116th annual convention - ncpa · create a marketing plan to introduce your nutrition niche to your...

116th Annual Convention

Date: Tuesday, October 21, 2014 Time: 2:45 pm – 3:15 pm Location: Austin Convention Center, Room 18AB, Level 4

Title: Business Opportunities: Expanding into a Successful Nutrition Niche in your Pharmacy ACPE # 207-000-14-235-L04-P 0.15 CEUs

ACPE # 207-000-14-235-L04-T

Activity Type: Application-based Speaker: Jennifer Hughes, PharmD, Greenwood Drug, Inc.

Pharmacist and Pharmacy Technician Learning Objectives: Upon completion of this activity, participants will be able to: 1. Discuss methods to evaluate your market for the viability of a nutrition niche. 2. Create a marketing plan to introduce your nutrition niche to your patients and community. 3. Summarize examples of cross-selling opportunities with prescriptions and

supplements/nutritionals.

Disclosures: Jennifer Hughes declares no conflicts of interest or financial interest in any product or service mentioned in this program, including grants, employment, gifts, stock holdings, and honoraria.

NCPA’s education staff declares no conflicts of interest or financial interest in any product or service mentioned in this program, including grants, employment, gifts, stock holdings, and honoraria.

NCPA is accredited by the Accreditation Council for Pharmacy Education as a provider of continuing pharmacy education. This program is accredited by NCPA for 0.15 CEUs (1.5 contact hours) of continuing education credit.

NCPA Disclosure Statement The National Community Pharmacists Association (NCPA) Office of Continuing Education makes every effort to develop continuing education activities that are scientifically based, accurate, current, and objectively presented. In accordance with the Accreditation Council for Pharmacy Education Standards for Commercial Support NCPA has implemented a mechanism requiring everyone in a position to control the content of an educational activity to disclose any relevant financial relationships with any proprietary entities producing health care goods or services and mange/resolve any conflicts of interest prior to the activity. Individuals must disclose to participants the existence or non-existence of financial relationships. NCPA does not view the existence of interests or relationships with commercial entities as implying bias or decreasing the value of a presentation. It is up to the participants to determine whether the interest or relationships influence the presenter with regard to exposition or conclusions. If at any time during this activity you feel that there has been commercial or promotional bias, please inform us by reflecting the information on the session evaluation form.

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Business Opportunities: Expanding into a Successful

Nutrition Niche

Jennifer Hughes, PharmDGreenwood Compounding Pharmacy

DisclosureDisclosure

Jennifer Hughes declares no conflicts of interest or financial interest in any product or service mentioned in this program, including grants, employment, gifts, stock holdings, and honoraria.

Learning ObjectivesLearning Objectives

1. Discuss methods to evaluate your market for the viability of a nutrition niche.

2. Create a marketing plan to introduce your nutrition niche to your patients and community.

3. Summarize examples of cross‐selling opportunities with prescriptions and supplements/nutritionals.

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Our BusinessOur Business

• Compounding and retail pharmacies under one roof. Two separate licenses.

• Approx 3,000sq ft pharmacy…298 linear ft of “regular” OTC and 20 ft of “specialty” supplements.

• Compounding of BHRT, Pain, Vet, Dental 600sq ft lab, approx 450 Rx/mo.

Less Space, Less VolumeLess Space, Less Volume

FT SHELVING

SPECIALTY

GENERAL

UNITS SOLD

SPECIALTY

GENERAL

Floor Space Sales

MORE PROFIT!!MORE PROFIT!!

PROFIT

SPECIALTY

GENERAL

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Separate Yourself from CompetitorsSeparate Yourself from Competitors

• Carry supplements that others can’t carry or won’t bother carrying. Professional lines.

• Third party verified – Quality matters!

• Find companies that will do the work for you –presentations.

• Be knowledgeable and available to help…pharmacists are the most available healthcare professional.

It DOESN’T Sell ItselfIt DOESN’T Sell Itself

• An Integrative Medicine trained doctor is our biggest source of clientele.

• Alternative minded patients – lots of people let down by docs.

• Knowledgeable staff – know your product and say it with confidence (but don’t lie!).

• Facebook, Twitter, e‐mail blasts.

• REFERRALS! People are friends with like‐minded individuals.

