Rite Aid’s Wellness format passes 1,000-store mark in second quarter

BY Alaric DeArment

CAMP HILL, Pa. — Rite Aid posted its fourth-consecutive profitable quarter Thursday as it reached a milestone in its store conversions and saw growth in the latest expansion to its loyalty program.

During the second quarter of fiscal year 2014, the number of stores in the chain that have been converted to the Wellness and Genuine Well-Being formats passed 1,000, with the total number of stores converted totaling 1,019 — including 114 under the newer Genuine Well-Being format — and expected to reach 1,200 by the end of the year. In a conference call with financial analysts to announce the quarter’s results, CFO Frank Vitrano said Wellness stores’ front-end same-store sales led non-Wellness stores’ by 3.4%, while same-store script count led by 0.9%. One key part of the Wellness format is the Wellness Ambassadors, specially trained staff who help customers with questions they have about health and wellness products and also help to funnel them toward the pharmacy; as of the end of the quarter, there were 1,700 Wellness Ambassadors working in stores.

Wellness65+, a supplement to the Wellness+ loyalty card program aimed at elderly customers, had 930,000 members enrolled as of the end of the quarter, and president and COO Ken Martindale said that seniors had been "very receptive" to it. Part of the promotional efforts around the program included a tour around the country, with 65 events in eight markets, thus allowing employees to build relationships with senior customers. Other wellness-related programs include flu vaccinations, and chairman and CEO John Standley said they were off to a "strong start" in the 2013-2014 flu season; the company aims to vaccinate 2.5 million people during the fiscal year.

As the chain cycles through the customers it gained during the dispute last year between Walgreens and Express Scripts, same-store script count was flat compared with second-quarter 2013, but offset by organic script count growth. Pharmacy same-store sales were up by 1.7% and included a 2.5% negative effect from new generic introductions. Standley said during the call that new generics have been stronger than expected, but cost increases for generics have also been higher, and the company expects that to put pressure on the company’s guidance over the next two quarters.

Sales for the quarter were $6.3 billion, up from $6.2 billion in second quarter 2013, while profits were $32.8 million, compared with a $38.8 million loss a year ago. Same-store sales were up by 1%, including the aforementioned increase in pharmacy comps and a 0.3% decrease in front-end comps. The chain operated 4,604 stores.

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A shot in the arm for pharmacy

BY Ann Latner

Results from a nationwide survey last year revealed that adults get immunized in pharmacies more frequently than anywhere else, other than physician offices. This should come as no surprise considering the convenient hours, ease of access and frequency of visits to pharmacies. But what is the legal status of pharmacy-based immunization, and what are the roles of the pharmacist?

Status of pharmacist immunizers

Thirty years ago, less than 10 states authorized pharmacists to administer influenza vaccines. By the end of the last decade, all 50 states, plus the District of Columbia and Puerto Rico, allowed pharmacists to immunize. As the numbers of authorizing states has grown, the number of pharmacists getting trained to immunize also has grown. According to the American Pharmacists Association, more than 200,000 pharmacists in the United States were trained to administer vaccines.

State law governs healthcare practice, including immunization practice, and each state has different regulations regarding immunizations. As a general rule, pharmacists have the authority to immunize based on a protocol with a physician — similar to nurses and physician assistants — or by prescription; however, the specifics vary by state, especially with regards to the age of the patient, the immunization process and the particular vaccine. Protocols are basically contracts that specify who has delegated the activity (i.e., a physician), identifies the pharmacist who is authorized by the protocol, states what types of vaccines the pharmacist is authorized to administer and defines procedures and criteria for pharmacists to follow, including when to refer the patient elsewhere and what to do in emergency situations.

Currently, 44 states/territories allow pharmacists to administer any vaccine; South Dakota allows only influenza and zoster (shingles); New York and Florida allow only influenza, pneumonia and zoster; and five other states allow some combination.

The role of the pharmacist
APhA adopted “Guidelines for Pharmacy-Based Advocacy” in 1996, establishing the role of pharmacists in the immunization process. These guidelines were reviewed in 2012 and contain five points:

  • Prevention — Pharmacists should protect their patients’ health by being vaccine advocates;
  • Partnership — Pharmacists who administer immunizations do so in partnership with
  • their community;
  • Quality — Pharmacists must achieve and maintain competence to administer immunizations;
  • Documentation — Pharmacists should document immunizations fully and report clinically significant events appropriately; and
  • Empowerment — Pharmacists should educate patients about immunizations and respect patients’ rights.

