Online veterinary pharmacies: Friends, not foes

Shutterstock.comWhen it comes to online pharmacies, pet owners have a plethora of options. We veterinarians typically have a pile of prescription requests sitting in our fax machine every day that have to be sorted and signed. My favorite is when I have to deny a request from a patient that has died or hasn't been seen for five years. Clients love that.

But however we feel about online pharmacies, they're here to stay, and the next logical step is to figure out how best to utilize them to improve client convenience, patient care and practice profitability.

Making compliance convenient

Denise Tumblin, CPA, a frequent speaker at the Fetch dvm360 conferences, says online pharmacy platforms are a powerful weapon in the fight for client adherence. Because as we all know, once a pet owner walks out our door, our influence over their activity fades quickly. We only have to ask clients why they still have five heartworm tabs left over at their annual visit to be reminded that what we tell them to do (give it year round!) isn't what they decide to do (only give it during the summer!).

One way to encourage client adherence to our recommendations is to make things easier and more convenient for them, especially when it comes to therapeutic diets and preventive care products. An online pharmacy is one of the best ways to do this, Tumblin says. Want proof? A 2012 study in human medicine found that patients who used online pharmacies had higher rates of medication adherence compared with patients who did not, meaning that online pharmacy users followed prescription instructions better.1

Now just wait a minute. I can feel open minds slamming shut-hear me out!

In a research project Tumblin conducted recently for Vets First Choice, 10 practices were examined to see how heavy use of online pharmacy platforms affected client adherence and practice profitability. In the study, the practices moved low-margin items, including therapeutic diets and preventives, to their online pharmacies. The results? Practices averaged 14 percent growth equivalent to $88,000 in added revenue per FTE veterinarian. They also noted better compliance with diet and medication recommendations, resulting in better patient care. Some of the platforms had the added benefit of alerting the practice when clients failed to refill their prescriptions, which allowed the clinic to follow up.

Boosting profitability-yes really!

But what about the margin? Those online pharmacy companies aren't providing their services for free. Don't we lose out on profit when we move pharmacy items online-and then fork over a cut to Vetsource or whoever is our platform of choice?

Not necessarily, Tumblin says. The pharmacy study group averaged 22 percent margin from the online items included in the study. Practices in Tumblin's Well-Managed Benchmarks Study average 21 percent margin from online pharmacy items.

Still not convinced you'll make up the loss in revenue? Don't forget the intangible costs associated with stocking inventory items. Veterinary consultant Marsha L. Heinke, DVM, EA, CPA, CVPM, says it costs a practice approximately 40 percent more than the invoiced amount to stock items in house, according to Tumblin. This cost is for labor associated with placing the order, moving the inventory, stocking the shelves, entering inventory into the computer, filling refills, answering phone calls about refills and setting up refill reminders. There's also shrinkage-ruined or expired products and theft. And, finally, there's the up-front capital investment necessary to stock an in-house pharmacy.

All of those costs go away when you sell through an online pharmacy. When you do the math and include the intangibles, Tumblin says, moving diet sales to an online pharmacy saves costs and improves profit over stocking in house.

Furthermore, she continues, staff members like online pharmacies because they can focus more on patient care and less on inventory and pharmacy duties. Tumblin encourages practice managers and owners to think honestly about how much staff time it takes to get a medication refilled by phone, from start to finish, and determine if that time could be used more profitably doing things like nail trims, laser treatments, blood draws, nutritional counseling and so on. How could you be using your team members' time if they weren't dealing with inventory on low-profit pharmacy items?

Living in an Amazon Prime world

Here's Tumblin's own story: She owns several pets and all of them are on therapeutic diets for one reason or another. For her, going to the clinic to get food is a hassle because if she doesn't call ahead, the clinic doesn't typically have it in stock. So the clinic has to order the diet, she has to go back, and in the meantime she's run out of food. By moving her orders to the clinic's online pharmacy, she reduces her own frustration, follows her veterinarian's dietary recommendations more closely, and saves time.

Face it. Our clients want convenience. They don't want the hassle of driving down to the clinic to pick up meds. If I'm honest, I want convenience. My husband thinks I'm an Amazon Prime addict. In fact, ordering on the computer is sometimes too much for me, so I have dash buttons. Out of toilet paper? Press the button and voila! Toilet paper magically arrives at my doorstep in two days with free shipping. As a busy mom of three kids with no time to deal with the lines at Walmart, I am grateful. Dash buttons save our bums from paper towels.

This is the world our clients live in, and we have to get on board or run the risk of the train leaving the station without us. It helps to know that adding pharmacy convenience adds value to the services we provide our clients, enhances our ability to care for patients, and even grows our practice's financial health.

Now if you'll excuse me, I have to go order more toilet paper.

References

1. Hou JG, Murphy P, Tang AW, et al. Impact of an online prescription management account on medication adherence. Am J Manag Care 2012;18(3):e86-90.

Dr. Sarah Wooten is a certified veterinary journalist, frequent contributor to dvm360.com and regular speaker at the Fetch dvm360 conferences. She divides her professional time between small animal practice in Greeley, Colorado, public speaking, and writing for both veterinary and pet owner audiences.