The Numark international conference gave pharmacists the chance to air their concerns on a range of issues to the backdrop of a Latin vibe. Neil Trainis reports from Buenos Aires…
As the Argentine gauchos made off in haste attempting to lasso a fleeing calf across the dusty plain of the plush Estancia La República ranch some 70km from Buenos Aires, a thought suddenly became hard to resist.
Perhaps this is what independent community pharmacists will have to resort to in order to grab some of the healthcare services on offer in their local communities in the coming years.
Maybe they should start lassoing local healthcare commissioners to get a few heads to turn their way. Perhaps a few MPs too, starting with Andy Burnham and Jeremy Hunt.
The lassoing skills of the gauchos would be hard to replicate but a pharmacist’s lasso is, of course, their pharmacy. The place their local public come for their healthcare needs.
Mike Johnson, head of OTC at Phoenix Medical Supplies, inadvertently touched on pharmacy’s ‘lasso’ as he attempted to impress upon the conference the importance of making an impact on customer perception through a powerful retail environment.
As did Brian Fisher, the commercial director of Quantum Pharmaceutical, who talked about the need for pharmacies to differentiate themselves from their competition to cater effectively for their customers. He cited five ways in which pharmacies could differentiate themselves: price, service, range, quality and design.
Asking pharmacists to ponder who their customer is now and what their customer base will look like in five years’ time, he said there were “classic examples” of companies who had failed to differentiate such as Woolworths and cautioned pharmacy not to follow suit.
‘Ignite the passion,’ was the theme of Numark’s international conference staged in the Four Seasons Hotel but which occasionally spilled out into Buenos Aires itself, the colourful, cultural, artistic, historical, vibrant Argentinian capital city.
Aside from a trip to the Estancia La República ranch, there was a gala dinner at Café de los Angelitos in Balvanera, a neighbourhood of Buenos Aires where delegates were treated to a hypnotic tango dance show and, for a few hours, transported back to the 1890s, an intoxicatingly decadent time when the coffee house, run by an Italian immigrant called Bautisto Fazio, served as a rendezvous point for compadritos, malandras and gaucho singers known as payadores.
The business sessions were, in typical Numark fashion, refreshingly interactive and practical and involved delegates at every opportunity. During more or less every talk they were given the chance to discuss the topics in small groups and air their concerns and thoughts.
And there was much to digest. Mandeep Mudhar, the director of marketing at Numark, said there was much pharmacies could do to stretch their influence beyond the pharmacy itself and into local communities as well as hospitals, prisons and care centres.
Wayne Harrison, pharmacy development manager at Numark, talked about pharmacy generating loyalty from its customer base through an understanding of their needs.
Clara Carter, sales director at Actavis UK, focused on ways pharmacists can maximise the skills of their teams. Setting clear objectives for the year ahead, she said, was vital to maintain a motivated workforce.
One hoped that by the finish, delegates returned to the UK armed with fresh ideas with which to ameliorate their pharmacies. Returning from Buenos Aires armed with that one special ‘lasso.’
Be prepared to continue working in ‘hostile environment’
John D’Arcy, the managing director of Numark, opened the company’s international conference in Buenos Aires by warning community pharmacy that it must be prepared to continue working in what he described as “a hostile environment.”
In what was a typically frank assessment of the UK’s healthcare landscape, D’Arcy, addressing the conference at the Four Seasons Hotel in the Argentinian capital, insisted pharmacy must be willing to function in a more-for-less culture if it is to impress upon commissioners its long-term value to the NHS.
Pharmacy, he said, must resist its traditional model and do things differently.
“It’s a hostile environment, very, very difficult to cope with. And if you feel overworked, underpaid, actually that’s probably how it is everywhere,” he told delegates including community pharmacists as well as representatives from the pharmaceutical world and the pharmacy press.
“The whole culture of today’s world is more for less. And so it’s difficult. And you think to yourself, ‘how do I respond to that vibe?’ You can take the view, ‘well, I’ll just keep on doing the same old thing hoping it will get better.’ That is just not going to work longer term.
“For years we’ve been talking about pharmacy moving to a new role and we’ve made a lot of progress politically. You have all party support for the role of pharmacy. But actually where we have failed is translating that political support into action on the ground.”
He added: “It is tough and it requires a different response. Fundamentally, all of us need to think differently about our business. The game is changing, we’re moving towards a service proposition.
“When you have a government, let’s face it, that is working within a bankrupt NHS, there has to be an opportunity for community pharmacy given its accessibility, given the resonance it has with patients.”
D’Arcy, however, insisted that pharmacy should not be ashamed of making a profit where it can. Profit, he said, was “not a dirty word.”
Falsified Medicines Directive may not yet enter pharmacy
Paul Smith, the chief executive of Phoenix, expressed his doubt that the Falsified Medicines Directive will be applied to pharmacies in the UK with a general election looming and calls for an EU referendum intensifying.
Speaking to Pharmacy Business at Numark’s international conference in Buenos Aires, Smith said the Directive, which would demand that pharmacists scan the barcodes of all medicines to ensure their legitimacy, may not after all come in if the UK pulls out of Europe following a referendum.
“They’ve extended the deadline and what has to happen is the delegated act has to come down from the European Commission. That wasn’t delivered this January of (2015) which they expected so what they said was they were putting that off to 2016,” he said.
“We are still yet to see the delegated act and what that means for us but it’s interesting that you could say ‘well, why have they put it off for a year?’ It could be that nobody particularly is interested in it as a value proposition.
