One of the first things a visitor to Plainsboro Pharmacy notices is the in-store signage.  Signs are prominently posted throughout the Princeton, New Jersey-based store letting customers know that if they don’t see what they are looking for, pharmacy staff will get them the items they need.  “That’s what it’s all about.  Helping patients.  It’s why we bought this pharmacy in the first place,” says Heba Macksoud who, along with her husband Yousry Macksoud, opened Plainsboro almost 18 years ago.

In the years since, Plainsboro has well-served its clientele.  The community is home to New Jersey’s second largest Indian community.  Residents tend to be highly-educated and family-oriented, with multiple generations living in close proximity to each other.  The pharmacy offers traditional dispensing services, along with non-sterile compounds, including pet medications, and durable medical equipment.  In addition, the pharmacy offers an impressive array of clinical services including immunizations and screenings.  The pharmacy is considering adding non-insurance products such as hydrotherapy & vitamin infusion treatments.

The Macksouds chose the PrimeRx™ pharmacy technology system as well as the PrimePOS™ point-of-sale module from Micro Merchant Systems.  “We certainly had a lot of technology providers knocking on our door,” Heba says.  But they chose PrimeRx™ for several reasons including:

• Heba says the system’s inventory management capabilities were a major factor in their decision.  “PrimeRx™ allows me to be on top of my inventory without having to pay a company to come in to count.  I’m constantly looking at what’s on my shelves and reviewing historical data.  The system makes it so easy,” she explains.  “This is especially important in today’s environment when no pharmacy wants to be holding expensive medications.”
• Ease of use. PrimeRx™ is designed in a very logical manner and is highly user-friendly.  “It’s very easy for our pharmacists to move between screens, Heba says.
• Third-party integrations. PrimeRx™ offers direct integration with almost 100 different third-party solutions for either no or low-cost add-ons.  This ensures pharmacies have continual access to the industry’s most innovative and useful technology solutions.
• Customer service. This was another huge factor in choosing PrimeRx™.  Heba says response times from the PrimeRx™ customer service desk have been excellent.  She also appreciates having direct access to the company’s executives – and software developers – who listen to her suggestions for additional functionality and come through with solutions.

Plainsboro Pharmacy initially chose PrimeRx™ in 2019, after their previous software company shut down operations. The Macksouds believe PrimeRx™ will help navigate the numerous changes that seem headed for the pharmacy industry, several of which are poised to have significant implications.

Changes in Medical Supply Practices

For Plainsboro Pharmacy, an especially unsettling change has affected the way in which patients receive their medical and surgical supplies.  Until recently, Plainsboro was a local source for products ranging from wheelchairs to walkers to commodes and everything in between. “We offered a full range of products which was a big help for our elderly patients,” Heba explains, “but the business model really changed, and we had to give it up.”  Specific factors that influenced their decision include:

1. The Amazon Effect. “People just find it easier to order the supplies they need and have them delivered to their homes,” Heba explains.  “We used to offer consults for patients facing surgery, but the convenience of online access has changed that.”
2. Access through Physicians’ Offices. Patients used to come to the pharmacy with referrals from their doctors for equipment and devices.  Now though, the doctors themselves have entered the market, and provide supplies directly to patients.
3. Reimbursements. There is a tremendous amount of work involved in trying to run these products through Medicare and then the reimbursement amount is less than the cost.

These changes, Heba says, have grown exponentially since Covid, a period that changed so much about how pharmacies operate.

A Period of Adjustment for Pharmacies

Plainsboro Pharmacy is certainly not alone in having to adjust to changing pharmacy practices.  Pharmacies nationwide face the daily realities of shrinking reimbursements and increasing DIR fees, at the same time that inventory and other business costs continue to rise.  For Heba and many of her colleagues, current conditions are not sustainable.  Which is why she predicts major changes are on the horizon with regard to pharmacy practices.

“The need for pharmacies is never going to go away, since people will always need their medications,” she says.  “But the current business model has to change.  I expect that over the next 10-20 years the entire pharmacy model will shift away from insurance companies.

“We could make $30 on your cat’s medication versus $2 on a patient’s amoxicillin,” the owners said in describing just how dire profit margins have become for today’s pharmacies.

“We no longer want to be beholden to the wholesale model, and nowhere has the current pharmacy model been more destructive than in the assessment of DIR fees”.

While owners like the Macksouds continue to navigate the changes occurring in the pharmacy landscape, PrimeRx™ will continue to help in the short-term.  Capabilities that address specific Plainsboro Pharmacy needs include:

• Recordkeeping: Plainsboro has found PrimeRx™ to be especially helpful in meeting audit-related documentation requirements.  Patient record retrieval is especially helped by the pharmacy’s use of the PrimePOS™ point-of-sale module, which facilitates proof of payment requirements.

• Reporting: Also like most small pharmacies, Plainsboro operates on a very tight margin.  Every dollar is important so pharmacists must carefully assess every decision that affects the bottom line.  PrimeRx™ allows visibility into core aspects of pharmacy operations with extensive reporting capabilities.  For Plainsboro Pharmacy, customized reports can be generated on topics that include:
  • Daily/Weekly/Monthly dispensing activity.
  • Accurate information about medications not picked up.
  • Copay information.
  • Inventory reports and sales information.
  • Patient refill reports, including information about patients who have fallen behind on their medications.

• DIR Fee Management. While no pharmacy technology system will ever alleviate the stress and hardship associated with DIR fees, PrimeRx™ can help pharmacies anticipate the amount that may be assessed.  The system automatically tracks key metrics that affect DIR fee calculations, once percentage estimates are entered, and allows pharmacies to track their performance based on those values.

• Patient Communications. An unexpected bright spot of the intense COVID-19 period was the large number of new patients who visited the pharmacy for testing and immunizations.  PrimeRx™ – through its PrimeCOMM™ communications module – facilitates the patient communication process by enabling automatic email and text messages.  Messages can be customized to remind a patient about an overdue refill, with a pickup reminder, or even with a Happy Birthday greeting.  Group emails can be sent on a wide range of topics including flu shot availability and upcoming pharmacy events.  The solution also allows pharmacies to send messages to subsets of patients.  For example, patients who take a certain medication can be reminded to get a refill, or about potential side effects.

• eVoucher and Denial Conversion Services. Plainsboro Pharmacy is able to help patients save money at point-of-sale – and obtain the precise medications prescribed by their doctors, through MMS eVoucher & Denial Conversion Services.  The system’s eVoucher solution allows the pharmacist to search for manufacturer co-pay coupons, which can be applied immediately at the register.  Heba says her pharmacy successfully applies an eVoucher coupon “about 10 times” per week.

Through Denial Conversion Services, pharmacies can convert claims rejected by a payer to “paid” status, thereby allowing patients to leave the pharmacy with their medications.  Pharmacies are reimbursed by Micro Merchant Systems for the cost of these medications.

Both Yousry and Heba Macksoud are grateful for the extensive capabilities available through PrimeRx™, and credit the technology with helping to improve workflow efficiency and overall pharmacy operations.  They both agree that “the human element is so important, especially in our small, hometown pharmacy.” These sentiments are hardly surprising.  After all, the pharmacy’s website proudly asks: “Your Doctor Knows Your Name.  Shouldn’t Your Pharmacist?”

As Heba and Yousry Macksoud continue to navigate the challenges of operating their pharmacy, patients will remain their top priority.   But in the background, PrimeRx™ will continue to work seamlessly, helping to manage pharmacy operations, and hopefully allowing a little more time for patient interactions.