Q&A: Mark Walchirk on positioning independents for success

BY Rob Eder

As McKesson ideaShare 2015 was just getting underway, DSN editor-in-chief Rob Eder caught up with McKesson president of U.S. Pharmaceutical Mark Walchirk about the state of the pharmacy business, how smart independent pharmacy owners are finding new ways to compete and what McKesson is doing to help independent pharmacies become more broadly integrated into the patient care team, drive improved outcomes and improve profitability.

DSN: Talk about the challenges and the opportunities facing pharmacy today.

Mark Walchirk: I think there are some really positive things going on in the environment, and there are some challenging things as well. In terms of some of the positives, certainly the market in the United States remains strong; I think the demographics create an opportunity for continued growth in pharmaceuticals. There’s still a tremendous opportunity with generic drug launches over the next few years. The Affordable Care Act has brought more people into the healthcare system.

So there are a lot of positives for retail pharmacy, but at the same time, there are pressures as well. I think primarily, it’s an intensely competitive environment that retail pharmacy faces: obviously, there’s still a lot of pressure on reimbursement. If you asked 1,000 independent pharmacists what their biggest challenge was, probably the number one  thing most of them would say is something associated with reimbursement. So, they have had to learn how to continue to provide high quality care and clinical services, in an environment where they are getting squeezed from a reimbursement standpoint. It’s forced independent pharmacy owners to be more creative about their revenue streams, and really think about not just filling prescriptions, but really finding new ways to take care of patients and work within their communities. They have had to learn to compete in different ways than they have in the past.

DSN: Consolidation continues to be a factor in the pharmacy industry. How is consolidation impacting independent pharmacies and what do independent owners need to do to thrive in this new era?

Walchirk: It’s interesting because I think that consolidation can have both a positive and a negative impact on independent pharmacy. You may not hear a lot about it. But we have a lot of store owners who maybe started with one or two stores, and they continued to grow in their communities, then all of a sudden they have eight or 10 stores in a geographic area where they actually have some concentration and some brand recognition. In fact, that’s been one of their keys to success.  

I would say that independent pharmacy has been very resilient. About 10 years ago, there were about 20,000 independent pharmacies, and everybody thought the demise was going to happen. And 10 years later there are still about 20,000 independent pharmacies. So, it’s pretty amazing really, the resiliency of independent pharmacy owners. They have had to learn how to compete in a different way. They have had to learn to find ways to build scale in their own environments. You’ve seen a lot of young pharmacists open up their own stores. And I think there’s almost a rebirth of independent pharmacy that is taking place and will continue to take place.

DSN: How is McKesson helping retail pharmacies expand their role and become an even more integral and connected member of the patient care team?

Walchirk: I think that’s one of the unique reasons why independent pharmacy owners are successful because they really do act as part of the overall healthcare team within their communities. This afternoon in the Opening General Session we highlighted a number of pharmacies from around the country and we recognized our Pharmacy of the Year award winner from the Marble City Pharmacy in Sylacauga, Ala. You could just sense that they were really a part of the community, and they weren’t there just to fill prescriptions. They provide care and assistance in a variety of fashions, whether it is medication synchronization programs, consulting services with patients, diabetes or cholesterol testing, or developing an infusion center.I think independent pharmacy owners have had to find new ways to serve their communities, and a focus on patient care has been a critical part of their success. Typically independent pharmacy is known for that special emphasis on care, and I think in the environment that we are moving toward, where quality of care is linked to reimbursements, independent pharmacy is positioned very well to thrive in that environment. Independent pharmacy can be a great driver of adherence and persistence programs.

DSN: What is the No. 1 thing McKesson ideaShare attendees should do when they return to their pharmacies next week?

Walchirk: I would hope that every independent pharmacy owner takes home at least one new idea, one new program or one new initiative from their time here. McKesson ideaShare can be somewhat overwhelming — there are probably 1,000 big ideas out there — but if every one of the pharmacy owners here took one new thing back to their stores and implemented it, I think the show would be a great success.


