How PSAOs and Wholesalers Undermine Pharmacies | Brett Louderback, PharmD, OpenBook

In an industry where wholesalers often undermine pharmacies, Brett Louderback, a dedicated pharmacist and first-time store owner in Nebraska, opens up about his path to pharmacy ownership and the creation of his consulting group. This episode delves into the pivotal insights from a car dealer that significantly shaped Brett's business strategy in the pharmacy sector: "You don't make money at the sale. You make it at the purchase." This philosophy is especially relevant in the context of the challenges pharmacies face with wholesalers, highlighting the importance of strategic acquisitions and negotiations.

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Key Discussion Points:

1. Leadership Philosophy:

   • Transition from a "benevolent dictatorship" to collaborative leadership with business partner Steve Bullock and the role of mentor Barry Kubo in shaping Brett's business acumen.

2. The Business of Pharmacy:

   • The evolution of Brett's pharmacy practice from traditional services to embracing consulting, recognizing the potential beyond the pharmacy counter. The conversation explores the critical aspect of identifying new business opportunities and core savings in the niche market of independent pharmacies.

3. Challenges with Wholesalers and PBMs:

   • A candid discussion on the struggles independent pharmacies face with wholesalers, PSAs, and PBMs, highlighting the opaque practices that jeopardize pharmacy profitability and sustainability.

4. Financial Strategies and the Future of Pharmacy:

   • Brett outlines four pillars crucial for negotiating with wholesalers, emphasizing the need for independent pharmacies to reclaim their financial footing and exploring potential reforms in pharmacy contracting and reimbursement models.

5. Advocacy and Vision for Change:

   • The episode touches on Brett's passion for addressing systemic issues within the pharmacy industry, including the dire need for transparency, accountability, and fair compensation practices. Brett's encounter with Senator Grassley is discussed, underscoring the significant policy decisions affecting pharmacy practice.

6. Personal Reflections and Advice:

   • Brett shares his thoughts on the future of pharmacy, pondering the decisions that aspiring pharmacists and current professionals face in an ever-changing healthcare landscape.