s Countdown to Supermarket pharmacies - Advantages and disadvantages? - Part Four | I2P: Information to Pharmacists - Archive
Publication Date 01/07/2014         Volume. 6 No. 6   
Information to Pharmacists

Editorial

From the desk of the editor

Welcome to the July 2014 homepage edition of i2P (Information to Pharmacists) E-Magazine.
At the commencement of 2014 i2P focused on the need for the entire profession of pharmacy and its associated industry supports to undergo a renewal and regeneration.
We are now half-way through this year and it is quite apparent that pharmacy leaders do not yet have a cohesive and clear sense of direction.
Maybe the new initiative by Woolworths to deliver clinical service through young pharmacists and nurses may sharpen their focus.
If not, community pharmacy can look forward to losing a substantial and profitable market share of the clinical services market.
Who would you blame when that happens?
But I have to admit there is some effort, even though the results are but meagre.
In this edition of i2P we focus on the need for research about community pharmacy, the lack of activity from practicing pharmacists and when some research is delivered, a disconnect appears in its interpretation and implementation.

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News Flash

Newsflash Updates for July 2014

Newsflash Updates

Regular weekly updates that supplement the regular monthly homepage edition of i2P. 
Access and click on the title links that are illustrated

Comments: 1

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Feature Contribution

Woolworths Pharmacy - Getting One Stage Closer

Neil Johnston

It started with “tablet” computers deployed on shelves inside the retailer Coles, specifically to provide information to consumers relating to pain management and the sale of strong analgesics.
This development was reported in i2P under the title Coles Pharmacy Expansion and the Arid PGA Landscape”
In that article we reported that qualified information was a missing link that had come out of Coles market research as the reason to why it had not succeeded in dominating the pain market.
Of course, Woolworths was working on the same problem at the same time and had come up with a better solution - real people with good information.

Comments: 5

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Intensive Exposition without crossing over with a supermarket

Fiona Sartoretto Verna AIAPP

Editor's Note: The understanding of a pharmacy's presentation through the research that goes into the design of fixtures and fittings that highlight displays, is a never-ending component of pharmacy marketing.
Over the past decade, Australian pharmacy shop presentations have fallen behind in standards of excellence.
It does not take rocket science - you just have to open your eyes.
Recently, our two major supermarkets, Woolworths and Coles, have entered into the field of drug and condition information provision - right into the heartland of Australian Pharmacy.

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The sure way to drive business away

Gerald Quigley

I attended the Pregnancy, Baby and Children’s Expo in Brisbane recently.
What an eye and ear opening event that was!
Young Mums, mature Mums, partners of all ages, grandparents and friends……...many asking about health issues and seeking reassurances that they were doing the right thing.

Comments: 1

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‘Marketing Based Medicine’ – how bad is it?

Baz Bardoe

It should be the scandal of the century.
It potentially affects the health of almost everyone.
Healthcare providers and consumers alike should be up in arms. But apart from coverage in a few credible news sources the problem of ‘Marketing Based Medicine,’ as psychiatrist Dr Peter Parry terms it, hasn’t as yet generated the kind of universal outrage one might expect.

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Community Pharmacy Research - Are You Involved?

Mark Coleman

Government funding is always scarce and restricted.
If you are ever going to be a recipient of government funds you will need to fortify any application with evidence.
From a government perspective, this minimises risk.
I must admit that while I see evidence of research projects being managed by the PGA, I rarely see community pharmacists individually and actively engaged in the type of research that would further their own aims and objectives (and survival).

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Organisational Amnesia and the Lack of a Curator Inhibits Cultural Progress

Neil Johnston

Most of us leave a tremendous impact on pharmacies we work for (as proprietors, managers, contractors or employees)—in ways we’re not even aware of.
But organisational memories are often all too short, and without a central way to record that impact and capture the knowledge and individual contributions, they become lost to time.
It is ironic that technology has provided us with phenomenal tools for communication and connection, but much of it has also sped up our work lives and made knowledge and memory at work much more ephemeral.

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Academics on the payroll: the advertising you don't see

Staff Writer

This article was first published in The Conversation and was written by Wendy Lipworth, University of Sydney and Ian Kerridge, University of Sydney
In the endless drive to get people’s attention, advertising is going ‘native’, creeping in to places formerly reserved for editorial content. In this Native Advertising series we find out what it looks like, if readers can tell the difference, and more importantly, whether they care.
i2P has republished the article as it supports our own independent and ongoing investigations on how drug companies are involved in marketing-based medicine rather than evidence-based medicine.

