Q&A: Independent Pharmacists Share the Importance of Community

It’s no secret that independent pharmacy has faced significant challenges in the last few years. With a laundry list of upcoming changes—compliance with the Drug Supply Chain Security Act (DSCSA) and impending direct and indirect remuneration (DIR) fee changes among them—it’s more important than ever before that independent pharmacies work together.

American Associated Pharmacies (AAP), a member-owned cooperative of more than 2000 independent and community pharmacies, is empowering these pharmacies to work together. Sonia E. Martinez, BPharm, a compounding pharmacist and the owner of Marco Drugs and Compounding in South Miami, Florida, and Jason Dykstra, PharmD, owner of Chino Valley Pharmacy in Chino Valley, Arizona, answered some of our most pressing questions about the importance of community, their work with AAP, and the biggest challenges that lie ahead.

Answers have been lightly edited for clarity.

Drug Topics: What is the biggest challenge you anticipate facing in your independent pharmacy next year?

Sonia E. Martinez, BPharm: I believe that the most significant obstacle we may face is the impending DIR fees cliffhanger set to happen at the start of the upcoming year. The DIR fees being taken from reimbursements from 2023 activity will coincide with those point-of-sale modified reimbursements with DIR removal set to commence on January 1, 2024.

Jason Dykstra, PharmD: We’re most concerned about continuing issues with prescription stock availability, pharmacy benefit manager (PBM) reimbursement, and contracting.

Drug Topics: DIR fee updates and the upcoming DSCSA compliance deadline are 2 big issues facing independent pharmacists over the next year. Do you feel like your pharmacy is prepared to face these challenges?

Martinez: We've been putting in a lot of effort to collaborate with our bank and secure a line of credit [to best manage cash flow in early 2024 with the DIR fee changes]. Additionally, we're in the process of creating an account with InfiniTrak, a vendor that AAP recommends, to manage our DSCSA responsibilities. Our goal is to get ahead of any potential challenges that may arise in 2024.

Dykstra: We are prepared for these 2 challenges. DSCSA is handled at the wholesaler level, and for the smaller outfits we will look into one of the various vendors offering a clearinghouse solution. For DIR fee mitigation, we are saving up a nest egg to float us just in case.

Drug Topics: We know how important community is to independent pharmacy owners. Are there any resources you can share with your community of fellow independent pharmacists to help address these challenges?

Martinez: I may have a bias, but I sincerely believe that being a member of AAP and utilizing its warehouse and programs are essential for the success of my business.

Dykstra: AAP has helped with preparing us for these upcoming challenges. At this year’s annual conference, we were introduced to options and information [needed to address them].

Drug Topics: How has AAP helped you and your pharmacy serve your community at the highest possible level?

Martinez: I firmly believe that utilizing the API Warehouse regularly and making the most out of AAP's programs, such as SmartSync and preferred vendors, has resulted in a significant increase in our gross profit dollars.

Dykstra: AAP continues to fight for us, by driving down our cost of goods, providing competitive pricing agreements, and rebates. Visits from the territory representative continue to help us purchase correctly and maximize our bottom line.

Drug Topics: Despite these challenges, independent pharmacists are more important than ever. What are you excited about in the next 6 months and looking forward into 2024?

Martinez: In my personal opinion, being a small business can offer an advantage in terms of pivoting and implementing strategies quickly. Additionally, it enables us to have more direct communication with our customers and patients.

Dykstra: I am excited about continuing to thrive in a tough market, grow our customer base, and differentiate ourselves in the services we offer

Drug Topics: What’s your best tip for your colleagues around creating and fostering their own community of fellow pharmacists?

Martinez: Based on my perspective, becoming an active member of our state pharmacy associations and the National Community Pharmacists Association (NCPA) is the best solution. By increasing their membership numbers, these organizations can exert their influence and support us better. Being an active member entails not only attending their meetings and conferences but also contributing to their PAC and legal funds.

Dykstra: Networking is very important, to grab ideas from other independents. You have to stay ahead of the game and not be behind, doing things the old way and failing. Your bottom line keeps you in business—you have to protect that at all costs. Differentiate yourself: In a market where a service is lacking, people will pay for svice! Make your pharmacy a warm and friendly environment; that is not the case at a lot of competitor pharmacies.