Latest / Pharmacy Podcast Network / Distribution Strategy and Partnerships: A Conversation with Tom Napolitano of Real Value Rx | Executive Dose

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Distribution Strategy and Partnerships: A Conversation with Tom Napolitano of Real Value Rx | Executive Dose · Pharmacy Podcast Network

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Speaker 1: You are listening to the Pharmacy Podcast Network.
0:24
Speaker 2: Welcome to Executive Dose, the podcast where pharmaceutical leadership meets
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Speaker 2: unfiltered insight. Hosted by Stephen Beckman, CEO of Your All Pharma.
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Speaker 2: Each episode explores the complex forces shaping today's pharmaceutical industry,
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Speaker 2: from global supply chain stress and regulatory shakeups to innovation
0:43
Speaker 2: in branded and generic drug markets. Join us as we
0:46
Speaker 2: engage sea level leaders and decision makers in candid conversations
0:50
Speaker 2: about navigating disruption, driving growth, and preparing for the next
0:54
Speaker 2: era of pharmaceutical transformation. Curiosity leads, strategy follows. This is
0:59
Speaker 2: the Executive Dose.
1:04
Speaker 3: Hey there, welcome back to Your Ralph Pharma's podcast series
1:08
Speaker 3: that we've been doing for some time. I'd like to
1:11
Speaker 3: say hello and welcome back my co host Steven Beckman,
1:14
Speaker 3: CEO of Your Ralph Pharma.
1:16
Speaker 4: Hey Todd, it's a pleasure to be here again. And
1:18
Speaker 4: we got another I think, really exciting topic and I'll
1:21
Speaker 4: give you the honors of introducing our guests today. But
1:25
Speaker 4: this is a program that we started back early this
1:30
Speaker 4: year in twenty twenty five, and we think the response
1:33
Speaker 4: has been very positive and we're looking forward to continuing
1:37
Speaker 4: to do this podcast as well as the Executive Dose podcasts,
1:43
Speaker 4: as a goal to really create a greater engagement and
1:48
Speaker 4: connection between what we do as a supplier all the
1:52
Speaker 4: way down through the pharmacist and patient, because ultimately that's
1:56
Speaker 4: what we do our jobs for. It down to making
2:01
Speaker 4: the health outcomes of patients better. And there's a lot
2:04
Speaker 4: of challenges all the way through our business, and so
2:08
Speaker 4: one of these things we can do is start tackling
2:10
Speaker 4: them a little bit more open. And that's why hopefully
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Speaker 4: we'll do it a little bit today.
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Speaker 3: I'm excited. And part of that ecosystem that you're describing
2:18
Speaker 3: are the right partners, and one of those partners is
2:22
Speaker 3: Real Value our ex and we've worked with Tom Napolitano
2:26
Speaker 3: and his team. Stephanie. Shout out to Stephanie Zimmerman and
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Speaker 3: one of my favorite people throughout the years of pharmacy
2:33
Speaker 3: and understanding. She's so intelligent, so intuitive into business development
2:38
Speaker 3: and understanding what the pharmacist is going through. Tom, welcome
2:41
Speaker 3: to the show.
2:42
Speaker 5: Thank you.
2:43
Speaker 6: I really appreciate being here. I agree with you. I
2:46
Speaker 6: agree with your sentiments on Stephanie.
2:48
Speaker 3: Yeah, shout out to Stephanie. Tom. I want to start
2:53
Speaker 3: with you for the listeners, and that is you know,
2:56
Speaker 3: this is a this is a different world that we're
2:58
Speaker 3: in today than when I started in pharmacy two thousand
3:02
Speaker 3: and four, and the temperaments change, you know, the sensitivity
3:08
Speaker 3: around margins and having strategic relationships with organizations like Real
3:13
Speaker 3: Value could make or break a pharmacy out there and
3:17
Speaker 3: just open up and give us kind of the state
3:19
Speaker 3: of the nation of where you think we are right now.
3:23
Speaker 6: So I think we're in a really dynamic phase. I
3:27
Speaker 6: was at HDA yesterday in Marshton, d C. I sit
3:30
Speaker 6: on their Government Council meeting. And in the past those
3:34
Speaker 6: meetings have been you know, one or two topics and
3:38
Speaker 6: nothing earth shattering, but now it seems like everything's hitting
3:43
Speaker 6: so fast that they're overwhelmed. We had like ten things
3:45
Speaker 6: to discuss, but a lot of it is good in
3:50
Speaker 6: the chaos. So, I mean, they really are starting to
3:54
Speaker 6: really talk about drug shortages and the causes of that.
3:59
Speaker 6: But there's so they talked about drug drug pricing, the
4:04
Speaker 6: other areas in government policy that affects you know, CMS
4:10
Speaker 6: and and reimbursement and all those kinds of things. So
4:13
Speaker 6: they went through all all of that and three point
4:16
Speaker 6: forty B was another big area that I personally don't
4:19
Speaker 6: get involved in in our business, but very hot topic,
4:22
Speaker 6: but some of the discussions around there. So the issue
4:26
Speaker 6: with with drug shortage, if I can touch on that
4:29
Speaker 6: real quick, is it's it's very apparent that in the
4:36
Speaker 6: in the market, in the industry, people saying drug prices
4:39
Speaker 6: are too high, and you have Inflation Reduction Act, you
4:42
Speaker 6: have a Trump coming out with something to address dress
4:46
Speaker 6: that as well, so you have all these things happening.
4:49
Speaker 5: But but really brand.
4:52
Speaker 6: Drugs, Yeah, they may be expensive, and they may that
4:54
Speaker 6: may they are expensive, but there's reasons for that and
4:57
Speaker 6: that could be addressed. But it's the generics that's the issue.
