Lisa’s Favorite Profit Producing Strategies & Tactics – Monthly Mastermind January 2024

Monthly Mastermind - January 25-2024

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Lisa’s Favorite Profit Producing Strategies & Tactics – Monthly Mastermind January 2024

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We’re going to go ahead and get started. So welcome to January, Happy 2024. I know it has been not not the most pleasant of a few weeks here, if any of you have like seen what I’ve seen from my own pharmacies and from others, you know, reimbursements are in the tank. Yes, many of them. It’s due to the DIR fee pocalypse that I’ve been talking about for the last like, seems like up teen years, but 18 months or so. Certainly, seeing your real Medicare reimbursements, and specially on brands has been very, very eye opening for lots of pharmacy owners. And especially if you didn’t have your estimated dir fees in your system, then it’s it’s a huge shock. But there’s also been other reimbursement, downfalls to it seems like a lot of other plans have been a lot lower as well. So it’s not just Medicare. So I thought for January, we kind of talked about the other side, we talked about some profitable things. You know, there’s only so much you can do on the Medicare side, which I highly recommend, you know, using either retail meds or just doing it yourself and out out sourcing, so to speak, those high cost, low profit, brand name Medicare prescriptions, I will tell you if any of you are on now, or listening to this recording later, there is no mathematical way to not lose money on a brand name with Medicare, there’s just not you can’t, there is no purchasing place, there is no contract good enough that you can basically dispense a brand name on Medicare and not lose money. And so that’s unfortunate. That’s, that’s not ideal. But so what we’ve been doing is we’ve been sending those brand name prescriptions to mail order filling the rest of their prescriptions, you know, obviously, it’s a selling OTCs, and DME and all the rest of the stuff to them. And that’s that’s greatly helped. And so that really helped in in this transition, obviously to the net dir fee at that point of sale. So, but today, we’re going to be talking about some profitable opportunities. While it’s very important to mitigate all those losses. Trust me, there’s no quicker way to fill your bucket than to stop the leaks. But also sometimes you just need to turn on the faucet a little harder. So that’s what we’re going to be talking about today. If you have any questions throughout, this is not meant to be a lecture. You can unmute yourself, raise your hand, put it in the chat. I’m happy to answer any and all questions, but we’re going to go through my favorite things, least his favorite things kind of you know, I guess I’m a little like Oprah, you know, all of our favorite things. So let’s share screens here. And we will get this show started. All right.
Here we go. So we’re going to be talking about my favorite profit producing strategies. If you’ve been listening to me for a while some of these are not new. And you have to implement them for 10 to actually work. And actually my inner circle call yesterday with our inner circle members. We focused on several of these and some of them had said You know, we’ve kind of like tried it before, but we honestly didn’t put much effort and so even some of the most successful pharmacy owners you know, are redoubling down and really putting to action, the strategies some have been focusing on already and are seeing huge improvements. And so these work they work now even in this day and age, most likely because they don’t involve most of them don’t involve PBN. So we’re gonna dive into this. So I want to make sure if you have any questions later, you know, you sometimes when you’re absorbing information, you don’t have a question right away, or you’re watching this recording, post any questions in the community chat or hit that Contact Us link inside the membership. Don’t forget about office hours on Tuesdays. Usually they’re hosted by me 99% of the time unless I’m on an airplane or something. But 10am Central Office Hours hop on, you can ask, ask me anything about anything. And, you know, you could log into your membership site, get access to that, get your employees access, this does not all have to be on you. I know. That’s one of the biggest things as a pharmacy owner back when I had my very first store, you know, I would learn some things and then I had to turn around and teach it to my staff and it became like this burden on me and I became that chokehold point. We don’t want that to happen to you. So you have up to 10 logins for your staff, partner, spouse, whomever. And you can email assistant at diversifier X, that’s juF. And he can help get you you can also do it yourself inside the membership but we’re also happy to help you get your employees access and get them plugged in and learn directly from us so it doesn’t have to go on to you. Don’t forget to get your membership ticket and use your special member link. I had a couple of members purchase tickets after the first of the year because they were waiting until after the first of the year and they forgot to use their member link. We of course made it whole and gave them a refund on the difference but I don’t want you to overpay for your summit ticket. So be sure to use your member link. Which there’s I put the member link right here you can also log Going to the website, we have the the summit link right there, front and center. And you can click that. And you can purchase as many tickets as you want at your member price. There’s no limit on member ticket prices. And so I