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I’ve been thinking about admitting wrong.

Mark Neuenschwander

Editor's Note: This is an early article by Mark Neuenschwander we have republished after the soul-searching surrounding a recent Australian dispensing error involving methotrexate.
Hmm. There’s more than one way you could take that, huh? Like Someday when I get around to it (I’m not sure) I may admit that I was wrong about something. Actually, I’ve been thinking about the concept of admitting wrong. So don’t get your hopes up. No juicy confessions this month except that I wish it were easier for me to admit when I have been wrong or made a mistake.
Brian Goldman, an ER physician from Toronto, is host of the award-winning White Coat, Black Art on CBC Radio and slated to deliver the keynote at The unSUMMIT for Bedside Barcoding in Anaheim this May. His TED lecture, entitled, “Doctors make mistakes. Can we talk about it?” had already been viewed by 386,072 others before I watched it last week.

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Dispensing errors – a ripple effect of damage

Kay Dunkley - BPharm, Grad Dip Hosp Pharm, Grad Dip Health Admin, MPS, MSHPA

Most readers will be aware of recent publicity relating to dispensing errors and in particular to deaths caused by methotrexate being incorrectly packed in dose administration aids.
The Pharmacy Board of Australia (PBA), in its Communique of 13 June 2014, described a methotrexate packing error leading to the death of a patient and noted “extra vigilance is required to be exercised by pharmacists with these drugs”.
This same case was reported by A Current Affair (ACA) in its program on Friday 20 June
http://aca.ninemsn.com.au/article/8863098/prescription-drug-warning

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Take a vacation from your vocation

Harvey Mackay

Have you ever had one of those days when all you could think was, “Gosh, do I need a vacation.”
Of course you have – because all work and no play aren’t good for anyone.
A vacation doesn’t have to be two weeks on a tropical island, or even a long weekend at the beach. 
A vacation just means taking a break from your everyday activities. 
A change of pace. 
It doesn’t matter where.
Everyone needs a vacation to rejuvenate mentally and physically. 
But did you also know that you can help boost our economy by taking some days off? 
Call it your personal stimulus package.

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Explainer: what is peer review?

Staff Writer

This article was first published in the Conversation. It caught our eye because "peer review" it is one of the standards for evidence-based medicines that has also been corrupted by global pharma.
The article is republished by i2P as part of its ongoing investigation into scientific fraud and was writtenby Andre Spicer, City University London and Thomas Roulet, University of Oxford
We’ve all heard the phrase “peer review” as giving credence to research and scholarly papers, but what does it actually mean?
How does it work?
Peer review is one of the gold standards of science. It’s a process where scientists (“peers”) evaluate the quality of other scientists' work. By doing this, they aim to ensure the work is rigorous, coherent, uses past research and adds to what we already knew.
Most scientific journals, conferences and grant applications have some sort of peer review system. In most cases it is “double blind” peer review. This means evaluators do not know the author(s), and the author(s) do not know the identity of the evaluators.
The intention behind this system is to ensure evaluation is not biased.
The more prestigious the journal, conference, or grant, the more demanding will be the review process, and the more likely the rejection. This prestige is why these papers tend to be more read and more cited.

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Dentists from the dark side?

Loretta Marron OAM BSc

While dining out with an elderly friend, I noticed that he kept his false tooth plate in his shirt pocket. He had recently had seven amalgam-filled teeth removed, because he believed that their toxins were making him sick; but his new plate was uncomfortable. He had been treated by an 'holistic dentist'. Claiming to offer a "safe and healthier alternative" to conventional dentistry, are they committed to our overall health and wellbeing or are they promoting unjustified fear, unnecessarily extracting teeth and wasting our money?

