How can a community pharmacy overcome online pharmacy competition?

For decades, community pharmacy has become rooted in the makeup of local communities, offering dedicated face-to-face services for its customers.

However, the pharmacy landscape is evolving and like companies in many other industries, there’s heightened competition from online providers.

• Challenges facing your community pharmacy
• How you can thrive amidst growing online pharmacy competition

First and foremost, let’s hone in on the threats online companies pose.

Challenges faced by online pharmacies

Since 2009/2010, the number of online pharmacies has grown substantially. In 2022/23 there were almost 400 distance-selling pharmacies, whilst the number of physical pharmacies has decreased.

Although the influx of online alternatives hasn’t confined brick-and-mortar branches to the history books, community pharmacists have challenges to overcome, stemming from increased competition, revenue impacts, operational costs, regulatory pressures, and workforce issues.

Increased Competition and Customer Retention

The rise of online pharmacies such as Pharmacy2U and Lloyds Direct has dramatically reshaped the pharmaceutical industry.

There’s no escaping the fact that customers gravitate towards convenience. This preference is particularly the retail case, with only 26% of people in the UK saying they prefer to shop in a physical store.

It’s unmistakable that some customers are being lured from community pharmacies and opting for online platforms that offer convenience and competitive pricing.

The convenience of home delivery and the often lower costs associated with online pharmacies have led to a significant decrease in foot traffic to physical pharmacy locations.

Consequently, community pharmacists are seeing a decline in in-store purchases, which is detrimental to their revenue streams​​ .

Revenue Impact

The migration of customers to online pharmacies doesn’t only affect the sale of prescription medications.
Over-the-counter product sales in Community Pharmacy have dropped as a result of customer migration to both online pharmacies and supermarkets where Pharma brands are accessible in an FMCG retail setting.

This decrease in sales volume directly impacts the overall profitability of these traditional businesses​​.

The decrease in in-store customers reduces the scope for cross-selling and upselling, with a subsequent knock-on effect for pharmacists.

Operational Costs and Efficiency

Community pharmacies face substantial operational costs that online pharmacies can largely avoid.

These costs include maintaining physical storefronts, utilities, and staffing, while community pharmacists must invest in and adapt to new digital technologies to keep pace with the competition, further adding to their financial obligations.

Integrating these new systems can sometimes be costly and time-consuming, requiring ongoing financial and human resources to manage effectively​ .

However, it’s a necessity that can’t be ignored, meaning pharmacists should seek technologies that deliver clear value against their investment.

Regulatory and Compliance Pressures

Community pharmacies must navigate a complex regulatory landscape, ensuring compliance with various local, national, and sometimes international regulations.

This is particularly challenging as they must adhere to stringent standards for their physical operations and any online services they may offer.

The need to comply with these regulations can be resource-intensive, requiring dedicated staff and substantial financial investment. This regulatory duty adds another layer of difficulty in competing with online-only pharmacies, which may have more streamlined compliance processes​​.

For instance, the Falsified Medicines Directive (FMD) requires all pharmacies to verify and authenticate the legitimacy of medicines before dispensing them to patients.

This regulation mandates the use of specific scanning equipment and software to check each medicine's unique identifier against a central database.

The implementation of FMD has been resource-intensive, demanding substantial investment in new technology and continuous staff training to ensure compliance.

As a result, community pharmacies face additional operational burdens that online-only pharmacies, with more centralised and automated systems, might handle more efficiently​ 

Workforce Challenges

The demand for locum pharmacists is increasing, driven by the need to fill temporary staffing gaps.

With an average hourly rate of £38.44 for locum pharmacists, this adds to the financial pressures on community pharmacies - and the challenges aren’t exclusively monetary.

Many pharmacists are seeking better pay and improved working conditions, leading them to pursue roles in GP surgeries and Primary Care Networks. This trend heightens the staffing shortages in community pharmacies, making it even more challenging to maintain service levels and operational efficiency​​ .

Community pharmacists are fighting significant challenges that threaten their traditional business model.

How community pharmacists can mitigate online pharmacy competition

Though community pharmacies are encountering unequivocal change, some approaches and services can be used to thrive amid competition from online alternatives.