just don’t want you to overpay for your summit ticket. We do, we are down to less than 100 tickets left. So if you do plan on coming, just get your tickets. Every year, I always have people saying, oh, I need to buy a ticket. But it says you’re sold out. And I’m a member. And it’s like I can’t magically make more space appear at the Omni. So please get your ticket. Because I there’s nothing I can do later. So Alrighty, let’s dive in. So number one, number one is my favorite profitable strategy. That’s also super, super easy. And that is direct billing, worker’s compensation. And there’s basically three ways to do it, you can do it yourself. You can use stream care, you can use Server X, there’s probably some other ones out there. But string care and Server X, I think are the biggest investors out there. And essentially, what direct billing workers comp means is on the left is kind of the traditional way, the way that you do it when you build my matrix or Tamesis or Express Scripts, which is you the pharmacy bill, the PBM. And the PBM gives you pennies, pennies on the dollar. And basically the stream Care Advantage is what this little graphic shows, but really direct billing is you bypass the PBM. So workers comp is actually very, very profitable and very easy to administer once you eliminate that PBM. And the reason that is is because in most states worker compensation reimbursement rates are set at the state level. So the state has a rule on its books that says workers compensations are going to be reimbursed at full aw P Just for example. But if you’ve started a contract with my matrix that says you agree to accept aw p minus 87%, then you lose 87% of your reimbursement they get to keep it because guess what the insurers the people who are paying the workers comp, they pay the exact same rate no matter who builds the claim. So if my matric bills them or your pharmacy bills them, they’re paying the state mandated rate in this instance, full aw up. But if you agree to my matrix terms, and you agree to accept less than you’re going to get paid less so PBMs will pay you for pennies on the dollar when you should really be getting dollars from these insurers. And so I used to DIY this myself and my pharmacy I kind of accidentally discovered this whenever I was researching a worker’s comp claim I was trying to get a hold of the adjuster i Calling a bunch of people, I finally got ahold the adjuster and they’re all just send the bill to this address. And I’m like, huh, like, send the bill. I was like, okay, so you know, I printed off a bill for my system. And I sent it in and when I got the check back, and they paid me the total amount. I was like, what, like, I got hundreds of hundreds of dollars, you know, like I just was my mind was blown. And that’s when I discovered this whole concept that you don’t have to use a PBM to Bill workers comp. Now to it, you can do it in most states. It’s some states aren’t as friendly to the little guys as others but in most states you can so kind of what are the benefits? Oh, that graphic was awful to sorry about that. But see, here’s a real numbers. So some real numbers of you bill a members all to one of the typical PBMs you’re getting paid probably $1.88 like pennies on the dollar. So you’re like why why would I go after worker’s comp, I’m getting a buck 88 That’s not even enough to pay for my vial, the sticker the lid and my time. But if you bill it direct now these numbers are after string cares, or Server X is fee because they do charge a fee, but it’s only on claims that you’re paid and money that you collected. So these new rates are after they get paid. So this is money to the pharmacy. So the $88 for the members all sertraline goes from $2.59 to $59.64. So celecoxib went from 1257 to 123 and 90 cents. And so these are just these are just a few examples. And so workers comp patients become very profitable, especially the higher the AW P and the lower cost of the drug. If anybody ever needs like on Danza, Tron or maybe even a lot of the pain pills, they have the highest WPS and low costs. They become very, very attractive. So workers compensation and all of this is done on the back end. And the reason i i talked about string care or Server X, I like string care a little bit more. I think string care is more aggressive. They kind of fight for you, so to speak, because a lot of adjusters and a lot of PBMs want to Well, the PBM is want to keep that business because they make a lot of money adjusters want you to build a PBM because it’s a whole lot less work on them. And so you kind of Get told oh no, just build a PBM, build a PBM build a PBM. And in some states, you are legally allowed, like you’re legally your your right to build Direct Bill is protected by law is what I’m trying to say. And stream care, we’re really fight with that. And they’ll help you kind of fight that adjuster server ex serve some more states than stringy care. But I also don’t think they’re quite as aggressive. So, you know, they’re but they’re both very similar. They provide great services, other people, they’re absolutely wonderful. So you can use either option, you can also DIY yourself, it takes a little more time, but you get to keep all of your reimbursements, you don’t have to share it with stream care or Server X. So you know, there’s definitely some benefits there. And you can kind of choose which way you want to go. So that is a direct billing worker’s comp, and I don’t just check in the chat to see if there’s any questions, I don’t see any. Okay. So number two is going to be very similar to number one, but it’s direct billing hospice. Now for most pharmacies have been running away from hospice, because it’s it’s high demand, it’s