Elements Magazine Vol. 13 Iss. 1 March 2024

COMMON ACCOUNTING ERRORS

How a professional can save your pharmacy money

Catering to Family Caregivers

How your pharmacy can make their job easier

WHEN DISASTER STRIKES

Safeguard your pharmacy from the unexpected

EPUBLISHER & EDITORIAL DIRECTOR

Matthew Shamet EDITOR

Gina Klein

GRAPHIC DESIGNER

Logan Whetzal

CONTRIBUTING WRITER

Cecilia Vigliaturo INTERESTED IN ADVERTISING?

elements@pbahealth.com

ON THE WEB

Detecting Early Cognitive Decline

Cognitive decline is on the rise. The World Health Organization estimates that about 50 million people have dementia worldwide, with Alzheimer's disease the most common form.

Making Room for Skin Care

Skin care doesn’t always revolve around beauty. Having a skincare section in your front end can complement your care services while acting as a source for preventative healthcare tools.

Why You Need an IVR System

In the beginning, an interactive voice response (IVR) system was a way to automate prescription refills by organizing patient voicemails. Today, however, it’s a customer-service phone system that’s computer operated and manages incoming calls.

Follow Elements magazine for pharmacy business tips and advice, news announcements, industry information, and exclusive offers.

THE SILENT AND DEADLY CHOLESTEROL

Promising drugs underway for millions at risk

Nearly 64 million people in the United States and 1.4 billion people worldwide are born genetically predisposed to the cholesterol known as Lipoprotein(a), or Lp(a). High Lp(a) levels are inherited from family and are a common independent risk factor for cardiovascular disease. Sadly, most people have no idea they’re at risk.

Lp(a) shares some characteristics in common with LDL, the bad cholesterol. This type of cholesterol leads to the buildup of plaque in arteries and causes reduced blood flow to the heart, brain, kidneys, legs, and other parts of the body. This can result in blood clots, deadly heart attacks, and strokes by middle age.

Unfortunately, exercise, a healthy diet, and other lifestyle changes have very little impact on levels of Lp(a). It’s also been found that taking medications that reduce bad cholesterol, such as statins, also fail. But there is promising news regarding Lp(a).

How to get screened for Lp(a):

• Talk with your healthcare professional about screening for Lp(a).

• Then, get a simple blood test that can be done at your doctor’s office or diagnostic lab center.

An experimental drug called pelacarsen, from drugmaker Novartis, was found to significantly drive down Lp(a) levels in 98 percent of people taking it. Researchers are now trying to find out whether the lower Lp(a) will truly reduce early and potential deadly heart attacks and stroke.

There are four other drugs that target Lp(a), and they’re currently in various stages of research. The early results for Eli Lilly’s drug, lepodisiran, showed that a single injection reduced levels of Lp(a) to undetectable levels for nearly one year. In fact, the drug can drive down Lp(a) by more than 94 percent for 48 weeks. Amgen’s drug, olpasiran, shows similar results; and a drug called zerlasiran is currently being studied by Silence Therapeutics. Pelacarsen, along with the other drugs mentioned, are given as an injection. An oral drug called muvalaplin is in the process of being tested by Eli Lilly.

The first, real-world results for pelacarsen won’t be revealed until sometime next year. In the meantime, doctors can continue treating patients’ other heart disease risk factors, such as managing their blood pressure and statins to bring down other forms of cholesterol. Doctors can measure patients' Lp(a) and identify high-risk patients. They can also be proactive about prevention by counseling patients to maintain a healthy weight, exercise regularly, stop smoking, and eat a healthy diet. While Lp(a) isn’t affected by lifestyle changes, it’s still important to lower your overall risk of heart attack and stroke.

TRENDS

A NEW YEAR, A NEW MINDSET

Bringing new opportunities into your pharmacy

With a new year and plans for new services dancing in your head, expect to encounter exciting, new challenges in your independent pharmacy, and also some frustrations. But don’t worry. It’s just part of the process of building up your business. The good news is that the challenges you encounter offer exciting opportunities for your pharmacy to grow and thrive.

For years, your pharmacy has been your patients’ go-to for all their healthcare needs. Keeping up with new technologies not only keeps them coming back, but also draws in new customers and keeps your business current. Staying stagnant, however, will eventually send customers to the competition instead.

There have been several important trends that emerged over the past few years, and they have changed the ways pharmacies operate. Here’s a look at what they are and how they can help you thrive in 2024.

The growth of online pharmacies accelerated during the COVID-19 pandemic. In 2021 the digital pharmacy market valued at $83.45 billion. By 2030, Polaris Market Research projects it to reach $340.17 billion.

ONLINE PHARMACIES

This year is all about pharmacies going digital. Online pharmacies offer access to pharmaceutical services through mobile apps and websites. With the use of emerging technologies, they’re able to provide services such as medication adherence tracking, virtual consultations, and personalized care via AI and machine learning.

To ensure safety and healthcare compliance, online pharmacies are accredited through Verified Internet Pharmacy Practice Sites (VIPPS). The overall process of dispensing and delivering the medications is also monitored by health organizations.

The growth of online pharmacies accelerated during the COVID-19 pandemic. In 2021, the digital pharmacy market valued at $83.45 billion. By 2030, Polaris Market Research projects it to reach $340.17 billion.

As with anything else, there are pros and cons that come with online pharmacy. This list may help you decide if it’s right for yours.

The Pros:

• Convenience: Online pharmacies offer a convenient way for patients to order, receive, and stay on top of their medications. Some offer automatic refill services, where patients can set up recurring orders for their medications. This ensures they receive their medications on time without the hassle of placing orders manually every month.

