Pharmacists Try Old-Fashioned Profit Remedies

Curt Davison is an archetype of the old-time apothecary.

He’s quick with a smile and a cheery hello when customers stroll into his pharmacy.

Most of the time, he knows his clients on a first-name basis and is familiar with their medical histories.

He is careful and is usually quick to dispense medical advice to those who come in to get a prescription filled. He can even be found with a mortar and pestle grinding up medications for special prescriptions.

Yet, independent pharmacists such as Davison are a rare breed. Many have fallen victim to chain drug stores, managed health care plans and cost-conscious insurance companies.

Of those who remain, many are just keeping from fading into the past.

“The days of the corner drugstore are disappearing,” said Davison, who has owned the Brands Buena Pharmacy in Ventura for the last 16 years. “And what gets me is that we really are a great community service that’s just getting kicked around.”

Since 1990 the number of independently owned pharmacies nationwide has plummeted from about 33,000 to a little more than 20,000 today, according to Brown Brothers Harriman, a New York-based industry research firm.

The cause, many say, is the dominance of managed health care organizations and their agreements with insurance companies and drug manufacturers.

HMOs and insurance providers can dictate to patients what drugs to buy and where to buy them to ensure that costs will be kept at a minimum.

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Drugstore chains, which buy in bulk and deal in volume, are often more cost-effective for both insurance companies and customers. And they open early, close late and keep the doors open on weekends.

Insurance companies have slashed their reimbursements to independent pharmacists from about $7 per prescription to $2, which independents say eliminates their ability to show a profit.

“If they want to go head-to-head with the big chains, they’re going to lose,” said Carlo Michelotti, director of the California Pharmacists Assn. “What they have to do is find something that’s going to set them apart.”

So independents have set out to do what the big chains won’t, in hopes that service upgrades will attract more customers.

One avenue many are pursuing is drug compounding.

Compounding is a process that customizes the delivery of drugs for a specific customer. For example, if a child is required to take a drug that is sold only in pill form, a pharmacist can grind the pill into a powder, put in a liquid, even add flavors, so the child will be better able to ingest the medication.

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Others package drugs in so-called calendar boxes, so clients know when and if they took their drugs at the right time.

Some even offer free delivery, often within an hour of filling the prescription.

“There is still a place for independents, and it’s in doing things like that,” said pharmacist Dave Rowe, who owns the Lombard Pharmacy in Newbury Park. “People want better care, and that’s what a lot of independents are trying to do.”

When people use independents, he added, they can be assured that a pharmacist will be the one filling the prescription, rather than rained pharmaceutical assistants employed by many larger chain stores.

For some pharmacists, however, all those changes are still not enough to lure sufficient numbers of customers.

Davison also devotes about as much shelf room in his pharmacy to greeting cards, candle holders and porcelain curios as he does to over-the-counter medications, adhesive bandages and other health-care products.

And he has started a service called cognitive counseling, where he speaks to patients about their medical needs and how best to manage medications prescribed by physicians.

Davison and other independents said they could increase the quantity of prescription sales, but worry that would cut into their level of service and care.

“I’ve thought about it, but I don’t think I’m going to play that game,” he said.

“If I’m going to go out of business, I’m going to go out being good and fair and doing the best job I can.”