high service, you know, you need to fill prescriptions, they’re always in a hurry. It’s always an emergency. But then you get paid, you know, these really crappy dollar amounts for these prescriptions. And that’s because what happened and workers comp is the exact same thing that happened to hospice is PBMs came in, they’re billing the full amounts to the hospice facility, they’re paying you tiny little pennies on the dollar to the pharmacy, and they’re keeping everything in the middle. But you can actually direct bill hospice, again, you can DIY, a lot of these hospice centers, especially in smaller towns are just small, little businesses themselves, and you can just send bills direct to them. Or you can use a company like better RX, which helps cut out the PBM helps facilitate that billing and that processing and workflow and saves the Medicare facility money, and you actually get more reimbursement. So the only people that lose are the PBM. So the patient gets better care. Hospice can save more of their money, use the money for it for the patient in other ways, and you actually get a decent reimbursement. And so hospices are everywhere. So this can be done in every single state, whereas in some workers comp states, you know, the laws are a little bit different. Hospice is completely different. Obviously, the hospice agency is ultimately the one who makes the decision. But if you can let them know that one of the benefits of doing this is they get their limited dollars to go further. So in hospice, they get a set amount per patient, and they have to take care of all of those patient needs. With that money. If the patient costs more than what they get, they lose money. If the patient costs less than what they get, then they’re able to make money. So the more that you can help them spread those limited dollars, the better off their care is going to be able to be in the more profitably, you’re helping make that hospital that hospice center, you get adequate payment, you know, I’m not looking to make a boatload off of hospice, I’m looking, I’m looking to make a fair amount. And when you get paid fairly, you know, instead of I remember, I discovered this was one of those things where I was losing money on a hospice patient. I happen to know the hospice providers, we’ve been a hospice pharmacy for awhile, I called the head nurse, and I was like, hey, is there any way you can pay me more for this? Like, I’m losing money? And she’s like, how could you know, we’re paying $47, or whatever it was for this prescription? And I was like, No, you’re not, I’m only getting $6. And they’re like, No, I’m, I’m showing my bill right here. And that’s when we started to realize that, you know, the PBM was keeping what was in the middle. So the hospice was being charged many times over what I was actually being paid. So, so then that’s when we discovered and I started billing the hospice directly. So you know, we started getting paid about 25 bucks for that particular drug, they saved over $20, we made over $20, and both people were happy, except for the PBM. And I don’t think any of us really care if the PBM is unhappy. And ultimately patients get better care, the hospice you know, the more money that they have, the better they can take care of their patients, they can take care of their nurses, and that all results in better patient care for sure.
All right. All right. Number Oh, I see something in the chat. Let me bring it up. Nope, that was just Mike letting y’all know. Alright. So number three, rpm and CCM. Now you might be thinking, what is rpm? And what is CCM? So remote patient monitoring and chronic care management. I’ve been touting these programs for over three years now. And they just keep getting better. Because Medicare sees how much money they’re able to save the more patients that are on these programs. The more early warning signs that are happening, the earlier intervention happens and it’s saving them a ton of catastrophic expenses on the back end. And so, essentially, almost every year, Medicare has continued to expand either by adding billing codes or increasing reimbursement amounts. And so remote patient monitoring and chronic care management is A fabulous strategy. This one takes a little bit more effort to kind of get out of the train station if you will, stream care or direct billing worker’s comp Server X, you can literally turn it on in a day like you can be billing to stream care in a day it’s it is not difficult all you do is change your back end on your your billing software, and it is easy peasy. RPM does take some work to get going you have to you have to work with a doctor or with a provider office. So creating that relationship if you don’t have one or or you know, going through those steps, but it is very much worth it to get it up and going. So in this one value care suite, this is not one that you can DIY. So I’ve talked in the other ones, you know, you can kind of DIY your direct billing, you cannot DIY rpm and CCM. Medicare requires the kind of software that value care suite is in order to track all of the readings because they all have to be automated, and they all have to be electronic. And in order for you to count for these kinds of services, you have to use some kind of software. And frankly, I haven’t found one that’s better than value care suite. So no other software comes even close that I have tried to the efficiency, the optimizations and basically the ease of use like you and and the other really great thing that I want to note on here, I didn’t put it on the slide, but it does not have to be pharmacist driven. What Medicare has done is you it’s allowed basically any trained personnel to do this care. Now. Now