CVS’s announcement that it will stop selling tobacco products at its 7,600-plus stores this fall was a marketing masterstroke. It’s hard to find a flaw in a decision that improves customers’ health, aligns with a recent smoking cessation program announced by the Food and Drug Administration, and won immediate endorsement from President Barack Obama and Michelle.
Clearly, the strategic planners at CVS headquarters in Woonsocket, R.I., know what they’re doing. But divesting themselves of a product that kills you when used as directed is just the most visible piece of their plan.
Here’s what the nation’s second-largest drugstore chain is ultimately after: CVS wants to be your “go-to” basic health care provider. Moving beyond its existing in-store Minute Clinic concept, CVS wants to become an alternative to the family doctor.
It’s a simple game of numbers. The country does not have enough primary-care physicians to take care of all of the new patients projected by the Affordable Care Act. As many as 7 million newly insured folks may face a physician shortage.
In California, Gov. Jerry Brown last year signed into law Senate Bill 493, which will help expand the pharmacists’ role, making it easier for pharmacists to step in to fill this gap.
The law allows pharmacists to administer and dispense drugs without a prescription, in certain cases, and authorizes them to order and interpret some medical tests. It also officially sanctions “advanced practice pharmacists,” who will be able to do even more, including performing patient assessments.
All of this may surprise some consumers. Until recently CVS, along with its major competitors, projected a different image. Just look at Sunday’s weekly newspaper circular. The front page has ads for beer, wine, whiskey, soda, paper goods and fish oil. The back page has ads for wine, beer, rum, tequila, vodka and champagne.
But well before last week’s announcement, CVS had been working hard to seize opportunities presented by the Affordable Care Act. The chain has been courting major health care provider networks, for example, such as the Cleveland Clinic and Emory Health Care, and is already aligned with about two dozen health systems.
CVS understands that getting paid to deliver improved health care outcomes for patients is fast becoming a “pay for results” matter vs. a traditional “fee for service” arrangement.
Independently owned pharmacies are reinventing themselves as well. They aren’t dropping cigarettes or alcohol, because they seldom – if ever – sold them. But they are banding together in cooperatives, carving out niche markets and turning to the pharmaceutical industry, health care systems and schools of pharmacy for support.
For example, the Good Neighbor Pharmacy group unites almost 4,000 family-owned pharmacies under a common “brand” to offer a suite of programs to improve patient health.
El Macero Drug in Davis represents one niche model. A full-service pharmacy, it also offers highly specialized dermatological care. A staff aesthetician gives facials and chemical peels in a private treatment room within the store, and customers can buy skin care products that aren’t available at Macy’s or Walgreens.
Pharmaceutical distributors and health care systems, meanwhile, have introduced programs to assist independent pharmacists who are ready to retire but don’t have anyone to hand the keys to. These programs, such as the Entrepreneurial Pharmacy Program at University of the Pacific, help to keep independent pharmacies in business, especially in medically underserved areas where the large chains are unlikely to venture.
In Visalia, for example, Pacific pharmacy students are helping the family-owned Town Center Pharmacy with a business plan. The owner gets fresh ideas. The students fall in love with running a small business. And the patients can continue to have a pharmacist who greets them by name and takes their calls late at night.
Kicking cigarettes off the shelves was about as subtle as a chainsaw, but that doesn’t lessen the virtue of CVS’s decision. At the end of the day, it was the right thing to do.
I applaud CVS. And I’m excited about the future ahead for pharmacists and pharmacies as they find new ways to help keep patients healthy.
Professor David Collum is chair of the entrepreneurship program at University of the Pacific’s Thomas J. Long School of Pharmacy and Health Sciences.