Every day, more discount pharmacy stores and chains are opening and assaulting health care consumers with the “we are cheaper” message. But is price the best way to achieve positive health care outcomes?
Community pharmacists are the only Australian health-care professionals to practise in a retail environment. When a patient ‘buys’ a medication, it is easy to see how they can think they are purchasing a commodity. This perception is further fuelled by the retail and price-promotion focus by many (if not most) pharmacies.
Multiple times each week, I receive a pharmacy sale catalogue in my mailbox. Yes, it has the vitamins and complementary medicines, the perfumes and general retail lines like soaps and so on, but it also contains an array of medicines that are promoted as cheaply priced.
There’s a tension between the three major players in this space: consumers, pharmacy owners, and the health system.
From a consumer perspective, anything that reduces the cost of an item is good. Cost of living is increasing, and everyone is looking for the next bargain. Price can be a huge motivator in driving purchasing behaviour and just about every retail outlet knows this and uses it to attract customers.
Many discount chains have large amounts of signage dedicated to giving the perception they are the cheapest, and if not, they will beat any competitor. This can attract customers for specific products they are seeking — usually products for a specific need, or high use items.
Pharmacy owners are in business, and they need to make a profit or their business will fail and close. The profit they extract from each sale provides all the business costs (rent, electricity, staff, wholesale cost of products) and also a return for the owner.
Therefore, the owner will try to maximise profit at every opportunity. This can be achieved by reducing costs or increasing selling prices of goods. This is true for any pharmacy owner, not just discounters. However, discount pharmacies generate the perception they are cheaper, so something has to give.
Some of the things targeted for cost reduction by pharmacies can be:
The health system aims to provide a high level of care for the most people possible at an affordable cost. Pharmacy owners will say the system doesn’t pay them enough to perform a variety of tasks. Consumers will say they pay too much out of pocket and the system should pay more. The system tries to maintain a balance between the two.
Discount pharmacies are driving down prices for a variety of non-prescription medicines and the government de-listed some medications it used to subsidise, saying their cost was the same or lower without a prescription. This makes price a factor and further leads to medicines having a perceived value in the consumer’s mind.
Medicines are the most cost effective and easiest to administer health intervention. Therefore the health system wants to ensure the Australian policy on quality use of medicines is followed to maximise the benefits for the patient and the budget, and minimise the harms.
Our pharmacy system is built around a retail entity where the income is derived from selling a product, not advice. Today’s pharmacy retail model is becoming a “race to the bottom” on price.
Pharmacies that give advice when selling a product, and have appropriate staffing levels to maximise health-care outcomes, are becoming rare as consumers follow the price to the bottom.
The problem with such medication consumerism is it increases the risk of medicines-related harm. Consumers should always ask questions about their medicines regardless of the type of pharmacy where they buy them. If your pharmacist doesn’t answer your questions to your satisfaction — go to a pharmacy that will.