Magazine article Drug Topics

LTC and Alternate-Site Pharmacy

Magazine article Drug Topics

LTC and Alternate-Site Pharmacy

Article excerpt

Independent pharmades looking for new growth opportunities should look into long-termcare (ETC) and alternate-site pharmacy. Gross profit margins can top 30%, while demographic trends and regulatory changes promote long-term growth.

"What you see in these populations is chronic illness/' said Layne Oliff, PharmD, Mature Health Communications, Westfield, NJ,, speaking to Health Mart pharmacy owners during the annual ideaShare trade show sponsored by San Franciscobased wholesaler McKesson, "A large segment of the long-term-care population has chronic problems and multiple medications, and that population is only going to be growing for years to come, ensuring growth in that space for pharmacy and pharmacy care," Oliff continued.

"In the alternate- site space, there is growth, because of FDA approval trends in biologies and individualized therapies that are being used in home infusion, hospice, and other nontraditional sites. You are giving specialty medications that typically require special laboratory monitoring, special dispensing services or systems. There is strong growth now and strong growth moving into the future."

Continuum of care

The long-term-care continuum begins after hospital discharge. Skilled nursing facilities, assisted living, independent living, active adult living, and living at home provide decreasing levels of care. The trend, said Oliff, is for earlier discharge from hospital to skilled nursing, which has raised the level of acuity in nursing homes. Rising costs and personal choice encourage patients to move down the acuity continuum and return home as soon as possible.

With the older segments of the population set to grow for at least the next 2 decades, retirement communities and geographic areas with older populations are growing. Not only do older populations use more pharmaceuticals, they use more alternate-site pharmacy.

"A pharmacy has a built-in market in an active living or retirement community," Oliff said, "It's retail on the surface, but you're really serving a long-term-care population. Older, active adults still get sick and need acute medications on top of their chronic-care needs. The person who is still active but has rheumatoid arthritis needs a provider for those regular infusions to keep active. The mix ensures pharmacy growth."

Economies of scale vs. flexibility

Long-term care already accounts for outsized proportions of prescriptions and spending. …

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