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Planning for Profit in 2015 – Your key to Business Success

Chris Foster

We are now entering a new financial year and it’s a great time to reflect on last year and highlight those things that went well and those that may have impacted negatively in the pursuit of your goals.
It's also a great to spend some time re-evaluating your personal and business short, medium and long term goals in the light of events over the last year.
The achievement of your goals will in many cases be dependent on setting and aspiring to specific financial targets. It's important that recognise that many of your personal goals will require you to generate sufficient business profits to fund those aspirations

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ReWalk™ Personal Exoskeleton System Cleared by FDA for Home Use

Staff Writer

Exoskeleton leader ReWalk Robotics announced today that the U.S. Food and Drug Administration has cleared the company’s ReWalk Personal System for use at home and in the community.
ReWalk is a wearable robotic exoskeleton that provides powered hip and knee motion to enable individuals with Spinal Cord Injury (SCI) to stand upright and walk.
ReWalk, the only exoskeleton with FDA clearance via clinical studies and extensive performance testing for personal use, is now available throughout the United States.

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Attracting and Retaining Great People

Barry Urquhart

Welcome to the new financial year in Australia.
For many in business the past year has been described as a challenging period.
Adjectives are a key feature of the English language.  In the business lexicon their use can be, and often is evocative and stimulate creative images.  But they can also contribute to inexact, emotional perceptions.
Throughout the financial pages of newspapers and business magazines adjectives abound.
References to “hot” money draw attention and comment.  The recent wave of funds from Chinese investors, keen to remove their wealth from the jurisdiction and control of government regulations is creating a potential property bubble in Australia.

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Updating Your Values - Extending Your Culture

Neil Johnston

Pharmacy culture is dormant.
Being comprised of values, unless each value is continually addressed, updated or deleted, entire organisations can stagnate (or entire professions such as the pharmacy profession).
Good values offer a strong sense of security, knowing that if you operate within the boundaries of your values, you will succeed in your endeavours.

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Evidence-based medicine is broken. Why we need data and technology to fix it

Staff Writer

The following article is reprinted from The Conversation and forms up part of our library collection on evidence-based medicines.
At i2P we also believe that the current model of evidence is so fractured it will never be able to be repaired.
All that can happen is that health professionals should independently test and verify through their own investigations what evidence exists to prescribe a medicine of any potency.
Health professionals that have patients (such as pharmacists) are ideally placed to observe and record the efficacy for medicines.
All else should confine their criticisms to their evidence of the actual evidence published.
If there are holes in it then share that evidence with the rest of the world.
Otherwise, do not be in such a hurry to criticise professions that have good experience and judgement to make a good choice on behalf of their patients, simply because good evidence has not caught up with reality.

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Laropiprant is the Bad One; Niacin is/was/will always be the Good One

Staff Writer

Orthomolecular Medicine News Service, July 25, 2014
Laropiprant is the Bad One; Niacin is/was/will always be the Good One
by W. Todd Penberthy, PhD

(OMNS July 25, 2014) Niacin has been used for over 60 years in tens of thousands of patients with tremendously favorable therapeutic benefit (Carlson 2005).
In the first-person NY Times best seller, "8 Weeks to a Cure for Cholesterol," the author describes his journey from being a walking heart attack time bomb to a becoming a healthy individual.
He hails high-dose niacin as the one treatment that did more to correct his poor lipid profile than any other (Kowalski 2001).

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Culture Drive & Pharmacy Renewal

Neil Johnston

Deep within all of us we have a core set of values and beliefs that create the standards of behaviour that we align with when we set a particular direction in life.
Directions may change many times over a lifetime, but with life experiences and maturity values may increase in number or gain greater depth.
All of this is embraced under one word – “culture”.
When a business is born it will only develop if it has a sound culture, and the values that comprise that culture are initially inherent in the business founder.
A sound business culture equates to a successful business and that success is often expressed in the term “goodwill” which can be eventually translated to a dollar value.

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ReWalk™ Personal Exoskeleton System Cleared by FDA for Home Use

Staff Writer

Exoskeleton leader ReWalk Robotics announced today that the U.S. Food and Drug Administration has cleared the company’s ReWalk Personal System for use at home and in the community.
ReWalk is a wearable robotic exoskeleton that provides powered hip and knee motion to enable individuals with Spinal Cord Injury (SCI) to stand upright and walk.
ReWalk, the only exoskeleton with FDA clearance via clinical studies and extensive performance testing for personal use, is now available throughout the United States.

