INSIGHTS AND PERSPECTIVES

Editor‘s note: A brave new world

BY Seth Mendelson

This year could be the most important year for retail since, well, since all the way back in 2017.

At the outset, it is certainly shaping up that way, especially with a host of major retailers looking to do all they can to compete with Amazon and its growing online presence, not to mention taking a few points away from each other.

Let’s just take a look at some of the recent events. As we discuss in our cover story this month, CVS Health is buying Aetna to become a larger player in the healthcare market. Target is buying Shipt, a same-day delivery service that company officials believe will give them a chance to better compete online, for a cool $550 million. Walmart is buying just about everything in sight to give the company all the ammunition possible to compete digitally.

Expect more of the same this year.

In fact, the merger/acquisition activity should kick up a bit in 2018 as the larger merchants continue to try to solidify their online presence with consumers, and some other players, including Kroger, Macy’s, Bed, Bath & Beyond and Toys ‘R Us, seek ways to stay relevant in this changing world of retail.

Why now? Several reasons, say the experts. One is that as the fear of Amazon taking over all of retail subsides and the reality that it is most definitely a major force in the industry takes hold, other retailers are beginning to make sensible and logical moves to compete. The second, some say, is that the money is available for retailers to make these moves, which means investors are willing to bet that certain smart, well-thought out moves will pay off for these retailers over both the short and long terms.

The road map exists. When Walmart was gobbling up market share in the mass and food retail segments in the 1990s and many industry observers feared the sky was falling for the rest of the industry, sensible operators took the right steps to establish their own niches in the marketplace. The result was mass casualties among the merchants who did not change, and a robust retail environment for those who did.

It is going to happen again, and the next 12 months will go a long way in determining which retailers have the foresight — and the intestinal fortitude — to take the right steps to survive in a new age of retailing.

Walmart, CVS and, perhaps, Target are taking steps to ensure not only their basic survival but their long-term success. Mistakes will happen and some money will be lost, but doing nothing is no longer an alternative in retail merchandising and marketing.

Yes, 2018 has all the makings of being a crucial year for retail. But it will not be any more crucial than 2017 was or 2019 will be. Welcome to a brave new world. Now go out and conquer it.

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Real-time interaction with patient data to enable robust pharmacy-patient coherence

BY Brian Eidex

Over 12.5 million people misused prescription opioids in 2015. Pharmacists have a great responsibility to track and manage the use of controlled substances and other drugs of interest not only for the betterment of the industry but for the good of humanity. Non-adherence also remains a huge burden of the healthcare system. Half of all patients with chronic diseases don’t take their medications as prescribed.

Unfortunately, solutions to these challenges have remained elusive due to the disjointedness of patient prescription data. For pharmacists, data coordination remains a major industry challenge, as does the incongruence among various states’ prescription drug monitoring programs. It remains to be seen if, when, and how a national database of drug use is implemented across the U.S. But it’s time for pharmacists to consider both the deep responsibility for and operational benefits of transmitting patient dispensing data to a contributory database.  After all, we can wait for the government to pass legislation based on their perspective, or each of us in the industry can take on the challenge to improve patient care and our positions within the healthcare system.

To improve patient engagement, pharmacists require meaningful and actionable data, insights and analytics. To get the full picture of who’s taking what and to what degree of adherence, pharmacists need to coordinate care through information sharing via a patient platform concept. Using the same technology infrastructure that exists for prescriber compliance and leveraging the same technology platform benefiting the insurance and banking industries today, patient transaction data would be transmitted to a protected system—with patient engagement as the ultimate goal.

From the standpoint of monitoring controlled substances, a pharmacist would be able to receive more advanced opioid scoring and alerts, including morphine equivalency. If a patient filled a prescription a few days before, at a pharmacy a few blocks away, the pharmacist would know it.  That could result in the pharmacist having a meaningful engagement with patients to help them with their situation.

Regarding patient adherence to other types of medications, the system would provide adherence score models to let pharmacists know if a particular patient is in need of further education or materials about the regimen to help produce better outcomes.  Again, the pharmacist is able to take an active role using actionable information to educate the patient.

Immunization opportunities would also be flagged via immunization registry access. A pharmacist could note, for example, if the patient in front of him was a candidate for the shingles vaccine, and even perform the immunization right in the pharmacy for an additional revenue stream.