granted, they can’t step out and do something illegal, you know, a class, a cashier can’t give advice on changing the dose of a drug. But the checking in on patients gathering readings, walking a patient through how to change a battery, or those kinds of things that happen. This is not a pharmacist LED type of services. So you can add these services with not putting a lot of burden on your pharmacist. So the value care Suite team is the most experienced that I have have come across, especially in the independent pharmacy space. They have more experience in helping pharmacies start in scale rpm and CCM programs, some of the biggest pharmacy providers that you can think of an independent pharmacy that provide these clinical services all us value care suite, which means they’re their team is just there’s no one better, they’re so knowledgeable, there’s never been a question that and or Brad have not been able to like answer and figure out and there’s there hasn’t been a problem I’ve been able to stump them with either. And I know a lot of times when I hear from pharmacies, oh, but I’m you know, I can’t do this cash base thing, because I’m in a, you know, low income area, or my patients won’t pay for that this kind of service is perfect for low income demographics. So this works fantastically one, those are the patients that tend to need more of this care. And you don’t have to worry about huge, you know, share of the cost or co pays or those kinds of things that might come with some other services that you’re trying to do. So this works even in low income demographics. Again, like I said, there’s a little bit more lift to get going. And so where do you start? How do you start? So we’ve been teamed up with value care suite now for over a year, they’ve put on monthly rpm and CCM calls just for our members. And we’ve recorded all of those. So there’s a whole series of calls. And the first I believe it’s the first seven calls are very linear. We they and and Brad really walk you through, like how to get started. And then the next one’s kind of hit on some very specific topics. But right up in the top membership in the menu, there’s an RPM and CCM link, if you click that, it’ll take you to all of the recordings. We also have lots of other trainings we’ve had Brad and Ian speak at our summit. We’re actually having one of our members Andy brown present at the summit this year. He’s up to I’ve lost track, I’ve lost track over six months on rpm and CCM and adds up to you know, last I checked in it was over $50,000 in profit every month that he’s getting from rpm and CCM and all he did was follow the value care Suite program. So we’re having Andy talk about it but there’s other training videos and stuff that we have in the memberships you can just search RPM as well in order to find those some of those other things but I this is one of those if you want to break into clinical, but you don’t have a lot you don’t have an extra pharmacist, maybe you are the pharmacist and you’re like I just can’t take on one more thing. RPM and cesium is really good because the software does the heavy lifting your support staff can do most of the work they only need to bring in the pharmacist if there’s some sort of patient problem that you know you need a pharmacist to come in and give advice for so I think it’s a fantastic program and you can get paid what you are worth so Alright, number four is higher margin prescriptions. So ever since about 10 days into January. I have been in New dated with what are the profitable stuff like I’m not making any money, what kind of stuff that I can dispense that is profitable. So I thought I’d go over some of them. This is just some of them, I try to post every month, especially for some of you that are newer members, I change our dashboard every month, and I try to highlight some things that are profitable, some are products, some are tactics or services. But we do try to highlight some things that are that are profitable, that are making money that we’re seeing out there. And if you want, I have other trainings on you know, kind of like how to approach higher margin prescriptions, because there is I think, a right way and a wrong way to to do these. So we’re going to talk about for today’s we’re gonna talk about alcohol swabs, clemastine, CoQ Santo and night trivia. And so we’re just going to go through these, this actually, I took the screenshot right from our community chat. So in our community chat, one of the group names is high margins and wins. So if you find something that works for you posted in there, so you can share it with other members. And this is kind of how some of this information, you know, gets shared between all of us. So alcohol swabs are kind of a unique thing, because we all dispense lots of prescriptions that need them. You know, I know a lot of people do ozempic and stuff, you know, they’re not making much money on or you’re or you’re losing money. I know many pharmacies lose about 30 to $40, if you dispense it, and so but you can make some of that with these alcohol swabs, and there are high reimbursing alcohol swabs. And whenever you give somebody an injectable, you should always dispense an alcohol swab prescription with it. Now you’ll need to get a prescription. Usually, you can just call the doctor. It’s usually not that complicated, and dispense it. So I put a screenshot here. There’s there’s other ones besides these. But there’s there’s definitely ones out there and you can get paid. I’ve seen 40 to $90. I’ve seen over 100 Depending on the insurance and the NDC for a box of alcohol swabs. So it can kind of help make up for that loss that you have on the ozempic side or the you know, whatever your injectable is.
