Retail Cost Research Articles

Transfer pricing and channel structure of a multinational firm under overseas retail disruption risk

Considering a chain-to-chain competition model, we formulate a new multinational firm's (MNF's) trade-off between global tax-planning gains (via transfer pricing) and channel decentralisation loss. In the presence of an established MNF's competition, it is optional for the new MNF to operate two divisions (one for domestic manufacturing and one for overseas retailing) or one integrated division selling products to an independent overseas retailer at a wholesale price. For the former, we characterise the new MNF's transfer pricing strategies and find that interestingly, MNFs might both keep profits in high-tax region due to the tense competition in the retailing stage. For the latter, we find that the new MNF's channel decentralisation via wholesaling can be a win–win situation for the established MNF and itself, when the new MNF's overseas retail cost is in a moderate range. We further examine the new MNF's overseas retail disruption risk and find that, this risk drives the new MNF to lower the transfer price sharply and intensifies the retail competition. We use contraction mapping argument to show the uniqueness of the system equilibrium.

Uncertainty-based electricity procurement by retailer using robust optimization approach in the presence of demand response exchange

In this paper, robust optimization approach is proposed to handle market price uncertainty in which the upper deviation from forecasted value of pool price will be considered for risk analysis for a retailer. Objective of this paper is minimization of energy procurement cost for retailer from pool market, forward contracts and demand response programs (DRP). Therefore, three new designs of demand response (DR) programs have been proposed in this study which retailer can use to procure their required energy. These new DR schemes consist of pool-order option, forward-DR and reward-based DR contracts. The robust optimization approach examines the retailer’s performance at risk-averse and risk-neutral strategies, in which risk-neutral explains the normal performance of retailer, and risk-averse explains the risky performance of retailer. The proposed robust scheduling of retailer is modeled via MIP model which can be solved using CPLEX solver under GAMS software. The achieved results show that the retailer cost in risk-neutral strategy is reduced due to use of new DR schemes. Also, in risk-averse strategy, retailer cost reduction is more than the risk-neutral strategy use of new DR schemes.

External Intervention or Internal Coordination? Incentives to Promote Sustainable Development through Green Supply Chains

To encourage firms to engage in green production, two different types of investment funding, namely external funds from agencies outside the supply chain (e.g., government subsidy), and internal funds from supply chain partners (e.g., greening cost-sharing with the retailer), are investigated in this paper. Based on game theory, the decision-making behavior and profits of a competitive supply chain consisting of a green manufacturer, a regular manufacturer, and a retailer are analyzed under both funding schemes. The results show that while both government subsidy and greening cost-sharing contract can achieve the goals of increasing a product’s degree of greenness and increasing the sales of green products, there are differences between these two methods in reaching these goals. Further, both via theoretical and numerical analysis, we find that although both the green manufacturer and the retailer can greatly benefit from government subsidy and greening cost-sharing contract, they may have different preferences regarding these two methods, which are mainly related to the size of the government subsidy, the fraction of greening cost-sharing with the retailer, the Research and Development (R&D) cost coefficient, the greenness sensitivity coefficient, and price sensitivity coefficient. Finally, the supply chain members’ behaviors (including the production and pricing decisions and, the choice of funds investment) are largely affected by the government subsidy mechanism.

Optimal replenishment cycle for perishable items facing demand uncertainty in a two-echelon inventory system

We consider a two-echelon supply chain with an upstream manufacturer and a downstream retailer for a single perishable product. The manufacturer processes raw materials into finished products, which are purchased by the retailer in each replenishment cycle. The raw materials of the manufacturer are highly perishable (i.e. perishing within hours or days), and the finished goods at the retailer face demand uncertainty and obsolescence. We model the manufacturer–retailer relationship as a Stackelberg game where the retailer is the leader and decides the replenishment cycle that minimises its mismatch cost between supply and uncertain demand. The manufacturer is the follower and decides its processing rate to minimise its unit cost for finished goods. Our results show that the raw material and finished goods lifetimes, which are interrelated through the duration of the replenishment cycle, have a significant impact on supply chain costs. Although raw material spoilage cost by itself is low, we show that short raw material lifetimes have a significant impact on the costs of both parties. Additionally, we find that while high manufacturer markups increase retailer costs, they reduce the manufacturer's costs due to large production batches.