• Access: An online pharmacy offers patients direct, 24/7 access to the service no matter the location. This alone solves the problem of access for the elderly, disabled, and those who live in rural areas.

• Private and confidential: Reputable online pharmacies prioritize customer privacy and employ secure systems to protect personal and medical information. Patients can order their medications without sharing health information or personal information in a public setting.

• Customized care: New technologies, such as virtual consultations, allow online pharmacies to provide care that has a personal touch.

• Increased efficiency : Automation and digitization of administrative tasks unify the internal processes. This increases the operational efficiency and may lower costs.

The Cons:

• No physical interaction: Some patients may miss traditional in-person consultations. Without physically being there, they may feel detachment.

• Technological barriers: Many adults who are either elderly or technologically challenged don’t access the internet. They also steer clear of healthcare websites or medical apps. This limits accessibility for certain demographics.

• Data security worries: With numerous data breaches in 2023, maintaining vigorous cybersecurity measures is vital to protect patient information. An online pharmacy should have a privacy policy page guaranteeing that personal and financial information will not be shared with a third party.

• Market competition: There’s a lot of competition in the online pharmacy market. Business owners aren’t only competing with each other; they’re also up against big companies such as Amazon.

TELEHEALTH SERVICES

Telehealth has completely transformed patient care by providing a safe and convenient way for patients to address medical concerns without leaving home. It’s a service your pharmacy should embrace because it can be used to enhance patient engagement and grow your scope of services.

One advantage of telehealth is that it can treat a wide range of illnesses. Some of the common ailments treated through telehealth include:

• Common illnesses: Telehealth can help with gastrointestinal issues, headaches, fever, and dehydration.

• Respiratory symptoms: Patients who are suffering from a sore throat, coughing, and nasal congestion can get help from a telehealth visit. Telehealth providers treat common respiratory conditions such as allergies, bronchitis, flu, and COVID-19.

• Skin conditions: From acne to dermatitis, telehealth providers can help with treatment. Depending on your telehealth service, patients may have the option to take a photo of their skin condition for the physician to examine.

• Minor injuries: A virtual healthcare provider can help in the healing of many types of minor injuries, such as mild lacerations and abrasions, burns, strains, and sprains.

Offering telehealth services in your pharmacy gives your patients some wonderful benefits, such as lower costs, convenience, and more time. Telehealth allows patients to receive quality care no matter where they live.

PERSONALIZED MEDICINE

Say goodbye to the one-size-fits-all pharmaceutical era as it quietly fades away. The future of pharmacy now lies in personalized medicine, where treatments are tailored to your patients’ genetic makeup, lifestyle, and specific health needs. This approach uses patient-specific information to optimize drug selection, dosing, and treatment monitoring.

Personalized medicine involves therapeutic drug monitoring (TDM), where drug levels are monitored in the patient’s blood to ensure therapeutic concentrations are achieved. TDM can aid in adjusting the dose, especially of drugs with small differences between their therapeutic and toxic doses, to optimize drug efficacy and reduce adverse effects.

Pharmacies can collaborate with genetic testing laboratories and healthcare providers to offer genetic testing services that provide insights into a patient’s response to various medications. From there, pharmacists can recommend a better therapy plan for the patient.

With the demand for personalized medicine on the rise, independent pharmacies are well placed to offer customized compounding services. There will soon be a growing focus on compounding unique medications to address individual patient requirements, allergies, and sensitivities.

PHARMACOGENOMICS

Pharmacogenomics is the study of how one’s genetic makeup influences their response to medications, and it’s gaining eminence. Here’s how it can benefit you and your patients:

• Personalized medication plans: You can use genetic information to create personalized medication plans for your patients. This ensures that patients receive the most effective and safe treatments based on their genetic makeup. This can lead to improved medication outcomes, increased patient satisfaction, and strengthened relationships with the community.

• Reduced adverse reactions: By considering genetic variations that impact drug metabolism, you can minimize the risk of adverse reactions and enhance the safety and well-being of your patient.

• Improved medication adherence: Medications that are tailored to individual genetics can enhance the effectiveness of treatment and increase adherence to prescribed treatments.

• Competitive advantage: By offering pharmacogenetic services in your pharmacy, you stand out and can attract patients who are seeking personalized healthcare solutions.

2024 is full of possibilities and challenges in the field of independent pharmacy. The more you embrace technological advancements, commit to learning, and see yourself as an essential member of health care, the more you’ll actively shape the future of pharmacy and grow your business.

SPRING CLEAN YOUR FRONT END

Freshen the shelves and boost sales

It’s spring! And if you haven’t already encountered sniffly, sneezy customers with itchy, watery eyes walking through your doors in search of relief, you soon will. The quicker you prepare, the easier it’ll be when the pollen wreaks havoc on your customers. And as a one-stop shop, don’t forget to mix in spring holidays and spring break items on your front-end shelves.

Listed below are some great tips to get your front end ready for all the hoopla:

OUT WITH THE OLD, IN WITH THE NEW

Clear away the paraphernalia that’s been taking over the front end in recent months and give the shelves a good dusting. Then, feature the top, over-the-counter (OTC) antihistamines and decongestants so your patients have options for relief. Offer a variety of products, and help them compare the features of each one, such as how long before they take effect; how long they last; what symptoms they alleviate; and what side effects to watch out for.

Vitamins should also be set up on the front-end shelves. With warmer weather, many people are ready to start eating healthier, exercising regularly, and taking vitamins and supplements to fill in the gaps.

