Abstract

When online retail giant Amazon launched its new pharmacy venture in November 2020, chain community pharmacy stocks, including Walgreens, CVS, and Rite Aid, tumbled in response. The market reaction suggested that community pharmacy stood to take a major hit in the wake of Amazon's newest enterprise. But, experts say that this newcomer to the pharmacy world gives community pharmacists the opportunity to demonstrate the unique value of the services they offer. “The key,” said Kurt Proctor, PhD, BSPharm, senior vice president of strategic initiatives for the National Community Pharmacists Association, “is that community pharmacists clearly communicate to their patients the value that they bring. You can’t rest on your laurels and assume that all your customers will be loyal. You need to be at the top of your game.” Independent pharmacies account for just over a third of all community pharmacies. While chain community pharmacies lost stores in the last decade, independent community pharmacies saw their ranks grow by nearly 13%, according to data from the National Council for Prescription Drug Programs. With an estimated 23,000 independent pharmacies operating across the country, Proctor said, “It's a healthy number, but there's not one on every corner. So, if someone is using an independent, it's a conscious choice to do so.” Those patients who make a conscious choice to use independent community pharmacies likely won’t find value in Amazon's services, said Dan Benamoz, BSPharm, founder and executive chair of Pharmacy Development Services, a pharmacy consulting service. Community pharmacies will always stand to lose patients who prioritize price or convenience over anything else. But those who see value in independent pharmacy should be the focus of pharmacists’ attention, Benamoz said. “If pharmacies are only focused on filling as many prescriptions as they can, there is a lot of reason to be concerned about Amazon,” said Marci Strauss, PharmD, who is a performance specialist at Pharmacy Development Services. “For those pharmacies that differentiate themselves, focus on patient care, and provide clinical services to help drive outcomes, those are areas where it will be hard for any entity like Amazon Pharmacy to compete. They are not in the community, and they don’t know their patients.” Pharmacy Development Services provides community pharmacies with strategies to help grow their business. Benamoz advises pharmacists who want to maintain their edge over Amazon Pharmacy to focus on relationships. “One thing that will survive the test of the digital era, and something that the younger generation is thirsting for too, is relationships,” Benamoz said. “When it comes to medicine, people would much rather have someone they can talk to and somebody who knows them.” An online retailer cannot know its customers the way a community pharmacist knows its patients. “I don’t care how many Prime trucks you see driving around the neighborhood, none of them are going to answer the phone at midnight when you have an emergency,” Proctor said. Besides fostering face-to-face relationships, many community pharmacies also have the capacity to offer the same high-tech conveniences, such as refill requests through smartphone apps, that online retailers do. In many cases, the small businesses can provide more personalized versions of these modern conveniences than their online counterparts. “Independents do hand delivery,” Proctor said. “That's not mail delivery. It's not sitting on your front porch; it's not sitting in your mailbox at whatever temperature the box happens to be that day. This is delivery directly to you at your door.” Pharmacists who are concerned about how Amazon Pharmacy may affect their bottom line can look back on how mail-order pharmacy affected their business at its inception. At the advent of this new pharmacy platform, many patients switched from their community pharmacies only after their health plans forced or heavily incentivized them to do so. Some evidence suggests that people who are forced to use a mail-order pharmacy when it is not their preference are more likely to discontinue their medications altogether. For those patients, the convenience of delivery by mail did not outweigh the value of their local pharmacy. “Many people love the convenience of online digital platforms like Amazon Prime,” Strauss said, “but there are so many patients, across every generation, who need the personalized care and the types of services that they could never get from an online platform.”

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