- CONDITION CENTERS
Supermarkets have become the neighborhood pharmacy for many Americans. Pharmacists who choose to practice in a supermarket chain are finding that the professional services they provide their patients rival the programs available in other community pharmacy settings.
Pharmacies are now a mainstay in the supermarket industry and they are the fastest growing segment of retail pharmacy, according to the Food Marketing Institute (FMI). The number of supermarket pharmacies has grown by more than 60% over the last 10 years.
“Supermarkets have increased the number of prescriptions they fill each year for the last 4 years and we expect that trend to continue,” said Cathy Polley, RPh, vice president of health and wellness at the FMI.
Chains such as Roundy’s, which operates Pick ‘N Save, Copps, and Rainbow Foods supermarkets in the Midwest, are committed to growing their pharmacy business. Roundy’s, which has nearly 90 pharmacies across its divisions, has plans for rapid pharmacy expansion, with the goal to eventually bring a pharmacy to each of its stores. The chain says it is committed to creating pharmacies that are true community health centers staffed with knowledgeable and caring professionals.
More pharmacists are choosing to practice in a supermarket setting because of the professional services the chains are offering their patients. Supermarkets are positioning their stores as health and wellness hubs for their customers— and they are expanding the variety of services they offer to their patients. Not only are the services comparable to those found at traditional drugstores, they can often be more extensive.
Expanding Patient Care at Kroger
Supermarket pharmacists are not only filling prescriptions, they are providing counseling and medication therapy management services. The trend toward offering more patient services is expected to continue and expand. “We continue to see the growth of medication therapy management services, with supermarket pharmacies embracing this important patient service,” said FMI’s Polley.
The Kroger Company, which operates a number of chains including Kroger, Ralph’s, King Soopers, and City Market, has expanded its patient services to include a number of overall health and wellness initiatives. Kroger pharmacists routinely steer customers interested in decreasing their overall morbidity/mortality risk conferred by chronic disease to the chain’s Smoking Cessation and Fitness, Nutrition, and Weight Management programs.
“The face-to-face individualized sessions of Diabetes and Heart Healthy Coaching programs provide self-insured employers with an alternative to telephonic disease management programs, and have yielded proven results similar to the well-known Asheville project,” said Bengy Mitchell, PharmD, pharmacy coordinator at The Kroger Company.
Most recently, in 2010, several Kroger pharmacies were recognized by the American Diabetes Association for providing a quality Diabetes Self-Management Education program. Kroger pharmacies are also a contracted provider for Medicare D medication therapy management for Humana and CCRx plans.
Hy-vee Grows in Specialty Pharmacy
Pharmacists who work in supermarket settings will continue to find new ways to expand their professional experience as supermarkets look to new ways to grow their pharmacy business. Specialty pharmacy is an area that Iowa-based Hy- Vee, Inc, which operates nearly 230 supermarkets in 8 Midwestern states, has recently moved into. A growing sector of the pharmacy business, specialty pharmacy comprised 5% of total prescriptions in 2003. By 2007, that figure had doubled to 10%, and it is expected to represent 20% of total prescriptions by the end of 2011.
Hy-Vee has identified specialty pharmacy as a key area and has teamed up with Amber Pharmacy, one of the nation’s largest privately owned specialty pharmacies, to form a new company that will provide more accessible services for patients dealing with complex and chronic health conditions. The joint venture, called Hy- Vee Pharmacy Solutions, is the first of its kind in the industry.
Patients with complex health care needs, such as patients with blood disorders, cancer, Crohn’s disease, hemophilia, and hepatitis, who often must deal with different pharmacy providers in multiple locations, will be able to obtain all of their medications and services from Hy-Vee Pharmacy Solutions.
Patients will be assigned a health care team— in which pharmacists work together with an enrollment specialist and patient care coordinator— to assist with insurance and financial administration, educational materials and resources, and follow-up care. The approach provides continuity of care—a major departure from the traditional care model. And it’s available at a patient’s local supermarket.
“Hy-Vee Pharmacy Solutions builds a bridge between 2 different segments of the pharmacy business,” said Bob Egeland, vice president of pharmacy operations for the chain, when the chain introduced the new venture. “We’re bringing together experts from retail pharmacy and specialty pharmacy to offer more convenient, more personalized service for patients with complex health needs.”