I know insulins have gone through some changes this year with the changes of prices. But you know, you should still be dispensing alcohol swabs, you know, you want your patients to hygienic ly inject for sure. So, my personal favorite is clemastine when it comes to drugs. This is my favorite for many reasons, and we’ll kind of get into all of them. So clemastine is an old school anti histamine. So it’s a class one anti histamine. It’s not a new one, like Zyrtec or Claritin, that, you know, only work for about half the people. So it worked. It’s great for allergies, you know, seasonal, acute, it’s good for colds, you know, anything that causes a lot of snot in that reaction. It’s great for and we actually use it a lot in dermatology patients. So we use it as an adjunct to whatever their DERM treatment is. So if they’re on topical steroids, topical vitamin D, topical immune modulators, a lot of times those creams, one they take a while to work, to, they don’t completely get rid of the symptoms. And you can only put on so much of the creams, but clemastine Because it’s an old school, anti histamine like, pills, the itch. And so what we’ve done with our DERM patients is talk to them see if they’re getting full relief, if they’re not getting full relief, we talked to them. Is it worse at night? Is it worse during the day, you know, like you find out a little bit. Most of our patients, it’s worse at night and their itching keeps them up at night. And it’s probably just because they’re not distracted. You know, if you’re busy during the day, or you’re working during the day, you kind of itch and it’s not at the forefront when you’re lying, still trying to go to sleep in your bed. All you can think of is like gee, how much does itches. And so it does cause drowsiness. And especially when you start the medication you kind of get used to that drowsiness just like a lot of other medications, but it works really well at night. So if you have people that have that post nasal drip, you know their nose gets stuffy at night or they’re they have all those sinus problems. Or if you have people with the itch clemastine is a fantastic prescription. They don’t have to take it around the clock. They can take it just at night. We do have some people that take it around the clock because man it eliminates allergies, like no tomorrow. It’s not on any watch list. This is an FDA approved drug. So you’re okay to use online coupon with Caremark it does come with a with an online very generous copay card. So most of your patients will pay $0 So it’s $0 to add on this therapy to whatever they’re on. And our patients just love it because it works. So it is a liquid it is a syrup. It’s only available in syrup clemastine used to be taboo just it’s just not available anymore. It’s not that it’s off the market, just the manufacturers that used to make it stopped making it and so the only one that’s left is this syrup. So I know I get asked that question a lot. All right. And here’s like some of the coverage so I grabbed some screenshots of the coverage. It has pretty broad coverage across a lot of the you know, standard insurances. These types of products generally are not covered by Medicare, because they don’t do the whole Medicare rebate thing but any of your commercial plans, your union plans, your state plans. I know it’s covered on New York State Blue. Those kinds of things like it’s covered on a lot of those plans. So I just took kind of a screenshot here. And just to show you kind of the variety of that, so caulk Santo, and you’re probably thinking like, What the heck is this? I haven’t heard of this. So caulk Santo is coming out very soon. And I’ve had a couple of members that have been checking some benefit checks on it. And so far, the early coverage is fantastic. So, but this is oxaprozin. So those of you that are old, like me, probably remember oxaprozin. But it’s just kind of fallen out of, you know, it’s just kind of not popular. Some of the other ones came on the market, you know, ketoprofen, and the Moxa cans and kind of just took that attention. So oxaprozin, and this is a 300 milligram dose. So it’s a little more flexible, it’s a lower dose, it does have a branded and generic. So some insurances in our benefit checks cover the brand, some cover the generic, and so there are there are two options there. The big thing about oxaprozin is it’s once a day dosing, you know, it’s with all these once a day dosing options, you kind of wonder why somebody like a doctor even prescribes, you know, ibuprofen 804 times a day anymore, like it just seems so archaic, to think of somebody actually taking a pill three or four times a day. So once a day dosing, and that is, you know, fantastic for people who are looking for pain and inflammation relief. This is an FDA approved drug. So again, it’s okay to use the online coupon with Caremark, like I said, it’s got some fantastic early coverage and our early claim checks. And it should be ready to order in the middle of March. So I’m really super excited for this one. We’re going to start blasting our doctors about it at the beginning of March. So that way they can, you know, get you have some time to get some education, we should be ready to go. So that one I’m really excited about night trivia you guys if you listen to me know how much I love nitric oxide testing, and nitric oxide health. So nitric oxide is so important for so many people with so many medical conditions. So it’s helpful for people with medical conditions, and then it’s good for just overall wellness and your nitric oxide levels can naturally go down, whether it’s due to age, stress your environment, drugs that you’re on the food that you’re eating, but or you’re just over 40 like me, like you just your nitric oxide levels start to start to wane. So there is a prescription product. So this is a prescription product. This is a supplement, it does have the folic acid, the one milligram of folic acid, so it is a prescription supplement. When you do order this it comes with a the barrel of saliva test strips so you can I’ve got my like non branded ones here, but so that way you can test people’s saliva and screen them if their nitric oxide levels are low, you can also then prove that this works for them. This is a supplement. So when it comes to Caremark you cannot use online coupons for supplements or devices. So do not use a