4:59
Speaker 6: And you can't throw generics into drug prices are too
5:03
Speaker 6: high because we used to on just regular maintenance drugs,
5:07
Speaker 6: which is most of the drugs we all take. They
5:09
Speaker 6: used to be eight ten manufacturers making them competing, always
5:15
Speaker 6: had an abundance of supply because there's so many players
5:17
Speaker 6: in that in that particular drug well through competition, uh
5:23
Speaker 6: and and really driving down prices with the wholesalers, and
5:27
Speaker 6: you know, you have your CVSS and your cardinals coming together,
5:30
Speaker 6: you have the other giants coming together and they squeeze
5:34
Speaker 6: these prices out to that these common generic drugs are
5:39
Speaker 6: you know, a bottle is being sold for a dollar,
5:41
Speaker 6: and that doesn't cover the expenses.
5:43
Speaker 5: Right, So now you have instead of ten, you go
5:46
Speaker 5: down to three. Right.
5:48
Speaker 6: So now instead of we have eight to ten manufacturers,
5:50
Speaker 6: now there's two or three. And then after COVID, you
5:54
Speaker 6: had all of the the FDA going out and catching
5:57
Speaker 6: up on lost time and all these you know, forty
6:01
Speaker 6: three's for these manufacturing facilities because of this catchup. So
6:05
Speaker 6: now you had three manufacturers. Now you just lost one
6:07
Speaker 6: because they're one. They got a forty three and they
6:10
Speaker 6: have to cure. So that's how these shortages happen. And
6:14
Speaker 6: so it's low pricing and it's just not enough players
6:17
Speaker 6: in the market.
6:18
Speaker 4: Yeah, Tom, that's a really really important and very accurate.
6:21
Speaker 4: So you know, for example, in our business, we supply levocaps,
6:27
Speaker 4: and the levathoxin market is currently supplied by over seventeen manufacturers.
6:33
Speaker 4: And so to Tom's point, what's really happening in the
6:37
Speaker 4: market is that companies are now at that point where
6:41
Speaker 4: they're not going to manufactured product anymore because the margin
6:44
Speaker 4: is completely evaporated. If not negative. And two, you know,
6:50
Speaker 4: the fact is that you know, the whole idea of
6:53
Speaker 4: Generics was to increte access to high quality drugs at
6:56
Speaker 4: affordable price. Right, we're trying to make sure that every
6:59
Speaker 4: patient has access to product, but sometimes you have to
7:03
Speaker 4: be careful that we're not over extending our skis. And
7:07
Speaker 4: I think that's exactly what has happened because now we
7:09
Speaker 4: don't have any controls that prevent multiple companies from around
7:15
Speaker 4: them come in. And when you really think about it,
7:17
Speaker 4: not every company has the same objectives. If you're taking
7:21
Speaker 4: a manufacturer maybe from India, they're more concerned about absorption
7:25
Speaker 4: at their plant. They're not worried about margin, so they
7:30
Speaker 4: come into market US or other and it's about market share.
7:33
Speaker 4: It's not about right pricing. As I like to say,
7:37
Speaker 4: you know, we've gotten to the point where and we
7:39
Speaker 4: get it. The system is always going to try to
7:42
Speaker 4: put downward pressure on pricing, and everybody does that, and
7:45
Speaker 4: different different components within the industry do more of it
7:48
Speaker 4: than others. But the point is that we have to
7:51
Speaker 4: get to the equilibrium where we have right pricing. In
7:54
Speaker 4: my honest opinion, right price is that we create the
7:57
Speaker 4: right dynamic of suppliers. We have to put more hurdles
8:01
Speaker 4: in some of these companies that are marketing or selling
8:04
Speaker 4: their products in the US, and we have to find
8:06
Speaker 4: a way that create value through the system. At the
8:09
Speaker 4: end of the day, manufacturers have to make money, wholesales
8:12
Speaker 4: and distributors have to make money. Payers have to be
8:14
Speaker 4: able to control their net cost. But ultimately we have
8:17
Speaker 4: to be and pharmacists have to make money. You know,
8:19
Speaker 4: pharmacists right now are losing money in many cases. So
8:22
Speaker 4: we've got to find a way that ultimately we can
8:25
Speaker 4: satisfy the system as we have it in the US
8:27
Speaker 4: and still be able to service patients. But I think
8:30
Speaker 4: unfortunately the pressure and Tom, I love you to comment
8:33
Speaker 4: on this, so on drug shorties, I think it's going
8:36
Speaker 4: to get worse before it gets better. I think obviously
8:39
Speaker 4: President Trump is doing certain things on the tariffs for
8:43
Speaker 4: certain reasons. We might agree or not agree, but I
8:46
Speaker 4: think some of them are to bring more manufacturing back
8:48
Speaker 4: on the US and bring more protection around inventory of
8:54
Speaker 4: drugs that are essential. And that's not a bad thing.
8:58
Speaker 4: But we have to still continue to try to do that.
9:00
Speaker 4: But if the tariffs and other things even state licensing
9:05
Speaker 4: from manufacturers and Tom, you have a increase cost on
9:08
Speaker 4: your end of the business. Now, all of a sudden,
9:11
Speaker 4: those pressures could continue to continue to go, and I
9:14
Speaker 4: think we're going to see more companies leave products in
9:19
Speaker 4: the marketplace. In fact, I believe the number last year
9:23
Speaker 4: TOM was and does newly approved and is only sixty
9:27
Speaker 4: percent were actually launched. That means forty percent didn't even
9:32
Speaker 4: go to market. The company received an approval and did
9:34
Speaker 4: not go ahead and launch it because the market conditions
9:37
Speaker 4: had become so unfavorable. But any other thoughts on.