Additionally, universal patient identification would provide another layer of security for prescribing, offering patient and demographic data to confirm the identity of each customer.  Supporting the use of a universal patient identifier, this platform would easily access other systems within healthcare, such as EHRs, lab systems, and hospital systems, as needed.

Operational benefits of amassing this data would be significant. For example, a pharmacy patient platform would enable basic functionality for states’ Prescription Drug Monitoring Programs (PDMP) compliance. Looking up controlled substance data for the state is often a clunky, time-intensive process. This system would query that information automatically for state reporting, creating a log for future access needs, such as requests from state regulatory authorities, and freeing up valuable staff resources for more time with customers.

The future of pharmacy is just a step away. Existing infrastructure is able to yield real-time interaction with the shared patient data to deliver solutions for a more streamlined, effective delivery of services. Informed providers and engaged patients result in better care and better outcomes: the possibilities are endless.


Brian Eidex is the current director of pharmacy at LexisNexis Risk Solutions Health Care, who holds 20 years of hands-on leadership experience in product management, sales and software development. His responsibilities with the company include generating new revenue from new and existing clients through client consultation and driving product management. LexisNexis prides itself on being able to use the power of data and advanced analytics to help customers make timelier decisions about hidden risks and opportunities by providing insights to people, the industry and society. 


 

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Rules of the Road: Learning from China’s trade structure

BY Ed Rowland

Jack Ma, the founder of Alibaba once said, “You should learn from your competitor, but never copy. Copy and you die.” As the Chinese consumer healthcare market continues to rocket forward, what can we learn from them?  For my dollar — or yuan — quite a bit.

In some ways, China is moving toward a U.S. trade structure although the emergence of traditional retail has been in the large shadow of e-commerce. Global powerhouses like Watson’s or Walmart have had different levels of success. Don’t underestimate some of the homegrown chains (Nepstar comes to mind) nor the uniqueness of the Chinese consumer. I am always amazed by the space allotted to traditional Chinese medicine vs. western brands. Chinese retail is deftly combining both. Their ability to readjust store space and globally source products is admirable. And who knew that Wisconsin produces some of the most prized ginseng? Ginseng-heads at a Green Bay Packers game doesn’t fit.

China also has forged a new world. Ma’s Alibaba is exhibit A with its two e-commerce divisions, TMall and Taobao, which we would recognize as Amazon and E-bay respectively. It’s a game-changer having these two under one roof. Having negotiated in setting up e-commerce consumer healthcare brand flagship stores (and not just TMall), I am struck by the interplay of pricing information between the two platforms. Taobao can and does feature branded product, bought on deal in the United States by aggressive small operators. The structured TMall trade promotion “requirements” coupled with the holiday price discounts is complicated. November 11, known as Double 11, is huge. The United States has nothing that matches the discounting depth. We could learn from this.

China’s Google is Baidu. (Or is it the United States’ Baidu is Google?) Given restrictions placed on the Internet, Chinese consumer healthcare e-commerce content is critical as a trusted source of product information. TMall, JD, Koala and many other e-commerce platforms have developed excellent product content out of necessity; we can learn from that.

The frantic pace of parallel growth of traditional and e-commerce consumer health care has also spawned some fascinating hybrids and governmental creativity. Known by several names, cross-border trade has fostered industry/tax authority cooperation. Think of it as a special tax zone; instead of smuggling to avoid a standard 17% import duty a compromise of an 11.9% tax rate has aligned all parties. The government heavily punishes any smugglers attempting complete tax avoidance and the companies have a more even playing field while paying a lower tax rate. It also ensures that knockoffs don’t make it as all companies value consumer trust.

Perhaps more unique are the so-called Demonstration Stores found in the Cross-Border areas. Consumers can sample products and then immediately go to a computer and order online for home delivery. Traditional Retail meets E-commerce and both win. How would a market research firm classify that revenue?

What can US companies learn from China’s consumer healthcare trade structure? Here’s a partial list:

  1. Content delivery. China’s e-commerce platforms are quite good given their realities.
  2. Logistics of HUGE temporary price discounts. Understand Double 11.
  3. Hybrid structures where e-commerce and traditional blur.

Long before Jack Ma, the famous Chinese military philosopher Sun Tzu wrote, “Know the enemy and know yourself; in a hundred battles you will never be in peril.” The Chinese Trade isn’t an enemy, but we can learn from them.


Ed Rowland is a Drug Store News contributing editor covering global issues. As the principal of Rowland Global, he believes in the promise of global business and supports companies in their strategy, tactics and execution of international growth initiatives.

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