Know Your Product…Know Your Product…

• Better to be an expert at 10 products, than a novice on 100.

• Find products that interest you – don’t sell just to make money!

• Start slow with products that appeal to a broad range of people

– Fish oil

– Glucosamine

– MultiVitamin

– Weight loss

– Calcium

– Iron, chelated

– Probiotics, “license plate”

– Vitamin D3

– CoQ10

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More mainstream than you think…More mainstream than you think…

• At least 40% of Americans utilize some sort of “alternative” treatment.

• Fish oil is the #1 reported “natural product” consumed by both adults and children.

• Echinacea was also popular for children…think probiotics.

• Alternative medicine is really only alternative to “the establishment” – fueled by BIG PHARMA

• Integrative, Functional, Holistic, Naturopathic Medicine, CCN, chiropractic, Acupuncture, even Yoga is considered alternative medicine.

Look For New Points of ViewLook For New Points of View

• Underground Wellness by Sean Croxton – #1 iTunes podcasts

• Dr. Sara Gottfried, MD – blog• Dr. Mark Hyman – books, blog • Dr David Brownstein – books, blog• Dr David Perlmutter – books, lecturer, practicing

neurologist• JJ Virgin – The Virgin Diet (elimination diet)• Mike Mutzel – The Belly Fat Effect• The Great Cholesterol Myth – Steven Sinatra,

MD/Johnny Bowden

The Great Cholesterol MythThe Great Cholesterol Myth

If you think statins are an ethical treatment…READ THIS BOOK.

If you think your cholesterol is the best predictor of heart disease…READ THIS BOOK.

If you think that depleting your body of CoQ10 doesn’t matter…READ THIS BOOK

If they forgot to teach you in pharmacy school that cholesterol has important BENEFITS…READ THIS BOOK

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The Lyon Diet Heart Study done by French Researchers to test the effects of different diets on heart disease.

605 men and women – all had survived first heart attack, had high cholesterol, smoked, ate junk food, didn’t exercise, and high levels of stress.

Divided into 2 groups: Mediterranean diet and “prudent” dietMediterranean – fresh fruits and veggies, olive oil, whole grains, legumes, nuts, seafood.Prudent diet – less than 30% calories from fat, 10% sat fat, max of 300mg cholesterol per day.

Result???


The study was stopped because it was deemed unethical to continue…

The Mediterranean Diet group had a 70% reduction in deaths and 76% reduction in cardiovascular deaths.

So, what happened to their cholesterol levels??THEY DIDN’T BUDGE. A 76% reduction in deaths from heart disease but NO CHANGE in cholesterol (neither total nor LDL)

The New England Journal of Medicine refused to publish the study.

(The Lancet later did)


• SUGAR is the dietary enemy…it is NOT fat or cholesterol.

• Chronic INFLAMMATION is the root problem.

• CALCIUM buildup in arterial walls is a better predictor…Agatston score developed by Dr Agatston(The South Beach Diet doc)

• STRESS may be the overriding trigger…the RosetoEffect.

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Coenzyme Q10Coenzyme Q10

• A powerful antioxidant which is an essential component in the mitochondria for production of ATP.

• All patients on statin drugs MUST be encouraged to take CoQ10 100mg BID.

• CoQ10 is important for energy production in the heart as well as preventing oxidation of cholesterol…pattern B LDL is the oxidized form which is “sticky” and inflammatory.

• Meta‐Analysis of 12 clinical trials found across the board significant decreases in blood pressure in CoQ10 supplements.

• Combine CoQ10 with GOOD Vitamin E to potentially lower CRP

Acetyl‐L‐CarnitineAcetyl‐L‐Carnitine

• Mobilizes fat to be used for energy – the heart gets 60% of its energy from fat

EVIDENCE:

• People who took L‐carnitine after a heart attack had significantly lower mortality rate compared to control group.

(1.2% death rate vs 12.5% for control)

• 80 heart failure patients divided into 2 groups…one group took 2gms ALCAR daily vs placebo. Significantly higher 3 yr survival.

• Significant improvement with intermittent claudication and 98meter increase in walking distance with PAD patients.

Omega 3 Fish OilOmega 3 Fish Oil

• Supplement for EVERYONE!

• Quality is so important with fish oil – US standards are poor; follow European or Norwegian standards to find quality products.

