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Capturing specialty market is essential for growth

BY Alaric DeArment

WHAT IT MEANS AND WHY IT’S IMPORTANT — Specialty pharmacy is one of the fastest-growing segments of pharmacy today, but only a minority of specialty drugs that end up in patients’ hands are dispensed through retail pharmacy channels.

But with the growing importance of specialty due to the aging population and the commoditization of the market for primary care drugs, more retailers want in on the action, so it wouldn’t be in their interest to have PBMs conquer too big a share of the market.

(THE NEWS: U.S. District Court dismisses most elements of antitrust suit against ESI-Medco. For the full story, click here.)

And it makes sense for a reason other than their bottom lines: Studies repeatedly have shown that patients who engage in face-to-face interactions with pharmacists show better medication adherence than those who don’t. Still, while chain retailers such as Walgreens, Costco Wholesale and Hy-Vee have a presence in specialty, mail-order pharmacies – including those run by pharmacy benefit managers – command the largest share of the retail specialty market and account for the fastest growth.

According to IMS Health, the specialty drug market was worth $42.8 billion during the 12-month period ended in June. Of that, nearly 30% went through mail service, while 10.1% went through chain and mass-merchandise stores, 5.7% went through independents, and 1.6% went through food stores. Meanwhile, mail service has seen the highest growth among all retail channels, 23.6%, followed by 12.9% among independents, 3.1% among chain and mass, and 2.2% among food stores. The remaining 52.7% of the market went through institutional channels, such as clinics, hospitals and long-term care centers.

At the same time, brick-and-mortar retailers account for a majority of dispensed prescriptions for HIV and other antiviral drugs and gastrointestinal anti-inflammatory drugs, as well as a significant percentage of systemic anti-arthritic drugs. IMS VP industry Doug Long said during a presentation at the National Association of Chain Drug Stores’ Pharmacy and Technology Conference in Denver that future growth in biosimilars would open up opportunities as well, as would treatment of autoimmune disorders.

The importance of specialty is evident from recent trends in drug innovation. According to Long’s presentation, drugs for specialty indications, such as types of cancer, chronic viral infections and autoimmune diseases have accounted for a significant portion of new Food and Drug Administration approvals. Because of that, whoever can best capture the patient populations that depend on specialty drugs will be in the best position for future growth.

What are your thoughts? Sound off in the comments below.

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Telehealth, kiosks are proving importance in future of U.S. health care

BY Antoinette Alexander

WHAT IT MEANS AND WHY IT’S IMPORTANT — Big news for SoloHealth as the number of consumer interactions made at its health-and-wellness kiosks surpassed 2.5 million while the company works toward its goal of 2,500 retail kiosks by mid-2013. But it is perhaps even bigger news for the future of the overall U.S. healthcare system.

(THE NEWS: SoloHealth surpasses 2.5 million consumer interactions. For the full story, click here.)

Why? Because the reality is that telehealth and kiosks will become an increasingly important part of the future of health care, helping to expand Rx-to-OTC switch possibilities and helping to expand access to primary care by connecting patients, physicians, pharmacists and technology.

Earlier this year, the Food and Drug Administration held a public meeting on ways to expand the Rx-to-OTC switch paradigm by utilizing the latest in communications and diagnostics technology and/or incorporating the retail pharmacist into the self-care decision protocol.

SoloHealth — which recently announced strategic investments and partnerships with WellPoint and Dell — was one of the companies invited to testify before the FDA’s public meeting on the switch paradigm as the kiosks could help to drive awareness around a particular condition or remedy, help educate the consumer and spark action. In fact, Bart Foster, SoloHealth CEO, said the kiosk is "precisely in the sweet spot of what the FDA is trying to do."

Then there’s the important role that telehealth can play in expanding access to primary care by connecting patients, physicians, pharmacists and technology. In fact, the importance of telehealth in improving access to care is already playing out.

