Presentation (CTI)

OBJECTIVES: The COVID-19 pandemic has expanded the role of community pharmacists within the U.S. healthcare ecosystem. Beginning with California and Oregon in 2016, states across the United States have enacted legislation allowing pharmacists to prescribe contraception. Although pharmacists in most states now have this authority, many independent community pharmacies report not offering contraception prescribing services. Prior interviews with pharmacists have identified cost and time as key implementation barriers. The objective of this study was to identify the break-even point for community pharmacists considering the provision of contraception prescribing services.
METHODS: A simulated budget impact model was developed in Excel. The model included fixed costs (training, certification, marketing, and other expenses), variable per-service costs (pharmacist time, product, supplies), and revenue assumptions (price per consultation, reimbursement, and monthly volume). Model outputs included total fixed costs, variable cost per service, effective price, contribution margins, break-even consultations, time to break-even, and projected annual profit.
RESULTS: Required continuing education costs were $295. Patient consultation fees were set at $45, and marketing costs were estimated at $1000. Consultation time was assumed to be 30-minutes, corresponding to a labor cost of $35 based on national average pharmacist salary. Monthly volume was assumed to be 10 consultations. Under these assumptions, the break-even point was reached after 130 consultations.
CONCLUSIONS: Projected profitability was sensitive to expected patient volume. Increased marketing expenditures may generate greater patient demand. Fixed costs required to deliver contraception prescribing services vary across pharmacies. In most states, a private consultation room is required, which may increase initial start-up costs for pharmacies without existing dedicated space.