart redoubles campaign for affordable care Weis provides convenience, value with Lifestyles Initiative When the world’s largest retailer expands its commitment to affordable health care, the impact ripples through the nation’s health system. Walmart changed the prescription drug market eight years ago when it dropped the price of hundreds of generic medicines to $4 for a 30-day supply, unleashing a price-cutting tide at the nation’s pharmacies that the company claims has already saved Americans about $5 billion. The chain boosted price competition among Medicare Part D drug plans when it partnered with Humana in 2010 to launch the Humana Walmart-Preferred Rx Plan, which provides low monthly premiums and access to 10 hypertension drugs for a penny each when filled at a Walmart or Sam’s Club pharmacy. And the chain quickly became a destination for low-cost immunizations when it began offering vaccinations against 10 diseases in August 2012. “Right now, in 1,400 of our stores, we have pharmacists giving immunizations and other inoculations, but we will make these services available in all of our stores with pharmacies sometime this year,” said John Agwunobi, president of health and wellness for Walmart U.S. Walmart is already the nation’s third-largest pharmacy provider, with more than 4,000 in-store pharmacies in all 50 Weis Markets successfully leverages both of its healthcare professionals — the registered dietitian and pharmacist — under one department called the Lifestyles Initiative. The department, headed by director Karen Buch, is all about providing solutions for consumers — whether they are consumers with pre-existing disease like diabetes or cardiovascular disease — that have a pharmaceutical component as well as a dietary component. Through its Lifestyle Initiatives team, Weis Markets deploys a team of dietitians into the food aisles to help patients navigate their shopping lists with foods optimal to a specific condition as part of a program the grocer calls Cart Smart. These 90-minute free tours for groups of six to 12 participants explore specific health condition needs that require better choices when it comes to food and nutrition. Tour topics include shopping heart smart, weight management, living with diabetes, living gluten-free and fueling up for fitness, among other conditions. Bringing convenience and value to the markets it serves, Weis Markets pharmacy also has had a robust immunization offering for the past three years across its 131 locations with a pharmacy. Weis Markets pharmacies offer immunization services for pneumonia, shingles, meningitis, tetanus/diptheria/ whooping cough and hepatitis A and B per state regulation. Under the Humana Walmart-Preferred Rx Plan, Walmart offers 10 hypertension drugs for a penny each when filled at a Walmart or Sam’s Club pharmacy. states. The chain also offers specialty pharmacy services, optical centers in more than 2,600 locations and more than 140 in-store, walk-in clinics. What’s more, the company’s health-and-wellness network will grow significantly over the next few years, given the company’s plan to accelerate the development of its small Continued on page 22 18 • March 2014 DrugStoreNews.com DrugStoreNews.com Weis offers Cart Smart tours to help participants explore better food choices. The Pennsylvania retailer also has a partnership with Geisinger Health System on several Careworks Walk-In Medical Clinics. Geisinger and Weis Markets have been working on a handful of clinics for four years and plan to expand the retail clinic model in the future. In addition to clinic and immunization services, Weis Markets provides a money-saving boost across hundreds of generic drugs with its “11 cents a day” program, which features 90-day prescription fills at a cost to the customer of $9.99. In many cases, that price is significantly lower than insurance or mail-order co-pays. March 2014 • 19 ‘More than a pharmacy,’ Wilkinson provides solutions Based in Nevada, Mo., Wilkinson Pharmacy operates seven stores in southwestern Missouri, providing pharmacy services, as well as home medical equipment, diabetic shoes, wheelchairs and prescription compounding. But the drug chain also describes itself as “more than a pharmacy — a healthcare solution.” Late last year, the chain participated in an awareness program centered around falls, a common potentially dangerous problem among elderly patients and among those taking medications that can cause drowsiness or coordination problems. The campaign, called “Falls Awareness,” included risk assessments on patients’ medications and in their homes. With the Affordable Care Act expected to increase the burden on primary care physicians, pharmacy retailers have Albertsons emerged as key providers of many of the services traditionally associated with doctors. Immunizations are among the services that have become important to Wilkinson. Pharmacists at the chain can immunize against flu, shingles, pneumonia and meningitis, and under coordination with patients’ physicians, they can administer other immunizations. Another service is