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What Clinical Services Can My Retail Pharmacy Provide?

By Dr. Diana Rangaves, PharmD, RPh

Retail pharmacies are now experiencing a paradigm shift because the economic climate cannot sustain the old business model. Pharmacies cannot grow and scale by simply providing prescription drugs to patients. The new industry is forcing pharmacies to find new ways of servicing their customers because people are expecting more from pharmacies. So, how can a retail pharmacy respond? The best way is by adding clinical services and programs that can benefit patients. Let’s look at five clinical services that you provide at your clinic.

POC Testing for Strep and Flu

A pharmacy can provide several CLIA (Clinical Laboratory Improvement Amendments) waived tests, like the strep and flu tests. Suppose your state allows you to set up CPAs (Collaborative Practice Agreements) with physicians so that you can provide antibiotic and antivirus prescriptions. In that case, your patients can get these drugs after testing positive on the POC test. Patients are willing to pay $60 for flu tests and less than $50 for strep tests; instead of $300 in emergency rooms. Since you will improve access to care and help patients save money, it’s a win-win situation for the clinic and the patient.

It is also important to note that the POC tests carried out in pharmacies have limitations. For instance, there are flu-test shots done in pharmacies that exclude very young and old patients, those with pre-existing lung disease, and patients with a higher chance of developing flu complications. These patients need to go to their physicians for testing.

Immunization Programs

Communities depend on pharmacies for immunizations, but most pharmacies mainly focus on giving flu shots. There’s a growing opportunity for pharmacies to adopt the entire immunization needs assessment. According to NASPA (National Alliance of State Pharmacy Associations), 48 states, Puerto Rico and the District of Columbia allow pharmacies to dispense vaccines. But there are limitations to dispensing some vaccines due to age and vaccines that require a prescription. States with limitations on the types of vaccines pharmacists can dispense include New Hampshire, West Virginia, Wyoming, and New York.

As a pharmacy, when providing vaccines, you should always look at the state’s immunization registry while filling prescriptions. Additionally, you can use the CDC guidelines to recommend the dosage to a patient based on their diagnosis or prescription. It is also important to note that not all registries are robust. Some pharmacies use their training to administer vaccines while they seek patients to confirm if they have been immunized before receiving the vaccines.

Smoking Cessation Counseling

Most community pharmacies have patients who smoke, and they need to know that you can help them quit. There are multiple ways that pharmacies can run a counseling program for smoking cessation. In fact, states like Arizona, Arkansas, California, Colorado, Idaho, Indiana, Iowa, Maine, New Mexico, and West Virginia have statutes of regulation to address the prescription of tobacco cessation products by pharmacists; it is the role of the pharmacy to act as the patient’s accountability partner on their journey to quit smoking.

A good way to start is by creating a protocol where your pharmacy offers 30-minute consultations where you discuss smoking cessation options with the patient, like OTC nicotine replacement products and other prescribed drugs. When it comes to the cost of the service, an affordable consultation fee works while the insurance covers the cost of prescription drugs.

Contraceptive Prescription

There is a continued push across the country to allow pharmacists to prescribe hormonal contraceptives and reduce the number of unintended pregnancies. The states with statutes allowing pharmacists to prescribe contraceptives include Colorado, California, the District of Columbia, Hawaii, Idaho, Maryland, New Mexico, Oregon, Utah, and West Virginia. You can provide 30-minute consultations and provide the contraceptives afterward. The contraceptives can be refilled to cover a year, and patients must visit a health doctor every three years.

Diabetes Prevention Programs

For the nation to increase the accessibility of diabetes prevention programs, pharmacies are the best places to screen and follow up on lifestyle changes. To empower the pharmacy to deliver DPS, pharmacists and technicians need to be trained about pre-diabetes and how to manage it. Pharmacists provide great accessibility to the community in the United States, especially in rural and urban areas. And that is why retail pharmacies are the best propagators of the national diabetes prevention program.

Pharmacogenetic Testing

Pharmacists are trained in pharmacokinetics, drug metabolism, and drug transport. This knowledge makes them suitable to handle pharmacogenetic testing. The genetic differences in a patient’s metabolism can specify the type of drug that can work and the dosage. 

If drugs like mental health drugs are not effective on a patient, a pharmacogenetic screening can identify why it is happening. The test involves performing a buccal swab on a patient and then taking a lab test. Once the pharmacogenetic report is available, the pharmacist discusses the results with the patient before prescribing a new drug.

Wrap Up

If you plan to add new services to your pharmacy, first understand the local pharmacy regulations. If you do not stay updated with the activities in your state, things might move fast, and you might be left behind. By adding these emerging clinical services to your pharmacy’s offering, you will increase revenues over time. This is especially true as payers expand reimbursement opportunities based on the increasingly central role of pharmacies in community healthcare. Lastly, clinical services attract new patients to a pharmacy. So, a wide array of services can bring in more patients who can seek other related services.

Editor’s Note

EnlivenHealth® recently introduced Amplicare Clinical Solution, an integrated platform designed to help pharmacies launch, administer, and get paid for clinical services. Visit the Amplicare Clinical Solution page to learn more.