Alex Berce, president of Good Value Pharmacy with four locations in Wisconsin, has been routinely gaining new patients since he began offering a rare pharmacy service: long-acting injectable medications. Most of the drugs in this class are antipsychotics, such as Invega, Abilify, Aristada, and Risperdal, and patients must receive them at a healthcare provider.
A few years ago, Wisconsin authorized pharmacists to administer injectables, which opened the door for new business. Prescribers, who are typically psychiatrists, were relieved to get the injections off their plates, and Berce was eager to take them on. Now the pharmacy administers more than 20 injections every month.
Berce didn’t have to do much to start generating interest. The first thing he did was track down all the psychiatry offices in the area and give each of them a ring. After that, word spread on its own, and since then referrals have continued to provide a steady stream of new clients without the need for additional marketing. He is one of the only providers of injectables in his area, so patients naturally funnel to his pharmacy. And his reports to the prescribers serve as free advertising, keeping his pharmacy top of mind.
″Word spreads pretty quick, especially when you’re routinely sending doctors the confirmation of the injection,” Berce said. ″After giving the injection every month it’s a reminder that Good Value just did this again for this patient.″
Growing his patient base
In terms of revenue, some manufacturers will pay a fee for administering the injection, but generally the injections are not a great source of income on their own. Most of the drugs are brand name, and payment runs through third parties, so they suffer from low reimbursement and DIR fees just like any other prescription.
The payoff of the service is the substantial boost in prescription volume. Berce hooks patients with the antipsychotics but nets their entire medication profile for the long term. Most prescribers don’t want to administer these drugs, so Good Value has almost total exclusivity on these patients. They don’t have to worry about competing with a chain pharmacy or big box store, either. And these patients, Berce said, are typically on several other medications, which they often end up transferring to his pharmacy.
To get those prescription transfers, Berce said it’s important to start building the relationship with the patient right away. ″I think part of the solution to making it work from an overall financial standpoint is talking to the patients after you’ve given the shot, developing a rapport,″ he said. And by the second or third injection, go ahead and ask them directly if they’d like to transfer the rest of their prescriptions.
In addition to antipsychotic injectables, Good Value offers Vivitrol, a drug that prevents relapse in patients recovering from opioid addiction. The general upshot for this drug is the same as the antipsychotics except that it takes a bit more work—patients need to submit a urine sample before they get the shot to prove they’ve been opioid-free.
Not every state allows pharmacists to administer injectables. At least 11 states do not, and 7 require a collaborative practice agreement. Pharmacists interested in offering injections should check with their state board of pharmacy.
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