Don’t forget about probiotics. They’re one of the fastest growing supplements on the market, not to mention very beneficial for our health. Help your patients select the right probiotic supplement, and always opt for one with a healthy blend of bacteria (bifidobacterium and lactobacillus).

It’s also important to stock some natural cold and flu items in your allergy section, such as:

• Eye drops

• Lip balm

• Neti pots

• Nasal strips

• Saline solutions

• Tissues

Adding some CBD products on the shelves can also act as a supplement to your patients’ medications this spring. CBD comes in many different forms (oils, creams, tinctures, chewables, etc.). No matter which kind you choose, it’ll be a great addition to your front-end offerings.

As a rule of thumb, it’s important to factor in your geographical location to tailor your endcaps and front-end displays to your patients’ needs. Allergy product sales often depend on your location. If you’re located in the Northwest region of the country, prominently feature decongestants along with pain relief to capitalize on this trend. However, if you’re located in the West, feature sunscreen along with allergy relief products.

It's also a great time to encourage your patients to clean out their medicine cabinets at home. Post signs around your pharmacy, and hand out flyers along with patients’ prescriptions that will help them identify any expired products. Be ready to suggest replacements they can find in your pharmacy.

HOLIDAY FUN

Don’t let spring holidays sneak right past your pharmacy. Instead, promote each holiday in your front end. Set up candy, gifts, decorations, and greeting cards on an endcap or two. The bulk of retail sales takes place during the last 7 to 10 days before a holiday, so be sure you’re ready to meet customers’ needs. Keep at least one endcap designated for these products.

MOM’S THE WORD

The month of May is a time to make moms feel special at your pharmacy. Mother’s Day is the third largest retail holiday in the U.S., and it’s a great time to show appreciation to the special moms who shop in your pharmacy. Offer a discount for all the moms, including birth moms, adopted moms, stepmoms, dog moms, etc. Be sure to include all of them in your specials.

FLU SEASON ISN’T OVER

Because cold and flu season isn’t quite over yet, keep some products in the front end for those who need them. Designate an endcap to display cold and flu essentials. Patients will need products such as tissues, pain and fever relief, decongestants, cough drops, and hand sanitizer. But don’t stop there. You’ll have plenty of patients wanting natural solutions, too. Create a display of vitamin C, hot and cold packs, vapor rubs, and saline solution neti pots. This will ensure your pharmacy has solutions for patients who prefer a natural approach to seasonal allergies, colds, or flu bugs.

PARTNERING WITH LOCAL PHYSICIANS

Collaborating with local physicians can be profitable for your pharmacy. Build an endcap or display around one of the many national health observances that occur in springtime. You can do this by building relationships with local doctors, clinics, and medical organizations. Partnering can result in mutual referrals. Introduce yourself to physicians in your area, and if your pharmacy focuses on a specific niche like diabetic care or compounding, let them know that. They might start recommending your pharmacy to their patients.

Partnering can also lead to personalized patient care, an increase in patient adherence, a boost to patient care programs, and improved education. So, don’t be afraid to reach out to local physicians. Building relationships is beneficial for you, them, and your patients.

SPRING BREAK NECESSITIES

Before the kids are released for spring break, stock some cheap, convenient items near the checkout counter to entice the impulse-buying parents who are getting ready to travel.

For instance, stock travel-sized bottles of products that’ll appeal to the families heading out for a quick getaway. Sunscreen, first-aid kits, hand sanitizer, acetaminophen, and so on. If you offer travel immunization services, be sure to promote them to the travelers.

Don’t forget about the families who are staying home over spring break. A staycation can include board games, puzzles, and outdoor toys.

SEASONAL PRODUCTS

A great way to celebrate the spring season is by selling the seasonal items families really want and need, such as:

• Gardening tools

• Protective hats

• Sunglasses

• Swim toys

• Beach towels

• Flip flops

• Outdoor decor

Each new season means a new opportunity to become your patients’ one-stop shop. When you stock the products they want at the right prices, your sales will continuously increase, and you and your patients, both, will be pleased.

FIND YOUR NICHE

Make your pharmacy stand out from the competition

Pharmacies have a lot of similarities. In fact, when customers visit one pharmacy, they sometimes feel like they’ve visited them all. That’s because pharmacies often fail to consider their patients’ interests, not to mention nationwide industry trends; so much so that consumers aren’t extremely loyal to any one outlet.

As a community pharmacist, it’s important that you make your pharmacy stand out from the others. Finding an area you can specialize in will turn your pharmacy into more than a place to pick up prescriptions; it’ll become a destination. Making your pharmacy stand out from the rest can improve profitability, drive recommendations, and reinforce a purpose.

Whether your pharmacy focuses on natural products, compounding, or diabetes care, having an established niche can make your pharmacy a guide for your community. Plus, you provide patients with a more personalized experience they can’t get from the chains. To make it successful, you have to do the research and add in a little flair to pique curiosity and draw customers in.

GET TO KNOW YOUR MARKET

Whatever your forte may be, it needs to be different than anything else in your local market. So, it’s important to find out what your competitors provide before you commit. One way to do this is by visiting your competitor chains to see what they have to offer. It’s also a good idea to look to your wholesaler or merchandise supplier for inspiration. Find out what they have available and what products you can use to cater to a specific group.

Evaluate the demographics in your area. If you have a lot of diabetes patients, specializing in products and services for diabetics will give new patients a reason to stop into your pharmacy.

DO THE MATH

No matter how trendy or cutting edge your new service may be, if it doesn’t have the capacity to raise your pharmacy’s revenue, it won’t last. In fact, it could become a financial blow.