health screenings, which pharmacists at Wilkinson can provide for such conditions as cholesterol and blood pressure, in addition to providing consultations with patients who have diabetes, or are looking to quit smoking or lose weight. Weight-loss counseling is provided through the Ideal Weight Loss program. appointment,” she added. “On a walk-in basis, all of our pharmacists can administer potentially life-saving vaccines to patients based on Centers for Disease Control and Prevention guidelines, and many offer quick, easy health screenings to help determine if a customer is at risk for diabetes, high blood pressure, heart disease, prostate cancer, thyroid disorders or even vitamin D deficiency.” Also available in some stores: low-cost rapid strep testing and immediate treat- ment with antibiotics when necessary “as part of a collaborative practice agreement with a local physician.” “Our companies are always looking to expand our wellness service offering,” Wilcox said. “Upcoming services include medication synchronization services, development of HIV Centers of Excellence and administration of travel vaccines.” Some food/drug combo stores also have added full-time registered dietitians, she said. Bi-Lo/Winn-Dixie customers don’t have time to make multiple trips to the pharmacy each month,” Fagan said. The company’s wellness outreach extends to its stores’ food aisles through a program called “thrive!” Designed by a BiLo dietitian, “thrive! teaches … shoppers how to make healthy, affordable choices both in the store aisle and at home,” the company said. Rite Aid compliance tool that helps Rite Aid pharmacists identify patients likely to be nonadherent. Rite Aid has also been exploring telehealth through a partnership with NowClinic. Now available in more than 50 stores, the virtual clinic connects Rite Aid patients in real time with doctors, who provide treatments and write prescriptions for a range of conditions; Rite Aid pharmacists are available to help with biometric screenings. H-E-B have with doctors.” On the horizon are an expansion of HE-B’s new specialty pharmacy service and the opening of its first outpatient pharmacy in a hospital in Odessa, Texas. “The focus of our business model there is going to be integrating with the hospital care team, and providing medications and discharge counseling to patients prior to their leaving the hospital,” Norman said. Continued from page 4 Wilcox called those pharmacists “an important part of customers’ healthcare team” who “communicate our services, findings and recommendations back to the patient’s primary care provider and collaborate with them to ensure patients are receiving optimal care, so that overall healthcare costs can be reduced.” “Many of our services do not require an Continued from page 5 — regardless of refill dates — can be filled at the same time. “We know our Continued from page 15 medication adherence. In addition, the Rite Care Prescription Advisor program is an important technology-based Continued from page 10 with “a full menu of immunizations … based on the protocol agreements we 20 • March 2014 DrugStoreNews.com Cardinal Continued from page 6 to-home medical supplies. The merger of AssuraMed “allows us to serve the growing number of Americans treated in home settings, particularly those patients recovering from acute episodes and those suffering with chronic diseases,” Barrett said. “That ability to bring health products and CVS Continued from page 7 invested on patient counseling. In 2013, the company also further expanded the program to serve Medicare patients — significant given two macrotrends in health care. First, America is aging rapidly; 15 million more seniors will enter Medicare by 2020, with Medicare drug spending expected to rise more than 8% in that time. The average senior ages 65 to 74 years old takes 27 prescriptions a year. Second, chronic disease and obesity continue to spike out of control; by 2015, it is estimated that 149 million Americans, roughly half the country, will suffer from one or more chronic diseases. The average senior with chronic conditions takes anywhere from 13 to 19 prescriptions a day, sees an average of seven physicians across four practices, and fewer than half of seniors are up to date on preventive health services. Another strong example of how CVS Caremark is leveraging its unique structure is in its 800-plus, in-store MinuteClinic retail clinics. In addition to rapidly growing its physical footprint and broadening its scope of practice beyond just acute care services like flu visits into more chronic care management and preventive health-andwellness services, CVS Caremark DrugStoreNews.com clinical services right into patients’ homes,” he added, “will be increasingly important as the delivery of care continues to move to more costeffective settings.” The result, said Cardinal’s CEO early this year: “For the first time in our history, wherever healthcare products or services are needed, at any stage of the patient experience, we are there.” Costco Continued from page 6 information on both individual