9:40
Speaker 6: That, Well, I mean, right there, if it costs two
9:43
Speaker 6: million dollars to five million dollars, let's say to bring
9:46
Speaker 6: a Nando and you, the pricing is so depressed that
9:53
Speaker 6: it doesn't make sense. So that's why I think you're
9:55
Speaker 6: seeing the passing because they're like, I'm not going to
9:57
Speaker 6: spend five million and potentially be out of the product
10:00
Speaker 6: in six months because it's it's underwater. So that I
10:04
Speaker 6: think that's the economics of that is coming into play.
10:08
Speaker 6: One thing I wanted to add that we're doing indirectly
10:12
Speaker 6: to help retail independence is we are carrying more small manufacturers.
10:17
Speaker 6: So these small manufacturers. They can't get to the table
10:21
Speaker 6: with the big three. When I say Big three, it sounds.
10:25
Speaker 5: Like I'm being negative. I was twenty one years a Cardinal.
10:27
Speaker 6: I'm not being negative, but it is a giant entity
10:32
Speaker 6: that impacts the industry and has a lot of control.
10:36
Speaker 6: But so we work with these small manufacturers that they
10:39
Speaker 6: can't get to the table. They just can't meet with,
10:42
Speaker 6: you know, Red Oak, which is CBS Cardinal. I'm just
10:44
Speaker 6: using them as an example as others. So we let
10:48
Speaker 6: them come to the table. Well, we're glad to talk
10:50
Speaker 6: to them. And we have been bringing items working with
10:52
Speaker 6: these small manufacturers that have created additional opportunities. You know,
10:59
Speaker 6: maybe in seat of a couple items, we're bringing the third.
11:02
Speaker 6: We're also bringing in items that is a new strength.
11:06
Speaker 6: So it's a small manufacturer, they're coming in with a
11:09
Speaker 6: strength between the high and the low, let's say, and
11:13
Speaker 6: all of a sudden, now we have a new flex
11:16
Speaker 6: dosing alternative for the pharmacies and they pay well because
11:21
Speaker 6: there's not ten players competing with it. So just those
11:25
Speaker 6: are kind of things that we're doing to help bring
11:28
Speaker 6: more solutions to the retail independence.
11:31
Speaker 4: Yeah, that's a great example and you're right. I mean,
11:33
Speaker 4: when we think of the big three distributors national wholesalers,
11:37
Speaker 4: they control over eighty percent of the drug flow. So
11:42
Speaker 4: it is important that we create a competitive dynamic at
11:45
Speaker 4: the wholesale level and distributor level, like yourself, right, we
11:49
Speaker 4: have to do things to help you just as you
11:52
Speaker 4: point out, and you've and we are in for full transparency.
11:55
Speaker 4: We do sell product to real value as you're out,
11:59
Speaker 4: and we would fit into that small manufacturer. So what
12:03
Speaker 4: we have to do is find better ways to create
12:07
Speaker 4: more diversity in access through the channel as well. And
12:13
Speaker 4: the question is how do we do that, Because if
12:15
Speaker 4: we can do that, then we could probably naturally create
12:22
Speaker 4: a fair competitive marketplace in terms of supply a product
12:25
Speaker 4: and then create the relative value needed to carry it
12:28
Speaker 4: all the way down through. And if we can do that,
12:30
Speaker 4: then ultimately I think we're going to have to get
12:34
Speaker 4: away from best price consideration. At best price, we're actually
12:42
Speaker 4: not doing service to the system and most importantly to
12:44
Speaker 4: the patient. And until we fix that, we can't work
12:47
Speaker 4: it back up because then the pharmacists can't get much better.
12:51
Speaker 4: So one of the things we have to find a
12:52
Speaker 4: way is how do we get to that dynamic in
12:56
Speaker 4: terms of us being able to get a right price.
13:01
Speaker 4: And I think if we can get a right price
13:03
Speaker 4: in the system, we don't need seventeen suppliers of legal
13:06
Speaker 4: throx and tablets. We could use eight, and I think
13:10
Speaker 4: we can achieve all the things that we want. They'll
13:13
Speaker 4: ensure the highest quality players are in the mix. It
13:16
Speaker 4: will ensure that pricing can stabilize more, which it actually
13:21
Speaker 4: has in generics over the last few years because of
13:24
Speaker 4: drug shortages. But what it's telling us is that if
13:30
Speaker 4: we do some of these things we don't have to force,
13:32
Speaker 4: it will naturally happen. And when that naturally happens, organizations
13:36
Speaker 4: like Real Value can be more successful and they'll be
13:39
Speaker 4: able to invest more into the pharmacy. And quite frankly,
13:42
Speaker 4: we as manufacturers can partner with an organization, a partner
13:46
Speaker 4: like Real Value to drive those things that will eventually
13:50
Speaker 4: help the pharmacists stay healthy. And the pharmacist has to
13:54
Speaker 4: stay healthy because not only do they fill those prescriptions,
13:57
Speaker 4: but they are taking care of our patients, and they're
14:00
Speaker 4: going to become equally if more important, given the access
14:03
Speaker 4: to physicians are becoming more challenging and so forth.
14:05
Speaker 5: So Tom What are some of.
14:08
Speaker 4: The things that you guys are doing outside of like
14:11
Speaker 4: drug shortage that is trying to enhance the product flow
14:17
Speaker 4: and or specific things you're doing with a pharmacy outside
14:20
Speaker 4: of what you already mentioned prior. Is there anything else?
14:23
Speaker 6: Yeah, So I think an area of excitement is AI
14:28
Speaker 6: and and I'm not an.
14:30
Speaker 5: Expert whatsoever, so this is not an AI show.