Service Provision in Distribution Channels

Consumers may need help using an inherently complex or information-intensive product after purchase. This paper studies the incentive for a manufacturer or a retailer to invest in pre-sales service effort that would reduce the consumer's likelihood of seeking after-sales support. Because providing pre-sales and after-sales support would incur costs for the provider, it is not evident whether the manufacturer or the retailer would be more effective in doing so, and whether both services should be provided by the same firm. We consider different models in which the pre-sales service and the after-sales support is provided by the same or different firms, and show that the service configuration in which both pre-sales service and after-sales support is provided by the retailer is desirable to both the retailer and the manufacturer. Interestingly, in this service configuration, although the pre-sales service is provided at the highest level among all configurations, consumers can show up in the largest numbers to seek after-sales support. We also study the possibility of the firms collaborating in providing pre-sales service, by allowing the manufacturer to share a portion of the retailer's cost of providing pre-sales service. As expected, if the manufacturer provides the after-sales support, cost-sharing by the manufacturer may increase both channel members' profits. However, if the retailer provides after-sales support, cost-sharing by the manufacturer helps increase the manufacturer's profit but, surprisingly, reduces the retailer's profit. In this case, the overall channel can still be better off, and as such, the manufacturer may be able to implement cost-sharing by providing an appropriate transfer to the retailer.

Software Price Modeling of Semaglutide

GlucosePATH is a clinically validated decision support system which creates drug regimens for patients with type 2 diabetes. Regimens are optimized for HbA1c, weight, side effect and benefit impact, adherence and cost using a composite score from 0 to 100. Used on a population level, GlucosePATH can model drug distribution for sets of clinical values, showing drug prescription frequency to that population. As new agents such as semaglutide become available, projected distribution of these options can be described at various prices. Among other things, this shows the maximum and optimal price for a new agent, given the cost and performance of existing agents. A data set of 191 patients with HbA1c >7 was drawn from a distribution of patients cared for by PCPs in a large health system. Total monthly cost of care was computed based on the mean retail cost drawn from the GoodRX API. Using scores drawn from GlucosePATH, drugs were redistributed to find the lowest total cost at which the population’s score was >70 out of 100. Total retail cost of care averaged $475.03 per month per patient for the 191 patients. Redistributed medication at this price generated a mean composite score of 71.5 at a projected mean HbA1c of 6.9. Two price points were established for semaglutide. The “maximal price” (MP) is the highest price at which use of the agent in the population does not exceed the control group’s retail cost of care and the composite score threshold is met. (That is, introducing the new agent does not increase cost or worsen results for the population.) The “maximal revenue” (MR) is the price at which the agent’s manufacturer maximizes their gross revenue for the agent in the population. Price optimization for semaglutide showed a MP between $800 and $825 (retail price: $808). At its MP, semaglutide would be prescribed to approximately 17% of the population with mean composite score of 76.1 and mean HbA1c of 6.9. At semaglutide’s MR of $450 per month, it would be prescribed to approximately 49% of the population and generate a mean composite score of 77.8 with a mean HbA1c of 6.9. Disclosure B. Eilerman: Speaker's Bureau; Self; AbbVie Inc., AstraZeneca, Boehringer Ingelheim Pharmaceuticals, Inc., Sanofi, Novo Nordisk Inc., Orexigen Therapeutics, Inc., Corcept Therapeutics, Eli Lilly and Company, Merck & Co., Inc., Janssen Pharmaceuticals, Inc.. Other Relationship; Self; PATH Decision Support Software LLC. L.J. Testa: Stock/Shareholder; Self; PATH Decision Support Software LLC.

