HealthOctober 14, 2019

Survey shows satisfaction with pharmacist discussion – but what’s next?

Results released last month from the 2019 J.D. Power  U.S. Pharmacy Satisfaction Study showed that patients enjoy visiting brick-and-mortar pharmacies and find a great deal of satisfaction from talking with their pharmacist. More specifically, nearly 90% of patients surveyed in the annual report said they communicate with the pharmacist and staff in-person.

Author: Marsha K. Millonig, MBA, BPharm

The 2019 U.S. Pharmacy Study measures customer satisfaction with brick-and-mortar and mail order pharmacies based on responses from 12,059 pharmacy customers who filled a prescription during the three months prior to the survey period of May-June 2019.

On a 1,000-point satisfaction scale, patients gave high ratings to their interactions with pharmacists:

  • 940 points when four or more issues were discussed
  • 917 points when two issues were discussed
  • 884 points when one issue was discussed

This does not surprise me given my experiences working as a pharmacist in a variety of settings over the past 25 years. When I am practicing at the pharmacy, I try to help at the will call window whenever possible because it allows for interactions without the pharmacy technician needing to ask the patient to step into the counseling area and having me visit there. At the window, I can tackle both dispensing and counseling duties at one time.

Observations from behind the counter

Patients are hungry for information. Several times a year, I make a mental note to track the questions I am asked during a pharmacy shift. The variety might surprise those unfamiliar with the day-to-day in the pharmacy environment. Last week during one short shift, on the OTC front alone, I was asked about:

  • The best type and dosage form of vitamins for a pediatric patient and what determined quality
  • What treatment a parent could try for allergies in a 2-year old child
  • The difference between several denture adhesives and dosage forms
  • What drug interactions existed for a dog being treated for a chronic condition with more than one medication
  • Which probiotic might work best for an adult patient being prescribed an antibiotic
  • Which product would be best for a sprained ankle and how to use it

Pharmacists are indeed the most accessible healthcare professional, and most of our counsel is provided to the patient at no cost. The counseling provided with a prescription is not separately compensated by the patient. Yet, in these times of decreasing reimbursements and continued pressure on pharmacy margins from direct and indirect remuneration (DIR) fees, lower-than-product-cost payments, and inability to service the patient’s entire medication needs due to some medications coming from specialty pharmacy, patients are still able to access and receive advice from pharmacists at nearly every corner … for now.

I wrote in May about the correlation between pharmacy closures and decreased medication adherence. State pharmacy association executives have talked about the calls they are receiving from owners desperately trying to keep their doors open. And it is not just independent pharmacies that are being impacted:

  • Shopko shuttered more than 300 stores earlier this year
  • Walgreens announced they would be closing 200 locations
  • CVS announced 46 closures
  • Several Lunds & Byerlys pharmacies closed their doors last month

Pressure continues to mount and the long-awaited and long-debated rebate and DIR reform rule was  by two high-level Trump administration advisors. The pharmacy community continues to pursue the reform, and we will need to wait and see on a viable solution.

Operations and staffing levels are being managed extremely tightly in response to this pressure. It is an increasingly rare occasion when I pick up a shift during which things are not behind or the daily pressure to keep up is not great. In the meantime, flu immunization season is upon us, and the goal to provide this important service is being emphasized in the pharmacy community. People have come to expect this important public health service from their pharmacist. This increased demand for services is being accomplished with the same resources we had before the traffic and need swelled. In the long-term, this balance is not sustainable. How long before patient satisfaction J.D. Power reported decreases?

Future outlook

There are some breaks coming. This week, the FDA has announced it is delaying enforcement of the Drug Supply Chain Security Act’s (DSCSA) return requirements on wholesalers to ensure all returned product has the barcoded product ID. I imagine this may also be pushed back for pharmacy/dispenser compliance next year.

Additionally, the United States Pharmacopeia (USP) announced this week that the effective date for new revisions made on June 1, 2019, to <795> Pharmaceutical Compounding – Nonsterile Preparations and <797> Pharmaceutical Compounding – Sterile Preparations, as well as a new chapter <825> Radiopharmaceuticals – Preparation, Compounding, Dispensing, and Repackaging has been postponed indefinitely until their appeals process has been completed. USP received appeals on certain provisions in <795>, <797>, and <825> from a broad range of individuals and organizations. My understanding is there is significant disagreement in the pharmacy community about changes to beyond use dates on one of the monographs among other key issues. Now, following its bylaws, USP will follow an appeals process which includes postponing the official date of the monographs. Stakeholders who submitted appeals on the compounding chapters have requested further review by an appointed panel.

Stay tuned on all fronts. I’ll keep you posted in the weeks and months ahead.

Marsha K. Millonig, MBA, BPharm, is president and CEO of Catalyst Enterprises, LLC, and an Associate Fellow at the University of Minnesota College of Pharmacy’s Center for Leading Healthcare Change.

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