The Pandemic Has Heightened the Need for Larger Retail Pharmacies to Anticipate Patients’ Needs, Behaviors

Pharmacy Times® interviewed George Rafferty, president of corporate partnerships at AmerisourceBergen, on how large retail pharmacies have been impacted by and been able to respond to the challenges of the COVID-19 pandemic.

Alana Hippensteele: So George, what are some of the challenges that large retail pharmacies have faced during the COVID-19 pandemic, and what impact have these challenges had?

George Rafferty: Yeah thanks, Alana, and I appreciate the opportunity to talk a little bit about what our experience has been with a lot of our customers, including our retail pharmacies.

Just a little bit of background: My team actually has what I call a mosaic of customers that retail is a big portion of our customer base. We also have health plans, independent especially pharmacies, etc, and there's a lot of consistencies I think across all those different customer types, but I'll hit on retail, at least to start with.

It's no surprise back a year ago yesterday that we officially went into the full declaration of a pandemic, and what was amazing for us in the wholesale space was no surprise that the tremendous surge in demand from both the patient and our dispensing pharmacy customers.

Just to get a little bit of perspective: We would typically ship about 4.3 million products on a daily basis, and literally overnight it increased by almost 50% to 5.6 million products. So, we saw the impact and the response of our customers immediately when a couple of things were happening. So again, when we started to go into lockdown, you started to see health plans that were allowing their patients to get 60 and 90-day prescriptions filled, and filled at retail, which drove a lot of the demand up.

So again, you saw a tremendous surge, and for us to make sure that we were equipped to be able to meet that surge for our customers as they were building inventory as their patients were coming in and really stocking up. So, I think that was one of the biggest things for us and seeing that immediate impact.

Now what's kind of interesting around that is there was a couple other dynamics that were happening at the same time. With that increased demand at retail, we did see—and quite honestly have continued to see—mail order grow in light of people trying to minimize contact, so mail order seemed to be [a good] option.

So, I think our retail customers were making sure they were prepared to meet the demand, and at the same time, trying to understand what was the dynamic and the behavior of the customer going to be short and long term.

I think quite honestly a lot are still trying to figure out what is the change of the behavior of the patient today, and why we certainly are seeing store traffic come back up in a lot of our retail customers. You know, there are still parts of the country that that are still pretty locked down and foot traffic is still challenging for some of our customers.

So, I think they all did a great job, and thank god that the wholesale channel in general was there to support the customer to get product in. I think really what's going to be the longer-term challenges is what is the experience of the patient going to look like in the future, and how do our retail customers respond to what could be some changing dynamics and changing consumer behavior.

Alana Hippensteele: Yeah, absolutely. What are some issues large retail pharmacies have been managing in relation to distribution during the pandemic, and how have pharmacies been able to overcome these issues?

George Rafferty: Yeah, it's a great question. I think one of the things become really apparent is that the role of pharmacy is and is going to continue to be more important in the community, which is a good thing.

We all hear that our pharmacist is our most trusted advisor, which is great. I do think that, even prior to the pandemic, but through the pandemic and going forward, I think the role of the pharmacy in the community is going to become ever more important. I think as we're seeing COVID-19 vaccines being rolled out, there's a lot to be said about the pharmacist having knowledge of his or her patient and who are those that need to have COVID-19 treatment.

So again, I think that the role of pharmacy is going to do nothing but be greater, for lack of better terms. I think in and our role in helping them is thinking about again how the patient's going to behave in the future, and how do we make sure that—and this is going to sound very simple—but the right product is there at the right time for when that patient comes in.

So, I do think there's going to be a lot of need for better analytics of understanding who the patient is when he or she is coming in what's the timing of that to make sure that this forecasting model really matches up to the forecast, and us being able to make sure that we're having the supply on there for when their patients come in.

So, I think that's really something that's going to be really important going forward, and not that it hasn't been in the past. But I think COVID-19 has really heightened the need for us to really have good data and insights into prescriptions, patient behavior so we can be as proactive in making sure that the pharmacist has the product when the patient comes in, and we play our role in working with pharmacy to make sure that we have enough information to make sure that we're there to meet the demand when they need it.

Alana Hippensteele: Yeah. Has the perspective of large retail pharmacies regarding the needs of individual communities changed in light of the pandemic? And if so, in what ways?

George Rafferty: Yeah again, I think the comment I made earlier is I think that the role or the position of pharmacy and pharmacist has become even more accentuated. I do feel that people are going to become even more reliant on the pharmacist.

