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PubMed1998

Community pharmacy practice in Japan--results of a survey.

OBJECTIVE: To survey the present condition of community pharmacies as future sites for pharmacy students' externship in Japan. METHOD: A questionnaire consisting of 55 questions was sent to 425 graduates from Kobe Gakuin University, School of Pharmacy, who owned or worked in community pharmacies. RESULTS: Of the 85 responders, about half were owners and half employees of pharmacies. Ninety per cent of pharmacy owners operated three and fewer pharmacies. Fifty per cent of pharmacies only dispensed drugs, 32% handled both OTC drugs and dispensing, and 18% handled only OTC drugs. Among the 44 dispensing pharmacies, 16 were one-to-one type pharmacies, 13 were located in front of the big medical institutions, nine dispensed prescriptions from various medical institutions and five were hospital-owned pharmacies. Forty-five per cent of pharmacies employed 1-4 part-time pharmacists and 52% employed 1-4 pharmacist assistants. Thirty-one per cent of prescriptions came from internal medicine departments and the daily number of prescriptions dispensed by each pharmacy was in the range 10-99 for 41% of the pharmacies and 100-199 for 36% of the pharmacies. The average daily number of prescriptions dispersed by each pharmacist was in the range 30-39 for 29% of pharmacies and in the range 20-29 for 22% of pharmacies. Pharmaceutical information was provided at 73% of pharmacies and patients were counselled orally on their medication at 80% of pharmacies. Patients' medication histories were recorded at 88% pharmacies. Only 15% of pharmacies conducted patients' medication counselling at their home, but 34% of pharmacies were planning to start this service. Community pharmacists attended very few professional meetings or continuing education programmes and only 20% of them obtained information through computers. Forty-seven pharmacists out of the 85 obtained their information from medical representatives of pharmaceutical companies and 32 pharmacists through marketing specialists of wholesalers. Ninety per cent of community pharmacists who responded thought that separation of prescribing and dispensing functions would progress further in the future and 50% of them thought positively about the future social status of pharmacists. Most of our graduates who responded were willing to accept pharmacy students from Kobe Gakuin University as externs at their pharmacies. CONCLUSION: Despite the low response rate, our survey suggests that community pharmacy in Japan requires substantial improvement. This is to ensure that pharmacists working in that sector can provide the quality information that is required for the optimum management of patients and that the environment is suitable for pharmacy externships.

Data Collection↗
PubMed2002

Choice of and overall satisfaction with pharmacies among a community-dwelling elderly population.

OBJECTIVES: To identify factors related to elderly consumers' choice of pharmacy types and their overall satisfaction with pharmacy services provided by: a single community pharmacy, multiple pharmacies with a primary community pharmacy, a single mail order pharmacy, and multiple pharmacies with a primary mail order pharmacy. DATA: Data were extracted from the Texas Tech 5000 survey of consumers, age 65 years or older, in West Texas. The survey contains information about the respondents' health services use, pharmacy service use, satisfaction with accessibility and quality, health insurance coverage, health beliefs, health status, and demographics, as well as other health-related factors. METHODS: An endogenous treatment effect model was used to examine elderly consumers' choice of and satisfaction with different types of pharmacies. The first stage of the estimation identified factors related to consumers' choice of pharmacies. The second stage estimated the effects of pharmacy types on consumers' overall satisfaction with pharmacy services, controlling for self-selection. RESULTS: The type of pharmacy was a significant determinant of satisfaction. Self-selection was found in the determination of consumers' overall satisfaction with pharmacy services. Controlling for self-selection, elderly consumers who used a single community pharmacy and who used multiple pharmacies with a primary mail order pharmacy were the most satisfied with their pharmacy services. The type of pharmacy that ranked lowest in overall consumer satisfaction was multiple pharmacies with a primary community pharmacy. Insurance coverage of prescription drugs was significantly associated with consumers' choice of pharmacy. The greater the number of prescription drugs a consumer took, the higher the odds were that they used multiple pharmacies. CONCLUSIONS: Although using a single community pharmacy may create close patient-pharmacist relationships and improve health outcomes, consumers may be diverted from this choice because of price concerns and insurance diversification.

Aged↗
PubMedDate not supplied

Evaluation of community pharmacy service mix: evidence from the 2004 National Pharmacist Workforce Study.