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Big ideas help kick off ideaShare 2015 with full day of education

BY David Salazar

SAN DIEGO — McKesson ideaShare 2015 kicked off Wednesday with a full day of continuing education sessions to help independent pharmacists remain at the cutting edge of patient care and pharmacy practice. Over the course of the four-day conference, McKesson will host more than 30 CE sessions, covering such important topics as medication synchronization, marketing in a digital world, building prescriber relationships and much more.

Drug Store News sat in on some of the sessions. Following are some key highlights from Wednesday and Thursday:

Medication Synchronization: Building the Foundation to Maximize Your Pharmacy’s Financial and Clinical Potential
Co-moderators Pam Bernadella, director of training and professional services for Health Mart; John Gregg, director of clinical operations for Health Mart; and Health Mart Pharmacy owner Bob Lomenick of Tyson Drugs discussed the advantages of adopting an appointment-based, medication synchronization program for an independent pharmacy, including improved patient outcomes and prescription growth. The session provided a five-step roadmap on how to implement a successful med sync program in just 90 days. According to a 2013 study published in the Journal of the American Pharmacists Association, patients enrolled in med sync programs had average adherence rates of more than 89% versus 57% adherence among patients not enrolled in med sync. In addition, for every 100 patients enrolled in a med sync program, pharmacies generated about three additional fills per patient, resulting in a $91,140 incremental lift in revenue.

“That’s more than an extra week of sales,” Bernadella said. “The financial benefit is real.”

Why Marketing Matters: Using Proven Strategies to Acquire Patients and Promote Your Pharmacy
Pharmacies that have incorporated medication synchronization into their practice, of course, need to advertise that service. Kevin Joyce, SVP EMG3, talked about how to do that effectively. Joyce laid the foundation for independent pharmacies to construct a comprehensive, affordable and effective marketing program designed both to acquire new patients and help retain existing patients.

Joyce suggested operators start small and be willing to constantly test and tweak the message. Operators should also focus their pitch to a defined patient group, which not only makes the message more effective, but also makes the campaign more affordable, he said. And there should be a specific call to action associated with the campaign, such as an invitation to participate in an event.

Marketing Your Pharmacy in Social Media, Mobile and the Digital World
Among the sessions emphasizing better ways for pharmacy owners to serve their customers, Elizabeth Estes, Ebus Innovation’s chief ideas officer, led a session outlining ways community pharmacies can acquire new customers and convert them into loyal customers through digital marketing.

Estes talked about the importance of mobile-optimized websites, leveraging Facebook marketing to engage the community, how to maintain a consistent digital presence, and how to deal with reviews on social sites like Yelp, and offered a toolkit for how to thrive in a permanently changed landscape.

“The digital experiment we all talked about and thought about four or five years ago is not an experiment — it’s a way of life. And it’s what our patients and what our consumers are doing,” Estes said. “There are a lot of opportunities for you to use these tools to engage your patients and to work with your patients with these tools.”

Seven Deadly Sins of Community Pharmacy

Hamacher Research Group VP Dave Wendland talked about the common mistakes independent pharmacy owners often make that cause them to fail to optimize sales at the front-end of the store. Among the many lost opportunities for increased sales, Wendland pointed to such missed opportunities as poorly used endcaps and merchandise displays, a reliance on traditional media and inconsistent planogram implementation

“There are countless opportunities for independent pharmacies to capture sales that are literally right in front of them, and that is the front of the store,” Wendland told Drug Store News. “Certainly as an industry, we need look no further than what CVS Health announced last week, which is they’re devoting more energies to the front end. Independent pharmacy needs to do the same.”

Positively Impacting Performance Measures One Patient at a Time
Janelle Ruisinger, associate professor at the University of Kansas School of Pharmacy, helped participants parse the different guidelines they could use to determine if a diabetic patient is right for statin therapy, and discussed typical reasons for non-adherence and potential solutions. Ruisinger emphasized that adherence goes hand-in-hand with improved performance on CMS’ Star ratings. Ruisinger quoted the World Health Organization, which calls pharmacists “an important resource for improving adherence to long-term therapy.”