Software Price Modeling of Ertugliflozin

GlucosePATH is a clinically validated decision support system which creates drug regimens for patients with type 2 diabetes. Regimens are optimized for HbA1c, weight, side effect and benefit impact, adherence and cost using a composite score from 0 to 100. Used on a population level, GlucosePATH can model drug distribution for sets of clinical values, showing drug prescription frequency to that population. As new agents such as semaglutide become available, projected distribution of these options can be described at various prices. Among other things, this shows the maximum and optimal price for a new agent, given the cost and performance of existing agents. A data set of 191 patients with HbA1c >7 was drawn from a distribution of patients cared for by PCPs in a large health system. Total monthly cost of care was computed based on the mean retail cost from the GoodRX API. Using scores drawn from GlucosePATH, drugs were redistributed to find the lowest total cost at which the population’s score was >70 of 100. Total retail cost of care averaged $475 per month per patient for the 191 patients. Redistributed medication at this price generated a mean composite score of 71.5 at a projected mean HbA1c of 6.9. Two price points were established for ertugliflozin. The “maximal price” (MP) is the highest price at which use of the agent in the population does not exceed the control group’s retail cost of care and the composite score threshold is met. (That is, introducing the new agent does not increase cost or worsen results for the population.) The “maximal revenue” (MR) is the price at which the manufacturer maximizes their gross revenue for the agent in the population. Price optimization for ertugliflozin showed a MP of approximately $300 (retail price: $270). At its MP, ertugliflozin would be prescribed to approximately 10% of the population with mean composite score of 76.8 and mean HbA1c 6.9. At ertugliflozin’s MR of approximately $175 per month, it would be prescribed to approximately 39% of the population and generate a mean composite score of 77.6 with a mean HbA1c of 6.9. Disclosure B. Eilerman: Speaker's Bureau; Self; AbbVie Inc., AstraZeneca, Boehringer Ingelheim Pharmaceuticals, Inc., Sanofi, Novo Nordisk Inc., Orexigen Therapeutics, Inc., Corcept Therapeutics, Eli Lilly and Company, Merck & Co., Inc., Janssen Pharmaceuticals, Inc.. Other Relationship; Self; PATH Decision Support Software LLC. L.J. Testa: Stock/Shareholder; Self; PATH Decision Support Software LLC.

An economic study on production and marketing of ducks in haor areas of Netrokona district

Livestock subsector of poultry in Bangladesh is playing important role to its economy in light of growing small business, sources of protein supply, and providing a livelihood for millions of people. The study was designed to investigate the profitability of duck producing farms and marketing system of duck enterprise in haor areas of Netrokona district. In total, 50 farmers were selected. Farmers were divided into three categories (small, medium, large). The study shows that the average gross return from duck amounted to Tk. 47023 for small farms, medium farms gross return was Tk. 57580.82 and for large farms it was Tk. 57013.83. All farms average gross return was Tk. 53872.55. Annual net return for small farms from duck amounted to Tk. 19603, for the medium farm it was Tk. 23275 and Tk. 24275.16 for the large farms. Undiscounted BCR for small, medium and large farmers were 1.71, 1.68 and 1.74 respectively. The study also shows that, the marketing costs of paikers, wholesalers and retailers were Tk. 1920, Tk. 3019.41 and Tk. 2859.4 respectively. The corresponding net marketing margins were estimated at Tk. 833.33, Tk. 1173.66 and Tk. 938.6 per 100 ducks. This study identified some of the problems and constraints associated with production and marketing of duck which were- scarcity of feed, higher price of feed, higher transportation cost, lack of capital, lower price of ducks. Based on findings, recommendations were made for the improvement of this prominent duck farming sector.Res. Agric., Livest. Fish.5(1): 65-74, April 2018

Availability, affordability and costs of pediatric medicines in Mongolia

BackgroundThe Essential Medicines List for Children (EMLc) was developed by the World Health Organization (WHO) to assist member countries to achieve Millennium Development Goals (MDG). The Government of Mongolia has adopted a National Essential Drug List (NEDL) with the seventh update published in 2014. The objective of this study was to determine the accessibility, availability and costs of essential pediatric medicines in Mongolia.MethodsA standardized methodology developed by the WHO and Health Action International (HAI) was employed to conduct a study on the availability, costs and affordability of pediatric medicines in Mongolia. A data collection tool collected information in regards to retail and wholesale availability and costs of essential pediatric medicines at pharmacy outlets during January and August of 2016.ResultsAvailability of individual essential pediatric medicines varied across the country. The average availability of medicines was 72.6% in the public sector (9.1–100%). Correspondingly, average availability of all selected medicines in the private sector was 76.7% (26.7–100%). Lowest price medicines were 2.45 times higher than the international reference price (IRP) in the private sector and was 1.95 times higher in the public sector. The lowest cost medicines in the public sector were more affordable for all conditions. The least affordable treatment was estimated to be for respiratory tract infections, or otitis media using amoxicillin clavulanic acid, suspension costing up to 1.03 days wages.ConclusionProcurement, supply and distribution of essential pediatric medicines needs to be regularly investigated in order to identify the availability and costs of pediatric formulations in Mongolia.

Transplant recipients are vulnerable to coverage denial under Medicare Part D.

