Apr 23 2021

Revenue Generation Ideas for Today's Pharmacy – Beyond Dispensing

Research by AmerisourceBergen found almost 80% of pharmacists anticipate playing a greater role in patient care and becoming a more integral part of patient health care teams. Currently, pharmacists say they spend just a tenth of their time counseling patients, as dispensing-related requirements take priority.

This gap between how pharmacists could be interacting with patients and how they actually spend their time illustrates what Deloitte calls an "underutilization" of today's pharmacists. Deloitte forecasts a fundamental change in the role of the pharmacist as technological developments alleviate many of the manual, time-consuming responsibilities associated with dispensing.

The Deloitte analysis goes on to envision a not-so-distant future in which robots manage dispensing processes, 3D printers manufacture customized medications, and algorithms help pharmacy staff make data-based decisions.

In other words, the pharmacy of the future is a highly-automated environment in which the pharmacist is an integral part – even more so than today – of patient health and wellbeing. This environment should allow pharmacists to spend more time on patient interactions and provide critically important clinical and educational services. Hopefully this will be a world in which pharmacists are reimbursed for providing those services, as states increasingly recognize the important role of pharmacists and federal action to grant pharmacist "provider" status remains pending.

Many pharmacies already offer patient services that go beyond dispensing services. The 2020 National Community Pharmacists Association (NCPA) Digest, an annual survey conducted to assess trends and performance among independent pharmacies, reported a variety of services that include:

  • Medication therapy management – 79 percent.
  • Influenza immunizations – 77 percent.
  • Non-influenza immunizations – 73 percent.
  • Blood pressure monitoring – 54 percent.
  • Sales of durable medical goods – 53 percent.

As technology becomes more adept at helping pharmacies manage workflows, and as decreasing reimbursement rates and increased DIR fee assessments put severe strains on the bottom line, pharmacies can generate additional revenue by offering various programs and initiatives. NCPA has compiled a comprehensive list of revenue-raising options for pharmacies, several of which may already be offered on a complimentary basis, some that go beyond traditional pharmacy initiatives, and others that can be implemented with minimal cost or allocation of resources. A few of those options include:

340B Contract Pharmacy Services. Section 340B of the Public Health Service Act requires pharmaceutical manufacturers participating in Medicaid to sell outpatient drugs at discounted prices to health care organizations that care for patients in vulnerable communities. NCPA encourages community pharmacies to reach out to the more than 17,000 health care facilities eligible to participate in the 340B program, many of which are located in rural areas. As NCPA notes, covered entities contract with pharmacies to provide medications and services covered through the 340B program.

Clinical Trials. Pharmacies have traditionally been involved in clinical trials in several ways, including serving as study coordinators or principal investigators, and by providing drug and record keeping services. NCPA suggests an additional option of partnering with research entities to recruit trial participants. They have stated, "These recruitment companies are sometimes hard-pressed to find volunteers, so it makes sense for health care professionals such as pharmacists to be a source of these referrals."

Immunizations. NCPA describes immunizations as "the number one patient care service offered by community pharmacies." Pharmacists currently account for nearly 30 percent of total flu shots administered in the country, and have become a preferred option for many consumers. Beyond influenza, pharmacists can consider expanding their immunization portfolios to include "travel" vaccines for diseases such as malaria and yellow fever. Immunizations can be quite lucrative, with PBA Health reporting that each flu shot can generate an estimated $20, a meningococcal group B vaccine can bring in $48 per shot, hepatitis B can raise $80, and the human papillomavirus immunization can generate an estimated $50 per shot.

Screenings. Health screenings are an important way to detect serious patient conditions, and an important way for pharmacists to serve their patients. Screenings can also be an important source of revenue for pharmacies that offer education and counseling services to help patients manage conditions and promote healthy lifestyles. According to NCPA, screening types include:

  • Fasting Blood Glucose
  • Blood Pressure
  • Fasting Cholesterol (full lipid profile)
  • Non-Fasting Cholesterol (TC/HDL)
  • Bone Density
  • Hemoglobin A1C
  • Depression
  • Tobacco 

Smoking Cessation Services. Cigarette smoking is still a major cause of death in the U.S., and is responsible for one in every three lives lost to cardiovascular disease. According to the Food and Drug Administration, adverse health effects from tobacco use cause more than 480,000 deaths annually in the United States, even after decades of public education about the dangers of smoking and legislation to restrict the sale and marketing of tobacco products. Although the majority of community pharmacies no longer sell tobacco products, NCPA suggests that pharmacist still have important roles to play, especially in regard to counseling services. Employers with significant numbers of smokers in their workforce are increasingly turning to pharmacist-led smoking cessation services as a way to improve employee health.

Weight Management Programs. Obesity has earned the title of "public health crisis" in the United States with as many as 70 percent of Americans considered overweight or obese. This serious situation is linked to chronic conditions including high blood pressure, type 2 diabetes, cardiovascular disease, and cancer, along with mental health issues. According to NCPA, weight management plans are a natural fit for community pharmacies and can be a great expansion to health and wellness services already offered.

The list goes on. As pharmacies consider expanding their portfolio of services, they should also take steps to ensure their technology system has the capabilities needed to support those initiatives. For example, will their system allow pharmacy staff to not only maintain patient immunization records, but also facilitate the reporting of required information to state and local reporting systems? If the pharmacy does decide to pursue 340B contracting services, provide specialty medications, or do compounding, can the system seamlessly manage those functions?

These are among the comprehensive capabilities offered by the PrimeRx™ pharmacy management system. PrimeRx™ is an established leader in its field, with a complete suite of services to manage core pharmacy workflows. PrimeRx™ stands apart with its steady flow of innovative upgrades – many designed in response to specific pharmacist requests – and integrations with dozens of the industry's most innovative breakthroughs. As an example, PrimeRx™ users are currently able to integrate with Wellness, which allows direct reporting to state and local immunization systems (IISs). This integration has been a critical step in facilitating pharmacies' role in current COVID-19 vaccine administration.

Clearly, pharmacies have ample opportunities to expand their scope of patient services, and earn additional revenue along the way. And the results can be quite lucrative. According to Pharmacy Times, last year's Pharmacy Development Services (PDS) Super Conference featured a presentation that outlined how pharmacies can realize an average of $8,800 per month from services including consultations, educational classes, and immunizations. With no relief from escalating DIR fees or shrinking reimbursements on the horizon, alternate sources of revenue can be a real lifeline, while simultaneously allowing pharmacists to expand their role as integral members of patients' health care teams.