Community pharmacy fills gaps in access and

Transcription

2014
Community pharmacy fills gaps in access
and affordability for patients, payers
A special report by Drug Store News Group
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of life
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greatest need
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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
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
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
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,”
10 • March 2014
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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.
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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.
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.
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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
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,
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
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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.”
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.
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
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
— regardless of refill dates — can be
filled at the same time. “We know our
medication adherence. In addition, the
Rite Care Prescription Advisor program
is an important technology-based
with “a full menu of immunizations …
based on the protocol agreements we
20 • March 2014
DrugStoreNews.com
Cardinal
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
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
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
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
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
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
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
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
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
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.
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