Transplant immunosuppressants are often used off-label because of insufficient randomized prospective trial data to achieve organ-specific US Food and Drug Administration (FDA) approval. Transplant recipients who rely on Medicare Part D for immunosuppressant drug coverage are vulnerable to coverage denial for off-label prescriptions, unless use is supported by Centers for Medicare & Medicaid Services (CMS)-approved compendia. An integrated dataset including national transplant registry data and 3years of dispensed pharmacy records was used to identify the prevalence of immunosuppression use that is both off-label and not supported by CMS-approved compendia. Numbers of potentially vulnerable transplant recipients were identified. Off-label and off-compendia immunosuppression regimens are frequently prescribed (3-year mean: lung 66.5%, intestine 34.2%, pancreas 33.4%, heart 21.8%, liver 16.5%, kidney 0%). The annual retail cost of these at-risk medications exceeds $30 million. This population-based study of transplant immunosuppressants vulnerable to claim denials under Medicare Part D coverage demonstrates a substantial gap between clinical practice, current FDA approval processes, and policy mandates for pharmaceutical coverage. This coverage barrier reduces access to life-saving medications for patients without alternative resources and may increase the risk of graft loss and death from medication nonadherence.

Retail Equilibrium with Switching Consumers in Electricity Markets

The ongoing transformations of power systems worldwide pose important challenges, both economic and technical, for their appropriate planning and operation. A key approach to improve the efficiency of these systems is through demand-side management, i.e., to promote the active involvement of consumers in the system. In particular, the current trend is to conceive systems where electricity consumers can vary their load according to real-time price incentives, offered by retailing companies. Under this setting, retail competition plays an important role as inadequate prices or services may entail consumers switching to a rival retailer. In this work we consider a game theoretical model where asymmetric retailers compete in prices to increase their profits by accounting for the utility function of consumers. Consumer preferences for retailers are uncertain and distributed within a Hotelling line. We analytically characterize the equilibrium of a retailer duopoly, establishing its existence and uniqueness conditions for a wide class of utility functions. Furthermore, sensitivities of the equilibrium prices with respect to relevant model parameters are also provided. The duopoly model is extended to a network that includes multiple retailers with capacity constraints for which we perform static and dynamic numerical simulations. Results indicate that, depending on the retailer costs, loyalty rewards and initial market shares, the resulting equilibrium can range from complete competition to one in which a retailer has a leading or even a dominant position in the market, decreasing the consumers’ utility significantly. Moreover, the retailer network configuration also plays an important role in the competitiveness of the system.

Three-Layer Supply Chain Production/By-Production Inventory Model Under Fuzzy Rough Environment

An integrated three-layer supply chain model for production and by-production system is formulated under fuzzy-rough (Fu-Ro)-environment. At first, supplier receives the deteriorating items in a lot and supplies the fresh units to manufacturer for production. Manufacturer has two plants: plant-1 and plant-2. Manufacturer purchases these fresh raw materials at a constant rate from supplier to produce the main product in plant-1. Retailer-I has purchased this product from manufacturer of plant-1 to sale to the customers. The residue units of plant-1 have transferred to plant-2 with constant rate to manufacture another usable by-product. Retailer-II purchases this usable by-product and sales to the customers. Ideal costs of supplier, manufacturer and retailer have been taken into account. By-production of residue units of plant-1 not only minimizes the environmental pollution, but also gives some return to the manufacturer. Due to the complexity of environment, inventory holding costs, idle costs and setup costs are considered as Fu-Ro type and these are reduced to crisp ones using Fu-Ro expectation. Supply rate, production and by-production rates are assumed as decision variables. Integrated model has been developed and solved analytically in crisp and Fu-Ro environments to find the optimum value of the decision variables and corresponding individual profits of the members of the supply chain are calculated numerically and graphically. Finally, the model has been realized with a case study of sugar mill.

On explicit solutions of a two-echelon supply chain coordination game

A contracting game under asymmetric information specific to two-echelon supply chain coordination between a retailer of unknown type and a supplier is studied. When the parameter which is private information to the retailer (holding cost) is known up to an interval of uncertainty, a uniform discrete approximation for retailer types leads to closed-form solutions where the joint (coordinated) optimal order quantity for a modified holding cost plays a major role. Furthermore, the closed-form solutions result in increasing information rent for higher types under easy-to-verify conditions involving strict lower limits on the total holding costs of retailer and supplier and the difference between uncoordinated optimal costs of consecutive retailer types.

