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How Independent Pharmacies Stack Up
In the Consumer Reports survey of more than 33,000 consumers, independent pharmacies outranked all national retail pharmacy chains and mass merchandisers in terms of:
- Overall satisfaction
- Speed and accuracy
- Courtesy and helpfulness
- Pharmacist’s knowledge
Reasons to Switch to Independents
In addition to higher overall consumer satisfaction, Consumer Reports offered several reasons why consumers might benefit from switching to an independent pharmacy:
- Greater expertise and more personal attention. The Consumer Reports article highlights for consumers that establishing a good relationship with a pharmacist they trust is the primary reason to choose a drugstore. Lucinda Maine, CEO and executive vice president of the American Association of Colleges of Pharmacy, is quoted, “You can and should expect your pharmacist to be both accessible and knowledgeable. If he or she is not, then you should take your business elsewhere.”Ninety-four percent of survey participants gave their independent pharmacists high marks in knowledge. Customers of independent pharmacies also praised their pharmacist’s accessibility and personal service, and reported they were much more likely to discuss their prescriptions with a pharmacist. In contrast, customers of large chain pharmacies often found it difficult to communicate with pharmacists, at times because they thought the pharmacists seemed too busy.
- Shorter wait times. Customers are much less likely to have to wait for prescriptions at independent pharmacies than elsewhere. Only 7% of customers said a prescription wasn’t ready when promised at an independent pharmacy and just 4% complained of long waits. At pharmacy chains, 19% of customers found that a prescription wasn’t ready and 21% experienced long waits. In addition to encountering fewer delays,Consumer Reports also mentioned that independent pharmacy customers encountered fewer medication mix-ups than those who shopped elsewhere.
- Consistent access to needed medicines. Overall, almost 40% of consumers surveyed reported that a drug they needed was out of stock in the past year. Independents like Health Mart had fewer out-of-stock drugs than most major pharmacy outlets. In the event of an out-of-stock, as a group independent pharmacies were more likely than other types of pharmacies to restock a drug later the same day or the next day.
- Individualized services customized to patients’ needs. Many independent pharmacies offer compounding, or custom-mixing, services to tailor medications for individual patients. Consumer Reports gives the example that independent drug stores “can make a medication without a certain dye for a patient with an allergy or create a liquid version of a drug for a patient who has trouble swallowing pills.” Additionally, the article highlights that independents often stock specialized medical items such as durable medical equipment. In addition, independents are most likely to offer anytime delivery services.
So, individuals who care about face-to-face service from pharmacists who offer personal advice based on knowing your particular health concerns, shorter wait times, consistent access to needed medications, and customized service may want to strongly consider switching to an independent pharmacy, as independents consistently outperform the chains in these areas.
Independent Pharmacies Save You Money
New Consumers Union survey shows community pharmacies offer not only superior service, but lower prices compared to chain competitors December 3, 2015
It probably surprises no one that independent pharmacies outperformed all chain competitors in customer service in a recent Consumers Union survey. But independents also beat major chain drugstores, supermarkets and big box discounters on price — and by a wide margin. In fact, among all national chains, only the pay-to-shop membership club, Costco, edged out independents on price.
* Published in the January 2016 edition of Consumer Reports magazine, the Consumers Union report was based on results from “secret shoppers” who called the pharmacies of more than 200 stores for price quotes on five common generic prescription drugs.*
The total averages of the price quoted (a one-month supply of each) were: Costco: $117 Independents: $136 Sam’s Club: $193 Target: $317 Walmart: $352 Kmart: $558 Grocery Stores: $561 Walgreens: $603 Rite Aid: $827 CVS: $855 The drugs in the survey included generic versions of Actos, Cymbalta, Lipitor, Plavix and Singulair. *Sam’s Club (a subsidiary of Walmart Inc.) and Costco are clubs requiring membership purchase to shop there, however non-members may purchase prescription drugs.
And the reasons to patronize independent pharmacists go far beyond price. Consumer Reports notes, “You’re much less likely to wait at an independent pharmacy than at another type of store.” Just 4 percent of customers at independents complained of long waits compared to 21 percent of pharmacy chain customers.
The Consumers Union report suggests this may be an intentional strategy by some chains to ensure customers have plenty of time to roam their aisles for other products. According to Consumer Reports, “At least 90 percent of shoppers at independents rated their pharmacy as Excellent or Very Good in speed & accuracy, courtesy & helpfulness, and pharmacists’ knowledge. No other type of drug store came close.”
