Diagnosis
Formulary preferences and pharmacy benefit designs have major influence over your success

Prescription
Understanding the world of pharmacists will get your brand’s prescriptions filled

In today's healthcare marketplace, in which drug reimbursement is often dependent upon formulary preferences and pharmacy benefit designs, retail pharmacists may influence whether a prescription written for your product gets filled. Bottom line – this is why you need to understand the world of retail pharmacy. Sales and market share are measured by prescriptions filled, not written. Thus, to succeed in getting your products filled, you need to pull through your products at the point of sale.

Who are retail pharmacists?

Generic vs. brand-name substitution

Retail pharmacists are highly trained, licensed healthcare professionals who work in pharmacies open to the public (e.g., chain drug stores, independent drug stores, and supermarket and mass-merchandiser pharmacies). In order to practice and become registered in the United States, pharmacists must have graduated from a school of pharmacy approved by the state board of pharmacy or accredited by the American Council on Pharmaceutical Education (ACPE). Pharmacy school graduates planning to become retail pharmacists today enroll in a Doctor of Pharmacy (PharmD) program, which includes extensive scientific coursework as well as experiential rotations. To become licensed, pharmacy school graduates must pass the North American Pharmacist Licensure Examination (NAPLEX), administered through the National Association of Boards of Pharmacy. Registered pharmacists carry the initials RPh (which stands for Registered Pharmacist) after their names.

What do retail pharmacists do?

Retail pharmacists have a number of important roles and responsibilities, which include:

• Conducting drug-utilization review (DUR) and claims adjudication to identify clinical and reimbursement issues
• Addressing clinical and reimbursement issues prior to filling prescriptions
• Dispensing prescriptions
• Providing cognitive services to customers.

Let's look at each of these responsibilities in more detail.

DUR and claims adjudication: As part of the process entailed in filling a prescription, a pharmacist typically begins by entering the prescription into the pharmacy's computer system. Through the computer system at the pharmacy, a pharmacist can check to see whether there are any clinical or reimbursement concerns involved with filling a prescription for a particular patient. DUR identifies clinical concerns (drug-drug interactions, contraindications) associated with filling a prescription for a specific patient, while claims adjudication identifies reimbursement issues (step therapy, prior authorization).

Retail pharmacists as marketplace experts

Dispensing prescriptions: Once pharmacists have cleared DUR and adjudication hurdles, they can take the next step and dispense the prescription. Many pharmacists dispense prescriptions themselves. In larger pharmacies, such as chain drug stores, pharmacists may supervise pharmacy technicians and thus delegate some dispensing responsibilities to those pharmacy technicians.

Providing cognitive services to customers: In addition to working with healthcare plans and prescribers, pharmacists also communicate directly with their customers. Pharmacists provide their customers with information about prescription and over-the-counter drugs, disease states and prescription-reimbursement information. Some work with managed-care plans and prescribers to help manage the medications of patients who take several prescription drugs to treat chronic conditions.