Industry study reveals mixed state of affairs for independent community pharmacists

In 2015, the number of independent pharmacies declined along with prescription volume. But results from the NCPA 2016 Digest unveiled at the National Community Pharmacists Association (NCPA) Annual Convention in New Orleans last month also showed that independent community pharmacies continue to be a vital source for patients in underserved areas.

The Digest, sponsored by Cardinal Health, provides an in-depth look at the $81.5 billion independent community pharmacy marketplace.

In addition to filling prescriptions, 81% of independent pharmacists offer medication therapy management (MTM), 67% provide immunizations, while 57% perform blood pressure monitoring, according to study data.

Net margins on Rx drugs continued to be slim due to third-party payer and government contracts that in some instances, according to the study, reimburse below acquisition cost.

The number of independent pharmacies declined from 22,478 to 22, 160 that employ more than 220,000 full-time equivalent workers.

The average independent community pharmacy location dispensed 60,943 Rxs (194 per day) in 2015. This figure represents a slight decrease from 61,568 prescriptions in 2014.

Contributing factors to the decline in prescription volume include: mandatory mail order, including steering those patients taking specialty medications; and preferred networks in Medicare Part D, according to the Digest results.

Financials

The Digest also showed that average sales in 2015 per location were $3,677,638, comparable to 2014. Gross margins remained relatively stable at 22.3%. Payroll expenses–as a percentage of sales–decreased from 13.0% in 2014 to 12.8% in 2015.

In 2015 35% and 17% of prescriptions in independent community pharmacies were covered by Medicare Part D and Medicaid, respectively, accounting for more than half of all Rxs sold.

In 2015, 14% of independent community pharmacists had total sales of more than $6.5 million: 34% had sales between $3.5 and $6.5 million; 22% had sales between $2.5 and $3.5 million; and 30% reported sales of under $2.5 million.

Hourly wages for staff pharmacists and technicians increased by 52 cents per hour to $55.89. Pharmacy technician wages increased to $14.37 per hour.

Patient care

According to study results, 81% of pharmacies are offering some type of medication adherence program. Also, pharmacists consult with physicians 9.7 times daily on prescription drug therapy: this includes generic product and therapeutic interchange recommendations.

Conversely, doctors accept pharmacist’s generic product recommendations 95% of the time, and 80% of the time for other therapeutic recommendations.

Technology/social media

Data from the Digest indicate that independent community pharmacists are embracing social media. Eight-seven percent of pharmacists post to Facebook; 28% have a Twitter account; and 62% use a mobile app.

Patient’s from rural communities were beneficiaries of the vital services that independent community pharmacists provide. The Digest study showed that 32% of independent community pharmacists are located in an area with a population of less than 20,000, while 50% are located in areas with a population between 20,000 and 50,000. More than 80% of independent pharmacies serve areas with a population of fewer than 50,000.

Table 1-- Independent pharmacy at a glance: 2015

Average number of pharmacies in which independent owner has ownership: 1.79

Average number of prescriptions dispensed per pharmacy location:

New prescriptions (49%) …………………………………………………………………29,532

Renewed prescriptions (51%)……………………………………………………………..30,961

Total prescriptions

Average prescriptions charge……………………………………………………………$56.37

Source: NCPA/Cardinal Health

Table 2:  Pharmacy Staff Positions

                                                                                    2013                2014                2015

Non-owner pharmacists                                              1.5                   1.5                   1.5

Technicians                                                                 3.3                   3.5                   3.2

Other Positions                                                           3.5                   3.4                   3.3

Total non-owner employees                                        8.3                   8.4                   8

Working owners-pharmacists and other positions      1.5                   1.5                   1.4

Total workforce                                                         9.8 (FTE)        9.9 (FTE)        9.4 (FTE)       

Source: NCPA/Cardinal Health