APhA identified pharmacists as having three main roles in immunizations. The first is acting as an advocate, and educating and motivating patients to get their flu shot, for example. The second role is as a facilitator — hosting others who vaccinate in the pharmacy. Some pharmacies have done this by inviting nurse practitioners or physician assistants in for a scheduled vaccination clinic. The third role of the pharmacist is as the actual immunizer. Currently close to 20% of adults get their influenza vaccine at the pharmacy, and this number is likely to grow as health care changes.

What does the future hold? Aside from such common immunizations as influenza and pneumonia, we will increasingly see pharmacists immunizing for other diseases — such as zoster, pertussis, tetanus-diptheria, typhoid, chicken pox, hepatitis, meningitis and more. Some pharmacies have travel clinics specifically to immunize patients against travel-related disease, and as new vaccines are developed, such as the HPV vaccination, more collaborative opportunities are created for pharmacists to work with other healthcare practitioners to protect the health of patients.

Ann W. Latner, JD, a former criminal defense attorney, is a freelance medical writer in Port Washington, N.Y.



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Study: Seniors gaining weight at greater risk of dying than seniors already overweight

BY Michael Johnsen

COLUMBUS, Ohio — Some overweight older adults don’t need to lose weight to extend their lives, but they could risk an earlier death if they pack on more pounds. According to a nationwide Ohio State University study released Thursday, people who were slightly overweight in their 50s but kept their weight relatively stable were the most likely to survive over the next 16 years.

They had better survival rates than even normal-weight individuals whose weight increased slightly, but stayed within the normal range.

On the other hand, those who started out as very obese in their 50s and whose weight continued to increase were the most likely to die during that period.

Overall, the results suggest that about 7.2% of deaths after the age of 51 are due to weight gain among obese people, at least among the generation in this study, stated Hui Zheng, lead author of the study and assistant professor of sociology at The Ohio State University.

“You can learn more about older people’s mortality risk by looking at how their weight is changing than you can by just looking at how much they weigh at any one time,” Zheng said.

While some extra weight seemed protective in this study, Zheng cautioned that these results applied only to people over 50. His previous research, published in Social Science & Medicine, suggests that being overweight may not be helpful for younger people.

Why is being slightly overweight protective for older people?

“It is probably because the older population is more likely to get illnesses and disease, especially cancer, that cause dangerous weight loss,” he said.  “In that case, a small amount of extra weight may provide protection against nutritional and energy deficiencies, metabolic stresses, the development of wasting and frailty, and loss of muscle and bone density caused by chronic diseases.”

“Our other research suggests that the negative effect of obesity on health is greater for young people than it is for older people, so young people especially shouldn’t think that being overweight is harmless,” he said.

While slightly overweight people (BMI of 25 to 29.9) whose weight was steady had the highest survival rate, those who moved from overweight to obese (BMI 30 to 34.9) were close behind.

“This suggests that among overweight people at age 51, small weight gains do not significantly lower the probability of survival,” Zheng said.

The third highest survival rate among the six groups was normal weight individuals (BMI of 18.5 to 24.9) whose weight increased slightly, but stayed within normal range.

Next came the Class I obese (BMI of 30 to 34.9) whose weight was moving upward.

Next to last were normal weight individuals who lost weight. Although the study attempted to control for illnesses among those studied, it may be that many of these individuals dropped weight because of illness.

The most obese individuals (BMI of 35 and over) who continued to add weight had the lowest survival rate of the six groups.

There weren’t enough people who started out as overweight and obese and lost weight to include in this analysis, Zheng said.

“We can’t really evaluate the effectiveness of planned weight loss on mortality. Even in the normal-weight people in this study, there was no way to tell whether weight loss was planned,” he said.

Zheng noted that the study took into account a wide variety of demographic and socioeconomic factors that may play a role in both weight and mortality among Americans. The researchers also controlled for whether the respondents smoked, whether they had a variety of chronic illnesses and how they rated their own health. The results stood even after all of these factors were taken into account.

Younger people are less likely to get many of the diseases that afflict older adults, which is one reason extra weight is not good for them, he said.

But Zheng said the main message for everyone, including older adults, is that packing on the pounds, especially if you’re obese, can be hazardous to your health. “Continuing to put on weight can lower your life expectancy,” he said.

This new study was published online this month in the American Journal of Epidemiology

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