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    Big-Box Pharmacy on the Rise

    Big-box merchandisers, including supermarkets, employ thousands of pharmacists and offer higher-than-average salaries.


    Status Quo

    Big box pharmacy brings pharmacists the promise of working more closely with patients and other departments to improve nutrition, introduce wearable devices that can monitor and encourage more physical activity, and conduct regular health screenings. Because big box retailers are among the largest providers of in-store medical clinics, there is even potential to work directly with other health-care providers.

    But it isn’t happening.

    Big box pharmacies are following the same business model as chain pharmacies. Pharmacy revenue is dependent on Rx sales and cash flow is at the mercy of pharmacy benefit managers and insurers. Filling a script for a common, multi-source generic for $4 to a cash patient could more profitable than filling the same script for a third part payer.

    Big boxes are also discovering that pharmacy is not an automatic competitive advantage. Nor are market-leading pharmacist salaries.

    Earlier this year, March Supermarkets, a regional Midwest chain, closed all of its in-store pharmacies. Pharmacy operations and inventory were sold to CVS.

    CVS bought Target’s in-store pharmacy and health clinic operations in 2015.

    Related article: The changing face of pharmacy

    “It’s all about the three M’s, money, marketing and metrics,” said Fred Mayer, RPh, President of Pharmacists Planning Services, Inc. and member of the Drug Topics Editorial Board. “Prescriptions are just one more widget and the goal is to sell as many of them as you can, as cheaply as you can. Whether you’re a drug chain or a big box chain, you have a fiduciary responsibility to your shareholders.”

    How big boxes view their responsibilities to employee pharmacists varies. Mass market pharmacists are generally positive about salaries, although working conditions can be less than ideal.

    “We have spent the last eight negotiating sessions chastising the chain over safety violations,” said Mark Rauss, PharmD, Treasurer and member of the negotiating committee of the Independent Pharmacists Association, which is negotiating a new contract with one of Kroger’s supermarket chains in California. Kroger declined to comment for this article.

    “It’s not about money, it’s all about working conditions and staffing levels,” Rauss said. “We want to help our employees make money in a good working environment. That’s tough when chains are being squeezed on reimbursement. The reality is that if the employer loses, employee pharmacists lose, too. Grocery chains are looking at stores without pharmacies.” 


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