Pharmacy First

Pharmacy First allows community pharmacists to dispense prescription-only medications for 7 health conditions, including antibiotics and antivirals, without requiring a visit to a GP, where clinically appropriate. These conditions are sinusitis, sore throat, earache, infected insect bites, impetigo, shingles and uncomplicated urinary tract infections in women.

In Scotland, Pharmacy First covers a much longer list of conditions that can be treated and they have Independent Prescribing Pharmacists (IPs) to provide this additional service.

Cegedim’s Pharmacy Services system is one of four NHS-accredited Pharmacy First IT systems.

It supports community pharmacies in delivering various benefits to their customers, differentiating themselves from online competitors.

Online Pharmacies struggle to provide NHS Clinical Services, including Pharmacy First, because they can't provide the immediate, face-to-face consultations required for prescribing medications under this scheme.

Direct interaction with a pharmacist is crucial for assessing the patient's condition and determining the appropriate medication, something that online-only services cannot replicate.

By leveraging systems like Cegedim’s Pharmacy Services, community pharmacies can effectively manage the regulatory requirements and operational complexities associated with Pharmacy First, thereby enhancing their service offerings and maintaining a competitive edge over online-only pharmacies.

Immediate Care and Accessibility

Whereas online pharmacies are subject to delivery times, which can delay treatment, community pharmacies can provide on-the-spot consultations and treatments, offering an unmatched level of convenience compared to online services.

This immediate care can be particularly beneficial in urgent situations where patients need quick access to medications and advice.

Personalised Interactions

What online pharmacies can offer in convenience, there are undoubted benefits of the human-centric services provided by traditional pharmacies.

Face-to-face consultations allow pharmacists to deliver accurate diagnoses and tailored treatments, building strong, trust-based relationships with patients.

This simply can’t be recreated by pharmacies operating online.

Comprehensive Services

Offering a wide range of services such as health screenings, vaccinations, and chronic disease management can make a community pharmacy a one-stop healthcare destination. This breadth of services enhances the pharmacy's value to its customers.

Community Engagement

Hosting health education events and workshops positions the pharmacy as a key community health resource.
These events can educate the public, promote preventive care, and strengthen the pharmacy's role in the community.

Instant Medication Access

Being able to dispense medications immediately after consultations ensures that patients can start their treatments without delay, improving customer satisfaction and health outcomes.

Regulatory Compliance

Following clinical pathways ensures that treatments are safe and effective, supporting antimicrobial stewardship and other health initiatives.

Implementing advanced pharmacy management systems can streamline these operations, improve efficiency, and provide real-time insights.

Integration with Pharmacy First allows community pharmacists to focus more on patient care, ensuring they can deliver high-quality, efficient, and personalised services, reaffirming their status as valuable members of the healthcare community.

Engage with the Community

Community engagement is crucial for community pharmacies to establish themselves as trusted health resources.

Several approaches can be adopted that online pharmacies can’t offer.

Health Education Events

Organising workshops and seminars on health-related topics educates the public and promotes preventive care. This positions the pharmacy as a trusted health resource.

Community Health Screenings

Offering free or low-cost health screenings for conditions such as blood pressure, cholesterol, and diabetes can attract foot traffic and provide valuable health insights to the community.

Partnerships with Local Organisations

Collaborating with local healthcare providers, schools, and community groups can help provide comprehensive care services and promote health awareness.

Medication Reviews

Providing one-on-one medication review sessions helps patients understand their prescriptions, manage their medications effectively, and improve adherence.

Support Groups and Counselling

Hosting support groups and counselling sessions for patients managing chronic conditions offers a platform for sharing experiences and receiving professional advice.

Seasonal Health Campaigns

Launching seasonal health campaigns, such as flu vaccination drives and allergy awareness programs, addresses timely health concerns and increases community engagement.

Optimise Operational Efficiency

Operational efficiency is crucial in ensuring community pharmacies can compete with online pharmacies by providing faster, more reliable services.

Pharmacy Manager, Cegedim’s premier PMR software, streamlines all aspects of pharmacy solutions.

By integrating efficient dispensing workflows, clinical checks, and real-time business intelligence, the Pharmacy Manager improves operational efficiency and reduces administrative tasks.

