PHARMACY

Ready for globalization of drug retailing?

BY Antoinette Alexander

CVS Caremark is looking to acquire an 80% stake in Onofre, the eighth-largest pharmacy chain in Brazil, according to published reports.

Are you ready for the globalization of drug store retailing? DSN is. And we expect it to continue. Why? That’s where the Rx growth is. Expect more of these deals. Where? Follow the money (i.e., emerging markets where Rx growth is still in high single- to low double-digits).

There are no substantial retail acquisitions left to make within the United States, so CVS could opt to grow organically in places like the Pacific Northwest, where it has no presence, or set its sights on emerging international markets where pharmacy growth is still robust.

What’s interesting about the deal — aside from the obvious fact that it marks the retailer’s first major expansion outside of the United States — is its simplicity and sensibility. Snapping up the 44-store Brazilian retailer enables CVS to expand its core retail pharmacy business via a manageable platform without the hassle of any complex financial arrangements, a fact that Pembroke Consulting’s Adam Fein also made note of Friday morning in his blog Drug Channels.

In fact, this is precisely the type of deal that some industry observers anticipated that CVS might make, as exporting the PBM model could prove quite challenging. Perhaps the PBM model would prove difficult to export but with all the growth in markets such as Brazil there is still plenty of profit to be made filling scripts at retail and selling merchandise on the front-end in these emerging markets.

Meanwhile, Walgreens expects to continue to expand throughout Europe, Asia and eventually will look to enter South America, company executives have noted.
 

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A.FEIN says:
Dec-11-2012 09:55 am

Actually, further European pharmacy expansion will be difficult for Walgreen or Boots. In most EU countries, pharmacy chains are either prohibited or severely restricted. Many countries require pharmacist ownership, e.g., France, Greece, Italy and Spain. Most EU countries also restrict the number of pharmacies under common ownership, or limit ownership to minority stakes beyond the first one. For example, Italy prohibits ownership of more than one pharmacy, while France limits chain size to 5 pharmacies. Boots already has a strong presence in the minority of EU countries that permit unlimited pharmacy chains (UK, Ireland, Norway). Adam Fein Drug Channels

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PHARMACY

Black holes and gray areas: State, federal authorities take a closer look at pharmacy compounding

BY Alaric DeArment

Authorities in Massachusetts are looking to tighten regulations on compounding pharmacies as the state health department announced some changes to the makeup of the Massachusetts Board of Pharmacy and sent cease-and-desist notices to three compounding pharmacies for alleged violations.

Retail pharmacies looking to get into sterile compounding and exercise greater control over that supply chain — as Walgreens did last month when it bought an independent specialty compounding pharmacy in Indiana — should take note because it seems there will be increased scrutiny on the practice following a nationwide outbreak of meningitis linked to alleged unsanitary conditions at the Framingham, Mass.-based New England Compounding Center.

At the same time, federal authorities are looking to crack down on an industry whose regulatory environment the Massachusetts health department characterized as a "gray area." In November, Food and Drug Administration commissioner Margaret Hamburg testified before the House Committee on Energy and Commerce, detailing the FDA’s response to the meningitis outbreak and requesting greater oversight for the agency over pharmacy compounding.

In her testimony, Hamburg herself said that the FDA’s ability to scrutinize and take action against compounding pharmacies that may be endangering public health has been held back by unclear and incomplete laws, some of which have led to legal challenges to the agency’s regulatory authority. Earlier that month, in response to the outbreak, Rep. Edward Markey, D-Mass., proposed legislation to strengthen the federal government’s ability to regulate compounding by ending the "regulatory black hole."

There are two basic forms of compounding: traditional or nonsterile compounding, which is done in the pharmacy and involves making products like creams and ointments, mouthwashes and suppositories; and sterile compounding, which refers to industrial scale compounding of injected drugs and requires specialized facilities and attention to sanitation and cleanliness.

Many pharmacy retailers, particularly independents, already do the former. With more and more retailers moving into specialty, the latter makes good business sense as well. But as state and federal authorities start taking a closer look at the practice, pharmacy retailers should pay close attention because things could start getting complicated.

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Focus on the loyalty card as the definitive barometer of pharmacy success, not won/lost ESI patients

BY Michael Johnsen

DEERFIELD, Ill. — Walgreens last Wednesday reported November sales of $5.9 billion, a decrease of 3.9% versus the same period last year. However, the company also noted it had enrolled 38 million customers for its new loyalty card program, which debuted in September. 

And while much of the discussion around Walgreens’ performance over this past year has been focused on the chain’s exit and subsequent return to Express Scripts, it’s a little unrealistic to look at Walgreens’ monthly comps right now and measure the chain’s success in getting those patients back. (Incidentally, about 40% of those customers have come back to the Walgreens pharmacy camp, speculated Credit Suisse research analyst Ed Kelly.) For example, in the comparable year-ago period Walgreens was still a part of the Express Scripts network. And last year results didn’t have the significant drag of a major hurricane that interrupted operations of a number of stores for the better part of a week, either. 

Better apple-to-apple comparisons will come at the end of January 2013, when you can measure the performance of a Walgreens fresh out of the Express Scripts network to a Walgreens folded back into that network. But even those comparisons won’t tell the full story, because Walgreens at the end of January 2013 will have well more than the 38 million enrolled loyalty card members that they have now. And while it may be early days for Walgreens’ loyalty card program as compared to the offers from Rite Aid or CVS Caremark, you can’t discount the influence those 38 million-plus best customers will have on performance on go-forward. It’s the experience differentiator that will help Walgreens — and others — compete with value-oriented retailers and a still-weakened consumer. 

Loyalty cards are also the common denominator that gives each of the big three drug channel retailers the confidence that they can capture the same patient. 

What do you think will be the big experience differentiator going forward? Is it loyalty cards, or is it something else? And between the big three, who has the inside bead on keeping their patients coming back for more? Post a comment below! 

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