For pharmacists wanting to make a real difference in their patients’ lives, the resources provided through the Pharmacy Solutions business allow them to provide face-to-face medication management services as well as diet and nutrition services, already available at Hy-Vee stores.
Linking Health and Nutrition
Although the specialty pharmacy aspect of Hy- Vee’s program is groundbreaking, tying diet and nutrition to health and wellness is far from unusual in the industry. Supermarket pharmacy departments are uniquely positioned to provide patient services that center on health and nutrition— the channel has been marrying its nutritional expertise to its pharmacy departments for some time.
Pharmacists practicing in supermarket settings have the opportunity to work with other health professionals to create a whole health environment for patients—one that is certain to produce superior outcomes.
“With more people managing chronic diseases than ever before, and given the link between diet and disease, the supermarket pharmacist has become a solution provider for customers looking to manage their total health and wellness,” said Polley. Polley said supermarket pharmacists and dieticians routinely work together on instore programs for specific disease states and patient groups that help patients shop the store more healthfully.
“Pharmacists practicing in a large supermarket chain have the opportunity to educate patient beyond providing information about their prescription and over-the-counter medications,” explained Dr. Mitchell. “In the supermarket setting, pharmacists have hands-on resources available to counsel on therapeutic lifestyle recommendations, most notably, nutrition recommendations that will help patients reach their health goals,” he said.
“A patient filling a cholesterol medication may have questions about diet recommendations given by their physician—limiting saturated fats, adding plant sterols—and our pharmacists can go into the aisles with the patients to show them examples of foods that would meet these criteria, or how to interpret the nutrition label—reinforcing the recommendation of both the guidelines and their physician,” noted Dr. Mitchell.
Dr. Mitchell explained that Kroger pharmacists work with dietitians to provide grocery store tours as part of the chain’s Diabetes Self Management Education program and Fitness, Nutrition, and Weight Management program. The tours, which would likely not be practical in other settings, provide an opportunity to work collaboratively with other health care providers and allow patients to get very specific, personal answers to questions about their diet and nutritional needs.
Kroger’s new initiative, HealthMatters at Kroger, explicitly connects nutrition and health within the chain’s stores to combat the obesity epidemic by helping customers make informed decisions about the products they buy. Launched in the Lexington market in 2010, the program includes Nuval Nutrition scoring of products, input from in-store dietitians, educational pharmacy health stations, and monthly health/wellness events.
Hy-Vee recently launched Begin, a healthy lifestyle and weight management program that helps patients make informed diet choices. During private or group consultations in the 10-week in-store program, participants can work with instore registered dietitians to learn how to make healthy diet and lifestyle choices.
Rivaling Drug Chains in Public Outreach
Pharmacists practicing at supermarket chains are offering many of the same patient services offered at drug chains and community pharmacies across the country. Screenings, vaccinations, and discounted or free medication programs are just a few of the programs supermarket chains are providing today. For example, Kroger, which offers vaccinations at most locations, provides more than 1 million vaccinations annually. In fact, the chain was awarded the 2010 Immunization Champion Award from the American Pharmacists Association. Biometric screenings (total lipid panel, glucose, blood pressure, weight/ body mass index) are another key part of the chain’s offerings and are available at select locations and for contracted employer clients. Several divisions of Kroger also offer screenings for other conditions such as osteoporosis, depression, chronic obstructive pulmonary disease, and peripheral arterial disease, among others.
In addition to providing pharmacy services, a number of chains have added in-store health clinics, which are staffed with nurse practitioners or physician assistants who can diagnose common illnesses and minor injuries and prescribe medication for treatment when necessary.
Supermarkets have also been aggressive on the patient outreach front, offering discounted or free medications for their patients in need. Florida-based Publix, for example, offers a 14-day supply of many commonly prescribed generic oral antibiotics to its customers for free—regardless of the patient’s prescription insurance provider or the number of prescriptions the customer needs filled. %u25CF
Ms. Sax is a freelance writer based in Chevy Chase, Maryland.