This means community pharmacists can spend more time on patient care and less time on paperwork with intuitive dashboards and automated dispensing, ensuring smooth and efficient operations.

Automation and Technology Integration

Investing in automated systems for inventory management, prescription processing, and administrative tasks reduces manual workload and improves accuracy.

Advanced Pharmacy Management Systems

Implementing comprehensive pharmacy management software streamlines workflows, tracks performance, and provides real-time data insights for better decision-making.

Efficient Stock Management

Utilising inventory management tools to maintain optimal stock levels, reduce wastage, and ensure the availability of essential medications is crucial for smooth operations.

Starting in 2025, the introduction of the Hub & Spoke initiative will further enhance stock management efficiency for independent pharmacies. This innovative model allows pharmacies to use a central supplier, or 'Hub', to manage their inventory. There are two primary models for this initiative:

• Model 1: The patient presents a prescription to the spoke pharmacy. The spoke sends the prescription information to the hub, where the medication is dispensed and sent back to the spoke pharmacy. The spoke pharmacy then completes any additional necessary steps, such as providing patient counselling, before dispensing the medication to the patient.
• Model 2: The patient presents a prescription to the spoke pharmacy, which then sends the prescription information to the hub. The hub pharmacy assembles and prepares the medication and supplies it directly to the patient.

These models aim to centralise the routine aspects of prescription assembly, which can be efficiently managed at the hub using automated processes. This centralisation frees up pharmacists and staff at the spoke pharmacies to provide more direct patient care and services, thus improving overall operational efficiency and patient outcomes.

However, there are considerations regarding patient safety and the clarity of responsibility. Model 1 is generally preferred because it maintains the relationship between the patient and the local pharmacy, which is essential for ensuring medication compliance and patient safety. Model 2, while potentially more efficient, could lead to confusion about who is responsible for patient care, particularly in cases of medication changes or complex conditions​

Workflow Optimisation

Redesigning pharmacy workflows to minimise bottlenecks and enhance productivity ensures smooth operation during peak times.

Staff Training and Development

Continuously training staff on new technologies, best practices, and regulatory requirements enhances their skills and efficiency.

Data Analytics

Leveraging data analytics to identify inefficiencies, track key performance indicators, and implement improvements based on actionable insights can significantly enhance operational efficiency.

Invest in Marketing

Effective marketing can help community pharmacies highlight their unique advantages and keep their community close. Offence is argued to be the best form of defence, and by standing out on the high street, pharmacists give themselves the best chance of preventing patients going online.

Cegedim’s Pharmacy Display service supports pharmacists in transforming their in-store marketing and offering dynamic customer engagement. Personalised, pharmacy-specific content is used to inform customers through high-quality digital screens paired with an agile Content Management System (CMS).

Pharmacists can boost their over-the-counter sales, launch flexible retail campaigns, and enhance workforce efficiency, all while maintaining NHS compliance.

This game-changing technology transforms how pharmacies connect with customers and showcase their products and services, whilst also offering a string of other benefits that can’t be matched by online providers.

Highlight Comprehensive Services

Promoting the full range of services offered, such as health screenings, vaccinations, medication reviews, and chronic disease management, informs customers about the pharmacy's capabilities.

In-Store Promotions and Displays

Using in-store displays to promote special offers, new services, and health campaigns can attract attention and provide valuable information to customers while they wait.

Loyalty Programmes

Implementing or enhancing loyalty programmes to reward repeat customers with discounts, exclusive offers, and points that can be redeemed for products and services encourages frequent visits and increases customer retention.

However, the truth is the best loyalty programme for patients is receiving excellent care and having positive health outcomes. Patients are more likely to trust in the people who have brought a real benefit to their lives through services, rather than a faceless online pharmacy.

Next steps for community pharmacies…

There’s no escaping that the upsurge in online providers presents unprecedented challenges to community pharmacists.

Yet, it’s important not to lose sight of the personal touch, trusted relationships, and immediate accessibility offered by local, physical branches that are valued by many customers and simply can’t be matched elsewhere.

However, it’s crucial to implement the aforementioned strategies and processes, such as digital health records and online appointment systems, marketing to improve in-store experiences, and software to improve efficiency to create a seamless and integrated healthcare service that appeals to modern consumers.