Take a hard look at your finances before you add a new service. Make sure you can afford the initial investment. Even small changes can cost a lot.

When you introduce your niche service, think hard about pricing. Check other pharmacies to see what they’re charging

for similar services. Do the math to determine how long it will take you to make a profit with the service at different price points.

Some experts advise pricing services higher than you think you should when you start out. That way, if the price ends up higher than it should be, it’s easy to lower it and get your patients excited about a deal. However, if your price it too low, it’ll be much harder for consumers to want to spend more.

CHOOSING YOUR NICHE

Having a specialty service in your independent pharmacy goes far beyond filling prescriptions. You have services that meet the needs of specific populations in your community, making them a destination. Here is a list of areas some pharmacies have added to their stores:

• Compounding

• Cancer Care

• Diabetes Care

• Vaccines and Immunizations (Including Travel)

• Vitamins and Nutritional Supplements

• Specialty Diets (Ketogenic, Paleo, etc.)

• Hospital-to-Home Transitions

• Family Caregivers

• Health Education

• Lab Testing

ON YOUR MARK, GET SET, GO

When you finally decide what attribute you want your pharmacy to serve, take a deep breath and go all in. That’s right. You and your staff need to be passionate and committed.

Own it. Constantly ask yourself what more you can do for the patients who are coming in for these products.

If diabetes care is your jam, don’t think that simply stocking a few products for diabetics will make your pharmacy a diabetes destination. You need to get deep into your specialty and provide a solution, not just products. Give advice and resources rather than just the information that’s already available.

Interview your diabetic patients and ask them about the products and services they use and need but aren’t being offered in the community. Be empathetic to those you’re trying to serve. This is how you get to understand those patients and what you can do to create better solutions for them. Check out websites, blogs, and social media to learn what people with diabetes are talking about. This can give you some great ideas on what to offer in your pharmacy.

SPREAD THE NEWS

So, you’ve determined your pharmacy’s niche. Now it’s time to spread the word. After all, you can’t succeed if nobody knows it exists.

Start by adding information about your products and services to your website, along with any other promotional materials you send out. Inside your pharmacy, set up a separate space for your specialty items. That way, your customers can easily see all the helpful products your store offers.

Create unique branding for your service that stands out for patients who come into your pharmacy frequently. This can pique their curiosity and prompt them to ask questions. You can build up excitement by inviting members of your loyalty program to try out the new service before it becomes officially available to the public. Get the word out through every avenue available, such as email marketing, social media, radio stations, and direct mail. Consider offering an enticing discounted rate to encourage people to try out your new service during the first week after you’ve introduced it.

After it has gotten off the ground, share the glowing testimonials from the happy patients who’ve already taken advantage of it.

STAY COMPETITIVE

Personalization is key in your pharmacy. Otherwise, why would patients want to go to your pharmacy for specialty supplements when they can just order them from Amazon?

If you want customers to keep coming through your doors, you must put personality into the solution you’re developing. Become connected to the patients you’re serving. Get to know them and invite them in.

Once you’ve committed to your mission, it doesn’t take very long to implement it once you’ve done your research. You have the advantage of flexibility. Your closeness to your community is right in front of you. That means all you have to do is look around!

CATERING TO FAMILY CAREGIVERS

How your pharmacy can make their job easier

way to take medications. For instance, you can explain the appropriate time to take each medication and explain any potentially dangerous or adverse interactions.

You can also educate caregivers on how to administer drugs via syringe, the correct way to measure liquid medications, and how to use glucose meters or properly take blood samples.

STOP POTENTIALLY DANGEROUS INTERACTIONS

It can be a challenge when your patients are taking multiple medications. It’s challenging for the caretaker to keep track of what time each medication needs to be given, while also looking out for potentially dangerous drug interactions. Some caregivers may not be aware that overthe-counter (OTC) medications can have serious interactions

or contraindications with prescription drugs. Encourage caregivers to put all the medications their patient is currently taking, both prescription and over the counter, and bring them to your pharmacy for you to review.

“Pharmacists can look at the full regimen of prescriptions and ask the right questions, such as, ‘Is your mom feeling dizzy? Is she feeling tired or anxious? Let me talk to the physician on your behalf and see if we can adjust her medications or try a different dose,’” Wendland said.

Once caregivers feel comfortable talking with you, word will get out that your pharmacy is not only knowledgeable, but also caring. This leads to an overall better experience for both the patient and the caregiver, and this is good for business.

KEEP THEM INFORMED OF MEDICATION COSTS

When you find cost-saving opportunities that your patients are eligible to receive, let them know. It may include information about Medicare Part D programs, or advice about switching to a generic version of a prescription medication.

ADJUST MEDICATION

If one of your patients is transitioning from a healthcare facility to home, it can be a challenge to keep medications in order. However, the transition can be a success by combining your know-how and a caregiver’s proximity. Caregivers spend a lot more time with the patient, so they can help monitor the patient for any complications or reactions to medication, as well.

HELP ORGANIZE MEDICATIONS

Recommend pill sorters for caregivers to organize their patient’s medication. By arranging medication, caregivers can be sure their patient is adhering to their treatment schedule. Show them the best type of pill sorter based on the patient’s drug regimen.

INTRODUCE THEM TO HELPFUL TECHNOLOGY

Advancements in technology play a large role in modern caregiving. Telemedicine, mobile health apps, and assistive devices are a huge part of modern caregiving. These tools also offer remote monitoring and real-time updates, which give caregivers and their patients peace of mind.

