Changes in the nation’s health care system have made pharmaceutical distributors more important than ever.
Large pharmacy operators have strengthened their alliances with the Big Three Wholesalers to maximize purchasing power, augment operational efficiency and work through such challenges as implementation of new federal regulations to ensure a secure supply chain.
The role of drug distributors is even more pivotal for small pharmacy chains and independent drug stores. In many instances, the capabilities and know-how that drug wholesalers provide are essential tools that enable those retailers to stay competitive in a field increasingly dominated by the likes of Walgreens Boots Alliance, CVS Health and Walmart.
Peyton Howell, executive vice president of global sourcing and manufacturer relations at AmerisourceBergen, offered insights about the evolving relationship between distributors and community pharmacies during a presentation and subsequent discussion at the recent NACDS Regional Chain Conference.
“The large wholesalers are really important for the regionals because of the scale and other resources we bring to help with growth areas like specialty pharmacy, and also help with the financial component,” she said. “Some of these expensive specialty products are challenging from an AR [accounts receivable] perspective, so we’re ready to work with our customers to make sure we mitigate any risk for them and have it be a seamless financial management cycle as they continue to grow, particularly in these specialized areas.”
While the back-end support provided by AmerisourceBergen and its major rivals, Cardinal Health and McKesson, facilitates the ongoing involvement of small chains and independents in the burgeoning specialty sector, the efforts of the big wholesalers and other pharmacy advocates helped convince the makers of biotech medications that community pharmacy was a viable channel for their products.
“A couple of years ago there was a pretty dramatic change in patient care in areas like hepatitis C, which is a class of medications that could have very easily only been available through mail-order and specialty pharmacies,” Howell noted. “It was very close, because the manufacturers were not fully aware of the scale of care that is now delivered in the community pharmacy setting.
“We shared data that we collected about how well community pharmacies were already performing in caring for hepatitis C patients who were taking older products. That information opened all of our eyes as to how much specialized care, including really important compliance and adherence programs, is appropriate in the community pharmacy setting, including regionals and independents.”
The experience with cutting-edge hepatitis C medications is applicable to many other specialty therapies, she asserted, including oral cancer drugs, self-administered injectables, and new treatments for multiple sclerosis and rheumatoid arthritis.
Howell had an opportunity to interact with executives from a number of regional chains during the course of the NACDS meeting and came away impressed with the dynamism evident in that part of the retail pharmacy business. “I was inspired by the amount of innovation happening in local communities,” she said.
Diabetes care is an area of particular note, according to Howell, who cited programs at small chains that closely coordinate the efforts of pharmacists and other health care providers, ensure that prescription and over-the-counter medications work harmoniously, and provide extensive patient training and counseling.
“It’s exciting to see the number of pharmacies that are taking more of a wellness approach to caring for their patients, and the number of retailers partnering locally, whether that’s with hospitals, physicians or payers,” Howell added. “In a time of change and uncertainty, it’s really energizing to see new approaches to local care emerging and what that means for all of us.”
AmerisourceBergen and the other major drug wholesalers are well equipped to support the drive to unlock the full potential of community pharmacy and enable members of the profession to practice at the top of their license.
“The challenge is the economics, and we are a low-margin business,” said Howell, “but if we can maximize efficiencies by delivering a broader range of services through our core distribution engine, that’s a win-win for us and our customers.”