Pharmacies, we have to talk… Your paper costs (and waste) are out of control.

Let’s take a deep look at your paper expenses and a few solutions to help you save.

Pharmacies print a substantial amount of paper every day. But, they have to, I get it. It’s required by state Boards of Pharmacy that they provide their patients with medication information with every prescription they dispense (some exceptions with refills in some states). And all that information is usually given to that patient on paper…EVERY prescription. And in my opinion, it’s a very outdated process. But as a fact, it’s extremely costly, and most, especially independent pharmacies, are likely spending more than they should.

Having practiced as a community pharmacist, I’ve experienced patients say, “I just need to the bottle,” or “what a waste, it goes straight in the garbage at home.” Over time, I began to recognize my “paperless” patients as they came in to pickup. I’m sure I’m not the only pharmacist who knew which of their “regulars” didn’t want the paper leaflets and would almost automatically just toss them at check out.

Pharmacy owners don’t really think about the cost of paper, which is understandable. It seems like an unavoidable cost. It’s like your electric bill. It’s something they HAVE to pay. But, what you may not know is that there is a way to decrease your costs on paper (and even toner). Just as you can by adding tints to your location to keep it cool and spend less on electricity, there some ways to save on paper.

But before we go into that, let’s look at a few examples of what pharmacies might be paying now for the paper they print.

You may want to sit down for this.

First of all, if you’re not buying your paper in bulk, you’re making a huge mistake. And by bulk, I mean by the pallet, usually 400 reams (200,000 sheets). From my research, that’s the only way costs begin to really decrease significantly. Buying it any other way doesn’t make much of a difference. If you’re not buying by the pallet, you’re probably spending 4-6x more on paper than if you bought in bulk. Buying by the pallet, your per sheet cost is only $0.01, versus when you buy in smaller amounts your per sheet cost is $0.04 to $0.06!!!

Let’s look at two examples with a few fair assumptions. Let’s say your pharmacy buys in bulk and one sheet of paper costs the pharmacy $.01 ($.04 if not buying in bulk) and the average prescription prints three sheets of written information on paper. I’ll keep the normal 365 days in a year, because although there are holidays and some pharmacies close on weekends, they’re also wasting paper in addition to their normal prescription count. Lastly, let’s assume the average toner will cost $150 per 25K sheets of paper. Here’s two examples:

Pharmacy Location #1

Total number of prescriptions per day: 100

Cost of paper per year: $1,095 ($5,475)

Cost of toner per year: $657

Total per year: $1,752 ($5,037)

Pharmacy Location #2

Total number of prescriptions per day: 400

Cost of paper per year: $4,380 ($21,900)

Cost of toner per year: $2,628

Total per year: $7,008 ($20,148)

Crazy right!? And this is a conservative estimate and one that mainly applies to retail pharmacies. Mail order and hospital pharmacies can dispense thousands of prescriptions a day. These numbers don’t even include shredding services or manual labor of keeping the protected health information on these papers secure. With the numbers above, assuming everyone buys in bulk and having 67,000 pharmacies (according to Wikipedia), that averages to about $294 million in printed paper per year. Um, holy crap!

We’ve established it’s costly, but what about the impact on the environment?

The Environment

In writing this article, I initially wanted to include some numbers as to what printing one sheet of paper does to the environment and how many trees per X amount of paper was being destroyed per year, but I couldn’t find overly convincing or accurate information. Which, actually makes sense. And that’s because paper is made from different types of trees. And these trees can very drastically in size and width. There’s no standard “tree paper” found in the “paper tree forest.” So any time you see any of those numbers reported, I’d take it with a grain on salt. Plus, different paper mills produce their paper differently, and it seems a lot of them are trying to do their part in making paper production as sustainable as possible, like by recycling their own water and making the bleaching process environmentally friendly; at least that’s what it looks like after watching a few YouTube videos.

But, if you really wanted to get some numbers, this guy tried his best to come up with a calculation: https://science.howstuffworks.com/environmental/green-science/question16.htm

Anyway, enough about the environment and sustainability, let’s get back to what I know, pharmacies.

Ways to Save

Between DIR fees continuing to eat away at profits, consumers demanding more convenience and technology, and an expectation of lower costs for prescriptions, I think it’s a good idea to start paying more attention to your costs of printing paper. It’s a cost that is more controllable than you think and there’s likely a lot of savings to be made. Let’s go through some solutions.

Buy in Bulk

From a cost standpoint, start buying in bulk! As I mentioned above, the numbers are staggering if you’re buying in bulk vs smaller quantities. You know you’re going to use the paper. Find a place to store it, find a supplier, and buy it in bulk!

Use Recycled Paper

This falls under more of the saving the environment bucket. But from a sustainability standpoint, you could use recycled paper in an effort to be more eco-conscious. Only problem is, recycled paper is often more costly than their “virgin” counterparts.

And lastly, consider going paperless! I’m giving this solution it’s own big section…

Find a Digital Alternative (Go Paperless)

From a cost and eco-friendly option, look for digital alternatives to providing prescription information on paper. Wait what…? YES! One thing most pharmacy owners may not be aware of is that there are solutions that exist that allow them to provide their patients with digital prescription information with every prescription dispensed. Let me explain.

Some Background

State Boards of Pharmacies are the ones who require prescription information be given to patients with every prescription. The FDA regulates the need for specific prescriptions to be dispensed with the Medication Guide. At VUCA Health, we’ve actually been advocating for clarification from boards on an alternative to paper to try to solve not only improvements in health literacy, but the costs associated with printing paper. We now have 41 states’ Board of Pharmacy supporting an eco-friendly option of providing digital medication information. I’ll include a list of those states below.

But how does the patient get the information exactly?

Here’s an idea, what about using a QR code on the patient’s prescription label so they can gain access to all the information they usually get on paper, in a digital format? Well, this isn’t actually just an idea. It’s what we do with a solution called MedsOnCue.

When pharmacies use MedsOnCue, they’ll see an immediate ROI (refer to above to see savings) and can allow their patients to opt-out of paper leaflets. Some pharmacies automatically opt all of their patients out of paper and make them opt-in to receiving paper. We’ve integrated with the leading pharmacy management systems in the nation allowing pharmacies to seamlessly activate the service. Using their smartphone, patients (and their caregivers) can then point their camera app at the QR code to access medication education videos, their pill image, and copies of the medication education they’d normally get by paper. Pretty cool, right? Check out this youtube video about how a pharmacy in Washington is using it.

So, it begs the question…how much is your pharmacy spending on paper?

Thanks for reading.

Take care,

-Richard

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Richard Waithe, PharmD | Richard@vucahealth.com

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Going Green States:

AL, AR, AZ, CA, CO, CT, DE, FL, GA, HI, ID, IL, IN, IA, KS, KY, LA, MA, MI**, MN, MO, MS**, ND, NJ*, NM, NV, NY, NC, OH, OK, OR, PA*, SC, SD, TN, TX, UT**, VA, WA, WI, WV.

* Although the Board of Pharmacy has not issued written approval, current state regulations do not require medication information to be provided to patients on paper.

** Although the Board of Pharmacy has not issued written approval, current state regulations do not require medication information to be provided to patients on paper when prescriptions are picked-up in the pharmacy. However, regulations do require that medication information must be provided to the patient on paper when the patient does not receive the prescription at the pharmacy (such as by delivery) or where communication barriers prohibit oral communication