“I strongly urge having a dedicated area of your website where a caregiver can go. This gives them the opportunity to bridge endless aisles of product that you may not have room for in your pharmacy, but you know your drug wholesaler carries,” Wendland said.

Additional Organizations That Support Caregivers

Having multiple places to turn to for help is important for those who are caring for loved ones. Below is the AARP’s list of organizations that support caregivers. Whether in person or online, your patients can find organizations that specialize in caregiver support.

Local programs:

Eldercare Locator eldercare.acl.gov

This U.S. government site can connect you with your local Area Agency on Aging, where you can find resources in your community to help you deal with the challenges you’re facing.

Support Groups wellspouse.org

If a patient of yours is feeling alone in the struggle of caregiving, talking with other family caregivers can help them lift their spirits and think through solutions to any problems they may be experiencing. Support groups are also helpful and can often be found through a local hospital or church. There is also a website called Well Spouse Association that coordinates a national network of groups for spousal caregivers.

Dementia-Specific Care alz.org/events

Community Resource Finder communityresourcefinder.org

This is an online database from AARP and the Alzheimer’s Association where you can find a range of programs and services in your area.

Caring for a loved one with Alzheimer’s disease can be worrisome and overwhelming. If a patient in your pharmacy is struggling with this, pass along the Alzheimer's Association website locator for support groups in your area.

Family Caregiver Alliance caregiver.org

This site can help you locate caregiver resources in your state.

Online Forums community.aarp.org

For caregivers, AARP has an online caregiving forum and a Facebook discussion group, the AARP Family Caregivers Discussion Group (facebook.com/groups), where your caregivers can meet others and share information and advice.

THE IMPACT OF CAREGIVING

• In a 2023 report, AARP found that 40 percent of all caregivers cite the emotional stress of juggling caregiving and working as their biggest challenge.

• More than half of caregivers find that caregiving makes it hard to take care of their own mental health.

• Nearly 4 in 10 caregivers say they never or rarely relax.

• 40% say caregiving makes them feel alone.

(American Association of Retired Persons (AARP) Report, 2023)

CHECK IN REGULARLY ON THEIR MENTAL HEALTH

Caregiving is challenging. It’s hard work, and the emotional and psychological demands build up over time. Keep tabs on the caregivers and offer them mental health screening in your pharmacy. Follow up by giving them information on mental health support, such as local peer groups or counseling. There are also community-based networks where caregivers share resources and offer mutual support.

FAMILY CAREGIVERS AND MENTAL HEALTH

• More than a third of family caregivers report emotional stress that accompanies caring for an adult loved one.

• Four in 10 caregivers rarely or never feel relaxed.

• More than half (56%) of caregivers report that the role makes it difficult for them to care for their own mental health.

• 41% report being lonely.

• Caregivers between the ages of 18-34 were found to be most likely to suffer from anxiety as a result of caregiving.

• Caregivers 65 and older reported the lowest levels of stress, anxiety, and depression.

• Women of all ages providing care reported higher levels of stress and worry than men providing care.

• 82% of caregivers say the role gives them a sense of purpose in life.

• 81% of caregivers say it makes them feel good about themselves.

(AARP Survey, 2023)

ADVISE THEM ON ADHERENCE PROGRAMS

Provide tips on how to improve a patient's adherence, such as setting alarms with reminders about medication or making a daily schedule with dosing times and instructions. Have the caregivers keep a log to track adherence. This will help you monitor the patient’s treatment.

GIVE TIPS TO MAKE IT EASIER

Show caregivers how they can lighten their load with products and services you offer in your pharmacy, such as:

• Compliance packaging

• Free delivery

• Lift-assist devices and chairs

• Grab bars and raised toilet seats

HOST SESSIONS AT YOUR PHARMACY

Consider hosting a learning session in your pharmacy on topics that will help make caregiving easier (i.e. how to keep family medical records, choosing a nursing home, or legal and estate planning issues).

“Have an open house. Invite caregivers in and give them a tour of the store. Show the products you have available. Maybe bring in a gerontologist to speak one evening and talk about aging,” Wendland said. “If you have an electronic billboard outside your pharmacy, try a message that says, ‘We understand family caregiving. Ask us how we can help.’ Everyone wants to make sure they’re doing the right thing when it comes to caregiving.”

OFFER PRODUCTS CAREGIVERS NEED

Make caregivers’ lives much easier by setting up your pharmacy as their one-stop shop for all their caregiver needs. Offer an assortment of home-health products in your pharmacy’s front end.

Stock products that will make life easier and more manageable at home, including:

• Bathroom safety devices

• Bed rails

• Canes

• Compression socks

• Diabetes care

• Home diagnostic equipment

• Incontinence products

• Magnifiers

• Oral rinse for dry mouth

• Pill boxes

• Walkers

• Wheelchairs

“It’s important to have affordable solutions, but vetted solutions that are quality,” Wendland said. “If you buy a $10 cane, but it doesn’t offer the support needed, that’s not a good $10 spent. But if you have a $20 cane that you have confidence in, put a ‘pharmacist recommends’ sign on that cane. Feature the right products at the right price and build integrity with caregivers.”

During every conversation you have with caregivers, remember that they’re patients, too, and need your personal care and support. Be encouraging and lift them up. Most of all, make sure they keep up with their own physical and mental health needs.

DIABETIC SALES

Boost your revenue by offering supplementary products

Your patients are important to you as a pharmacist. You want to make sure their healthcare needs are taken care of. Your diabetic patients have many needs, which means catering to their disease can bring in additional revenue. Very few conditions are more profitable than diabetes, and that’s because of the nature of the disease.