Pharmacists Rank Among Most Trusted Professionals
Pharmacists placed second among the country’s most trusted professionals in a Gallup poll, retaining a spot in the top 3 for the tenth consecutive year.
Pharmacists have once again been ranked among the country’s top professions in terms of honesty and ethical standards. In an annual poll conducted by Gallup, pharmacists placed second among the professions listed, with 75% of respondents expressing a high or very high opinion of their honesty and ethical standards. This is the highest honesty rating the profession has ever received in the poll.
“In the Gallup’s more than 3-decade-old survey the level of respect for pharmacists has been consistently high,” said National Community Pharmacists Association CEO B. Douglas Hoey, RPh, MBA, in a press release. “We don’t rest on our laurels; instead each year we strive to become better.”
“Their second place ranking this year illustrates that pharmacists are highly-trusted medical professionals, with a minimum of 6 years of professional education to receive their degree and license,” said National Association of Chain Drug Stores President and CEO Steven C. Anderson, IOM, CAE, in a press release. “Not only do community pharmacists dispense prescription medications, but they also provide a number of health services that help patients improve their health and also reduce health care costs.”
The poll placed pharmacists ahead of physicians, who received a 70% honesty rating, but behind nurses, who received an 85% honesty rating. Before nurses began to be included in the survey in 1999, pharmacists routinely took first place in the survey, according to Gallup. The profession’s honesty rating has never dipped below 60% throughout the history of the survey.
“Our hope is that the decision makers in the private and public sector who make policy and choose prescription drug plans will tap further into the expertise and results pharmacists can bring to health care,” Hoey added. “For example, the trust that Americans place in their pharmacists makes these highly trained health care professionals a prime resource to help improve outcomes and reduce costs by boosting patient compliance with their prescribed medication regimen.”
What are the pros and cons of big pharmacies versus small ones?
Any pharmacy can fill your prescriptions because they all have access to the products, so I think it comes down to what matters most to you. Also, if you have prescription coverage, the prices will be the same or very similar no matter where you go. Consider distance from home or work, time of day you typically go to a pharmacy, and how complicated your drug regimen is. Often, the pharmacist at a smaller, independent pharmacy will have more time to talk with you about your medications. However, they typically have shorter hours and are not open late at night. It’s generally easier to develop a relationship with a pharmacist at a smaller pharmacy, but if you like a pharmacist at a bigger store, ask for the days and hours he or she works. Talking with patients when I worked at a small, independent pharmacy was the best part of the job! I strongly advise patients to use one pharmacy so that all your medication records are available for the pharmacist to review. Checking for drug interactions is a big part of filling any prescription. If you must fill a prescription at a different pharmacy, be sure to let the pharmacist know what other medications you take.
Stacy Wiegman, PharmD , sharecare.com
Why Choose an Independent Pharmacy?
These days, shoppers can pick up over-the-counter medicine and prescriptions from any big chain retailer: Target, Wal-mart, Kroger, Walgreens, CVS, Rite-Aid, etc. The convenience of picking up your medicine while shopping for groceries or clothing is appealing to most people.
However, people shouldn’t be so quick to neglect using an independent pharmacy.
There are six reasons why an individual should choose to shop at an independent community pharmacy versus a big chain retailer’s pharmacy. Those six reasons are as follows:
Buying locally from an independent pharmacy supports the local economy.
When customers buy from an independent pharmacy, jobs are created for pharmacists, pharmacy technicians and other staff. Also, a large percentage of the money spent stays in the community as to going to a large chain’s headquarters located in another state.
Customers can get the “Mayberry” experience.
When people think of “The Andy Griffith Show,” one word always comes to mind: friendliness. When you shop at an independent pharmacy, you get this same disposition. In fact, it’s not uncommon for customers to develop personal relationships with the staff. The value is placed on you and not your money – unlike big chain stores, whose service mostly come with rude attitudes and long wait times. You are far more likely do develop a personal relationship with the staff at your local independent pharmacy. A personal relationship ensures great service.
Independent pharmacies have shorter wait times.
Big chain retailers seem to attract big crowds, which in turn, mean long lines. However, independent pharmacies will work to have you out in a short time. They realize that you have other things to do besides wait for your medicine.
You can choose from a variety of over-the-counter products.