“The WHO recognizes pharmacists as important to helping improve adherence and so hopefully we can step up to that challenge and make big changes and help our patients out there,” Ruisinger said.

 20 Great Ideas to Build Relationships with Physicians
One common theme at McKesson ideaShare 2015 revolved around forging stronger relationships — between pharmacies and customers, potential customers, and even prescribers. Marsha Millonig, CEO of Catalyst Enterprises, and Dr. Paul Mulhausen, chief medical officer at Telligen, discussed the potential for collaboration between pharmacies and doctors undergirded by a professional and mutually respectful relationship — what Millonig referred to as a covenant between pharmacist and patient, as well as pharmacist and physician.

Milhausen emphasized the pharmacy’s need to fill a niche in providing care and preventing adverse drug events — special populations like the elderly and those with serious mental illness are examples of these — in a way that adds value to the physician-pharmacist relationship.

“If you can’t bring added value to the collaboration, you will be irrelevant,” Milhausen said, adding that if pharmacies can add value to the relationship, there will be pay off down the road.


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McKesson ideaShare 2015 showcases three key drivers to independent success


SAN DIEGO — Thousands of independent pharmacy owners from across the country are attending McKesson ideaShare 2015, here at the San Diego Convention Center this week, to explore the latest tools and strategies to help independent operators enhance patient care and improve profitability.  

“As the industry continues to evolve, pharmacists are being pushed to elevate their role as healthcare service providers,” stated Mark Walchirk, president of McKesson U.S. Pharmaceutical. “McKesson and Health Mart are driving innovation in this environment through continued investment in new business-building tools, clinical solutions and technology being highlighted here at McKesson ideaShare to help impact patient care and outcomes, as well as seize opportunities for growth.”

“Health Mart has experienced tremendous growth over the past several years by providing tools and support that enable members to deliver superior patient care and quality outcomes, bring more patients into their stores and expand their services for more revenue,” added Steve Courtman, Health Mart president. “This week, Health Mart will showcase key solutions designed to help grow their business.”

This year’s McKesson ideaShare 2015 — which opened June 24 and runs through June 28 — focuses on providing solutions across three areas of independent’s business: gaining access to preferred networks, building a patient base within the competitive pharmacy industry, and realizing the promise of reimbursable patient care and disease management services.

The action kicked off Wednesday, where it was standing-room only for the full day of continuing education sessions, covering dozens of critical topics from medication synchronization, marketing in a digital world, building prescriber relationships, and more. In all, McKesson will host more than 30 accredited CE sessions over the course of ideaShare 2015.

Gaining access to preferred networks
Health Mart is focused on helping pharmacies get the credit they deserve for improved patient adherence and quality outcomes, and gain additional access to preferred networks. This year at McKesson ideaShare, Health Mart will focus on two core areas: improving clinical performance and pharmacy-based adherence support.

Health Mart has a number of programs to help pharmacies address nonadherence, including interpreting their EQuIPP scores. More than 80% of Health Mart stores are now enrolled in EQuIPP to track their pharmacy quality performance, and the number of Health Mart stores with one or more measures in the top 20% continues to increase. Health Mart continues to educate members on behavioral coaching, medication synchronization and comprehensive medication reviews, as well as such intervention tools as refill reminders. In the fall, Health Mart will host its third series of Town Hall meetings focused on medication synchronization. The latest edition of Health Mart’s “Drive Improved Pharmacy Performance Playbook” will be highlighted at the conference.   