and group coverage through its online Costco Health Reform Info Center, with links to the health insurance marketplace for each state and a guide to navigating health exchanges and answers to questions about qualifying for a coverage subsidy and other issues. “With the rapidly changing landscape of healthcare reform, Costco has partnered with top insurance carriers to provide our members with competitive options both within statebased exchanges and the Federally Facilitated Marketplace, and other carriers and plans that will only be available outside of the marketplaces,” the company noted. also is working with large payers and health systems to create innovative new programs through MinuteClinic. In 2012, MinuteClinic began adding a reduced co-pay program for its PBM customers to utilize its clinics for more preventive care and wellness services, physicals and biometric screenings. By 2013, it had more than 8 million people enrolled in these types of programs. MinuteClinic also is participating and helping to innovate care in the rapidly emerging new models of care and new quality standards that are emerging under health reform. One strong example is a program that is underway in Hawaii, where CVS Caremark is partnered with the state’s Blue Cross Blue Shield Program, HMSA. CVS Caremark’s MinuteClinic locations in Hawaii are linked into HMSA’s new Patient-Centered Medical Home structure, and will coordinate acute and chronic care for HMSA patients. In addition, its Hawaii CVS/pharmacy stores will share patient adherence and gaps-in-care information gathered through Pharmacy Advisor with HMSA doctors and case managers. And most recently, its stores raised the commitment to health and wellness when the company announced that it would stop selling cigarettes and tobacco products in its stores this year. Delhaize Continued from page 7 mins, herbs and supplements that complement your diet and your prescriptions.” The focus on health extends to Delhaize’s own employees, who have access to on-site clinics and biometric screenings at their regional headquarters. “One of our big strategies in 2014 and 2015 is to move to a tobacco-free campus, starting with our corporate offices and hopefully moving into the retail space later,” said Joanne Abate, director of health and wellness strategy. Lovelace Continued from page 13 As licensed by the New Mexico State Board of Pharmacy, Lovelace pharmacist clinicians are able to prescribe medications in some cases, change dosages, order and interpret diagnostic tests and provide patient education. Lovelace pharmacists already “participate in an enhanced patient discharge medication program at our hospitals that deliver patients’ medication to their bedside before discharge,” system spokeswoman Laurie Volkin said. March 2014 • 21 Face-to-Face with Community Pharmacies 1 PHARMACIES HELP Thrifty White Continued from page 16 asserted. “We have created more time for our pharmacists to delve into clinical services, building partnerships … with other members of the healthcare team, such as physicians … and nurses.” A priority has been boosting patient adherence, in particular by shifting thousands of patients to a synchronized, once-a-month prescription refill system. The program makes it easier for patients to comply with their medi- Supervalu Continued from page 16 pneumonia, tetanus, meningitis and other diseases; • An automatic prescription refill service, called RefillAdvantage, which includes a call by the pharmacist to remind the patient that the script is ready for pickup; and Walgreens Continued from page 18 To that end, Walgreens continues to roll out its “Well Experience” store format. The goal, said spokesman Jim Cohn, is “to help position our pharmacists to play a larger role in health care by spending more time providing patient consultations and other personalized services.” That includes everything from immunizations and health screenings in stores and workplaces to medication therapy management, Medicare Part D plan review and “bedside medication delivery and follow up” in collaboration with hospitals and health systems, Cohn said. Walgreens also is expanding diagnostic lab testing services and specialty care, including “more personalized care for patients with such conditions as HIV… and hepatitis C.” cation regimens. But it’s also served as a platform for monthly, face-to-face meetings between patient and pharmacist ranging from “a basic consultation … up to a full medication therapy management session,” Weippert said. Adherence efforts are just one facet of what pharmacies like Thrifty White can bring to a reforming health system in desperate need of cost-effective solutions, Narveson said. For instance, the chain doubled the number of flu shots it administered in the 2012-2013 flu season versus the previous year, and recently hired its first nurse. • An online drug library that provides “accurate and up-todate medication information.” Also now available from Supervalu pharmacies: an interpretive telephone service. The service gives pharmacists the ability to communicate in