camera or do not use the manufacturer coupon on Caremark, you can use it on your other PBM. No problem. So far, I’ve seen it covered like on every catamaran plan. That’s just what I’ve seen so far. I’ve heard some Express grip plans are covering it too. And so this this is fairly new, it’s only been out for I think, not quite two months yet, so that that dispensing data is still kind of coming in. But it’s really good. If you dispense any erectile dysfunction drug, most of those men have nitric oxide deficiencies. And I don’t if you don’t have nitric oxide, it doesn’t matter how much Viagra you take, at some point, your nitric oxide levels will get so low that the Viagra is not going to work. And so any of your ED patients you should be screening them for nitric oxide, your High Blood Pressure patients, your thyroid patients, your diabetics, many, many more. We have a whole class on nitric oxide health inside the membership. But this really is an awesome product. I’m looking, I have my staff looking for just one patient a week. Again, I’m one of those where I like to dispense some things that make some money, but I also don’t like to go crazy. But and so the attribute has done done really well for us when it’s not covered under patient plan and we’ve screened them for that nitric oxide level. If the prescription is not covered, or it just doesn’t work out for them, we didn’t do recommend our over the counter nitric oxide cell. So we usually get one or the other. It’s like we either get the prescription or they buy the nitric oxide over the counter and either way it’s a win in my book and a win for the patient. So I really do love the night trivia. All righty. I don’t see any questions feel free again, guys. You can ask any questions? All right. Number five is weight loss compound tactics. So if you’re not a compound, are you You may have to kind of tune out for this for a little bit. Or you might know somebody who’s a compounder. And you can share this information with them. Obviously, weight loss drugs are all the rage right now. So I wanted to talk a little bit about some compounding options that maybe, you know is a little bit off of something that you haven’t talked about before. So I’m going to briefly touch on some non sterile and then I’ll touch on some sterile options. Non sterile, so many people don’t know about Tehsil fencing Tehsil fencing is a peptide, and it is, it is
allowed to be compounded because it meets all the FDA rules for being able to be compounded. It’s one of the few peptides that are able to be compounded, but it’s an oral peptide. So if you’re like a non sterile pharmacy, and you’re like, Man, I can’t do the injections, everybody wants the injections. You know, like this is a great option for you. It’s meant to be oral tesofensine capsules, super easy. As you all know, capsule formulations are super easy. And it’s a great opportunity. Also, PCCA just released their sub manga, which is their sublingual formulation for high molecular weight products. Not that Sima interest appetite or necessarily that high molecular weight, but they specifically made this for the peptides and the GLP ones. So that is an option. If you can order that from PCCA I did not hear back if because I PCC sell some of their stuff to non members and other things you need to be a member. So I’m not sure how they’re exactly launching this, they might be launching to members only. But this membership is generally worthwhile. If you’re going if you’re going into compounding and you really want to scale there’s nothing wrong. I mean, I can’t say anything bad about the PCCA membership show, especially now that they have the monthly payment thing. It makes it much more you know an easy pill to swallow, if you will. So that’s an opportunity and nasal sprays I think are the next best opportunity. I have a lot of familiarity you can say with nasal sprays and peptides. In California when I practiced and lived in California, I worked a lot with like the some of the plastic surgeons and some of the body builders stuff and they did a ton of peptides nasally. And so I’ve seen it work I’ve seen the SEMA and the Tres appetite work as well for patients just know that your ingredient cost is going to be a bit higher than the injections because the dose has to be a little higher because you don’t get obviously the same ratio of absorption as you do from your nasal when is when you’re injecting it into the body. But that is an option for non sterols. Nasal is not a sterile solution. So another option for you is you can just partner with the central fill pharmacy, Southland pharmacy, serving Patel is probably the one that I would recommend though there’s there’s several central fill pharmacies out there. And that means they fill it, they’re licensed in your state, they ship it to you, and then you get to sell it to your to your patients. So you pay them what what you know, they’re charging, so you could pay them $150 For the injection, and then you can sell it to your patient for 200 or 250 or whatever, you know, whatever you’re selling it to them for. So that’s how central fill it works. And then some of the traditional options, you know, the different strengths of phentermine, we used to do phentermine lollipops all the time. LDN low dose Naltrexone is used a lot in weight loss, all the different combinations out there of the Topiramate and those kinds of things, you can make some really unique combinations. The one I’ve seen a lot is the Topiramate the LDN with B 12 and B six, you know, so you’re making like this different combination and putting it together. So I know GLP ones kind of get all the current the craze but you still have a ton of options if you’re a non sterile pharmacy. Alright, alright, switching over to the sterile side. Obviously, if you can sterile compound, you should be doing the GLP ones there is more demand than there is supply. I know pharmacies, we actually have two members here in Texas with me and as soon as they’ve gotten all the approval and all of their testing. I mean, they had prescriptions coming in the next day. So there’s definitely more demand than there is supply for the GLP ones. In your areas. There’s some big pharmacies that have stopped delivering some states, some big pharmacies have closed downs due to some problems. So there’s definitely a lot of options. Once you’re doing some GLP ones