Meanwhile, McKesson’s Sponsored Clinical Services Network will be introducing phone-based pharmacist coaching to expand the reach of its award-winning Pharmacy Intervention Program. These manufacturer-sponsored coaching sessions have consistently increased patient adherence by up to 30%. Launched at McKesson ideaShare 2014, the LoyaltyScript@Retail program provides pharmacists with a timely, convenient means of providing patient savings and enhanced care, with easy, in-store access to co-pay savings offers for a growing list of brands via McKesson’s online portal. More than 13,400 pharmacies are participating in the program, and pharmacists have used the tool at the counter to help patients start their therapy.
Bringing new patients into the store
Competition for patients is stronger than ever, which is why Health Mart continues to invest in national and local marketing tools to help bring more patients into its stores. To help Health Mart owners promote their pharmacy their way, Health Mart pharmacies have access to matching funds for local marketing activities that give owners the flexibility to promote their specific service offerings and distinct strengths, attract new patients and reinforce their value to existing patients. (For an in-depth look at how Health Mart is helping to bring new patients to the store, see DSN’s exclusive interview with Health Mart director of marketing Michelle Gilliam.

Expand patient-centered services for more revenue
Health Mart is helping pharmacies implement vaccination programs and other clinical services that shift the focus to the patient, and help owners grow their pharmacy businesses and drive profitability. At McKesson ideaShare 2015, Health Mart introduced a new Vaccine Starter Kit program and the latest 340B software tools for its Macro Helix solution.

As reimbursement pressures continue to compress retail margins, vaccines offer a unique revenue opportunity for stores. The Vaccine Starter Kit gives pharmacy owners the ability to establish a vaccine practice in their own stores, with 12 months of hands-on customer support from a vaccine subject-matter expert who covers all of the key steps for starting a vaccine administration program. The Vaccine Starter Kit program is open for enrollment at McKesson ideaShare 2015, with services beginning in August 2015.

At the meeting, Macro Helix featured its latest 340B software tools designed to help pharmacies interested in engaging in 340B or who are approached by a 340B clinic about participation as a contract pharmacy. The McKesson 340B team on Thursday morning conducted the CE session, “Strategies to Support a Healthy 340B Contract Pharmacy Program,” outlining attributes of a well-managed 340B contract pharmacy and strategies to build healthy relationships.

McKesson invests in Health Mart
McKesson continues to make investments to help Health Mart and independent pharmacies improve their bottom line, operate more efficiently and thrive in the future, giving them the ability to better serve their patients and grow their pharmacy business.

One of the additional solutions McKesson will offer at ideaShare 2015 is StarWellness for Medication Synchronization. As the pharmacy industry rapidly shifts with an increase of narrow networks and a growing importance on clinical performance as a consideration for network access, AccessHealth is offering this medication synchronization software tool from PrescribeWellness. AccessHealth will highlight this important addition to its suite of services, which helps increase pharmacy efficiencies through consolidated reimbursement processes, and the tools needed to help pharmacies drive better patient outcomes and become top performers.

McKesson also will launch a mobile-optimized McKesson Connect “Mobile Companion,” allowing pharmacies to manage core product search and ordering activities from any mobile device. The McKesson Connect Community, which lets pharmacists and owners collaborate with peers, has grown 40% since last year, with 6,000 members participating in 1,300 discussions.

Each year, McKesson also has emphasized the importance of pharmacy ownership. McKesson’s RxOwnership team will host on Friday the annual Ownership Transfer Luncheon, featuring a panel discussion with pharmacy owners who have participated in the RxOwnership program. The panel will review recent industry changes and discuss their road to ownership and how RxOwnership advisers can help other independent pharmacists with their ownership goals. In the past year, McKesson has helped 382 owners start new pharmacies and has helped more than 2,700 pharmacies through the ownership-transfer process since 2007.

In addition, this year McKesson will be launching the Adherence Performance Solution, an online dashboard from McKesson Pharmacy Systems & Automation (MPS&A) that provides valuable data to help pharmacies understand and act on patient medication adherence behaviors. The Adherence Performance Solution dashboard helps identify patients for pharmacies to target for adherence programs based on their current prescription history and activity. Pharmacies can also generate data to compare their adherence performance to the rest of the market segment and help prove the value of their pharmacy to preferred prescriber networks. MPS&A also is launching a cross-platform point-of-sale system and previewing a new Clinical Programs Solution.


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Which area of the industry do you think Amazon's entry would shake up the most?