Pharmacy Management Consultants, University of Oklahoma College of Pharmacy, P. O. Box 26901 Oklahoma City, OK 73126-0901, USA.
Res Social Adm Pharm. 2010 Sep;6(3):209-20. doi: 10.1016/j.sapharm.2009.07.003. Epub 2009 Sep 17.
There is growing concern over increasingly limited access to local health care, including pharmacies, for rural citizens of the United States. Although geographically distant from most competitors, rural pharmacies may still struggle to generate an acceptable profit to remain economically viable. Therefore, a method for calculating the economic viability for a community pharmacy to recruit a potential new owner to assume the entrepreneurial risk is an important issue to consider when evaluating rural pharmacy access.
The primary objective of this study was to use a modified break-even analysis to predict the future financial potential of the current pharmacy business to attract a new owner. The secondary objective was to forecast a risk level for a Nebraska county to sustain the number of pharmacies in the country beyond current ownership.
This research used data provided by pharmacies that responded to a Nebraska Medicaid cost of dispensing (COD) survey in addition to data from the US Census Bureau, US Office of Management and Budget, and the Nebraska State Board of Pharmacy. Break-even analysis was used to determine the point where the prescription volume of the pharmacy not only covered the variable and fixed costs but also maintained a reasonable profit to attract new ownership. Counties were classified into 3 risk levels based on the projected available prescription volume and the number of pharmacies in each county. Sensitivity analysis was performed on the risk levels to determine the impact of variance in projected available prescription volume on the projected future outlook for the pharmacies in each county.
Regression analysis of responses to the COD survey indicated that the annual break-even prescription volume ranged from 44,790 to 49,246 prescriptions per pharmacy per annum. The number of rural Nebraska pharmacies was projected to decline from 126 to 78. The number of counties in Nebraska without a single pharmacy was projected to increase from 19 to 26, and the number of counties with just one pharmacy was projected to increase from 17 to 31. Thus, the number of counties with 1 or no pharmacy was projected to increase to 57 out of the total 93 Nebraska counties.
The forecasted closure of pharmacies in rural areas will cause significant portions of the state to be without a pharmacy. Low county populations will be unable to sustain a local prescription volume large enough to remove them from the high risk of pharmacy closure.
美国农村居民越来越难以获得当地医疗保健服务，包括药店。尽管农村药店与大多数竞争对手在地理位置上相距甚远，但它们仍可能难以获得可接受的利润，以保持经济可行性。因此，对于社区药店来说，有一种计算经济可行性的方法，即吸引潜在的新所有者来承担创业风险，这是评估农村药店准入时需要考虑的一个重要问题。
本研究的主要目的是使用修正后的盈亏平衡分析来预测当前药店业务的未来财务潜力，以吸引新的所有者。次要目的是预测内布拉斯加州一个县的风险水平，以维持该国目前所有权之外的药店数量。
本研究使用了对参与内布拉斯加州医疗补助配药成本（COD）调查的药店提供的数据，以及来自美国人口普查局、美国管理和预算办公室以及内布拉斯加州州立药剂师委员会的数据。盈亏平衡分析用于确定药店的处方量不仅覆盖了可变成本和固定成本，而且还保持了合理的利润，以吸引新的所有者。根据每个县的预计可用处方量和药店数量，将各县分为 3 个风险级别。对风险级别进行了敏感性分析，以确定预计可用处方量的变化对每个县的药店未来前景的影响。
对 COD 调查的回复进行回归分析表明，每年的盈亏平衡处方量范围为每所药店每年 44790 至 49246 张。预计内布拉斯加州农村地区的药店数量将从 126 家减少到 78 家。预计没有一家药店的内布拉斯加州县的数量将从 19 个增加到 26 个，而只有一家药店的县的数量预计将从 17 个增加到 31 个。因此，预计将有 57 个内布拉斯加州县（占总数的 93 个县）的药店数量将增加到 1 个或没有药店。
农村地区药店的预测关闭将导致该州的大部分地区没有药店。低县人口将无法维持足够大的当地处方量，从而使他们免受药店关闭的高风险影响。