14:34
Speaker 6: In fact, probably three or four months ago, I was
14:35
Speaker 6: one of the people like, oh, we're going to the
14:38
Speaker 6: robots had taken over. But but now that I understand
14:42
Speaker 6: it better, it really it comes down to it's not
14:47
Speaker 6: that the decision are going to be made for us
14:50
Speaker 6: and we don't have control. It's nothing like that. It's
14:52
Speaker 6: it's again, it's it's speed of information. So if you
14:56
Speaker 6: go back to when Apple came with the with the
14:58
Speaker 6: personal computer, that was a big jump.
15:01
Speaker 5: The Internet was a huge jump.
15:05
Speaker 6: Mobile phone, you know, using our cell phones as a
15:08
Speaker 6: device was another jump. So I view this as another
15:12
Speaker 6: information jump. And so when I had when I joined
15:16
Speaker 6: Real Value six years ago, we had one or two analysts,
15:20
Speaker 6: and we've grown that to close to ten analysts we
15:24
Speaker 6: call data scientists, and so they've the last couple of
15:28
Speaker 6: years really been cranking through information. Is so much data,
15:31
Speaker 6: so that helps us understand what costs we should be
15:36
Speaker 6: asking well, what price is a competitive price to sell at?
15:39
Speaker 5: What items should we carry?
15:41
Speaker 6: So they were already doing that, but now that they've
15:44
Speaker 6: last three months have been using AI and in fluxing
15:46
Speaker 6: that into it. At first it's kind of scary, but
15:49
Speaker 6: really when it stepped back, it's just more information, much
15:53
Speaker 6: much faster.
15:55
Speaker 5: So where we might say, oh.
15:56
Speaker 6: We're going to be obsolete being replaced, no, it's actually
15:59
Speaker 6: just giving us more information to make better decisions fast
16:02
Speaker 6: and that that information is coming really fast.
16:04
Speaker 5: So we're going to know.
16:07
Speaker 6: What doctors are prescribing, what drug where, what you know,
16:11
Speaker 6: what's being sold by pharmacy. There's so much data you
16:14
Speaker 6: can market to. You can connect dots that we're never
16:18
Speaker 6: able to connect before finding that doctor that needs to
16:21
Speaker 6: know about this this medication that will help patients, and
16:25
Speaker 6: letting a pharmacy connect those dots. Hey, you can fill
16:28
Speaker 6: the script. There's people that need it. We're getting down
16:31
Speaker 6: to that granularity and just understanding. I think this is
16:35
Speaker 6: going to help also with the manufacturers, so they're going
16:40
Speaker 6: to understand better how you know what's driving their pricing,
16:44
Speaker 6: their movement. I think they're going to get better with
16:46
Speaker 6: their demand forecasting, their coal chain, monitoring, their all those
16:54
Speaker 6: things that go into and I think serialization. Unfortunately, it
16:59
Speaker 6: was multi multi million spent on cerialization across the industry
17:05
Speaker 6: when we probably would have had a solution now that
17:08
Speaker 6: would have been a fraction of that. So that just
17:09
Speaker 6: shows you know how much things are changing so fast.
17:13
Speaker 6: So again, I just think we're getting so much information
17:15
Speaker 6: we're going to fine tune and I think it's going
17:17
Speaker 6: to help the pharmacies with cost and also getting them
17:21
Speaker 6: the items, the right items faster.
17:24
Speaker 4: Yeah, Tom, I want to touch on serialization a minute
17:27
Speaker 4: because you brought it up on the back end, but
17:28
Speaker 4: I think you're absolutely right. You know, right now the
17:31
Speaker 4: things that are most challenging are things like working capital. Right,
17:35
Speaker 4: take your average local independent pharmacy. It costs them money
17:41
Speaker 4: to carry product and they have to wait for reimbursement.
17:45
Speaker 4: If they can be more efficient, and we got efficient
17:49
Speaker 4: from the manufacturer through the distributor wholesaler down to the pharmacy,
17:54
Speaker 4: that's one thing. So I think the question is there's
17:56
Speaker 4: no doubt that AI is going to assimilate more data faster,
18:01
Speaker 4: make it clearer. And then the question is how do
18:04
Speaker 4: we translate to things that are contented create real value.
18:10
Speaker 4: I know that was pretty good you on Friday. That
18:12
Speaker 4: was a little plug. You can spend dollars later. So
18:15
Speaker 4: the point is, so working capital be one of them.
18:20
Speaker 4: Do you think things like AI can help in the
18:23
Speaker 4: pharmacy physician dynamic. Let's take up a product like ours
18:29
Speaker 4: and lebal throcks and capsules, huge, huge market. It's ninety
18:33
Speaker 4: percent generic, but we know there's a population of patients
18:37
Speaker 4: that are not served well by generic tablets because there
18:42
Speaker 4: are allergy related or other tolerability is who's associated with
18:46
Speaker 4: some of the inactives where the profile of our product
18:50
Speaker 4: has three ingredients, right, So find subpopulations out there that
18:56
Speaker 4: would definitively do better in terms of health outcome.
19:01
Speaker 5: This is a way that maybe.
19:02
Speaker 4: We can start drilling that down and providing that information
19:05
Speaker 4: not only to the pharmacists, because a lot of times
19:07
Speaker 4: the patient will be talking to the pharmacists and have
19:09
Speaker 4: that then can create that dialogue back with physicians and
19:12
Speaker 4: then the whole thing works and then you guys have
19:14
Speaker 4: a better understanding of what type of products fit where
19:18
Speaker 4: within those population. Not just so you see prescriptions going out,
19:21
Speaker 4: but we understand why those prescriptions are going out and
19:24
Speaker 4: that should happily help facilitate the whole the process on efficiency.