more than 150 languages to help non-English-speaking patients order their prescriptions. In February, the company also announced that all of the more than 50 primary care worksite health centers managed by its Take Care Employer Solutions Group had been granted accreditation by the Accreditation Association for Ambulatory Health Care as patient-centered medical homes, in compliance with nationally recognized standards of care. It’s a big step for a pharmacy provider and highlights Walgreens’ progress as a comprehensive source of cost-saving health solutions. “We’re changing the culture in health care by driving a new model for care delivery and creating a better overall patient experience, and the medical home accreditation from AAAHC further validates the impactful work we’re doing,” said Trent Riley, divisional VP for Take Care. It’s about “reducing costs and improving health outcomes,” he added. Walmart Continued from page 18 formats, Neighborhood Market and Walmart Express. Walmart currently operates some 350 Neighborhood Market stores and 20 Express units, all of which contain pharmacies. In February, the company said it would double its growth plan for smaller stores with pharmacies, with another 270 to 300 units coming this fiscal year. Besides its growing menu of pharmacy care services, “With our healthier foods initiative, we’re helping customers easily identify healthier food options,” Walmart reported. That initiative — “to make food healthier and healthier food more affordable” — was launched in 2011 and drew praise last year from First Lady Michelle Obama and other nutrition advocates. Wegmans Continued from page 19 Indeed, Wegmans was an early champion of healthier eating and nutritional marketing with the launch more than two decades ago of a line of natural and healthy foods under the tagline, “Food You Feel Good About.” The company also promotes a big selection of organic foods — it even runs its own organic farm in upstate New York — and identifies “hearthealthy” foods with a special tag on hundreds of products. Wegmans also was an early advocate of promoting healthier lifestyles in its own business practices. Way back in 2008, the chain announced that it would no longer sell tobacco products and began offering smokingcessation programs to its employees. Wegmans’ pharmacy customers have rewarded the chain with high marks for its health-and-wellness offerings. The company consistently scores high in the annual pharmacy consumer satisfaction survey conducted by J.D. Power and Associates. 22 • March 2014 DrugStoreNews.com PATIENTS USE MEDICINES SAFELY AND STAY HEALTHY. Pharmacies are best known for their commitment to medication safety and effectiveness: providing accurate prescriptions, helping patients take medications as prescribed and safely, and sharing knowledge on drug interactions. 2 INNOVATIVE PHARMACY SERVICES DO EVEN MORE TO IMPROVE PATIENT HEALTH AND QUALITY OF LIFE. Increasingly, pharmacies provide vaccinations, health education, and disease state testing and management. Through personal interactions with patients, face-to-face consultations and convenient access to preventive care services, pharmacies are helping to shape the healthcare delivery system of tomorrow – in partnership with doctors, nurses and others. COMMUNITY PHARMACISTS LIVE, WORK AND SERVE PATIENTS IN EVERY STATE AND CONGRESSIONAL DISTRICT - INCLUDING YOURS Average distance = 1.83 miles within region based around urban center Average distance = 10.06 miles outside region based around urban center Nearly all Americans (89%) live within five miles of a community pharmacy. (NCPDP Pharmacy File, ArcGIS Census Tract File. NACDS Economics Department) 3 WIDELY TRUSTED AND ACCESSIBLE, PHARMACISTS ARE EXTREMELY VALUED BY THOSE IN GREATEST NEED. Pharmacists rank consistently among the most trusted professionals, and among the most approachable and accessible in healthcare. People who take prescription medications regularly, manage chronic diseases, use emerging pharmacy services, and who are older have even stronger positive opinions about pharmacies. Particularly in rural and under-served areas, the appreciation for pharmacists proves particularly strong. 4 PHARMACY SERVICES IMPROVE HEALTHCARE AFFORDABILITY. From helping patients take their medications effectively and safely to providing preventive services, pharmacies help keep people healthier. That prevents costly forms of care down the line. Pharmacists also help patients identify strategies to save money, such as understanding their pharmacy benefits, using generic drugs and obtaining 90-day supplies of prescription drugs in retail pharmacies. ABOUT NACDS NACDS represents traditional drug stores and supermarkets and mass merchants with pharmacies. Chains operate more than 40,000 pharmacies, and NACDS’ 125 chain member companies include regional chains, with a minimum of four stores, and national companies. Chains employ more than 3.8 million individuals, including 175,000 pharmacists. They fill over 2.7 billion prescriptions yearly. Please visit nacds.org. Brought to you by