Despite being major chain retailers, their pharmacy departments don’t always carry that special over-the-counter product you are looking for. Truthfully, you might discover that they carry a limited selection. When you shop at an independent pharmacy, you’ll likely to find a product that helped your mother in her younger years whenever she was sick – now available to heal you as well.
An independent pharmacy offers customers more services.
Have you ever known the big chain retailers to offer free home delivery? Better yet, do they offer home delivery at all? No, they don’t. However, independent pharmacies do. This service is great when you’re too sick to leave your home. Other services you can find at independent pharmacies are blood pressure screenings, prescription compounding, travel immunizations, large supply of durable medical equipment, medication therapy management and a host of other services. Check with your local pharmacy to see what valuable services they offer.
The owner resides in your state and not at another location.
Chain retailers are headed by corporations in big offices in big cities. Of course, they never meet the people who make their businesses a success. This differs with an independent pharmacy. The owner lives in the same state and likely interacts with the people who make his business successful; particularly since he probably still works there. Furthermore, his business is likely to be family owned.
As you can see, an independent pharmacy has a lot of advantages over large retail chains.
The sad reality is that major retailers only see customers as “business.” Fortunately, an independent pharmacy views its customers as “people they love to serve.” Thus, this is why it’s better to choose an independent pharmacy for your pharmaceutical needs versus the major retail chains.
12 Secrets Every Pharmacist Knows (And You Should, Too)
1. Chain-store pharmacists have quotas to meet.
Fifteen minutes: that’s how long pharmacists at chains like CVS, Walgreen’s, and Rite Aid have to fill a prescription once it’s called in. One CVS pharmacist, who wants to remain anonymous, even compares the process to McDonald’s. “Sometimes it’s [filling] 25 medications at once, bang, bang, bang,” he says. “If we take longer than we’re supposed to, we get written up and have to meet with district managers. It can even affect bonuses. It’s a lot of pressure.”
2. Mornings are the best time to fill prescriptions.
Like doctors, pharmacists—especially those at mom-and-pop shops, who don’t have quotas to meet—are less likely to make you wait first thing in the morning. As Martin Ochalek, a pharmacist in Miami, puts it, “Once the doctor calls start coming, it slows down everything.” The exception? Independent pharmacies. “Any time of day is a good time to call in a prescription since they need the business,” says Joey Jimenez, a former pharmacy tech who specializes in compound (or “made-from-scratch”) drugs at Total Pharmacy Supply. Another timesaving tip: call before you go to confirm your prescription is ready for pick up.
3. If it takes longer than 15 minutes, be patient.
Getting the wrong prescription can have serious consequences, which is why it pays to be patient. “Time pressures can contribute to medication errors,” says Sally Rafie, PharmD, a medication safety specialist at the UC San Diego Health System. “The pharmacist does far more than count pills and place them into a bottle. Pharmacists are reviewing allergies, drug interactions, dosing, and much more to be sure you get a medication that will be safe and effective for you.”
4. Doctors’ handwriting really is that bad…
So bad, in fact, that it can lead to mistakes—which is why pharmacists need to be extra vigilant when filling prescriptions. “It’s amazing how horrible their writing is sometimes,” says Ochalek, who recalls a time when he received a child’s prescription for amoxicillin that appeared to be three to four times the proper dosage. While a call to the doctor can clear up any issues, it’s an extra step—one that usually ends with the customer waiting longer. Jimenez is a proponent of electronic scripts. “But not everyone has switched to the system yet because it’s an additional cost,” he says.
5. Pharmacists don’t set prices.
There’s no denying that medications are expensive, even with health insurance. But unlike typical retail stores that choose how much to mark up products, pharmacies have no say in what they charge. “Customers are not aware of what’s going on with the pricing of drugs these days,” says Jack Porter, a pharmacist in Beverly Hills. “A cream that used to cost $10 can cost $150 all of a sudden, and I would love for people to be aware of that.”
6. You can’t—and shouldn’t—always get a generic.
First, a primer on generics: According to the FDA, they are “identical to a brand-name drug in dosage form, safety, strength, route of administration, quality, performance characteristics and intended use.” So why do they cost less? Once a brand-name drug hits the market, it holds its patent for around 20 years, and no other pharmaceutical company can make or sell it until the patent expires. But once it does, companies are free to manufacture it—without the cost of building it from scratch.
Keep in mind that not every drug has a generic, and that even when one does exist, a pharmacist may not always recommend it. Says Porter: “I don’t substitute certain medications that treat seizures because the generic dissolves at a different rate,” which is an occasional difference between generic and brand name drugs. “On the generic, there’s a chance they could still have a seizure. I wouldn’t take the chance.”