19:29
Speaker 4: So efficiency would be one working capital management, anything else
19:32
Speaker 4: you see as a defined outcome, whether it be at
19:36
Speaker 4: the wholesaler distributed level or at the pharmacy level from
19:39
Speaker 4: the use of AI.
19:40
Speaker 6: So on the on the levo your product, and I'm
19:45
Speaker 6: going to return the favor. It's unique in that it
19:48
Speaker 6: serves a population that I think twenty five percent of
19:52
Speaker 6: the population can have a side effect from the one
19:56
Speaker 6: of the inactive ingredients in the in the normal form
20:00
Speaker 6: of librathoxin, but yours is unique that it doesn't have
20:03
Speaker 6: that ingredient, and so it can help twenty five percent
20:06
Speaker 6: of the people that take it. What I'm saying AI
20:10
Speaker 6: can do is right now. You and I probably talked
20:13
Speaker 6: months ago. Hey, Tommy, interested in carrying this product?
20:16
Speaker 5: Go? It sounds great.
20:17
Speaker 6: Where are those patients exactly and how do we and
20:20
Speaker 6: how do we find them? Because they can be in
20:23
Speaker 6: distress and don't even know there's an option. So what
20:26
Speaker 6: I'm seeing through our AI, through our marketing and through
20:30
Speaker 6: the analytics, we have the ability to find those patients.
20:36
Speaker 5: That sounds scary, but it really is.
20:38
Speaker 6: You can find where they are, you can learn how
20:40
Speaker 6: to market to them and get the word out that
20:43
Speaker 6: there's there's other options, and then also to getting that
20:46
Speaker 6: in information to the pharmacies. We are working on those
20:49
Speaker 6: things and that is going to make that is going
20:51
Speaker 6: to make an impact if.
20:53
Speaker 4: We switch screws a little bit and we think a
20:54
Speaker 4: little bit back up at the relationship right because the
20:57
Speaker 4: goal of this podcast is really take the reallyationship from
21:00
Speaker 4: manufacturers down to patient. What kind of things as a
21:03
Speaker 4: distributor are your greatest challenges right now and how are
21:09
Speaker 4: some of those challenges or opportunities could be potentially addressed
21:14
Speaker 4: with healthier relationship with the manufacturer Because at the end
21:17
Speaker 4: of the day, if we're fixing it up on the
21:19
Speaker 4: front end, it should hopefully trickle down ultimately to the
21:21
Speaker 4: pharmacist and patient. So, when you think about the dynamic
21:24
Speaker 4: that you're facing as a distributor right now, what are
21:28
Speaker 4: some of the things that we should be thinking about.
21:31
Speaker 4: What's some of the things that we should be tackling
21:32
Speaker 4: in terms of opportunities more challenges that we have to overcome.
21:37
Speaker 6: So I think we have been. I think our relationships
21:40
Speaker 6: with manufacturers have grown strong in the last couple of
21:43
Speaker 6: years because of all the problems, all the shortages. But
21:46
Speaker 6: we'd certainly talk a lot more than we used to,
21:48
Speaker 6: which is which is a good thing.
21:51
Speaker 5: But I think.
21:55
Speaker 6: It it comes down to if manufacturer is communicate with
22:01
Speaker 6: us right now.
22:02
Speaker 5: I think I'm trying to get back to that.
22:04
Speaker 6: They right now struggle with their relationships with the with
22:09
Speaker 6: the Big Three. I'll mention that again that's their focus,
22:14
Speaker 6: and so that creates some some shortages there. But we
22:18
Speaker 6: work with manufacturers to say, hey, we know you have
22:22
Speaker 6: a situation with the manufacturer. You know you you have
22:25
Speaker 6: you have contracts with the Big three, but we have
22:27
Speaker 6: shortage issues here and we help them understanding, hey we
22:32
Speaker 6: can we can buy your item, maybe a little bit
22:35
Speaker 6: higher price than than your your contracts, which is fine,
22:40
Speaker 6: but open some of that up to us and let
22:42
Speaker 6: us sell and feed it to the retail independence.
22:45
Speaker 5: And that's been happening.
22:46
Speaker 6: We've been having these discussions, which be called one time
22:49
Speaker 6: buyas it's outside your normal contract. But we're able to
22:53
Speaker 6: do more of these and be more flexible to get
22:56
Speaker 6: products to the customers because if Cardinal's out of some
22:59
Speaker 6: Cardinal only has well McKesson san Kora, they only have
23:02
Speaker 6: one one in a backup. But we're able to come
23:06
Speaker 6: in and harry several different items and work with those
23:09
Speaker 6: manufacturers to keep the flow of products to the independence.
23:13
Speaker 6: And that's our focus is independence. That's not that hospital
23:16
Speaker 6: is not important and all that, but that's our focus
23:19
Speaker 6: is we have retail independence and having those relationships and
23:22
Speaker 6: dialogues on a daily basis with the manufacturers, we are
23:25
Speaker 6: bringing more products to them.