I can only speak from my own experience: I have an elderly mother who really locked herself down during the pandemic. I can't talk about the name of the pharmacy, but the pharmacist's name was Dave, and she really relied heavily on him, and it was all done by phone to really help her navigate her medications during this time period.

I think [the pandemic] is enhancing more and more that patient-pharmacist relationship, I think it is just further enhanced by this, and I think it's going to continue down that path. People are getting used to going in now and getting vaccines, and they've gotten flu vaccines in the past, and now many retail pharmacies are providing the COVID-19 vaccines and travel vaccines when we can all travel again. I think that the pharmacy is going to become kind of the epicenter of community that's delivered and supported at a local level.

Alana Hippensteele: Yeah, absolutely. What are some of the ways large retail pharmacies may be expanding their role in community care moving forward, and what challenges may they face in these efforts during the pandemic?

George Rafferty: Well, I think this is a really great question. I feel like every time you ask me a question, I tell you that it’s a great question.

But I think that the importance of the pharmacists in the consultancy role that they're going to play with their patients—again, the example I gave of my mother—I think there's going to be more of that.

I think, let's face it, there's a lot of challenges in retail pharmacy today, including tremendous reimbursement pressures, cost to fill being a challenge oftentime, is being able to be operationally efficient to allow the pharmacist to do what he or she does best, which is practice at the top of their license. I think there's going to be a continued demand on that, and I mean that in a good way, for the pharmacist to provide their services, while at the meantime being able to manage a lot of the operational and reimbursement pressures that they're faced with, and how is there a system out there that allows them to really focus on the clinical aspect of their job, and not have to worry about their job. You talked about the role of the wholesaler, we want to make sure that the pharmacist never has to think about: Does he or she have product up on the shelf.

So, if we can check that box as a wholesaler for the pharmacist, that allows he or she to spend more time at what I think will continue to be the focal point of pharmacy, which is the clinical aspect of it. I think we got to have to continue to find ways that we take some of the reimbursement pressure off these pharmacists, so they're not spending time trying to make sure that they get reimbursed with a product that they're trying to find the best price for the product out there, and they're spending time more on what I would call kind of those administrative tasks versus what again what I think will become more of a demand or want from the patient from more of a consultation standpoint.

Alana Hippensteele: Yeah. Moving forward, what do you believe will be the lasting impact of the COVID-19 experience for retail pharmacies?

George Rafferty: Well, it's a really great question. I think there are a lot of questions that are yet to be answered, and this is one of the things that we're trying to help our customers understand. Again, I don't think we know what the lasting impact is going to be on patient behavior.

So, I know myself as a consumer, many of the ways I consume now are very different than the way I acted as a consumer prior to COVID-19. I'm not just talking about prescriptions and health care, really everything in my life has changed in a way, and in some ways, it's made things a lot more convenient.

So, I think that there are things that I know I personally as a consumer will probably do differently once we're kind of out of this, and I think that's going to be a little bit of the question for our retail pharmacy: What does the patient expect and want from me now post-COVID-19. How and where I pick up my medications, what type of consultancy services am I going to want from my pharmacist, how do I manage foot traffic coming into my location versus meeting the patient where he or she wants to pick up their prescription. I think a lot of those are still unknown.

Listen, I always believe that there's going to be a place where a consumer is going to want to walk into a retail location. When we come out of this and move away from social distancing, which I actually heard someone the other day say physical distancing is probably the better word to use, but I think people are going to flock back into retail spaces, restaurants, etc, once they're allowed to.

But I think it may be different, and how often they do it could be different, and I think that's really one of the big questions and the challenges right now is what's it going to look like once this is over and people feel really comfortable to go out and interact on a regular basis. So, I think it's a little bit of the unknown right now.

But I'll tell you what I've seen as retail pharmacy has really responded tremendously already on figuring out how they navigate through what is COVID-19 today by providing enhanced services to their patients and more options for picking up their prescriptions, or can they combine their prescription with an [over the counter (OTC)] item.

So, I think in a lot of ways we've already seen retail pharmacy try to respond back, and if it's curbside pickup or the drive-through, which we've had for years, but I think more and more patients are probably using drive-through. I mean we're seeing drive-through COVID-19 tests right now, and I think that's going to continue; people really are going to expect convenience out of this.

That could be a convenience in the store, or convenience in another way, but I think people want convenience coming out of this, and they almost expect it because, we did find that as horrible as this has been, there have been some services that actually have improved. So, I think it's kind of figuring out that balance going forward.

Alana Hippensteele: Yeah, absolutely. Thank you so much for taking the time to speak with me today, George.

George Rafferty: I appreciate it, thank you very much.