Coordinated Two-Echelon Inventory Model for Optimal Inventory and Shipment Decisions under Exponential Price Dependent Demand

In this paper, a two echelon inventory system with a single-warehouse and single-retailer is considered. Mathematical model is developed for the retailer, warehouse and for the entire chain by incorporating the ordering/setup costs, carrying costs and transportation costs. Replenishment quantity at the retailer and the number of shipments from the warehouse to the retailer are considered as the decision variables. The objective of the proposed work is to demonstrate the optimality of centralised inventory & shipment decisions and total relevant costs at the respective entities and the chain. Numerical example is considered and the model is solved using the computer program written in MATLAB. From the research findings, it is concluded that the percentage variation in optimality of total transportation cost of the supply chain is in decreasing order with respect to the increased ordering cost of the retailer and set-up cost of the manufacturer. Finally, few managerial implications are derived based on the sensitivity analysis.

A new supply chain network design approach, regarding retailer's inventory level and supplier's response time

This paper deals with the retailer's location problem, when inventory costs for retailers and response time costs for suppliers have been considered. Generally, in a supply chain, most of the parameters are not deterministic, for this reason, we considered demand and service time as stochastic parameters, and queuing theory has been used to prepare a comprehensive mathematical model. In this system, each supplier has been represented with an M/M/1 queue and each retailer has been represented with an M/M/1 queue with bulk arrival. Due to the computational complexity of the proposed model, a genetic algorithm has been proposed to obtain acceptable solutions in a reasonable time. Further, performance of the proposed (GA) is compared against LINGO package software for small-sized problems. Our computational results suggest that the proposed GA is able to solve our mathematical model, especially for large sizes. To evaluate performance of the model, a real example of dairy supply chains has been prepared, which confirmed efficiency of the model.

A new supply chain network design approach, regarding retailer's inventory level and supplier's response time

This paper deals with the retailer's location problem, when inventory costs for retailers and response time costs for suppliers have been considered. Generally, in a supply chain, most of the parameters are not deterministic, for this reason, we considered demand and service time as stochastic parameters, and queuing theory has been used to prepare a comprehensive mathematical model. In this system, each supplier has been represented with an M/M/1 queue and each retailer has been represented with an M/M/1 queue with bulk arrival. Due to the computational complexity of the proposed model, a genetic algorithm has been proposed to obtain acceptable solutions in a reasonable time. Further, performance of the proposed (GA) is compared against LINGO package software for small-sized problems. Our computational results suggest that the proposed GA is able to solve our mathematical model, especially for large sizes. To evaluate performance of the model, a real example of dairy supply chains has been prepared, which confirmed efficiency of the model.

Optimal ordering policy for deteriorating items under down-stream trade credit dependent quadratic demand with full up-stream trade credit and partial down-stream trade credit

Nowadays, the use of the offer of delay payment is a very impressive tool to boost the market demand by attracting more customers. In this paper, we propose an inventory model, in which a retailer receives a permissible delay on the entire purchase expanse from the manufacturer (i.e., an up-stream full trade credit). In comparison, the retailer asks customers to pay some percent of purchasing cost at the time of receiving the product to reduce default risk (i.e., a down-stream partial trade credit). We consider the product with maximum fixed-life time deterioration and to reduce deterioration of the product, seller spends capital on preservation technology to preserve the item. Here, down-stream trade credit dependent quadratic demand is debated which is suitable for the products whose demand increases initially and afterward it starts to decrease. Industries like fashion and electronics most probably deals with this type of demand. The objective is to minimise the total relevant cost of retailer with respect to cycle time, down-stream trade credit and investment for preservation technology. The model is supported with numerical examples. Sensitivity analysis is done to derive insights for decision-maker. Graphical results, in three dimensions, are exhibited with supervisory decisions.