23:27
Speaker 4: Yeah, Tom, it's glad to hear you say that, because
23:30
Speaker 4: one of the things that we've done as an organization
23:32
Speaker 4: is try to narrow that gap a little bit between
23:36
Speaker 4: the large national wholesalers and the rest of the organizations
23:40
Speaker 4: like yourselves out there, because there in many cases and
23:43
Speaker 4: I'm not going to say anything specific to one company
23:46
Speaker 4: or one product, but the fact is there is a
23:49
Speaker 4: it can be a fairly large spread between the pricing
23:54
Speaker 4: that and how it goes to these different partners. And
23:58
Speaker 4: by bringing a little bit closer together and raising the
24:02
Speaker 4: opportunity for more distributors to be available to their customers
24:06
Speaker 4: in certain areas for all kinds of reasons. So that's
24:10
Speaker 4: I'm very happy to hear you say that, because that's
24:11
Speaker 4: one of the tenets by which we've tried to operate
24:16
Speaker 4: is to is to great greater access to them. What
24:21
Speaker 4: about things like your role in educating pharmacists, right, you know,
24:28
Speaker 4: pharmaceutical industry. I will say this, I've been into thirty years,
24:32
Speaker 4: We've been somewhat elitist, and a lot of the things
24:36
Speaker 4: that we've done over the years into marketing. We go
24:39
Speaker 4: out and we do market research and then we decide
24:42
Speaker 4: what all our customers need. And I think one of
24:44
Speaker 4: the things that we've changed, at least especially at your
24:47
Speaker 4: aw is that we want to listen. And I think
24:49
Speaker 4: your point about conversation is the most important thing. I
24:53
Speaker 4: always taut to my team. There's three c's and what
24:56
Speaker 4: we do connect, collaborate, and communicate, and through that we
25:00
Speaker 4: can learn a lot more about how we can service
25:03
Speaker 4: because ultimate, at the end of the day, if the
25:06
Speaker 4: patient's not taking the drug and the pharmacyt is not
25:08
Speaker 4: dispensing a drug, everything we're doing before it really doesn't
25:10
Speaker 4: count that much. So we've got to find better ways
25:13
Speaker 4: to bring all the value through to the patient. So
25:17
Speaker 4: are the things that you know when you think about
25:19
Speaker 4: collaboration and connectivity or the interdependence of what we do.
25:24
Speaker 4: We all have to be working together, and if we
25:27
Speaker 4: work better together, it is going to create more benefit.
25:29
Speaker 4: Is there things that you see that you're able to
25:33
Speaker 4: do now with independent pharmacists or or any of your customers.
25:36
Speaker 4: It says, hey, we can provide more education programs, we
25:40
Speaker 4: can provide more insight on I don't know, inventory management
25:46
Speaker 4: things that then can actually translate to how we could
25:48
Speaker 4: collaborate as a manufacturer with a partnership like real value.
25:54
Speaker 5: Yeah.
25:54
Speaker 6: So I mean, I'm not going to get into the
25:56
Speaker 6: marketing of real value, but we are constantly educating our
26:00
Speaker 6: pharmacies with information on products, and you know that's par
26:06
Speaker 6: for the course, but we do a lot of a
26:07
Speaker 6: lot of education on why they should be prescribing certain drugs,
26:11
Speaker 6: what the benefits are and I'm not even just talking
26:14
Speaker 6: financial but also the benefits to the patient and this
26:17
Speaker 6: co pays and we educate them on all that. But
26:22
Speaker 6: one thing we also do is I mentioned that I
26:24
Speaker 6: was at HDA this week, and you know, we're a
26:27
Speaker 6: small wholesaler, but we sit our CEO sits on the
26:31
Speaker 6: border directors there and I sit right outside the board.
26:36
Speaker 6: I'm on the outer ring, but I'm also a member
26:40
Speaker 6: of the policy council. But when we're there, you know,
26:43
Speaker 6: the larger wholesalers are focused on the larger things that
26:48
Speaker 6: move the needle nationally. You know, it's like three P
26:51
Speaker 6: forty B, let's say. But we're there really thinking about
26:56
Speaker 6: retail independence, and I don't think the other giant companies
27:00
Speaker 6: they are. They're thinking about the everything. So we do.
27:05
Speaker 6: And j D Collier, he's on the Serialization Council with HDA,
27:11
Speaker 6: so we're really connected with learning and then we can
27:16
Speaker 6: pass that information down to retail independence. I think we
27:19
Speaker 6: were really starting to educate on serialization a couple of
27:23
Speaker 6: years ago, before a lot of wholesales were even talking
27:26
Speaker 6: about it, you know, making them understand what's coming. JD
27:30
Speaker 6: had some podcasts that was I think even with Todd Uh.
27:33
Speaker 6: You know, so we we tried to give them information
27:36
Speaker 6: that maybe they would be forgotten about, you know, if
27:40
Speaker 6: we weren't didn't have a seat at the table. And
27:42
Speaker 6: when I say we, we small wholesales, not just us.
27:46
Speaker 4: So think about something like writing right, I mean seeing
27:51
Speaker 4: large national chains closing the doors. So what's what's your
27:55
Speaker 4: perspective on the future in terms of pharmacy and how
27:59
Speaker 4: we're delivering. Do you see that the remaining a national
28:03
Speaker 4: national pharmacy is getting bigger? Do we see a resurgence
28:07
Speaker 4: of independent pharmacy? Is actually interesting, there's an independent pharmacy
28:11
Speaker 4: in our area todd and I area that's now bought
28:14
Speaker 4: up to former Right aid sites. So and and how
28:20
Speaker 4: would that change potentially a landscape for pharmacy and or
28:23
Speaker 4: patient Any thoughts there in terms of you're dealing with
28:26
Speaker 4: your downstream customers.
28:28
Speaker 5: That's a loaded question, So say saying it again real quick,
28:35
Speaker 5: I'll make sure I'm answering.
28:37
Speaker 4: I guess what I'm asking is, you know, we're seeing
28:39
Speaker 4: a dynamic change in pharmacy right We're seeing an organization
28:44
Speaker 4: like Right Aid exit. We're seeing some signs that maybe
28:49
Speaker 4: once was considered a dying component of pharmacy, being independent
28:53
Speaker 4: pharmacy maybe der resurgence. So how do you based on
28:59
Speaker 4: your interaction and these are your downstream customers, what what
29:03
Speaker 4: do you see for the future in pharmacy, how how
29:05
Speaker 4: it might shape going forward.