“It’s interesting that we’ve got an election this year. Now if we get an election and you get a Conservative election, they’ve talked about having an EU referendum. You find yourself out of the EU, then why would you do the Falsified Medicines Directive which is an EU-delegated power?
“Now I’m not saying that would happen but, as somebody said, ‘let’s kick it off the long grass because of that reason’ and the influence of Europe people don’t like as much.”
Smith added: “Everybody does not want falsified medicines in the system but are there easier ways, the cost involved in these processes of getting there, there are very little instances of sometimes this happening. Sometimes you think these things never come in.
“But if we’re not in the Euro zone, why would you do it? Don’t get me wrong, I think it’s more likely to happen but you could also see a scenario of events which means it wouldn’t because how do you want to deal with it if we’re not in Europe?”
New generics purchasing scheme announced
Numark used its international conference in Buenos Aires to unveil a new scheme it believes will provide its independent members with a generics purchasing solution covering more than 1,350 generic molecules.
The scheme, known as Numerics, will give pharmacists market-led priced generics with additional tiered discounts based on monthly spend. It will allow Numark members to buy all of their generics through their PMR system from their Numark wholesale and enjoy a maximum 10% rebate on qualifying products.
“Numerics is a complete solution across the whole range of generics with no affiliation to any one brand or manufacturer,” said Raj Nutan, Numark’s director of commercial operations (pictured).
“The objective is to get the best price for every molecule through Numark’s buying power whilst encouraging and incentivising our members to buy all of their generics through Numark rather than shopping around.
“Instead of members spending time hunting around for cheap lines saving a few pence here and there, they can save time and not only get competitive net pricing, but also earn a rebate each month. This will release them to spend more time with patients.”
Numark also revealed it has joined forces with UHY Hacker Young to help independent members benchmark where their pharmacy business is nationally and regionally in terms of gross profit, overheads and wages.
We dance to the tune of government when it comes to IT strategy
Ian Taylor, the managing director of Rx Systems, expressed his concern to the Numark Conference in Buenos Aires that “we dance to the tune of government” when it comes to pharmacy IT strategy.
IT has been an issue of contention for some time within pharmacy, given the debate swirling around access to patient care records and perceived incentives for GPs to engage and train for EPSR2.
Taylor decried the absence of a contractual agreement between service providers like Rx Systems and government agencies such as the Health and Social Care Information Centre which he said was crucial in supporting what is “a critical system.”
“Taking England for example, electronic prescriptions have been an agenda item at government level,” he told Pharmacy Business during the conference being held in the Argentinian capital.
“There’s an expectation in getting pharmacy engagement in electronic prescriptions and there would be significant benefit for pharmacy’s simplification of (the) drug tariff, openness of claims and that’s not come to the fore.
“The level of complexity for all providers in supporting electronic prescriptions is significant, it’s massive in many respects and it overtakes the majority of our focus when pharmacy is questioning certain components of electronic prescriptions when it mustn’t be forgotten that pharmacy system providers are there to support our pharmacy customers.”
He added: “There’s no contractual formal agreement, interaction between us and organisation like HSCIC (Health and Social Care Information Centre). We are delivering a critical system which pharmacy and patients are dependent on but at the moment there is no formal structure in the support of that.”
When asked if he thought that would change in the foreseeable future, Taylor said: “It must change. It absolutely must change. (We need) full clarity and understanding for who is responsible for what.”
Forget national, make it happen at a local level
Mimi Lau, the director of pharmacy services at Numark, told the company’s international conference in Buenos Aires that community pharmacy’s future largely rests on its ability to make things happen locally.
Addressing the conference, entitled Ignite the Passion, she urged pharmacists to place less emphasis on what is happening nationally and engage with commissioners and be proactive at a local level.
“Don’t wait for things to happen locally. There’s not much you can influence nationally but get involved locally,” she said, before asking delegates to discuss the value of providing services.
She asked the conference whether they thought it would be worth providing a H pylori service for £20 per patient even if the pharmacist did not think it was worthwhile from a financial perspective.
That question received a mixed response from delegates and Lau cautioned that by refusing to provide the service, pharmacies could be jeopardising their chances of securing future services.
Innovative technology launched to drive efficiency
Numark announced it has partnered with PharmAssist Solutions to provide its members with what it described as “innovative technology” aimed at driving compliance, efficiency and margin into independent pharmacies’ purchasing decisions.
Unveiled at Numark’s international conference in Buenos Aires, PharmAssist Solutions focuses on full group warehousing and retail control solutions to individual user compliance packages while PharmAssist Elite manages the order function for single outlet or small groups of pharmacies.
It includes Cascade, a programme that always orders the lowest priced molecule from the group of suppliers the pharmacy selects, dealing with out of stocks and code mapping errors in real time via a seamless link to RX Systems’ PMRs (NumarkAssist, ProScript and ProScript Link).
Numark said the system assesses prices over a large range, leading to an improvement in pharmacy profitability across generics, parallel imports, surgical and OTC products.
“As part of our function as a head office to independent pharmacy, we need a range of partners that can provide our members with access to buying solutions that help them gain control of the supply end of their business,” said Raj Nutan, Numark’s director of commercial operations.
“Our suite of offerings includes schemes from Teva and Actavis, our Numerics generics scheme and now a technology-led system ― PharmAssist Elite. Whatever type of pharmacy or pharmacies you run, and however you prefer to manage your buying, we have a solution for you.”