From staffing costs to OTC woes: the financial impact of COVID-19 on five Canadian pharmacies

There are consistent themes when asking pharmacist-owners about their financial experience during the pandemic. For example, the cold and flu shelves went untouched. Other experiences vary, especially if the pharmacy participated in the vaccine rollout, and how much pharmacies were paid per shot. Here’s what five Canadian pharmacist-owners said about their pharmacies’ financial picture during COVID-19. Laura McDonald Epic Pharmacy (Pharmasave) Tofino, British Columbia Has the pandemic had a positive or negative impact on your business? Overall, the financial picture has declined in some regards but I have found that my core base of patients, my local patients, are more compliant and more invested in their own health and keeping their bodies strong. In what areas of the store did you see gains or losses, or increased costs? I have a fairly uniquely curated front store: a lot of local, natural, environmentally-friendly product mix. I sell lululemon, for example. Our West Coast communities have really rallied to support local and that’s been really appreciated, but there’s only so much a small population of 1,800 people can do. The front store has been greatly affected with the revenue stream because tourism brings in a lot of income to fill the gaps. Did the vaccination campaign change your financial picture? Vaccination was carried out by public health. We didn’t have a role, but we were educators and the phone would ring several times a day and we’d have to explain what was happening. A lot of my staff had to stay up to date on timing, dates, phone numbers, how to register, what if you have to register again or what happens if you’re not a B.C. resident. We weren’t administering vaccines but we were certainly an ally in terms of informing. Do you think your pharmacy’s finances will eventually return to normal? We feel like we’ve been on a roller coaster ride and there have been ups and downs and I couldn’t say if it will return to normal. What is today might be different tomorrow. There’s still a resounding fear that we could be back to where we were in a matter of weeks or months. As a pharmacist-owner, what have you found the most challenging aspect of the last 17 months? Staffing has been the biggest challenge. It has been so difficult, managing all of the elements: keeping your employees safe, keeping them present, keeping them engaged and wanting to come to work. I have 15 employees. We have a strong mental health program at the store locally. We have check-ins and I’ve brought in a counsellor. It’s not anything specific to working at a pharmacy, it’s just the overall society and what everyone has endured in their own personal life, and that transposes into work. I’ve had to compensate my staff in different ways than 17 months ago. There was a time when they’d be making more money not working than working, so we’ve had to be creative with solutions: keeping strong compensation packages and nice benefits and a good work-life balanced week. We’ve had to hire more staff so people can have lighter shifts because everyone is stressed and anxiety levels were changing all the time. We really wanted to make sure everyone felt supported at the store. I think the mental health aspect for any human in the past 17 months - if you’re in a leadership role and not paying attention to that then your business would definitely be suffering. Melissa Hozack Pharmasave Redcliff Redcliff, Alberta Has the pandemic had a positive or negative impact on your business? Overall, it has been fairly good in terms of the financial side. We even created a whole company during the pandemic, called TruMe Whole Health. Our main product is branched chain amino acids with electrolytes. We’re wholesaling our products to pharmacies and chiropractic clinics and health and wellness stores all over Canada and the U.S. Obviously that’s going to increase our revenue. Hopefully for other pharmacies that were struggling through COVID we could give them something that would increase their revenue and help people get healthy. In what areas of the store did you see gains or losses, or increased costs? We were ahead of the curve getting PPE stock. Things are good financially because we had that big spike last year. My husband would be on McKesson at midnight making sure we got isopropyl alcohol and gloves. We definitely stayed ahead of the big surge of things and never really ran out. With the government of Alberta going to one month dispense instead of three-month dispense, we had those increased fees over each month. We saw a decrease when it went back to three months. Some of the basket sizes were small because people weren’t actually coming into the store. We had delivery, curbside pick-up and virtual counselling for our weight loss patients. We could only allow eight people in the pharmacy. Sometimes it felt like we had to hurry people along. Did the vaccination campaign change your financial