Effect of Medicare Part D Reimbursement on Community Pharmacy Profitability
Reisetter, Dunson, Kolassa, Schwab

This study measured the effect of Medicare Part D on community pharmacy profitability using data from the first months of implementation.  Gross margins for individual prescriptions before and after January 1, 2006, were compared to determine any changes.  A random sample of 30 prescriptions from each of 10 community pharmacies across the United States was examined to compare total pharmacy compensation for individual prescriptions.  The average gross margin decreased 22.3% after implementation of Medicare Part D.  If 30% of all prescriptions will be covered by a Medicare Part D provider, that decrease in gross margins will result in an overall decrease in margins to 22.0% from 23.6%, assuming margins for the other 70% of prescriptions remain constant.  Such a decrease would likely result in a 21.1% reduction in the average total owner compensation for community pharmacies in the US. This study was funded by a grant from the Community Pharmacy Foundation.

Generic Substitutions and Critical Dose Medications: Summary Report
The Pharmaceutical Marketing and Management Research Program

This summary report includes the findings from a national survey of physicians. The survey was conducted by the Pharmaceutical Marketing and Management Research Program of the Research Institute of Pharmaceutical Sciences at The University of Mississipp. This project was supported by a research contract from Dupont Pharma.

Hospital Pharmacy Management-The 1993 National Survey of Hospital Pharmacy Directors: Summary Report
The Pharmaceutical Marketing and Management Research Program

Hospital pharmacy directors from across the nation were surveyed to examine their attitudes toward the administrative aspects of their positions and the souce and adequacy of their administrative training. The study found that, generally, hospital pharmacy directors feel their academic training in pharmacy did not prepare them for their current roles, with this aspect of training providing only 11% of the skills necessary to perform their current duties. The lack of formal training in administrative skills and techniques appears to have carried through their careers, since on average, the respondents attribute over 50% of their administrative skills to on-the-job training.

1990 National Survey of Retail Pharmacies: Generic Drug Substitution - Generic Drug Pricing
The Pharmaceutical Marketing Research Program

1990 National Survey on Generic Substitution: Summary Report
The Department of Management and Marketing/School of Business Administration and The Pharmaceutical Marketing Research Program

1991 National Survey of Retail Pharmacies - Pharmacy Clerks: Summary Report
The Pharmaceutical Marketing and Management Program

Reductions in Pharmaceutical Price Growth: An Assessment of List Price Changes in the U.S. Pharmaceutical Market 1989 to 1992
The Pharmaceutical Marketing and Management Research Program

Critics of the pharmaceutical industry, while admitting that price growth has slowed, continue to assert that drug prices are rising rapidly and that pharmaceutical firms take undue advantage of patients and payers by raising prices well above the current levels of inflation. While price increases in the past have exceeded inflationary rates, there are several compelling reasons for this historical price growth. This research was conducted to establish and document the actual changes in pharmaceutical pricing, utilizing the same methodology developed by the most severe critics of the industry. While these methodologies, which are described in Appendix One are not precise, in terms of measuring price growth, they are easy to communicate to and are readily understood by those without in-depth knowledge of pharmaceutical market dynamics.

Generic Substitution and Narrow Index Therapeutic Index Drugs - A National Survey of Retail and Hospital Pharmacies: Summary Report
The Pharmaceutical Marketing and Management Research Program

The results from these surveys indicate that in general, retail and hospital pharmacists are fairly comfortable performing generic substitution and they view generics as being safe and effective in most situations. While the respondants were postitive in their views on the broad subject of generic substitutions, three products (Coumadin®, Lanoxin®, and Dilantin®)consistently emerged as "special cases" where pharmacists are reluctant or not willing to substitute. Typically, generics are encouraged by third party payers to reduce costs. Mandatory use of generics was not always percieved to be cost effective. Some of the respondants reported cases where up to three times as much of the generic drug was needed to maintain effective therapeutic levels. As managed care continues to evolve, pharmacists may often find themselves faced with being pressured to substitute for products that they consider to be critical dose drugs. Pharmacists need to thoroughly consider this professional dilemma and develop a planned procedure for dealing with the situation.