29:09
Speaker 6: So, I think the the independent pharmacy world has been
29:13
Speaker 6: going down the last decade, you know, just number of stores.
29:16
Speaker 6: So some of the things we're seeing with the chain
29:19
Speaker 6: selling is actually a positive because I think it's opening
29:23
Speaker 6: the door for some retail and pennance to open up.
29:27
Speaker 6: So I think that's that's all good.
29:30
Speaker 4: So okay, so I think it is a good thing.
29:32
Speaker 4: I think we're some st stability now an opportunity for
29:36
Speaker 4: independent pharmacy, especially in key regional areas where you know,
29:40
Speaker 4: maybe the big chains are not focusing on to give
29:43
Speaker 4: them a position to be successful, you know, and they
29:45
Speaker 4: have to be successful as a business equally as they
29:50
Speaker 4: are successful in delivering the care they give to the
29:52
Speaker 4: patients on a daily basis. But you know, we also
29:57
Speaker 4: now have things like digital pharmacy. How's digital pharmacy play
30:00
Speaker 4: and impact what you do as a wholesaler.
30:03
Speaker 6: It's it's really it's it's complicated. That's why I hesitate
30:06
Speaker 6: in even answering because there's so many moving pieces. I mean,
30:10
Speaker 6: I do think the number of stores are going to
30:12
Speaker 6: start to increase. I do think the stronghold that the
30:17
Speaker 6: big three have, and again I always i sound like
30:19
Speaker 6: I'm saying that the enemy not but the stronghold they
30:21
Speaker 6: have is becoming less important as brand drug Brand drugs
30:27
Speaker 6: used to drive and control the whole industry.
30:29
Speaker 5: You know, we know that's a fraction of what it
30:32
Speaker 5: used to be.
30:33
Speaker 6: So I think you're going to start to see retail
30:36
Speaker 6: independence be able to push back a little bit on
30:39
Speaker 6: these vendor agreements where they you know, they have to
30:41
Speaker 6: buy ninety percent of the generics. I think that dynamic
30:44
Speaker 6: is going to start to break down and there'll be
30:47
Speaker 6: more true competition, which will open up I think some
30:52
Speaker 6: pricing and some better costs for pharmacies.
30:55
Speaker 4: You're talking about creating a more equilibrium in the in
30:58
Speaker 4: the industry and as a result all to that, it'll
31:01
Speaker 4: allow greater dynamic interplay all the way down to the
31:04
Speaker 4: pharmacy in terms of their choices. Yes, access, and that's
31:09
Speaker 4: what's really important for somebody like you Ral, because when
31:13
Speaker 4: we're trying to do things differently, we have actually put
31:16
Speaker 4: a premium on the pharmacy channel. That's one of the
31:18
Speaker 4: reasons we've worked so hard with Todd and why we've
31:21
Speaker 4: taken such an emphasis to understand the pharmacy because I
31:25
Speaker 4: think in time, some of these things are actually going
31:27
Speaker 4: to force such write aids out. It's going to force
31:30
Speaker 4: change of prescriptions being filled elsewhere. It's not going to
31:34
Speaker 4: all be consumed back by the large national change. So
31:37
Speaker 4: how's that impact the independent pharmacy, how's that impact retail
31:40
Speaker 4: pharmacy or online pharmacy? Excuse me? And I think that's
31:44
Speaker 4: going to create a conversation and dialogue that's going to
31:47
Speaker 4: open things up. So really, at the end of the day,
31:49
Speaker 4: part of the challenges that we've had that might be
31:53
Speaker 4: a really good thing that's come out of things like
31:55
Speaker 4: drug shortages is the fact that it's going to force
31:59
Speaker 4: the conversations. When you hear Tom say, look at I've
32:01
Speaker 4: talked more to my manufacturers in the last two years
32:04
Speaker 4: than I probably did the prior five years. That's a
32:08
Speaker 4: good thing. You know, that's a really good thing because
32:11
Speaker 4: at the end of the day, that's what we want
32:12
Speaker 4: to do because ultimately, I think as a pharmaceutical industry,
32:15
Speaker 4: we have to continue to be better at listening more
32:18
Speaker 4: and understanding.
32:19
Speaker 6: And I do think we're going to do better in
32:21
Speaker 6: the rural community areas that I think that's an uh
32:24
Speaker 6: that's clearly an undeserved market. But if we can find
32:28
Speaker 6: ways through you know, teledox and that kind of stuff.
32:31
Speaker 6: But also I think you'll see an opportunity for more
32:34
Speaker 6: bricks and mortar in some of these more rural communities
32:37
Speaker 6: because of all this, so that I'm hoping that helps
32:40
Speaker 6: them too.
32:42
Speaker 4: When we when we look probably wrapping this up, because
32:45
Speaker 4: we're probably coming up to about our thirty for these podcasts, Tom,
32:49
Speaker 4: when we flecked on some of the topics that we
32:51
Speaker 4: talked about today, how does that translate the leadership? So,
32:58
Speaker 4: what do we think we have to do? What do
33:00
Speaker 4: you have to do as a distributor, And I'll share
33:02
Speaker 4: what I think we have to do as a manufacturer
33:05
Speaker 4: to take these insights, these experience and the challenges and
33:08
Speaker 4: opportunities that we're seeing, and what is our responsibility maybe
33:12
Speaker 4: in terms of leadership to ultimately drive what I think
33:18
Speaker 4: we all got in this business for to some extent
33:20
Speaker 4: at the end of the day, I hope that everybody
33:22
Speaker 4: has at least ten to twenty percent in that says
33:25
Speaker 4: I did this because I wanted to work in the
33:27
Speaker 4: industry that was doing good, in an industry that was
33:30
Speaker 4: helping patients and helping people. I know That's why I
33:33
Speaker 4: got into it was ultimately I felt that I could
33:36
Speaker 4: look back on a career that I did more good
33:39
Speaker 4: than harm in this world. So when you think about
33:41
Speaker 4: it from a leadership perspective, where's the leadership that the distributor,
33:46
Speaker 4: wholesaler needs to go and the manufacturer. Maybe through these
33:49
Speaker 4: insights we can find some things that also can help
33:51
Speaker 4: us translate down to the pharmacy and patient.