picture? Doing the vaccinations has been really good. There’s been good uptake in our community. In Alberta we were paid $25 per dose and if we did it on the weekend it was $35 per dose. That side of it was really helpful. At one point we also had asymptomatic testing available at the pharmacy. Do you think your pharmacy’s finances will eventually return to normal? I think it's going to go back to normal as far as day-to-day stuff at the pharmacy. I feel like we’re starting to get there. As a pharmacist-owner, what have you found the most challenging aspect of the last 17 months? The most challenging was the poor communication and the lack of vaccine supply. We had definitely a lot of extra staffing that was probably unnecessary if we were able to just do it on our own. There was frustration in terms of how things were ran, but we made it work as best we could. We’d stay in late or come in on a Sunday to get everyone vaccinated. We’re the only pharmacy in a town of 5,000 so that’s what you have to do. We’ve administered more than 2,000 vaccines. I think looking forward, the biggest challenge is this new vaccine booking system. We do vaccination clinics all over the place – food banks, women’s shelter, police stations, schools – I have no idea how that is going to work with a centralized booking system through Alberta Health. Read: Community pharmacies weigh financial impacts of COVID-19 vaccination campaign Kristen Watt Kristen’s Pharmacy Southampton, ON Has the pandemic had a positive or negative impact on your business? We took a big hit financially. Initially it was the extra costs of buying PPE, installing plastic barriers and blocking off the store for walk-in customers for three months. The 30-day fill mandate took a lot of time in terms of staff and stocking the pharmacy. In what areas of the store did you see gains or losses, or increased costs? Is my cough and colds section all expiring? Yes. We actively discouraged people from coming in to buy these products, because if they had the symptoms, we didn’t know if they had COVID or not. Unless you’ve had a test, you don’t know. From a business perspective, it didn’t go well, but it protected staff. Anything that was purchased during the initial phase of the pandemic cost more. I worked hard to source PPE, which was expensive. Surgical masks that would normally cost 27 cents were $1 a piece, and we offered them free to patients who forgot their mask. Did the vaccination campaign change your financial picture? The vaccine campaign for us was a total financial loss. I’m still doing the numbers, but I believe it cost double than what we got paid. People assumed we would make the money with extra traffic in the store, but that didn’t happen. My June sales were down by $7,000 compared to June 2020. The costs were all in the payroll. It was extremely intense in terms of labour. On the first day vaccines were announced, the pharmacy received 700 phone calls. Our existing staff couldn’t manage it all. I had to bring in more staff. The Ontario Pharmacists Association has asked pharmacists to quantify the costs, but I don’t think I could quantify my time. I probably make $12 an hour. My husband and I and our personal bank account financed the vaccination of our community. Do you think your pharmacy’s finances will eventually return to normal? Will things return to normal? Perhaps, from a workflow perspective and a cost perspective. But I still have multiple enquiries every day about third doses. Those who are coming in for first doses are taking longer. Every time something is posted in the media, the pharmacy's inbox overflows and the phone keeps ringing. Pharmacists get paid zero dollars for vaccination hesitancy counselling. So in terms of time, it remains at a loss. As a pharmacist-owner, what have you wound the most challenging aspect of the last 17 months? The hardest part of the last 17 months has been the moral injury. The pandemic brought out the best in people, but it also brought out the worst. The entitlement and the demands – people wanting what works for them. There were 10,000 people on the vaccine waiting list, in an area with a population of 12,000. We got lost. It was lost on people that we are people, that we have children. This model of providing care in community pharmacy is not sustainable. Unless we make it sustainable, we will lose independent pharmacies. Adam Silvertown Pace Pharmacy Toronto, Ontario Has the pandemic had a positive or negative impact on your business? The impact was significant in the initial stages of the pandemic – significant to the point that we had to reduce staff hours and cut back on many things that we normally wouldn’t have. I made the decision to reduce everybody’s hours across the board as opposed to eliminating certain people entirely; I didn’t want to lay anybody off. I think most of them understood the situation and were okay with it. In what areas of the store did you see gains or losses, or increased costs? There was a lull in the number of prescriptions