For example, convenient care industry pioneer Kevin Smith embarked on a new journey in 2010 to further revolutionize access to health care with Zipnosis.com. How it works: The patient logs onto the Zipnosis site, answers a set of questions that mimic those that a healthcare provider would ask the patient and, based on the responses, goes to the next appropriate question. Once the patient completes the evaluation, a healthcare professional — a physician, nurse practitioner or physician assistant — receives a text message and the patient receives a response within an hour with a recommendation.

The services offered by Zipnosis are limited to such minor, acute ailments as sinus infections, sore throats and bladder infections. Each "visit" is a flat fee of $25 paid via credit card or HSA/Health Savings Card.

Furthermore, Rite Aid has partnered with OptumHealth to provide "virtual clinics" through the launch of NowClinic online care services at select stores in the Detroit area. The program is designed to allow Rite Aid customers to interact in real time with doctors and OptumHealth nurses. Rite Aid has indicated that the program has gained traction and it is considering expanding it.

To be sure, many other companies are getting into the telehealth space. These are just a few  examples, and there’s no doubt that the future opportunities for both kiosks and telehealth are significant. Yes, SoloHealth’s announcement that consumer interactions made at it health-and-wellness kiosks have surpassed 2.5 million is important but it is really just the tip of the iceberg.

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Retailers in Pa. and Calif. no longer swimming against a sales tax undercurrent

BY Michael Johnsen

WHAT IT MEANS AND WHY IT’S IMPORTANT — As of Sept. 1, some 1.2 million Pennsylvanians will be able to go to bed at night secure in the knowledge that their jobs won’t be drowned out by some online juggernaut. And by the middle of September, 3.1 million Californians will be able to breathe that same sigh of relief. That’s how many retail employees there are across those two states. And now that Amazon.com will be levying sales taxes of 6% and 7.25% in each of those states, respectively, that’s how many retail jobs no longer will be threatened by an unlevel playing field.

(THE NEWS: Amazon.com to begin collecting sales taxes for purchases made in Pennsylvania. For the full story, click here.)

Just last week, DSN senior editor Antoinette Alexander outlined why multichannel retailing is so important — 60% of consumers will make their purchases online for only a 5% savings. Only five states don’t charge a sales tax (Alaska, Delaware, Montana, New Hampshire and Oregon). There, retailers are on more of a level playing field. The lowest state sales tax is Colorado, at 2.9%. Beyond that sales taxes range from between 4% at the low end and 7.25% at the high end.

In Pennsylvania and California, and in the six other states mentioned in the story, brick-and-click retailers no longer iwill have to discount their merchandise another 6% to 8% just to be in line with Amazon.com’s prices (or any online retailer with a physical presence in each of those states, for that matter). A $100 purchase will no longer cost a consumer $106 (plus gas) at retail, and $100 (plus free shipping) through that online retailer.

That doesn’t mean Amazon.com no longer will be a formidable competitor to the retailers in Pennsylvania and California. And it doesn’t even mean Amazon.com will no longer field a significant competitive advantage in every sector in which they compete. They will and they should.

But let’s face it, the Amazon.com business model is different from traditional retail. They have the buying power of a national chain without the capital costs of brick-and-mortar retail. The future of retailing is gravitating toward online convenience. Adapt or go home. (Check out how Walgreens is making their offering all about the "experience, experience, experience" with one seamless, multichannel play in the Sept. 24 issue of DSN.)

But that’s fair game, because the emphasis for many of the retailers we cover in the pages of DSN is to turn their multichannel offerings into a tactical advantage despite all of that. She wants to shop online? Sure. She wants to then pick that purchase up in the store on her way home from work? OK, no problem. She wants to shop in the store and then have it shipped to her home within the day? If they aren’t already, a lot of retailers are moving in that direction, too.

She wants to save another 6% by hopping over to another URL? Nope, sorry, can’t do that anymore.

What are your thoughts? Sound off in the comments below.

 

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