and kind of you know, making your money and getting your foundation of your sterile lab going, you know, eyedrops are easy to add, NAD is easy to add hormones are easy to add. You can do a lot of those things for you know, kind of adding to your sterile. I think it’s really important to sterile, probably even more so than non sterile that you diversify your offerings, because things can kind of come and go and you know, the willingness of patients to pay because a lot of sterile sterile products are cash. Obviously, they’re a little bit more costly than the non sterile. So I think it’s really important to have like a diverse versified portfolio, one of the growth strategies that I would recommend is to compound or partner with non sterile or non compounding pharmacies. So we talked about, you know, the central fill pharmacies, which you don’t have to be a central fill, those pharmacies can just be referral partners for you. So you don’t have to go through all that legality stuff of the central fill, you could just partner with a non compounding or a non sterile compounding pharmacy, they send prescriptions to you, you fill it, dispense it to the patient, just like you would. And then you can reward that pharmacy for sending you that referral. And so you can create some nice partnerships. So if you have trouble growing your sterile compounding pharmacy, I would definitely look into partnering with either non sterile compounding or just non compounding pharmacies, because I guarantee they probably have practitioners that they have relationships with that are asking about it, and they don’t really have any good place to send them to. All right, last but not least, is bargain hunting. So this is something we really started doing very heavily in my pharmacy. Last year, as we were watching our brand usage go up and the whole debacle of we were taking in transfers, but they were only transferring the brand name medicine because the other pharmacies in town weren’t covering it, you know, and all this kind of stuff. And so we really started leveraging the match our x, some more. And so if you’re not on matchrx, I highly recommend just creating an account. And just you know, bargain hunt on there, you can find some really good buys sometimes like, we have bought some of the brand name insulins, the brand name injectables, it’s amazing sometimes what’s on there, you know, people get a prescription, they label it for the patient. And then the patient never comes in. And of course, that can’t be returned, because you know, it’s had a label on it. And so there’s some, you know, there’s some really good opportunities where you can get some things that are far below the typical cost that you might be able to find it for, and you’re helping out another independent pharmacy owner by getting it off their hands. So instead of you know, the whole thing being wasted, you know, if they paid 1000 bucks for it, they might be willing to let it go for 900 or 850, just to recoup some of that. So it’s we’ve, on average, I want to say it’s been about 30 503,000 to $3,500 of monthly savings, that that we found on there, just by bargain hunting. So my texts don’t go on there every day. Because they they just end up saying, Oh, we’re busy or whatever, but two or three times a week, probably, it’s really easy. It’s kind of like shopping on Amazon, it’s it’s really not that hard. We have still offloaded a lot of our brands, but we you know, we’ve kept some of them a lot of commercial ones and whatnot. And so now our employees know, if we’re ever losing money on something, or we don’t seem to be making much or something like that we owe, they now know to go to match our x and look there. So anyways, I highly recommend, it’s free to create an account, there’s no problem, create an account, you know, you have to you have to do your license lookup and that kind of stuff. So that’s really easy, but I definitely would pre preview it, look at it and see what kind of bargains you can find. Because you can find a lot of cheap brand names on there. Obviously, they have a lot of generics too. We’ve probably used it more for the brands. But anyway, so I wanted to put that in there as well. So any questions or comments on any of those?
Let’s see, we got Amy, Chris, Sean, John. You can unmute or you can chat and put it in the chat if you have any questions. No. All right. So again, don’t forget to get your member ticket, use your member link. That way I don’t have to refund you the difference. And you get to save money up front. I don’t want you to overpay. Also don’t forget about these member perks. I know some of you are new members. So some of this will be just a recap. But you get unlimited graphic design requests. Our graphic design team is become yours. We follow your instructions and kind of you know, do what you want us to do and they can make edits until your heart’s content. Don’t forget about office hours on Tuesdays at 10am Central. Add your employees to the membership let them go through Let us help your employees you don’t have to be that middleman. Um all of our essentials and up members you can schedule a call with Mike even if you’re not a coaching member, you can still you know talk to Mike every you know, once or twice a year just to kind of get that direction of like hey, what do I need to do? Where do I need to go? If you need help inputting your KPIs. You can have Mike help you with that. Say Hey Mike, I see this awesome KPI dashboard. I don’t exactly know what to do like Mike can help you walk you through that. I think the most important thing is to remember is like we’re here to help you like we’re here to to help and take burden Have you not add burden to you? So use us get your employees involved, and let us work with the employees, let us you know, kind of carry that bucket of water for you and get them connected in so that they can be a real support to you, instead of a drain on your energy and time. So, that is about it that I had for you today. Did any of y’all think of any questions? In the meantime? I don’t see any in the chat. Let me see. I don’t see any over there. No. That there is one in the chat. Oh, there is one there is there is? Yeah, I don’t see it. I didn’t get it. Okay, well, then you you say it, Mike.
Yes. Any specific examples scenarios on how to get our x from doctors for identifying to Vera for the patient?
