an analysis of the pressure points on dispensary profit margins the big squeeze an analysis of the...
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THE BIG SQUEEZE
An Analysis of the Pressure An Analysis of the Pressure Points on Dispensary Profit Points on Dispensary Profit
MarginsMargins
NORMAN THURECHT
[email protected] 3222 8316
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THE BIG SQUEEZE• SOURCES OF PROFIT
• WHAT HAS BEEN HAPPENING?
• 4th AGREEMENT & REMUNERATION CHANGES
• GENERICS – CLAWBACK
• COMMUNITY SERVICE OBLIGATION
• PROPOSED CHANGES TO GENERICS
• CATEGORY WINNERS & LOSERS
• TAKING ADVANTAGE – S2 & S3 COUGH & COLD ALLERGY
• COMPETITIVE LANDSCAPE
• SUMMARY
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SOURCES OF PROFIT Pharmacy average sales 2004/05 $ Prop’n
Total Sales 3,067,438
• Dispense Sales 2,019,144 65.8% • Retail Sales(inc S2/3) 1,048,293 34.2%
• Retail Sales(ex S2/3) 769,154 25.1% • Sales S2/3 279,139 9.1%
(SOURCE: JR PHARMACY SERVICES)
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Gross & NET Profit Sources 2004/05
GP $ Prop’n Margins
GP$ (inc discs) – Disp 600,887 (61%) 29.8% Retail (total) 378,538 (39%) 36.1%
S2/3 only 128,403 (13%) 46.0%
Net Profit Sources (EBIT) $$ Dispense $243,272 +100% Retail (incl. S2/3) zero 0%
Proportion discs & generics/EBIT 50%+ 8 mths Feb ‘06
(SOURCE: JR PHARMACY SERVICES)
SOURCES OF PROFIT
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What has been happening?• Increase Patient Contrib.
12/04 to 1/06 increased 25%Currently $29.50 – more scripts now out of PBSWarehouses discounting
• Increased Petrol Prices
• Interest rate rises
• 20 Day Safety Net Rule
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20 Day Rule• The new Safety Net 20 day rule means that
for certain PBS medicines a repeat supply of the same medicine within 20 days will fall outside the Safety Net.
• Meaning: the cost will not count towards the Safety Net
threshold if the Safety Net threshold has been reached, the
charge will be the usual PBS contribution – not the reduced Safety Net amount.
CUSTOMERS SPENDING PATTERNS CHANGING
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PBS Pescription Volume Qtrly
-6.00%
-4.00%
-2.00%
0.00%
2.00%
4.00%
6.00%
8.00%
10.00%
Dec 03Qtr
Mar 04Qtr
June 04Qtr
Sept 04Qtr
Dec 04Qtr
Mar 05Qtr
June 05Qtr
Sept 05Qtr
Dec 05Qtr
Mar 06Qtr
June 06Qtr
Quarter
% C
hange to p
rior
Qtr
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4th Agreement• Total funding $11.1 billion• Reduced wholesaler margin to 7% +$70 for
items >$1,000• Fee increases on 1/12/05 and 1/7/06• 10% pharmacy mark up unchanged but $40
flat payment for items > $1,000• CSO funding pool of $150m (pharmacy
may not get all of it)
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12.5% Clawback
• Agreement only
• Clawbacks on 1/8/05, 1/12/05, 1/4/06 & 1/8/06
• Each time the Govt saves ($220mill @ 1/8/06)
• Brand pharma loses
• Generic loses too – but…..volume
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Generics & 12.5% ReductionBranded Item Pre 1/8 Now Change
Pravacol 40 61.84 54.11 (7.73) (12.5)%
+ Mark-up 6.18 5.41 (0.77)
+ Fee 5.15 5.15 -----
Sale Value 73.17 64.67 (8.50) (11.6)%
GP $
Fee + Mark-up 11.33 10.56
W/Saler disc. (5%) 3.09 2.71
GP $ 14.43 13.27 (1.16) (8.0)%
GP % 19.72% 20.51%
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Generics & 12.5% ReductionGeneric Item Pre 1/8 Now Change
Lipostat 40 40.98 35.86 (5.12) (12.5)%+ Mark-up 4.10 3.59 (0.51)+ Fee 5.15 5.15 ---
Sale Value 50.23 44.59 (5.63) (11.2)%
GP $Fee + Mark-up 9.25 8.74Generic Incentive (30%) 12.29 10.76GP $ 21.54 19.49 (2.05) (9.5)%
GP % 42.88% 43.71%
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Generics & 12.5% ReductionIn this example, pharmacy GP$/profit increases 47% by switching:
Branded Item
Pharmacy GP$ $13.27
Pharmacy GP% 20.51%
Generic Item
Pharmacy GP$ $19.49
Pharmacy GP% 43.71%
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Generics vs Brand Summary
• Consequences of Clawback:
• Government saves• Wholesalers losing more than Pharmacy
Switching CSO New w’salers
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CSO
Lipitor 20mg – New Cost to PharmacyPre July Post July
Mfter Cost $44.95 $44.95W’sler M/up 11.11% 7.52%PTP $49.96 $48.33W’sler Disc 5.5% 2.3%NIS $47.21 $47.21Loyalty Disc 0% 2.5%Net Cost $47.21 $46.03
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CSOLipitor 20mg – New GP% and GP$ Pharmacy
Pre July Post JulyPTP $49.96 $48.33Mark-up (10%) 5.00 4.83Disp Fee 4.94 5.15Total $ Dispensed $59.90 $58.31
GP $12.69 21.2% $12.28 21.06%Difference $0.62 (before 21c increase)
$0.41 (including increase)
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CSODiscount needed to remain the same?