ВПЛИВ НАКИПУ НА ВИТРАТУ ПАЛИВА ПАРОГЕНЕРАТОРНИМИ УСТАНОВКАМИ НАФТОГАЗОВОГО ТЕХНОЛОГІЧНОГО ТРАНСПОРТУ

The paper considers the problem of the impact of the furring on the heating elements of mobile steam generating installation (SGI), widely used in oil and gas industry for the dewaxing of wells, pipe-lines, oil and gas as well as other equipment by the saturated steam of high and low pressure, and for other domestic and industrial needs. As steam-generating installations operate in field conditions at large distance from the main bases of their location (storage and registration), this leads to the forced consumption of physically and chemically untreated raw water. As a rule, this is subsurface natural water, water from rivers, lakes, pond, etc. Operation of steam-generating installations on the untreated water results in formation of the scale , which causes excess fuel consumption and failure of the steam generator boiler as a result of the coil burnout. However, even in the course of operation on the treated feed water the scale is formed on the walls of the coil, it decreases the operation efficiency and requires periodic descaling by means of acid treatment after 48 – 72 hours of operation. Operators often create the conditions for the creation of the thick layers of the scale and excess fuel consumption for the obtaining of the needed amount of steam, as compared with the data, specified by the regulatory documents on the installations operation. The paper contains the analysis of the impact of the scale layer thickness on thermal losses of the steam-generating installation boiler and the impact of the fur layer on the excess fuel consumption of the mobile steam-generating installation. Mathematical dependence of the excess fuel consumption on scale layer thickness is obtained. It was shown that the emergence of the scale causes not only economic but also ecological problems. In order to eliminate the negative impact of the scale on steam-generating installation operation the construction of the cleaning element was suggested. Application of the suggested device will enable to save up to 10.5 % of the fuel (approximately 121.5 kg/hr.). Taking into account the retail cost of the diesel fuel 27 UAH./l it is possible to achieve savings of 3280.5 UAH/ hour of the operation of one steam-generating installation. Thus, problem, considered in the paper is rather important for the enterprises of oil and gas industry.

Customer's reaction to cross-channel integration in omnichannel retailing: The mediating roles of retailer uncertainty, identity attractiveness, and switching costs

Although omnichannel retailing has gained significant interest among academics and practitioners, the mechanisms through which customers react to Cross-Channel Integration (CCI) in omnichannel retailing remain unclear. To this end, this study builds on the Push-Pull-Mooring (PPM) framework to unpack the processes through which uncertainty, identity attractiveness, and switching costs of omnichannel retailers play pushing, pulling, and mooring roles in shaping customers' reaction to CCI. We further explore the moderating influence of showrooming in these relationships. Survey findings reveal that uncertainty, identity attractiveness, and switching costs of omnichannel retailers partially mediate the effect of CCI on customer retention while fully mediating the relationship between CCI and interest in alternatives. We also uncovered that customer showrooming strengthens the negative relationship between CCI and retailer uncertainty. We conclude this paper with theoretical and practical implications of our findings.

Utilizing Community-Based Pharmacies to Improve Vaccination Rates in Patients With IBD

Introduction: Patients with Inflammatory Bowel Disease (IBD) are at increased risk for vaccine-preventable diseases (Farraye FA, et al. Am J Gastroenterol. 2017 Feb;112(2):241-258). Gastroenterology and internal medicine practices often do not offer vaccinations in their offices. Administration of vaccinations to IBD patients at local community-based pharmacies may offer a cost-effective option. Our aim was to determine the cost, benefits, and other barriers to vaccinating adult IBD patients at their local pharmacy. Methods: We conducted a review of the largest pharmacies in the US using 2015-2016 annual fiscal reports based on prescription revenues and number of stores. Mail-order pharmacies were excluded. We contacted each company to collect data on availability of vaccination for Influenza, Hepatitis A, Hepatitis B, combined Hepatitis A and B, Prevnar (PCV13), Pneumococcal (PPSV23), and Zoster. We assessed for cost variations across the country, discount availability, pharmacy operating hours, and how pharmacies document vaccine administration. Results: We identified seven pharmacies that account for >90% total prescription revenues that oversee between 433-9105 stores. The costs for a single vaccine are comparable between pharmacies (Table 1). Retail costs appear constant across the nation, but actual cost to the patient varies based on insurance provider and plan. The cost variation is notable between vaccines; the most expensive vaccine is Zoster (mean $246, range $224-$273), and the least expensive is Influenza (mean $19.50, range $14.99-39.99. The health plan and employer determine the actual cost to the patient.Table: Table. Cost in Dollars for Self-Pay Patients and Pharmacy Operating HoursConclusion: Vaccination rates for IBD patients are low, in part related to lack of vaccine availability in gastroenterology and internal medicine practices. Thus, alternative methods to conveniently administer vaccines are needed. Referring IBD patients to local community-based pharmacies bypasses the challenges of determining whether IBD patients should receive their vaccines at gastroenterology or primary care offices. This uncertainty often delays successful and timely vaccination. Benefits also include convenient patient access on a walk-in basis and the assurance that larger chains are typically fully stocked with inventory. Pharmacies process vaccination charges like a prescription, and patients receive the bill in the mail. Further research examining the affordability of community based pharmacy vaccination versus administration in an office based setting is ongoing.