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Pharmacy 2014 - Pharmacy Management Conference

Neil Johnston

The brave new world of health and wellness is not the enemy of Pharmacy, it is its champion.
Australian futurist, Morris Miselowski, one of the world's leading business visionaries, will present the Opening Keynote address on Pharmacy's Future in the new Health and Wellness Landscape at 2.00pm on Wednesday July 30.
Morris believes the key to better health care could already be in your pocket, with doctors soon set to prescribe iPhone apps, instead of pills.
Technology will revolutionise the health industry - a paradigm shift from healthcare to personal wellness.
Health and wellness applications on smartphones are already big news, and are dramatically changing the way we manage our personal health and everyday wellness.

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Generation and Application of Community Pharmacy Research

Neil Johnston

Editor’s Note: We have had a number of articles in this issue relating to pharmacy research.
The PGA has conducted a number of research initiatives over the years, including one recently reported in Pharmacy News that resulted from an analysis of the QCPP Patient Questionnaire.
Pharmacy Guild president, George Tambassis, appears to have authored the article following, and there also appears to be a disconnect between the survey report and its target audience illustrated by one of the respondent comments published.
I have asked Mark Coleman to follow through, elaborate and comment:

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Countdown to Supermarket pharmacies - Advantages and disadvantages? - Part Four

Joseph Conway

articles by this author...

Joe Conway is an Irish born pharmacist who qualified in the UK in 1998.
After completing a residency in a hospital in London, he embarked on a 3 year locum stint that involved working all over the UK, Ireland, and Australia in over 350 pharmacies of all varieties (hospitals large and small, community, even a prison pharmacy).In 2002, Joe emigrated to Australia and worked in the Private Hospital sector gradually moving in to management positions with Slade Pharmacy where he developed a keen interest in Oncology services. In 2006, Joe took up a position setting up a Pharmacy service to a newly built Day Hospital in Frankston, Victoria. The Pharmacy now conducts over 40 clinical trials.
Joe is currently studying for a Master of Biostatistics to help him progress in the area of clinical trials, and think outside the square (or at least be left-field).

Editor's Note: This is the fourth article in a series by Joseph Conway.
He has made a number of assumptions and predictions within the article series, floating the proposal that if Australia adopts the New Zealand model of Countdown Pharmacy, there are a range of advantages and disadvantages.
In this final article Joe blows apart the notion that supermarkets are cheaper than pharmacies by completing a survey of products held by pharmacies and supermarkets in common.
To his surprise, he found that pharmacy is currently more than competitive with supermarkets, taking away the supermarket trumpet call that they would provide cheaper prices than pharmacies.
It would seem that pharmacy can still remain in the race to be competitive, with the point of difference being provision of patient information. The latter service may need to be tidied up, even charged for if there is value for money.

Supermarkets – Are they currently cheaper than Chemist Warehouse or Pharmacy Online?

When I was writing this, I wondered whether Australian Supermarkets are as cheap as they might have us believe.
To examine this, I decided to select a list of items that would traditionally be regarded as pharmacy, but, are now sold both in Supermarkets and pharmacies.
I selected 35 products where the same (or very similar) products were for sale on 4 publically accessible websites. These were:

Chemist Warehouse - www.chemistwarehouse.com.au

Pharmacy Online - www.pharmacyonline.com.au

Woolworths -www2.woolworthsonline.com.au

Coles - www.colesonline.com.au

I picked Chemist Warehouse and Pharmacy online as I feel that they are price competitive and they appear to have up-to-date prices for their stock online. For my research, I walked through various Woolworths, Coles and Chemist Warehouse stores in SE Melbourne. I have outlined the prices and I challenge readers to see if their stores are cheaper than Chemist Warehouse or if my figures are wrong.

Summary:

I used the total cost of the 35 items from each website and used this figure to compare all four websites. The total cost of the 35 items was:

Chemist Warehouse - $292.45

Pharmacy Online - $293.51

Woolworths - $344.31

Coles - $352.24

Figure 4.1 :
Bar Chart illustrating the total cost of 35 items at Chemist Warehouse, Pharmacy Online, Woolworths, and Coles obtained on 29
th November 2012 from their respective websites:

 

 

Figure 4.2: Table showing the 35 products and their costs obtained from online websites on 29th November 2012:

To see larger pdf version- click here


Some interesting findings:

  • Deep Heat® seems to be cheaper at Coles and Woolworths than in the two pharmacies.