7. Don’t wait until you’re out of medicine to order refills.
As we all know, doctors are busy people—and they’re the ones who hold the key to you getting a refill for your medication. Which is why it’s important to give your pharmacist a few days to get ahold of them. “Doctors don’t always call back promptly, and it’s not automatic that you can get a refill the same day,” Porter says. A good rule of thumb: let the pharmacist know when you have five or six pills left. “This is especially true for maintenance drugs like blood pressure meds. Missing a day or waiting extensive periods of time between dosages can have harmful effects,” adds Jimenez.
8. Don’t use the pharmacy checkout if you’re not picking up a prescription.
We’ve all been there before: The checkout line snakes into the aisles and all you want to buy are a few toiletries. But resist the temptation to pay at the pharmacy. “While pharmacists are happy to help, it distracts them from the important work they’re doing, which can lead to unintentional errors,” Rafie says. “And don’t ask the pharmacist where to find the batteries, diapers, or restrooms!”
9. Build a relationship with your pharmacist.
You wouldn’t switch doctors each month—and the same approach should be applied to your pharmacist. “Like any healthcare provider, patients are better served if they develop a relationship with their pharmacist,” says Jordan. “They’re willing to spend extra time with you, and it’s always helpful to know the person on the other end of the phone line.” In addition to getting more personalized attention, it’s also more practical to stick with one place. “It’s a lot of extra work for the pharmacy to keep transferring the prescription,” says Rafie, adding, “There’s no way each pharmacy can have all the information they need on file to make sure a medication is safe for you.”
10. Know the meaning of “as directed.”
You may have noticed a doctor write “as directed” on a prescription. This indicates to the pharmacist that the doctor has already explained to the patient how to use the medication. While some medicines’ instructions are obvious, others can be taken many different ways. “I’ll get people who come in with a prescription and ask, ‘why am I taking this?’ ” Porter says. “It’s important to look at the prescription when you get it, and leave the office with some understanding of what it is—especially if it says ‘as directed.’ ”
11. Ask the right questions…
…though a good pharmacist will automatically provide many of the answers, including when to take the medication, whether or not to take it with food, what the side effects are, and if it needs to be refrigerated. “A patient needs to walk out of a pharmacy confident that they know what to do,” Porter says. “If they’re not, then they need to ask more questions.” In the end, the customer is the one who will suffer the consequences. According to Jordan, “If people stop taking medication before they should or don’t use them as prescribed, they may end up in the emergency room or having to take additional, higher-cost drugs as a result.”
And while allergies are typically included in your medical file, speak up if the pharmacist doesn’t ask (though he or she should). As Porter puts it, “The ultimate responsibility is on the patient to make the pharmacist aware.”
12. Don’t buy medicine online.
Just because some prescription drugs are a click away doesn’t mean you should give into the convenience—even if they cost a little less. (The exception: something you have been taken regularly without any issues, such as birth control pills.) “The financial advantage is there, but the biggest problem is people end up using medications incorrectly or not recognizing side effects,”Jordan says. “You’re so much better off going through a pharmacist, where you can get advice face-to-face.”
Community Pharmacists Play Key Role in Improving Medication Safety
As trusted community health advisors, pharmacists can promote the safe use of medications and improve clinical outcomes.
Americans rely on prescriptions to manage their health issues. In fact, according to health care market intelligence from IMS Health, prescription sales in 2009 grew by 5.1% versus 1.8% in 2008. Consequently, as more medications are prescribed to patients, the more likely it is that those patients will experience medication interactions if they don’t receive proper education from their health care professionals. Sadly, it appears that adverse interactions, medication overuse, and errors are a perennial problem. A recent study by researchers at the University of California, San Diego, and the University of California, Los Angeles, found that fatal medication errors rise in the month of July, just when new medical residents arrive at hospitals.
There is a powerful tool that can be employed to help patients avoid dangerous drug interactions and adverse health effects—that tool is the pharmacists themselves. The pharmacist often interacts with patients more often than the prescribing medical professional. Helping patients understand their medication regimens certainly improves health outcomes, but it also strengthens pharmacist–patient relationships and helps reinforce the role of the pharmacist as a trusted health advisor.
Pharmacists are in a unique position to improve medication safety because:
• Pharmacists have the time and clinical expertise to make a difference in the way patients manage chronic conditions for which they may be taking multiple medications.
