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|Articles - August 2011|
|Wednesday, July 20, 2011|
Page 4 of 6
Like many independent pharmacists, Balo belongs to a wholesale provider group, in his case the Good Neighbor Pharmacy, a brand that gives members access to private-label purchasing, marketing materials and managed care networks. The store’s niche products and services include free home delivery, specialized “bubble packing” that allows seniors to keep track of medications in their homes, and customized drug preparations that range from cancer medications to veterinary antibiotics. Hard-to-find skin care creams, Medicare-approved “durable medical supplies,” and an old-time soda fountain featuring $2.75 root beer floats add to the offerings.
Like most independents, the bulk of Paulsen’s annual pharmacy sales, about 85%, come from prescription drugs — the national average is around 94%. Chain stores, by contrast, rely more on “front end” merchandise such as food and toiletries that can be marked up to compensate for flat rate drug reimbursement or dispensing fees.
Market diversification gives the Rite Aids of the world an edge. Nevertheless, in the David vs. Goliath tale community pharmacists like to spin about themselves, the giant is not so much the chains — or the government — as the pharmacy benefit managers. Most independents have contracts with the three biggest PBMs — Medco Health Solutions, Caremark and Express Scripts —but typically have little control over the terms. “The medicine might cost $200 and the contract pays us $202,” says Ann Murray, who, with her husband, John, owns two Murray’s Drugs, one in Condon and another in Heppner. “Most businesses have to make 20% to cover overhead,” Murray says. “You can’t expect pharmacies to survive by giving it away.”
The biggest problem with PBMs is they push consumers toward their own mail-order pharmacies, says John Murray. When the PBMs sell direct, they are able to negotiate better rates with drug manufacturers, and offer deals such as a three-month supply of medication for the cost of one. In the last few years, Murray estimates he’s lost about 20%-50% of his prescription business to mail order.
Aimed at reducing costs, mail order actually increases waste, Murray and other pharmacists contend, because patients change prescriptions before 90 days or because people take the medicine improperly. PBMs counter with their own studies saying that people are more likely to take medicines when by ordered by mail — and that mail order saves consumers and health plan sponsors money. “Independents always argue that we’re squeezing them out of business,” says Thom Gross, a spokesperson for Express Scripts, adding that independents are actually more profitable than other drug channels, including PBMs.
The National Community Pharmacists Association is engaged in an ongoing battle with the PBMs, an effort that includes lawsuits related to deceptive practices and unfair competition. Pennsylvania and New York are also considering legislation prohibiting PBMs from mandating their customers use mail order.
Thursday, December 11, 2014
There’s a fascinating article in the December issue of the Harvard Business Review about a profound power shift taking place in business and society. It’s a long read, but the gist revolves around the tension between “old power” and “new power” as a driver of transformation. Here’s an excerpt:
The authors, Henry Timms and Jeremy Heimans, don’t necessarily favor one form of power over another but merely outline how power is transitioning, and how companies can take advantage of these changes to strengthen their positions in the marketplace.
Our Powerbook issue might be viewed as a case study in the new-power transition. This annual book of lists provides information on leading businesses, nonprofits and universities in the state. Most of the featured companies are entrenched power players now pursuing more flexible and less hierarchical approaches to doing business. Law firms, for example, are adopting new technologies and fee structures to make legal services more accessible and affordable.
This month we also take a look at a controversial new U.S. Securities and Exchange Commission rule requiring public companies to disclose the median pay of workers, as well as the ratio between CEO and median-worker pay.
Part of the 2010 Dodd-Frank financial reform law, the rule will compel public companies to be more open about employee compensation, with the assumption that greater transparency will improve corporate performance and, perhaps, help address one of the major challenges of our time: income inequality.
New power is not only about strategy and tactics, the Harvard Business Review authors say. “The ultimate questions are ethical. The big question is whether new power can genuinely serve the common good and confront society’s most intractable problems.”
That sounds like a call to arms. Or a New Year’s resolution. Old power or new, the goals are the same: to be a force for positive change in the world. Happy 2015!
Wednesday, October 22, 2014
BY JASON NORRIS
Historically, when the leaves fall, so do the markets. This year, earnings, Europe, energy and Ebola have in common? Beyond alliteration, they are four factors that the investors are pointing to for this year’s seasonal volatility.
Thursday, November 20, 2014
BY OB STAFF
Farmers, grocery stores and food processors cash in on kale.
Friday, December 12, 2014
BY LINDA BAKER
A conversation with Oregon state economist Josh Lehner.
Saturday, December 13, 2014
Checking in with the managing director of Arnerich Massena.
Wednesday, November 26, 2014
BY NISHANT BHAJARIA | OP-ED CONTRIBUTOR
By now, anyone who knows about it has a position on President Obama’s executive order on immigration. The executive order is the outcome of failed attempts at getting a bill through the normal legislative process. Both Obama and his predecessor came close, but not close enough since the process broke down multiple times.
Thursday, December 11, 2014
BY JESSICA RIDGWAY
Lawger upends the typical hourly based fee model by letting clients determine the cost.
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|Obama to announce end of Cuba isolation|
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