  • Sudafed® was more expensive at Coles than the other three. Compared a 20 pack in Coles/Woolworths with a 24 pack in Chemist warehouse/Pharmacy Online.

  • Every week, certain products are cheaper as they on special at Coles and Woolworths. In this analysis, I studied the prices on one day 29/11/12 and the prices quoted could vary when they are on special.

  • Mintec® was cheaper at Woolworths as it was on special. Normal price appears to be $9

  • The price of Glucosamine and Krill Oil seemed high at Woolworths and contributed significantly to the overall cost. I checked in store and online and these were the lowest prices that I could find on 29th November 2012

  • Ostelin® seemed to be consistently cheaper in Woolworths and in the weeks before 29/11/12, it was on special for $8.99 for a 60pack.

  • I couldn’t find a generic Paracetamol/Ibuprofen home brand for Chemist Warehouse. Many Pharmacy Discounters appear to me to be obsessed with brands.

  • The standard of the aisles in Woolworths and Coles was impeccable. In contrast, the three Chemist Warehouse stores that I visited seemed much more untidy (in my biased view) in comparison with little facing up of products.

Discussion:

The two Pharmacies (Discount) appeared to be 15-18% cheaper than Coles and Woolworths as illustrated by my figures. To get a better comparison, more products need to be compared, but my figures might be of comfort to the many pharmacies that have come to think of themselves as charging too much for their goods and services. You could also suggest that Coles and Woolworths are not quite as cheap as they might have you believe.

Maybe, Chemist Warehouse has more buying power for these items than Coles or Woolworths has at the moment in this area?
I doubt this.

Maybe, generic margins on prescriptions are helping to cross-subsidize cheaper prices on OTC products at the pharmacies?

From the results of walking many stores, if Woolworths and Westfarmers were allowed to run pharmacies, then I believe that they would run different models to cater for the heterogeneous needs of a wide population of patients.
Supermarkets are convenient for patients- maybe even more convenient than most pharmacies are for the majority of customers currently?
It’s easy to stock up on Painkillers, vitamins and indigestion medicines as you stroll from aisle to aisle. I feel that the prices might reflect this in Coles and Woolworths.
In the event of deregulation, I believe that Coles and Woolworths might run a convenient pharmacy model with better service levels.
Places like Big W and Kmart might run bigger and cheaper Chemists with a focus on having the cheapest prices.
You are better selling 20 items a day making $5 profit each (total profit = $100) than selling 40 items making $2 profit each (total profit = $80).
It’s more complicated than this, but hopefully this simplistic example illustrates why I think that convenience might be a determining factor to the prices of the 35 items in Woolworths and Coles.

I think that pharmacy owners are possibly panicking at the moment (with Price disclosure promising to cut pharmacy prescription margins to below cost) and those who think that providing their goods at the cheapest prices should not be the only option might take heart from my findings.
If a pharmacy is conveniently located for patients, then, that pharmacy may not need to charge the lowest prices.
If discounting leads to a reduction in service levels, then certain populations of people (e.g. Elderly) will not like this and the lower service level could be detrimental for them and potentially leading to higher overall healthcare costs. Many people place other issues higher than sale price such as location and service.
Not all pharmacies should be “Aldi’s” such as some Discounter Chemists appear to be.
Maybe, it’s okay for some of us to be “Coles” or “Woolworths” with our price offer to patient at least.

I don’t know if pharmacy will be deregulated before 2020.
My gut feeling is that Woolworths and Coles are not ready just yet.
It’s a momentous task tied to creating changes in both Federal and State legislature and only those without inside knowledge of the industry would assume that it can be suddenly done within 2-3 years. It’s an area built on trust and getting it wrong could have disastrous consequences for your brand.
As an employee pharmacist, all I really care about is that my customers get the best service from me and I work in an environment that provides career prospects and fulfilment.
I have had these during my pharmacy career with Pharmacy Owners.
If you have a good idea, it’s easy to have it applied and that is very rewarding.
I don’t know if the same applies at Woolworths and Westfarmers. I have talked to employees of both companies and I think that for them, there are advantages and disadvantages to working for big corporates.
In the end, as outlined in other articles, consumers ultimately decide what will happen and in the age of the internet and more open discussion, I think that it’s their hearts and minds that have to be won in this debate…

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