If you asked anyone (in any way connected to pharmacy) about the financial health of pharmacy today, the response would be largely by way of lamentation, & weeping and gnashing of teeth.

Government cut backs, never ending reductions in drug costs, elimination of ‘professional allowances’, depressed wages, unemployment, and it goes on and on.  Not a pretty picture.

But is this an accurate picture really?  Well it all depends on what you define as ‘pharmacy’.

I have written before about the difference between a pharmacy and a pharmacist.  The two are so different with different goals and objectives that they hardly share a common genesis.

A pharmacist is an individual who practices the profession of pharmacy, drawing upon the education he/she received, and in adherence with the regulations as set out by his/her provincial regulatory body.

A pharmacy is a place, a store, a department, a kiosk where stuff is sold.  Some of this stuff is health related and OK, but a lot of this stuff is useless, the opposite of health related, and often even harmful.

Just look at the next grocery store or big box merchandiser you approach.  The name of the store is front and centre: Sobey’s, Metro, No Frills, Food Basics, Super Store, Walmart etc.  Then in large letters, usually to the right side of the front door logo, is just the word ‘PHARMACY”

What does this one word signify to the average consumer?  What is the word intended to inform the shopper as to the type of merchandise which will be found inside the premises?

Apart from the obvious ‘prescriptions’, which are increasingly not the priority of the non-pharmacist owner of the pharmacy, the word is supposed to convey to the shopper that drug store type merchandise (DSTM in industry parlance), & so called Schedule 3 drugs are available for sale.

DSTM can be virtually anything from tooth paste, to hot water bottles, to health & beauty aids, candy, soft drinks etc. etc.  …all stuff which can be sold anywhere, but which usually people go to the ‘drug store’ to purchase.  Here the words ‘drug store’ stands in for ‘pharmacy’.

Then there’s Schedule 3.  This is all the stuff which “although does not need the direct intervention of the pharmacist, must be within a specified distance from the pharmacist, in case the consumer wants to ‘consult’ with the pharmacist.   This includes cough syrups, analgesics, hemorrhoids preparations, vitamins, antihistamines etc. etc.   …so called over the counter drugs or OTC’s.  This stuff can only legally be sold in a ‘pharmacy’.

So now we now understand why all the members of Big Pharmacy Retail (BPR) have inserted a ‘pharmacy’ into every grocery store or big box merchandiser.  It’s an opportunity to create increased store traffic and to boost revenues through increased sales.  This is exactly what BPR is supposed to do…sell as much stuff as possible.  Any stuff.  BPR now controls over 80% of Canadian pharmacy sales.

Interestingly as well, the sales volume of all the other stuff that the grocery store sells, like carrots, meat, beans, bread etc. all goes up by more than 10 % just because the DSTM & Schedule 3 stuff is under the same roof.  Increased store traffic.

The truth is that much of this OTC stuff is ineffective and/or useless.  Most vitamins are way over hyped.  Cough syrups are both useless and can be harmful.  Then there are the ridiculous diet aids, fat flushes and COLD-FX  And a thousand other products which are hyped on television to a gullible audience which will purchase anything it sees on TV…one big waste of money, and which any respectable pharmacist would try to persuade a patient to walk away from.  Such action would of course not be consistent with the non-pharmacist retailer’s objective, which is to sell stuff.  Hence the contradiction between a pharmacist and a pharmacy.

There is big money to be made in selling OTC’s, DSTM, and all Schedule 3 stuff.  Not so much money selling Schedule 2 drugs (a drop in the bucket) nor selling prescriptions which are becoming less & less profitable by the day.

The truth is that most consumers of so called Schedule 3 drugs, just pick up what they want (and have been presold on) from the shelf and leave the store.  No ‘pharmacist intervention’. Maybe 10 % will ask “which is the best cough syrup?” as they look confused at 40 feet of cough syrups with various claims slapped on the labels.  Hard to answer this question and remain honest to the profession which is always to act in the interest of the patient.

Schedule 3 products are dream products for BPR.  These are products have limited distribution channels for reasons mostly dealing with dubious regulatory issues, and are driven by big money advertising, not pharmacist recommendation.

In this story, the pharmacist is a prop. The pharmacist presence allows for the word ‘pharmacy’ to be slapped to the side of the building, and hence allow for the sale of all this high margin restricted distribution stuff.

Also, the designation ‘pharmacy’ conveniently allows the regulatory bodies to collect big bucks annually by way of so called accreditation fees.   Not sure what is being accredited.

So now at least we know what the word ‘pharmacy’ means.  The word ‘pharmacist’ remains a bit of a question however, as the profession attempts to evolve in a fast changing, cost reduction environment which is totally dominated by non-pharmacist pharmacy business owners.

The conclusion to this story is still up in the air, but the plot at present is not looking too good for the profession of pharmacy.  Pharmacy however is looking great.  Making lots of money.