Diabetes patients visit the pharmacy more than others. They fill more prescriptions, and they have more comorbidities that go hand in hand. That’s why tailoring your pharmacy to address the numerous health issues associated with diabetes isn’t a one-time gain. Patients are tethered to their pharmacy because of their increased need for preventative and maintenance-based solutions. They also rely on your recommendations as a pharmacist. So, focusing on those with diabetes enables you to help your patients and boost your revenue at the same time.

EDUCATE THEM

Patients get overwhelmed when looking around at the numerous products that are important to all aspects of diabetic care. They simply don’t know where to start.

As their pharmacist, your job is to educate them. Help them understand there’s more than just blood glucose testing. There are a multitude of products they need to know about. Diabetes is an invasive condition because it affects your skin, your eyes, and it affects how you eat. Addressing these problems requires the right products.

Without your guidance, patients might select less effective products. If they reuse a lancet or syringe, they’re increasing their risk of infection. And if they eat candy instead of fastacting glucose products like tablets, gels, or shots to raise blood sugar during a hypoglycemic event, they can enter a state of hyperglycemia.

BE THEIR DIABETES DESTINATION

If you want to be their go-to diabetes expert, provide all diabetes-related products in one central area in your pharmacy. Your patients want one place where they can find exactly what they need. A simple section of the store that carries everything, along with an education component to it, is vital. They don’t want to walk down a maze of aisles to get what they want.

It’s important to note that there are many conditions rooted in diabetes, such as skin irritations, neuropathy, eye problems, digestive issues, and more. Make sure your diabetes front-end section clearly defines what each individual product is and why patients need it. You might also consider placing educational signage or brochures near related diabetic products. Do this for both blood glucose meters and fast-acting glucose products, lancets, skin care, and foot care. In addition to placing items related to diabetes care together, highlight products throughout the store. For example, mark every sugar-free product with a gold star, making it easy for diabetic patients to navigate your store.

CONDUCT MEDICATION REVIEWS

One of the most overwhelming and emotionally taxing parts of living with diabetes is managing multiple medications. You can help ease your patients’ burden by reviewing their medications with them.

Discuss any medication interactions, inform them about possible side effects, and help them plan their medications. And, be sure to let patients know you offer medication reviews.

How to inform your patients of medication reviews:

• Slip a brochure in prescription bags for insulin

• Put up a sign near the pharmacy counter

• Tell patients about the service when they pick up their prescriptions

OFFER EDUCATION CLASSES

Offer diabetes education classes in your pharmacy to help your patients better understand their condition and manage it. Here are some possible education programs to offer:

• Food tour: Take your patients on a tour through a local grocery store. Hire a diabetes educator or nutritionist who can explain how to read food labels.

• Healthy-eating classes: Have a local nutritionist host a class to provide helpful ideas and tips on eating well.

• Senior center days: Hold a simple diabetes education class at your town’s senior center. This makes it much easier for older patients to learn about the disease.

• National Diabetes Education Program: This program provides patient education materials and tools to help healthcare professionals better care for patients with diabetes or who may be at risk for it.

PROMOTE MOBILE MANAGEMENT

The use of smartphone apps, email, and texting can help diabetes patients better manage their condition. And because people are always on their smartphones, they will see a reminder within a reasonable time.

Your reminders will help them stay on track with their medication and blood sugar testing. It’s also a good idea to

point out a few good mobile apps that are built to help them manage their diabetes. Here are some you can recommend:

• MySugr

• Sugar.fit

• WeCare Diabetes

• One Drop

• Glooko

Remember, while your front-end diabetes section can help your patients find products that are ideal for them, they need your expertise to make sense of it all. Ask them about their needs and help them find the right products to make their days easier.

DIABETIC PRODUCTS TO CONSIDER OFFERING

Having a diabetes section in your pharmacy is a start, but you can take it a step further. Explain to patients why they need supplementary products beyond meters and test strips. This will maximize your diabetic product sales. Here are five additional items to stock:

Lancets

Diabetics need a new lancet for every test they take to reduce the risk of infection and pain. Be sure to have a healthy supply at all times.

Supplements

A daily fiber supplement is important because it adds nutritional support and slows the uptake of sugar into the bloodstream.

Skincare products

A daily deep-moisturizing skincare regimen is vital to avoid nerve shrinkage. Diabetes can shrink the nerves in the periphery resulting in the inability to sweat properly.

This leads to dry or cracked skin that can cause infections and other complications. A daily lotion regimen gets patients in the habit of checking their skin for wounds.

Glucose products

Your pharmacy will also need fast-acting glucose tablets, gel, or a shot containing a pre-measured amount of a fast-acting carbohydrate. This raises blood sugar during a hypoglycemic event without causing a blood sugar spike.

It’s also a good idea to provide glucose testing. You can’t test them every day, but you can help make sure they understand how to properly test their blood sugar levels. You can also check to make sure they’re keeping up with it. This will give them confidence and peace of mind.

Syringes

Don’t forget to stock a silicone-coated syringe in your diabetic-care area. Be sure there are no surface imperfections, and it has various gauges and lengths. A quality syringe ensures a comfortable patient experience. The proper length is also vital for injecting insulin correctly.

COMMON ACCOUNTING ERRORS

How a professional can save your pharmacy money

You encounter unique challenges day in and day out in your pharmacy, especially with managing financials. Accounting is an essential part of your business, and it can easily make you feel in over your head. You may be getting by from month to month, but you probably aren’t boosting your potential. And if your accounting isn’t accurate, you might be putting your pharmacy at risk.