• Pharmacists are an affordable and accessible health care resource. For many patients, it is probably easier to consult with a pharmacist than with a physician.
• The community pharmacy often becomes the de facto community health center, with pharmacists acting as the first point of care.
• Pharmacists already play an active role in coaching patients on potential side effects of their medications and why it is important to take them exactly as prescribed.
For patients with chronic conditions, pharmacists have an opportunity to monitor their patients’ use of combined medications and pass along information about possible interactions. However, to increase the effectiveness of these ongoing interactions, pharmacists need a plan for how best to communicate with their patients, because an ad hoc approach does not yield success.
Ongoing Counseling and Education
A structured framework for patient consultations can improve the way patients monitor their medications and prevent potential problems with medication safety or drug interactions. In general, such programs include the following steps:
Screen for any issues: Ask patients about existing health issues, such as high blood pressure or diabetes, that might worsen due to medication interaction.
Discuss all medications: Schedule oneon- one time with patients to go over all their medications. This step can help prevent side effects or drug interactions resulting from prescriptions from multiple doctors.
Educate patients: Remind patients of the role and importance of each medication in their regimen.
Emphasize adherence: Stress the importance of adherence for better outcomes.
One example of a structured approach to medication safety is the Pharmacy Quality Commitment program, offered by McKesson, which helps pharmacists reduce medication errors for their patients by offering a workflow for the prescription process and an online system to record interactions with patients. McKesson also offers assistance to pharmacists looking to take on a greater role in improving patient care and medication safety. Sponsored Clinical Services are an integrated set of services sponsored by payers and manufacturers that provide eligible patients with access to advice and education from trained pharmacists. These programs support both pharmacists and patients to improve patient outcomes.
All of these medication-monitoring programs can help keep patients safe by reducing harmful situations—and overall, by creating a bond between patient and pharmacist that helps connect the pharmacist to the care process.
The Value of Patient Education
Thanks to the Internet, pharmacists have quick access to a wealth of information about medication safety—information they can easily share with their patients. The Institute for Safe Medication Practices (www.ismp.org) offers fact sheets and tools on medication safety. For instance, the site offers printable PDFs on “high-alert medications” (those that can cause significant patient harm when used in error) and a “do not crush” list of medications that should not be crushed or chewed. (See also the Pharmacy Times Medication Safety column by Michael Gaunt, PharmD, in each issue.)
The combination of educational materials and ongoing patient counseling can go far toward detecting and preventing safety issues. For example, diabetes patients often suffer from other debilitating conditions, such as high blood pressure, high cholesterol, and obesity. These conditions may require additional medications along with a patient’s diabetes regimen. Pharmacists play a key role in ensuring that patients understand the interplay of medications that help manage diabetes. Since diabetes causes considerable strain on health care costs and management— according to the Centers for Disease Control and Prevention, 10% of all health care dollars are spent on diabetes and 20% are spent on conditions that result from diabetes—pharmacists can do their part to help manage these costs.
Recently, I was visited by a regular patient who requested a potentially dangerous combination of prescriptions. The patient was hypertensive, diabetic, and on kidney dialysis. He requested Humulin 70-30, Lantus, and Humalog, all at once, which immediately raised a red flag. As you probably know, Humulin 70-30, Humalog, and Lantus represent a combination of fast-acting, intermediate-acting, and long-acting formulations. Had the patient taken all 3, his blood sugar might have dropped significantly, resulting in a hypoglycemic state, or possibly death.
It turns out that the patient was refilling his regular prescription for Humulin 70-30 from 1 doctor and filling 2 new prescriptions from a recent hospital visit. I contacted the patient’s primary care physician to make him aware of these new prescriptions, and we agreed to fill only the new medications (Humalog and Lantus). In a situation like this, the community pharmacist often serves as the patient’s front line of defense against potentially dangerous medication combinations.
Pharmacists as a Community Resource
Medication errors and interactions have a financial cost as well as an impact on the well-being of an individual. When patients become ill due to safety issues, recovery time increases. As the health care industry and patients look at ways to reduce health care costs, community pharmacists can be part of the solution.
Pharmacists play a vital role connecting patients and medical professionals. They are specially trained to help manage side effects and counsel patients on taking multiple medications effectively and safely, and they are also more easily accessible than physicians. Community pharmacists offer a trusted environment in which to reduce medication errors and improve safety, while reducing costs and improving the quality of care.