Essay 25
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written by carpediem2100  June08/2006

An alternative market model may be the solution for improving the profession
of retail Pharmacy.  As discussed in a previous essay, Essay 23, the current model
consists of profit tied to prescription volume.  This leads to a disincentive to 
remove customers off medicines.  It also results in no motivation for the pharmacist
to spend time to review customers' drug-history.  For instance, allocating time towards 
selling more prescriptions, (or widgets), results in more money; whereas spending time 
checking for drug-related problems or drug-interactions adds no money to the "bottom line".

	Here is a draft of the model
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Step1:	Sell drugs at little or no profit.  Drugs should be sold to the customer at
the same cost as the drugstore gets from the supplier.  It would not be unreasonable
to factor in a small mark-up in price to offset carrying charges. Perhaps 3% - 5%
should be added on? (I haven't worked out the math to what the percentage should be.
Maybe, the percentage should be 0%, if the model allows it).

Step2:	Associate a clinical fee for the service of a clinical review.  Each time a
review of the drug-history/drug-profile is performed, the pharmacist shall charge a
fee.  To take this concept to a further extreme, a fee shall only be incurred if the
result of a clinical review results in catching a problem which benefits the customer
(this may not favor the "cash-register" of the drugstore though).

Step3:	Make the clinical review service optional.  Customers who wish a review will
request it and be obligated for the costs.  Customers are not forced to have this
clinical service against their will.  To illustrate this:  Mrs. Jane Doe has been
taking blood pressure "pill X" for 9 months.  The last time she had her prescription
filled was 2 months ago, when at that time she requested a drug-profile review and
she paid for it and the pills.  She now comes into the pharmacy for a refill of "pills X" 
and has no medical complaints or questions.  Nothing in her life/lifestyle has changed 
and she says her recent discussion with the doctor was reassuring.  Jane indicates she
does not wish a review done and thus is only charged the cost of the drugs with 
little or no financial markup.  In this instance, Mrs. Doe saves money.



- The financial transaction aspect of selling drugs to the customer, whether it be by cash, 
credit card or drug insurance can be handled by pharmacy assistants or technicians.
- The distribution aspect of selling drugs to the customer can be handled by
pharmacy technicians or robots.
- The clinical review of the drug-profile, or other clinical related questions should
be handled by pharmacists.

Ideally a working model will favor the customers' health, and finances.  The pharmacy
would not lose money.  The pharmacy would make a reasonable profit but not an absurdly
high profit considered to be highway robbery.