to fill, with physicians not seeing as many patients and non-essential practitioners closing their offices. There was a big drop in the types of prescriptions that you might see outside of the normal. I can’t remember ever having to pull expired cough and cold medicines off the shelf in all the years that I’ve been practicing. People weren’t getting colds, which is a good thing, but from a business perspective we weren’t selling those products either. The cost of PPE was significant, especially early on when the price was outrageous. We got dividing barriers, not thinking that they would be as permanent as they have been. The things we set up originally have been changed because of the way it looked and it didn’t function as well as we would like. The cost of cleaning, the cost of sanitizing chemicals, the wipes, the alcohol; last year threw everything for a loop. Another cost was deliveries. For some prescriptions it would cost more on deliveries than we made on the actual medication and therefore it was a loss. Did the vaccination campaign change your financial picture? We were not involved in the vaccination campaign. We just don’t have the space to accommodate the type of operation that would be required to provide vaccines at that scale. Some patients still asked for vaccine-related advice. Do you think your pharmacy’s finances will eventually return to normal? In terms of staffing things have returned to normal, thankfully. The new normal. Everything’s a new normal. We’re not back to where things were. I don’t think it will go back to where things were. We’re moving forward and making do with whatever the situation is today. As a pharmacist-owner, what have you wound the most challenging part of the last 17 months? It’s not just one thing. It’s everything else everyone was worried about – stress about the unknown, what was going on, safety of our families – but as an owner I was also worried about the welfare of my employees and as a business owner I was worried about the viability of my business. I wonder if people think that pharmacies are sitting pretty because we were able to stay open. Every industry was impacted in a negative fashion at some point, and that includes our industry. Read: Checking in with pharmacists after a year of upheaval Graham MacKenzie Stone's Pharmasave Baddeck, Nova Scotia Has the pandemic had a positive or negative impact on your business? Overall, for the whole year, everything was what I would call slack. We were pretty much on track for what the previous year (2019) was, almost to the dollar. In what areas of the store did you see gains or losses, or increased costs? We started with the 30-day supply mandate so we were switching everyone from 90 days. It was extra work but those extra dispensing fees helped for the bottom line. The front of store was definitely a bit off last year. Nobody was getting sick, there were no colds or flu, so the OTC section was kind of low. We have a seasonal category where we do a lot of bug spray, sunscreen, that was a little bit down. Other sections started to rebound; food would always sell fairly well. In 2020 we had a ton of Easter candy, so we decided to give it away. We bagged it all up in individual bags and we had drive-by where people would come by and we’d hand it out. It is a tough time around here, there’s not a lot of money around Cape Breton, so we just thought we’d do that. Did the vaccination campaign change your financial picture? What really did help save us was the income from the injections because that was paid for by the province. We had the same staff, we just shifted them around. My wife Bev was doing the screening, we had a main person watching patients while they were in the waiting area and we had a volunteer nurse and another nurse we hired a few times. In terms of staffing there wasn’t really much extra cost. Maybe a little bit, but nothing crazy. Only about 800 people live in Baddeck. We’ve given about 6,200 vaccines. As a pharmacist-owner, what have you found the most challenging aspect of the last 17 months? One of the most challenging things was trying to decide whether or not to do alternate day shifts. We would have an A shift and the B shift and one would work one day and the other would work the next. That can be pretty hard on staff. We would do that for a month at a time, and then switch back when things looked like they were getting back to normal, and then switch back to alternate days again. That was a tough call to make. Looking back on the entire 18-month period, the toughest part personally for me has been doing the vaccines. It is just crazy how much family time it takes away. There were days at a time where we hardly saw our own kids and it was tough on the staff because no one can take vacation of any value other than half a day here. Interviews were edited for length and clarity.

From staffing costs to OTC woes: the financial impact of COVID-19 on five Canadian pharmacies

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