33:54
Speaker 6: So I could tell you I don't think I've ever
33:57
Speaker 6: worked so hard and my team, I mean, it's twenty
34:01
Speaker 6: four to seven, we're all going. And the reason I
34:03
Speaker 6: say that is because we understand there so much opportunity
34:07
Speaker 6: right now and if we don't keep up with what's
34:11
Speaker 6: going on in you know, we mentioned AI what's going
34:15
Speaker 6: on in Washington, it's things are happening at tenfold than
34:20
Speaker 6: it used to. We have to keep pace and understand
34:23
Speaker 6: what's going on to best serve our customers. And that's
34:27
Speaker 6: and for the traditional wholesale is just going to sell
34:32
Speaker 6: products and at their price, those days are going to
34:35
Speaker 6: be over. You need to be plugged in. You're with
34:39
Speaker 6: your inventory systems, your compliance systems, your marketing. Everything has
34:44
Speaker 6: to be plugged in and fine tuned to better serve
34:48
Speaker 6: the customer. And I think that's what we're doing. We're
34:51
Speaker 6: working really hard on our systems, our inventory, trying to
34:56
Speaker 6: really be as lean and efficient as we can be.
35:00
Speaker 4: Well, Tom, I'm sure your downstream customers appreciate that. And
35:03
Speaker 4: I think you said some things that are really important,
35:05
Speaker 4: which kind of circles back as a good clothes for
35:07
Speaker 4: what we've been talking about. Things like AI and other
35:09
Speaker 4: things are going to force us to move even faster,
35:13
Speaker 4: and most of us probably say we're moving fast anyways.
35:16
Speaker 4: And then I think the second part of that is
35:18
Speaker 4: the exchange of knowledge capital. You know, we have to
35:24
Speaker 4: be willing to exchange some of this and and and
35:27
Speaker 4: take it down and see because at the end of
35:30
Speaker 4: the day, I've always heard that, you know, you put
35:32
Speaker 4: a bunch of pharmacists in a room, and not all
35:34
Speaker 4: of them are great business people, but they're great pharmacists.
35:38
Speaker 4: And there's something that's probably great saying great business people.
35:42
Speaker 4: But the point is it's still a business, very difficult
35:46
Speaker 4: to navigate with all the changes and at the pace
35:49
Speaker 4: of which you just articulated. So I think that's what
35:52
Speaker 4: we need to do. And from a manufacturer, it starts
35:54
Speaker 4: with us to be able to have that same kind
35:57
Speaker 4: of mindset that Tom just spoke about cellar distributor level
36:01
Speaker 4: is how do we find those pathways of exchange of
36:05
Speaker 4: information at the higher level, how do we find ways
36:08
Speaker 4: to differentiate things than the way we've done it in
36:11
Speaker 4: the past. And I think that's a really key point
36:14
Speaker 4: that Tom made, is that you know, we have done
36:17
Speaker 4: it the way we've done it for a pretty long time. Tom,
36:19
Speaker 4: if we think both of us has been in this
36:21
Speaker 4: industry for thirty plus years, yes, But I think finally
36:25
Speaker 4: at this particular point, I'm starting to see the kind
36:28
Speaker 4: of the door going to change. Their door is going
36:30
Speaker 4: to open up, I should say, in terms of some
36:31
Speaker 4: real change as it relates.
36:33
Speaker 5: To supply chain.
36:34
Speaker 4: It's exciting, you know, to the pharmacist and patient, and
36:37
Speaker 4: that's where we have to be in a proactive seat.
36:41
Speaker 4: So Tom, I really want to take the time of
36:44
Speaker 4: avatat in myself to say thank you for being a
36:47
Speaker 4: part of this podcast.
36:49
Speaker 5: Oh, it was my pleasure. And we just have to
36:51
Speaker 5: get our seat belts on because the world's going to
36:53
Speaker 5: change really fast.
36:54
Speaker 4: Yes it will. It's going to continue to change fast,
36:57
Speaker 4: and ultimately our elment gull should never change. That is
37:00
Speaker 4: to focus on the patient and still create value all
37:03
Speaker 4: the way through. So you have a great company name
37:06
Speaker 4: and real value. I know you delivered to your to
37:10
Speaker 4: your customers. We're very happy to be a partner with
37:14
Speaker 4: you in the products that makes sense and we continue
37:18
Speaker 4: to look forward to having these dialogues and we'll talk
37:20
Speaker 4: to you soon.
37:21
Speaker 5: I appreciate you guys, Thank you very much.
37:23
Speaker 3: For more information on real Value, check out Real Value
37:26
Speaker 3: rx dot com. Once again, that's real Value our x
37:30
Speaker 3: dot com. And head on over to your ralpharma dot
37:34
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37:38
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37:41
Speaker 3: reach out to the Pharmacy Podcast Network if there's any questions.
37:45
Speaker 3: We would love to connect you with with the innovators
37:49
Speaker 3: of the pharmacy industry. And thank you so much for listening.