OBJECTIVES: To describe the mix of pharmacy services being offered in different types of community pharmacy practices and to identify factors associated with a community pharmacy offering pharmacy services. DESIGN: Cross-sectional study. SETTING: Community pharmacies (independent, chain, mass merchandiser, and supermarket pharmacies). PARTICIPANTS: Pharmacists practicing full-time or part-time who worked in community pharmacies and responded to the 2004 National Pharmacist Workforce Survey. INTERVENTION: Mailed survey from the 2004 National Pharmacist Workforce Survey, which included core content questions for all sampled pharmacists and supplemental surveys that included workplace questions for a selected subsample of pharmacists. MAIN OUTCOME MEASURES: Type and frequency of pharmacy services being offered in a community pharmacy, including dispensing and product-related services (e.g., specialty compounding), and pharmacist care services (e.g., immunizations, smoking cessation, health screening, medication therapy management, wellness screening, nutritional support, and disease management services). RESULTS: Four pharmacist care services were reported as being offered at more than 10% of community pharmacy practices: immunizations, smoking cessation, health screening, and diabetes management. The number of pharmacist care services offered at a community pharmacy was positively associated with having at least three pharmacists on duty, innovativeness of the pharmacy, status as an independent pharmacy, and status as a supermarket pharmacy. More than one half of the community pharmacy practices did not offer any of the eight pharmacist care services included in a pharmacy service index. CONCLUSION: Pharmacy services were reported at relatively few community pharmacies, and were associated with pharmacy innovativeness, pharmacist staffing levels, and pharmacy setting. Some community pharmacies are offering pharmacy services as part of their business strategy, while others are dedicated to dispensing services. Continued study of pharmacy service availability in community pharmacies is needed to improve our understanding of our capacity to deliver such services, including medication therapy management services.

Community Pharmacy Services↗
PubMed1999

Factors affecting bargaining outcomes between pharmacies and insurers.

OBJECTIVE: To model the bargaining power of pharmacies and insurers in price negotiations and test whether it varies with characteristics of the pharmacy, insurer, and pharmacy market. DATA SOURCES/STUDY SETTING: Data from four sources. Pharmacy/insurer transactions were taken from Medstat's universe of 6.8 million pharmacy claims in their 1994 Marketscan database. Sources Informatics, Inc. supplied a three-digit zip code-level summary database containing pharmacy payments and self-reported costs for retail (cash-paying) customers for the top 200 pharmaceutical products by prescription size in 1994. The National Council of Prescription Drug Programs supplied their 1994 pharmacy database. Zip code-level socioeconomic and commercial information was taken from Bureau of the Census' 1990 Summary Tape File 3B and 1994 Zip Code Business Patterns database. STUDY DESIGN: The provider/insurer bargaining model first employed in Brooks, Dor, and Wong (1997, 1998) was adapted to the circumstances surrounding pharmacy and insurer bargaining. DATA COLLECTION/EXTRACTION METHODS: The units of observation in this study were single Medstat claims for each unique insurer/pharmacy combination in the database for selected pharmaceutical products. The four products selected varied in the conditions they treat, whether they are used to treat chronic or acute conditions, and by their sales volume. Used in the analysis were 9,758 Zantac, 2,681 Humulin, 3,437 Mevacor, and 1,860 Dilantin observations. PRINCIPAL FINDINGS: We find statistically significant variation in pharmacy bargaining power. Pharmacy bargaining power varies significantly across markets, insurers, and pharmacy types. With respect to market structure, pharmacy bargaining power is negatively related to pharmacies per capita and pharmacies per employer and positively related to pharmacy concentration at higher concentration levels. In addition, the higher the percentage of independent pharmacies in an area, the lower the pharmacy bargaining power. With respect to socioeconomic conditions, pharmacy bargaining power is higher in areas with lower per capita income and higher rates of public assistance. CONCLUSIONS: The bargaining power of pharmacies in contract negotiations with insurers varies considerably with exogenous factors. Local area pharmacy ownership concentration enhances pharmacy bargaining. As a result, anti-trust law prohibiting the collective bargaining of independent pharmacies with insurers leaves independents at a disadvantage with respect to chains.

Commerce↗