As pharmacy moves in the direction of patient-centered care, immunization plays a key role in this shift.
Offering immunization services in the pharmacy is a key part of a shift in focus from providing pill-centered care to providing patient-centered care, explained Victoria Hennessey, PharmD, owner at the Community Pharmacy of Springdale, during a presentation at the National Community Pharmacists Association 2022 Annual Convention. That is where the role of the pharmacy within health care is headed, according to Hennessey.
“That's why you all are here—because that is where we're going,” Hennessey said. “You got to think about the patient as a whole and their needs as a whole.”
When considering the reasons for offering a robust vaccination service in a pharmacy, Hennessey explained that there were a few key areas that stood out to her regarding why it was important for her pharmacy. Specifically, it helped to remind her and her staff of the reasons they went into the pharmacy field in the first place—to serve patients and communities.
“[To do that,] we want to make sure that they're protected against vaccine-preventable illness,” Hennessey said. “Also, during the COVID-19 pandemic in the vaccine rollout, it showed our professionals’ dedication to public health and preventive health. We've seen what a big impact we can make in that arena.”
Additionally, Hennessey noted it’s also okay to offer immunization services to help the pharmacy’s financial bottom line as well. Specifically, with declining reimbursements remaining a problem for many pharmacies across the country, vaccines are a lucrative service that can help fill in for financial challenges the pharmacy may be facing.
“So when you're thinking about, ‘Well, what does my community need,’ or when you're thinking about what vaccines you're going to offer in your pharmacy, you can actually go to the CDC’s website and go to VaxView. You can drill down by your state, your county, and see what the vaccination rates for certain vaccines are,” Hennessey said.
Hennessey noted that the latest data used by the CDC for VaxView is from 2020, with the immunization rates showing that there remains room for improvement. Specifically, when looking at data on pneumococcal vaccine coverage in the United States as a whole, she found that approximately 70% of patients aged 65 years and above were covered in 2020 for pneumococcal disease.
“That's still 30% of patients that need vaccinating,” Hennessey said. “But when we change that to [age] 18 to 64 [years], in patients who qualify or who need a pneumococcal vaccine—so we're talking about our diabetic patients and patients with asthma, COPD, and other conditions that put them at higher risk for severe pneumococcal disease—it’s 29.2% [who are covered].”
With 70% of qualifying patients under the age of 65 who are not receiving this vaccination, there remains a need for providing greater attention to pneumococcal vaccinations in this patient population, Hennessey explained. To understand how to approach addressing this issue, Hennessey decided she needed to first assess how many of their patients who were coming to their door to pick up prescriptions every month also needed vaccinations.
“We had a fourth-year pharmacy student do a research project and estimate how many vaccine opportunities we have within our current population and then create a business plan to grow them,” Hennessey said.
Using these data, they were able to estimate the average gross profit (GP) per vaccine among qualifying patients to assess the potential.
“This is something our software specifically does. We were able to create categories of patients who qualify: patients with diabetes, patients with asthma, or patients getting corticosteroid inhalers,” Hennessey said.
Her team then narrowed down the dataset even further by focusing in only on qualified patients who had not received a vaccine at their pharmacy, who had picked up medications in the past 3 months, and who had commercial insurance or Medicare.
“When we find out the results, I just about fell out of my chair,” Hennessey said.
For zoster vaccinations, the potential GP was $60,035; for COVID-19, $187,479; for pneumococcal, $15,183; and for Tdap, $42,880. Counted together, this was $305,577 in gross profit being left on the table.
“So you can see here just by looking at what our potential GP was, we have to do something,” Hennessey said. “This is an opportunity.”
Hennessey V, Hittle A. Every Shot Counts: Boosting Immunization Efforts. Kansas City, MO: National Community Pharmacists Association 2022 Annual Convention; October 3, 2022.