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Immunizations: New Revenue for Pharmacies; Grateful Patients

by Kevin Schweers | Jan 19, 2016

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Nearly all independent community pharmacies must develop niche services to generate revenue streams that are not tied to prescription drugs and which satisfy important patient needs. To help address this NCPA established a Diversified Revenue Opportunities Web page and this blog post spotlights how one community pharmacist established—and is expanding—one of these opportunities: immunizations.

We profiled three community pharmacists and their active immunization practices in the August issue of America's Pharmacist. Recently we asked these pharmacists what's new regarding immunizations and what they'd advise a fellow community pharmacist whose pharmacy does not currently offer this service.

The following is our discussion with Gretchen Kreckel Garofoli, PharmD. She's both a pharmacist at Morgantown, W.Va.'s Waterfront Family Pharmacy as well as a clinical assistant professor at West Virginia University School of Pharmacy.

NCPA: You were interviewed around June 2015 for America's Pharmacist. What's new in the immunization practice at your pharmacy since then?

Garofoli: Since June 2015 we have continued to give a lot of Prevnar vaccines (numbers with this vaccine have skyrocketed over the past year) and have been busy administering influenza vaccines at the pharmacy and at off-site clinics over the past few months.

NCPA: How is the current influenza immunization season going so far?

Garofoli: Although our pharmacy's influenza immunization numbers are down slightly from last year's season, we have still given a large number of influenza vaccinations. We are continuing to promote the vaccine to those who come into our pharmacy. Potential reasons for lower numbers of influenza vaccines administered in the pharmacy are changes in insurance coverage for some of our patients (their new insurance only covers the vaccine at their physician's office) and the belief that the flu vaccine "doesn't work" as many people heard of the low efficacy of the vaccine for the 2014-2015 season and even after providing education to these patients they are still unwilling to receive it.

NCPA: What do you (or would you) say to a fellow independent community pharmacist who does not offer immunizations in their pharmacy?

Garofoli: Immunizations are a great source of revenue and help to keep you competitive in the pharmacy market as many pharmacies offer vaccines. By giving immunizations, it is a great way to reach patients who may not have a regular physician that they see, so you are helping the public health effort by ensuring that these patients are up-to-date with recommended immunizations. With the expanded hours that community pharmacies offer it is easy for a patient to stop in and receive the vaccinations that they need without an appointment. With many states giving pharmacy interns the authority to administer immunizations, your interns could play a big role in growing this service in your pharmacy.

NCPA: What resistance or biggest problems did you encounter when starting (or expanding) your immunization practice? And how did you overcome those?

Garofoli: One of the biggest problems in our state is the limitations imposed by our laws and regulations regarding pharmacist provided immunizations. To overcome this obstacle, we advocate for pharmacist provided immunizations at the state level to expand the number of vaccines that we can administer as pharmacists.

NCPA: In some areas the national chain pharmacies and supermarkets heavily market their flu shot offerings. Is that true where you live? If so, how do you compete with that?

Garofoli: We have a very loyal patient base and many of our patients will get their influenza vaccines from our pharmacy although there are some who will go to the supermarkets so that they can get their "loyalty perks". The number of our patients who decline vaccinations at our pharmacy due to the marketing campaigns of the chains and supermarkets is very low. With regards to competition for the influenza vaccine, one of the main competitors in our area is a hospital that sends nurses out to numerous area businesses, senior centers, and other civic organizations for influenza vaccine clinics.

NCPA: Have you noticed any changes with regard to health insurance plans covering pharmacist-administered immunizations? Can you give a rough approximation of how many do cover it?

Garofoli: Many of the health insurance plans in our area cover pharmacist-administered immunizations, but there are some that only cover the vaccine at physician offices. We are able to paper bill using the CMS 1500 forms for one of the main insurances in our state, which takes time and effort, but it is worth it to make sure that our patients are taken care of at our pharmacy.