Pre July Post July
PTP $49.96 $48.33W’sler Disc 5.5% 2.3%NIS $47.21 $47.21Loyalty Disc 0% 3.36%Net Cost $47.21 $45.62 PTP $49.96 $48.33Mark-up (10%) 5.00 4.83Disp Fee 4.94 5.15Total $ Dispensed $59.90 $58.31
GP $12.69 21.2% $12.69 21.76%
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• Wholesaler loyalty = highest discount
• Pharmacy has to give it!
CSO
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Proposed Changes to Generics
• Australian Newspaper 31/8 – Draconian changes will not occur
• Possibilities:
increasing the clawback;
reducing the PTP for generics (ie: reduces your
discount); and/or
making it mandatory for Pharmacists to substitute
generic for branded drug
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Proposed Changes to Generics
Increase clawback to 17.5%In this example, pharmacy GP$/profit still increases by switching, but…..
Branded Item (Previously 12.5%)
Pharmacy GP$ $12.80 $13.27Pharmacy GP% 20.90% 20.51%
Generic Item
Pharmacy GP$ $18.67 $19.49Pharmacy GP% 44.10% 43.71%
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What are the Issues?Can not assume PBS volumes will growPBS GP$ will continue to be clippedGenerics!!!Services and disc decrease if not loyalMust obtain efficiencies from the
dispensing processMust embrace total store healthcare
outcomes for customers
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Economically irrational regulations often give rise to
economically irrational
business strategies
(McKinsey – special collection 11 may (McKinsey – special collection 11 may 2006)2006)
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CATEGORIES - IMPROVE
“ANOTHER MISTAKE THAT BOOTS
MANAGEMENT MADE MANY YEARS AGO WAS
DROPPING ITS BABY PRODUCTS, WHICH RESULTED
IN THE LOSS OF THE DISPENSING BUSINESS”
(Richard Baker – CEO Boots NAM News 16/3/06)
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CONSIDER SOLUTIONS
PAIN ASTHMA ALLERGY CHILDREN AGED POWER CATEGORIES POWER OF BRANDS
COUGH & COLD
Average – 46% gp 31 linear mtrs 15% retail sales
Better/Best – 48% to 55% gp 50+ linear mtrs 19% retail sales
TAKE ADVANTAGE – S2/3TAKE ADVANTAGE – S2/3
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CUSTOMERS…..WILL DETERMINE YOUR FUTURE
“Do yourselves a favour – forget the product and embrace the outcome. Then you’ll make enough sales at enough margin.”
(Hilary Kahn – Retail Pharmacy July 2006)
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COMPETITION2005 KPIs – Pharmacy, Warehouse, Supermarket
P’cy W/hse S/mkt
Area m2 211m2 700m2 1,834m2
Sales/m2 $14,527 $10,000 $14,043
Retail sales/m2 $5,728 $6,015 $14,043 GP % - Disp - inc discs 29.8% 21% n/a
- Retail - inc s2/3 36.1% 28% 23.7%
- Total 31.9% 24% 23.7% Wages/Sales (inc owner) 13.2% 9% 10%
Wages/GP $$ 41.3% 37% 42%
Rent/sales 3.9% 3% 3%
Total O/H/Sales 24.0% 17% 19%/16%
Source – JR Pharmacy Services Client Averages
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P’cy W/hse S/mkt
EBIT/sales 7.9% 7% 4.6%/7.6%
Stock Turn - Retail 3.7 5 15
- Total 13.2 7.5 15
Retail GMROII $2.09 $1.89 $4.67
COMPETITION2005 KPIs – Pharmacy, Warehouse, Supermarket
Source – JR Pharmacy Services Client Averages
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Pressure Point Solution
4th Agreement Remuneration Leverage from Dispensary
(HMR, Retail etc)
Softening PBS Volume Leverage from Dispensary
(look for efficiencies)
Generic Clawbacks Substitute where possible(caution consumer
reaction)
CSO Focus on loyalty with W’saler
Message
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THE BIG SQUEEZE
An Analysis of the Pressure An Analysis of the Pressure Points on Dispensary Profit Points on Dispensary Profit
MarginsMargins
NORMAN THURECHT
[email protected] 3222 8316