Prescription Volume

Basara, L.R., The impact of a direct-to-consumer prescription medication advertising campaign on new prescription volume. Drug Inf. J., 30, 715-729,1996. 

The extent to which a drug is used is clearly important, but may be complicated by the pathological mechanism of the adverse reaction. The significance of prescription volume is different for reactions associated with the initiation of treatment from reactions that do not become apparent until the drug has been taken for an extended period. 

How can the pressure of increased prescription volume be balanced with the increased focus on patient care and access to patient information necessary to providing pharmaceutical care ... 

Several key factors drive the need for automation. A national shortage of pharmacists in the face of ever-increasing prescription volumes is one major impetus. Another is the profound need to reduce the incidence of medication errors. Still another is the opportunity created by automation to enhance the role of pharmacists in patient care. Finally, consumers demand for speed and convenience further enhances the attractiveness of automation in pharmacy operations (Lewis, Albrant, and Hagel, 2002). Technology has the ability to accelerate the movement of pharmacists from the traditional dispensing focus to that of a patient-centered role. 

To increase the average daily prescription volume by 10 percent at the end of the year Poor ... 

Would Good Service Pharmacy be better off financially by accepting or declining the contract How do you determine whether it is worse to accept a very low reimbursement rate or lose about 20 percent of your prescription volume ... 

Recognizing that there are many fixed costs in pharmacies, another evaluation technique that will be discussed is differential analysis. This analysis accounts for the fact that many pharmacy expenses change little as the prescription volume increases or decreases. Finally, pro forma analysis will be discussed. This analysis factors in the different volumes of prescriptions... 

The differential cost is the average variable cost, and to calculate this cost, it is necessary to divide the average COD into the fixed and variable components. The most obvious variable expenses is prescription vials and labels. If the total prescription vial and label cost is divided by the number of prescriptions, the cost for the vial and label is 0.17 for each prescription. The other direct cost was the computer, but that is a fixed expense. It is assumed that the indirect expenses do not vary directly with prescription volume for example, the rent and advertising costs will not change just because the prescription volume changes. 

Note It was assumed that the total prescription volume, the average COGS, and the average COD did not change. While these assumptions may be inaccurate, it is still possible to obtain an accurate comparison by using comparable assumptions for both scenarios. 

Sam Bell has been able to increase prescription volume and is selective about the plans that he accepts. He uses a third-party network for some aspects of his business management. A financial analysis to determine which plans to accept would be beneficial rather than simply using 90-day supply as the key criterion (Table 17-5). 

The prescription volume at Feel Great Pharmacy is expected to be sufficient to support the incorporation of an automated dispensing system. 

To calculate the total costs to provide a service, consider how much pharmacist and supportive personnel time will be involved in offering the service, as well as fixed costs and per-patient costs. One way to estimate how much time will be spent on providing direct patient care is to consider the time spent with each patient and how many patients will be targeted. The pharmacy s computerized database may be able to be supply the number of clients on a specific medication or with a specific health condition. This may help to estimate the number of potential patients for the service. This step is important because one of the first targets for a new value-added service can be the pharmacy s existing clientele. This will also ensure that there is an adequate population of patients to support such a service. Of course, one of the goals of offering a new service may be to increase the number of clients attracted to the pharmacy and therefore to increase prescription volume or prescription-related purchases. A... 

In 2001, the number of retail prescriptions was 3.3 billion, which is an increase from 2.7 billion in 2000. By 2005, this figure neared 3.4 billion prescriptions (NACDS, 2007). This increase in prescription volume, when combined with the shortage of pharmacists, often results in a decrease in the amount of time available for direct pharmacist involvement in patient education. A 1999 study involving community pharmacies in eight states revealed that 87 percent of all patients received written information with their prescriptions. However, only 35 percent of pharmacists made any reference to the written leaflet, and only 8 percent actually reviewed it with the patient (Svarstad, 2000). Contributing to this gap in patient education is the failure to provide patients with understandable written instructions. 

Efforts to restrict benzodiazepines in New York State (2,7) and to ban triazolam (Halcion) in the UK (7,41) and the Netherlands (SEDA-4,v 42) have likewise been fraught with controversy. For example, the requirement to use triplicate prescription forms in New York has been effective in reducing prescription volumes, including arguably necessary and appropriate prescriptions (43). A 1979 suspension of triazolam availability in the Netherlands was overturned in 1990, while a 1993 formal ban in the UK has remained in force (44). Two extensive reports have included recommendations for resolving the special problems posed by the Halcion controversy (44,45). 

Under the Essential Small Pharmacies Scheme (ESPS) pharmacies with a low monthly prescription volume, located in an area not served by another pharmacy, may apply for additional payment to compensate for the low prescription volume. 

Where it is not possible to reformulate or develop combination products, the response in the marketplace to the loss of a patent can be very dramatic. In the UK particularly, and to an increasing extent in the US, the entry and penetration of generic competitors into the market can be very swift. In other European countries there tends to be much more brand loyalty and the penetration of the market by generic competitors is much slower. As example of how rapidly the market in the UK can change following patent loss is given by (enalapril) Innovace (Figure 10.10) where, within a few months, prescription volumes for the branded product had fallen to a fraction of their pre-patent loss level. 

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