Let's Get Down to Business: The Value of Pharmacy Immunization

Amid an evolving health care landscape, pharmacists’ growing role in administering influenza and other vaccines can provide them with new opportunities to enhance their business and improve patient health.

Pharmacists’ scope of practice in immunizing patients has expanded significantly over the past few decades. Although laws and restrictions vary, pharmacists are now authorized to administer vaccines in all 50 states, the District of Columbia, and Puerto Rico.¹ This shift has largely been a boon to patients, who often pay less to be vaccinated at a pharmacy than in a physician’s office.² Furthermore, patients have found pharmacy-based immunization services to be more convenient and accessible than those offered at other health care settings, according to John Beckner, RPh, the senior director of strategic initiatives at the National Community Pharmacists Association.

“Over the years, [physicians] have relegated [immunizations] to pharmacists for a variety of reasons,” Beckner told Pharmacy Times^®. “Given the number of times patients visit pharmacies compared with the number of times they go to a physician’s office, it makes sense for them to get that service at a pharmacy.”

Beckner highlighted independent pharmacies as locations at which immunization services could thrive. Although independent pharmacies have not embraced these services as universally as their chain competitors, he noted, the high loyalty they have earned from their patients makes them ideal for vaccination locations.

“I think, certainly from an independent pharmacy standpoint, it’s all about relationships,” Beckner said. “Independent pharmacies have differentiated themselves over the years by the relationships that they have formed in their communities with patients and other health care providers.”

Independent pharmacists who are just beginning to offer immunization services should start slowly with influenza vaccines and pneumococcal vaccines, Beckner recommended; when they are ready, pharmacists can expand to other vaccines recommended by the CDC’s Advisory Committee on Immunization Practices, including those for zoster, tetanus, hepatitis, and measles, mumps, and rubella (MMR). When permitted by state law, pharmacists can also administer the MMR vaccine and other essential childhood vaccines to infants and children. Those who are unable to do so should at least educate parents on the importance of vaccination, he added.

If supported by local demographics, independent pharmacists should consider offering travel vaccine clinics in which they provide consultation and vaccination to potential travelers, Beckner suggested. He said success with these events could serve as a springboard toward other advanced health services, such as point-of-care testing and health screenings, which can help independent pharmacies to differentiate themselves from their competitors.

“By providing services such as immunizations, point-of-care testing, and health screenings, you are branding yourself as a health care destination,” he explained. “Combine that with the relationships you’ve formed and you have a very strong offering.”

FINANCIAL OPPORTUNITY

Immunization services represent a significant financial opportunity for pharmacies as well, with the vaccine market expected to reach $49.27 billion by 2022, up from $32.31 billion in 2016, at a compound annual growth rate of 7.5%.³ Notably, pharmacists can generate revenue from both the immunization services and the additional business brought in by patients seeking vaccination. According to 1 estimate, “a 20% vaccination rate can drive a 6% increase in front-end sales.”⁴ Acknowledging this potential for profit, Beckner advised independent pharmacists to market their services by leveraging their relationships and reaching out to schools, churches, and other groups in their communities. It is also important, he added, for pharmacists to be familiar with reimbursement procedures and to bill for the both the vaccine and its administration.

“There is no question that immunizations can be an important source of revenue, but there are some idiosyncrasies with various plans in terms of being paid fairly for both products and services,” Beckner said. “Don’t sell yourself short; if you’re doing a half-hour travel consult, make sure you’re billing for it.”

With vaccination rates falling short of Healthy People 2020 goals,⁵ pharmacists have a particularly crucial role to play in promoting immunization among their patients, according to Beckner. Encouraging pharmacists to be proactive in screening patients and educating them on the benefits of vaccination, he also indicated that collaboration with other health care professionals was key to ensuring that patients receive all of their recommended vaccines.

“I think doctors and pharmacists can work together; particularly with vaccines that require a 2- or 3-dose series,” Beckner stated. “A patient might go to a doctor’s office for the first dose of a series and visit a pharmacy for subsequent doses.”

Ultimately, Beckner emphasized that pharmacy-based immunization services not only save costs and produce revenue, but also improve patient health and contribute to better outcomes, illustrating the value that pharmacists bring to the entire health care team.

“Offering differentiated services such as immunization is very important, but more and more, these services lead to improved outcomes and that’s where pharmacists can add value,” he said. “That’s hopefully where payors are going to take notice and look at the impact of pharmacists on total health care costs."

References

• Pharmacist-administered immunizations: what does your state allow? American Pharmacists Association website. pharmacist.com/article/pharmacist-administered-immunizations-what-does-your-state-allow. Published October 1, 2015. Accessed July 9, 2018.
• Winegarden W. New study: patients could save time and money if neighborhood pharmacies can administer more vaccines. Pacific Research Institute website. pacificresearch.org/new-study-patients-could-save-time-and-money-if-neighborhood-pharmacies-can-administer-more-vaccines. Published April 17, 2018. Accessed July 9, 2018.
• Vaccine market by technology (live, conjugate, toxoid, recombinant), disease (influenza, DTaP, HPV, hepatitis, rotavirus, TT, polio, MMR, varicella, dengue, TB, rabies), route (IM, SC, ID, Oral), end user (Pediatric, Adult) & type - forecast to 2022. Markets and Markets website. marketsandmarkets.com/Market-Reports/vaccine-technologies-market-1155.html. Published August 2017. Accessed July 9, 2018.
• Dudzinski R. Immunizations: shot in the arm for retail pharmacy. Chain Drug Review website. August 29, 2017. chaindrugreview.com/immunizations-shot-in-the-arm-for-retail-pharmacy. Accessed July 9, 2018.
• Williams WW, Lu PJ, O’Halloran A, et al; CDC. Surveillance of vaccination coverage among adult populations-United States, 2014. MMWR Surveill Summ. 2016;65(1):1-36. doi: 10.15585/mmwr.ss6501a1.