Say that again? How to identify what
the patient for that drug to knit shirt. Oh, nine trivia
night trivia. Yeah, we just send them a fax. So we have some facts, templates. Um, you guys can look in the in the membership, but we just send a fax mostly say, hey, we tested you know, the patient’s nitric oxide level in the pharmacy, they were low. We’ve already you know, check the insurance, it’s covered on their insurance, you know, can we get a prescription for, you know, night trivia. So we just send them over a fax request or an E script request, you know, kind of depending on how you how you function. And most of the time, that’s all the doctors need. Sometimes they’ll ask, like, what is this but most of our doctors, we’ve already like say, hey, you know, we’ve sent them fliers and we’ve sent them things. It’s like, hey, we carry these products. But yeah, we asked for the prescription. Like we’d let them know, we’ve talked to the patient. We’ve identified this patient, this would be beneficial here, you know, it’s covered on their insurance. Here’s, you know, it’s not the copay, you know, those kinds of things. So we kind of solve all those questions for them. And usually they just e script back a prescription. Does that answer the question? Okay, yes, you say? Yes. Okay. Good question. Any others? Please. So
I’m just gonna tell you I sold I sold oxaprozin for a number of years deeper. Oh, you did? Yeah. That was actually funny. I was remember I was like kind of name sounds so familiar. But so long. You know, it was that was like first drug I sold. You know, when I went to Cirque de pro back in the day. Yeah, I was just gonna say that was a big seller, man. I mean, that thing. Orthopedic Surgeons love that. rheumatologist loved it. We you know, we sold the heck out of that thing. And I think I think our competitor was like, relevant at the time. Yep. Yep. Then the Cox two inhibitors came out and you know, then that,
yeah, they kind of died when the COX inhibitors came out. And of course, all the problems with the COX inhibitors came a few years later, and then they just those never kind of got like research.
Yeah, they never did. It was they were big sellers, though, we sold a ton of that stuff that and we had good results and seemed like with that class of medication. You know, I always just, I sold all pretty much all a ton of those different products, but it was like, probably like a 60% response rate, like, you know, if someone doesn’t get a response, switch to another one. And also, you’ll find that one that your body just seems to respond to I don’t know why that is. But that just seemed like the way that you know, and totally, it seems to work.
Yeah, that’s the way that’s all Yeah, all of those insights. But no, you’re right. And I think this is going to go over really, really well, especially for those little bit older prescribers. You know, the ones in their mid 40s and older because they remember this drugs they remember like how well they work. It’s once a day dosing. You know, I mean, like, it’s got all the benefits that you’re looking for. And it’s an approved drugs you can use the coupon and so you can get these patients that are taking multiple pills of ibuprofen or whatever a day, get them switched to this oxaprozin And they’ll probably pay no copay and they’ll only have to take it once a day. Like when when when right so yes, we have Cox Santo flyers and templates, those will be added from the manufacturer as soon as they all have final approval from the from the FDA on the flyers. So probably within a week or two, they’ll have those in the in the folder but I want me grab I want to grab you the folder real quick and that you can get the same link so you grab it here
helps if I spell it correctly
Alright, I’m gonna put this in the chat here. So this is this is the folder that it will be in once they they have the oh, I guess it’s already in there. They actually they did add it. So yes, it’s in there. You’re good to go. So it’s in that link. So yeah, you can send that out to doctors. That is the pharmacy brochure there the the the pharmacy one that usually has like the AW up and like all of that Add stuff on there. Um, let me get you the doctor version that doesn’t doesn’t have that on there
all right. So that is the pharmacist one and here’s the prescriber one. So that’s all it’s, you know, looks the same, but it’s just a little bit different for the prescribers. Good question. Where do you get the oxaprozin? So it will most likely be carried, you know, it’s not out yet, but it will most likely be carried by real value products. Axia, which is Cochran? Well, logistics, those types of secondary wholesalers will will carry it so we won’t be available like at your at your primary, it’ll be available through the secondary market. So I’ll type those ones in here. And I keep a list of those. So I’ll update it as soon as it’s obviously available and who? Who, who’s carrying it. Good question. already? Well, I want to be respectful of your time. And thanks for joining. And if you think of a question later, again, just hit that Contact Us button if you want to send a private message, or you can post in the community chat. And we’ll hop on there as well. And that is about it. So enjoy the rest of your Thursday. Enjoy the rest of your week. And I’m going to be teaching the peptide compounding training class this weekend. So I’ll be in Idaho, so hopefully, I don’t freeze to death or anything you know, and bringing all my Colorado gear so hopefully I’ll survive and whatnot. Hope you guys have a great weekend and we’ll talk to you again tomorrow or later. Yep, no more questions. All right. Bye, guys.

Date: January 25, 2024
Time: 12:00 pm