Your numbers need to be precise. Not only to handle your cash flow each day, but to be able to set long-term goals. When done correctly, you will receive important insights into your pharmacy’s financial health. But if you manage it incorrectly, your business will quickly sink.

Everyone makes mistakes. What’s important is that you catch those mistakes and avoid them next time. Here’s how:

BE AWARE OF YOUR NUMBERS

Stay on top of your finances and know where you stand. Don’t drive blind. When you’re on top of your funds, you’re able to set goals for your pharmacy and find areas that need improvement.

Having reliable numbers and knowing how to use them is vital. Use resources such as the NCPA Digest from the National Community Pharmacists Association, which highlights independent pharmacy financial trends. With this, you’ll be able to see how your pharmacy’s numbers stack up.

DON’T MANAGE YOUR SYSTEM HAPHAZARDLY

Make a time commitment to put a proper system in place. Without one, your business will lack the structure it needs to operate efficiently and effectively.

KEEP TRACK OF YOUR EXPENSES

You can’t properly manage your business if you aren’t tracking money in and money out. Record all your spending, save all your receipts, and keep your personal and business accounts separate.

While failing to record your spending may not hurt your business, it will eventually cost you. If you don’t have proper record keeping, you’ll end up paying income taxes you wouldn’t have had to pay if you had noted all your expense deductions.

TRACK OUTSTANDING RECEIVABLES AND REIMBURSEMENTS

Be sure to track the money that’s coming in. It’s just as important as watching what’s going out. Track payments from your patients for your products and services as well as reimbursements from their insurance. Lacking a proper system to record your outstanding receivables and reimbursements can result in a loss of thousands of uncollected dollars.

HIRE AN ACCOUNTANT

There’s nothing wrong with wanting to hire a professional. After all, accountants don’t try to fill their own prescriptions. They go to their pharmacists. Like you, accountants and tax specialists are experts in their field. They can save you a lot of time and money in the long run by keeping your records safe and organized, entering details into your system, taking care of your business, keeping track of deadlines, contracts and much more. They ensure your expenses are tracked, bills are paid on time, and will even advise you on what opportunities to invest in.

There are a lot of accountants to choose from, but the accountant you use for your personal finances is not a wise choice since they won’t understand the pharmacy business. Find someone who understands the intricacies of community pharmacies, and someone with impressive accounting skills. This gives you two options to choose from. You can either find an accounting firm that specializes in community pharmacies or opt for a consulting firm that provides operational guidance, support, and accounting for pharmacies like yours. Whichever you choose, be sure they’re a good fit and that they speak in terms you understand.

Accounting firms that specialize in pharmacy understand such things as what the reimbursement process can do to your cash flow and ways to mitigate the negative effects. They know the appropriate options for minimizing your tax commitment and how to assess the financials for a pharmacy you may be thinking about acquiring. They understand how benchmarks like wholesaler acquisition cost (WAC), average wholesale price (AWP), and average actual cost (AAC) influence what you charge and are reimbursed for pharmaceuticals. Plus, they can do all the usual things as well, such as processing invoices and payments and filing tax returns.

On your journey to find the right accountant, look at the value and not just the cost. When it comes to your pharmacy’s accounting, it pays to look past the upfront fees to see the future value of your investments.

Looking for an accounting firm that knows the ins and outs of community pharmacies? Check out the resources below: FINDING THE RIGHT ACCOUNTANT FOR YOU

• Community Pharmacy Trade Association

https://ncpa.org/

• National Society of Accountants

https://nsacct.org

• Service Corps of Retired Executives

https://score.org

Accountants offer the following value-added services:

Tax planning

A good accountant will start your tax planning from the start to make sure you get the maximum benefit of tax-sheltering or tax-reducing opportunities. They’ll also help you minimize the amount of taxes you pay.

Audits

Your accountant will help you keep good documentation. That way if you’re reviewed or audited you won’t run into trouble with the Internal Revenue Service (IRS). The IRS can request to review any business transaction at any time.

The most typical review for pharmacies happens with sales tax (GST/HST/PST) returns. This is when the IRS requests to see the top 10 expenses claimed in your most recent return. If you notoriously save your receipts and have a good accountant by your side, you decrease your chances of being hit with penalties and interest for lack of documentation. You don’t want to be questioned and find that there may be fraud present. This can lead to an audit.

Bookkeeping

With all the busyness in your pharmacy each day, it can be difficult to know who you owe or who owes you. With daily deposits from insurance plans, frequent purchases from vendors, and your point-ofsale (POS) system, it’s nearly impossible to know your exact financial status at any time.

An accountant can keep financial statements and finances up to date and organized on a daily, weekly, monthly, and annual basis. That way, you’ll know exactly what your financial situation is at any time.

Accounting

Up-to-date bookkeeping will help your accountant with financial documents such as a profit-and-loss statement, balance sheet, and cash flow statement to show the business’ financial health.

Accounting services help you understand what all the numbers mean and help identify if there is an opportunity for growth or issues that need to be addressed. At that point, your accountant will offer business advice to address the issues.

WHEN DISASTER STRIKES

Safeguard your pharmacy from the unexpected

In the face of the world’s natural disasters, you play a vital role in protecting public health and providing essential care to your community. As a frontline healthcare provider, you’re often among the first responders during emergencies, offering critical services and support during all the chaos and uncertainty.

Emergencies are bound to happen in your community, but you don’t want to be caught unprepared when one strikes. Whether it’s a tornado, blizzard, hurricane, flood, or a power outage, you need to be ready. With the proper planning, you can protect your pharmacy business from the unexpected.

