Opening a pharmacy

Q. I live in a rural area, and my patients have to travel far to get their prescriptions filled. I'm thinking about opening a pharmacy in my office. Are these generally profitable? What are some key things I would need to keep in mind to increase the chances that the new pharmacy is profitable?

A. In general, pharmacies are marginally profitable, but the upside is that they're a great convenience for your patients. The big advantage of having a pharmacy in or near your office is that it substantially increases your patients' medication adherence because they are more likely to have prescriptions filled right there in front of you. It also reduces the need to offer samples. From a legal standpoint, the real question is whether you intend to open a retail pharmacy in which anyone can walk in, or a dispensing pharmacy in which you provide drugs only to patients whom you are treating. That's an important distinction, because most states allow the latter but some do not allow the former. Then, there are issues in getting recognized by pharmacy benefit managers, which are companies hired by health plans to manage subscribers' pharmacy benefits. Additionally, there will be regulatory issues under state law, so check with your state medical society. Finally, if a physician is dispensing controlled substances, there are additional legal issues.