According to the Journal of Accountancy, more than 60 percent of U.S. small businesses do not have a formal emergency-response plan and fail to back up their financial data off-site. Additionally, The Small Business Disaster

Nearly 25 percent of businesses do not reopen after a disaster. This is why having an emergency disaster and continuity plan in place is so important. It can reduce the risk and help your pharmacy recover faster.

By planning ahead, you can stay in business after a disaster strikes. Here’s how:

CREATE A COMMUNICATIONS PLAN

This will keep you in touch with your patients, suppliers, and employees. Give your employees information on when, if, and how to report to work after a disaster. Working remotely

JUST IN CASE …

Not sure you have all the safety measures in place in your pharmacy? Use the following four resources to create, evaluate, and enhance your disaster preparedness and business continuity plans for your pharmacy:

The Federal Emergency Management Agency (FEMA)

The program, Ready (ready.gov), by FEMA can help you learn what measures your pharmacy should take before, during, and after a natural disaster to keep your doors open, or to rebuild as soon as possible. Ready offers information for businesses about natural disaster preparation.

The Disaster Recovery Institute

This nonprofit helps organizations prepare for — and recover from — disasters. The Disaster Recovery Institute Preparedness Study, conducted by software maker Sage North America, found that while 94 percent of small U.S. businesses back up the financial information stored on their computer systems, most store their backups on-site. However, backing up on-site isn’t enough to protect you from losing your data, especially if your location is prone to natural disasters, theft, or hardware malfunction. Your data needs to be backed up off-site if you want to be able to recover it.

is an option to consider if there’s administrative work that needs to be done.

Keep your important contact information up to date and check your plan each quarter to be sure you have the right agencies, phone numbers, and contacts listed. This includes your insurance agent; drug enforcement administration (DEA); police and fire; state pharmacy association; and employees.

It’s also wise to designate a spokesperson ahead of time to talk with patients and/or the media. Be sure this person is familiar with your social-media channels and understands the ins and outs of your pharmacy.

CHECK YOUR INSURANCE

Call your provider and make sure your policies have enough damage coverage.

SPEAK WITH AN INSURANCE AGENT

Find out how to protect your business with insurance for fire, tornados, earthquakes, floods, and more.

(drii.org) also provides resources and education that can help your pharmacy develop a continuity plan to continue providing patient care and services following a disaster.

American Red Cross Ready Rating

This self-guided program (readyrating.org) helps businesses like your pharmacy better prepare for emergencies. You can access preparedness assessments, emergency-planning forms, customized feedback and recommendations for improvements, and helpful videos with membership to this free program.

Pharmacists Mutual Companies

Pharmacists Mutual (phmic.com) is a specialized insurance company that offers insurance coverage designed specifically for pharmacies. They can help your pharmacy manage risk, identify liabilities, and manage costs if losses do occur.

KEEP COPIES OF IMPORTANT RECORDS

Put building plans, insurance policies, bank account and employee contact information, and other important documents in a waterproof container. This should be stored in an off-site location.

DEVELOP PROFESSIONAL RELATIONSHIPS

Make sure you’re connected with more than one company in case your primary contractor cannot service your needs.

PREPARE TO SUPPORT OTHERS

Be cognizant of any support your employees, clients, and communities may need.

HELP YOUR PATIENTS PLAN

Remember that not all emergencies take place immediately. Some, like hurricanes or snowstorms, give you a few days to prepare before the mayhem moves in. That means you can reach out to your patients who would especially be harmed by non-adherence if they didn’t have access to their medications. Create and follow a plan for ensuring your patients have enough medication to get through the forecasted end of the emergency situation.

It’s also important to educate your patients before severe weather hits or during the time of year when it is most likely to hit. These tips from the FDA are perfect for sharing on your social media, through email, or by adding it to your pharmacy’s phone system as part of the hold message:

• Have an up-to-date list of your medications on hand along with dose and indication.

• Keep a log of how much medication you have.

• In the event of limited pharmacy access, receive early refills.

• To prevent exposure to floodwater, place medication in watertight containers.

• Have ice on hand for refrigerated medications.

These steps should also be a part of your disaster planning. That way, when threatening weather is on its way, you can quickly jump in to keep your patients safe.

When Should You Close Shop?

Your patients expect your pharmacy to be open when they need refills on their medications. When prescription refills are delayed, it can cause lifethreatening complications. So, it’s important to have a plan should an unlikely disaster take place. Here are some guidelines you can follow that will help you make that difficult decision during a crisis.

When traveling isn’t safe

Many weather-related incidents make driving to the pharmacy dangerous. Whether it’s snow, ice, flooding, or earthquakes, it can be a scary situation. Depending on the condition, if it’s risky enough that no one should be on the roads, the best thing to do is close for the day.

When your store can’t function

If your pharmacy loses water or electricity or sustains serious damage, operating it safely may not be an option. However, if there’s another pharmacy nearby that is fully operational, consider partnering with them to meet the needs of your patients while you get your store up and running again. Add this agreement to your plan, and be willing to offer the same for other pharmacies.

When you can’t pay employees

Employees should be paid for the work they miss due to an emergency or disaster that required the store to close. Missing out on paychecks unexpectedly can put them in a difficult financial situation. Furthermore, it can create stress that affects their performance at work.

If you find out your employees were affected in other ways by the disaster, such as damage to their home or vehicle, losing their paychecks will exacerbate their situation. If you absolutely cannot afford to pay employees for missed work in a disaster, be sure to write up a policy explaining that they need to use PTO if they have it available or go unpaid if they don’t. It’s important to let them know what to expect so it will soften the blow if it happens.