• “Standard” companies use GMP guidelines for purity…does not address oxidation or amount of DHE/EPA in product.

• Most recommendations are for 1000mg of Fish Oil per day. Most labels tout 1000mg fish oil…that is the TOTAL amount in the gel, NOT the amount of DHA+EPA.

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Amount Per Serving%Daily Value†

Calories 10

Calories from Fat 10

Total Fat 1 g 2%Polyunsaturated Fat1 g **Fish Oil Concentrate

1.29 g **

Total Omega‐3 Fatty Acids

967 mg **

EPA (eicosapentaenoic acid)

515 mg **

DHA (docosahexaenoic acid)

385 mg **


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MagnesiumMagnesium

• Has over 300 functions in the body…and most people are deficient.

• RELAXER – dilates the arteries to lower blood pressure, relaxes muscles, helps with sleep.

• Magnesium does what a calcium channel blocker does…only with extra benefits instead of side effects.

• Helps manage blood sugar – low magnesium levels correlate to insulin resistance. Magnesium is needed to metabolize sugar.

• Calcium and magnesium have a symbiotic relationship…intracellular calcium levels rise when magnesium drops.

MagnesiumMagnesium

• Magnesium deficiency is rampant.

• We use often for muscle cramps, muscle pain (fibromyalgia), anxiety.

• Fill a bath with Epsom Salts for a cheap way to get magnesium, plus the benefits of relaxation.

• Magnesium is great for constipation as well (laxatives), but look for poorly absorbed forms.

• We use Magnesium Glycinate as the absorbable form, and a magnesium citrate for constipation.

• For leg cramps we use a Cal/Mag combination.

MultivitaminsMultivitaminsSupplement Facts

Serving Size 1 Tablet

Each Tablet Contains % Daily Value

Vitamin A 3,500 IU (29% as Beta‐Carotene)

70%

Vitamin C 60 mg 100%

Vitamin D 400 IU 100%

Vitamin E 30 IU 100%

Vitamin K 25 mcg 31%

Thiamin 1.5 mg 100%

Riboflavin 1.7 mg 100%

Niacin 20 mg 100%

Vitamin B6 2 mg 100%

Folic Acid 400 mcg 100%

Vitamin B12 6 mcg 100%

Biotin 30 mcg 10%

Pantothenic Acid 10 mg 100%

Calcium 200 mg 20%

Iron 18 mg 100%

Phosphorus 20 mg 2%

Iodine 150 mcg 100%

Magnesium 50 mg 13%

Zinc 11 mg 73%

Selenium 55 mcg 79%

Copper 0.5 mg 25%

Manganese 2.3 mg 115%

Chromium 35 mcg 29%

Molybdenum 45 mcg 60%

Chloride 72 mg 2%

Potassium 80 mg 2%

Boron 75 mcg *

Nickel 5 mcg *

Silicon 2 mg *

Tin 10 mcg *

Vanadium 10 mcg *

* Daily Value not established.

Ingredients: Calcium carbonate, folic acid, vitamin K1, magnesium oxide, nickel and tin??, dl‐alpha tocopherol

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MultivitaminsMultivitamins

Ingredients: chelated minerals, methylcobalamin, 5MTHF, K1 and K2, vitamin E with mixed tocopherols…levels comparable even at 1 capsule dose. Zinc/Selenium levels biggest concern.

MultivitaminsMultivitamins

Zinc Carnosine chelateZinc Carnosine chelate

• Marketed as a drug in Japan since 1994.

• Works to heal the gut and small intestinal lining

• Benefits heartburn, ulcers, leaky gut…in as little as 3 to 7 days.

• Speeds healing

• Off label in Japan for stomatitis and radiation burns in mouth.

• Dose 75mg BID to treat

• May decrease to QD for maintenance…if patient doesn’t want to or is symptomatic upon stopping

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Clinical PearlsClinical Pearls

• To methylate/metabolize estrogens use Resveratrol, NAC, and TMG. MethylB12 and MTHF are not enough.

• Theanine is a wonderful anti‐anxiety supplement…non‐sedating.

• The Microbiome is a new field of emerging research.

• Vitamin E will do as much harm as good if it is alpha tocopherol alone. Mixed tocopherols and/or high gamma tocopherol forms are necessary!

• CoQ10 and Vitamin E work well together…synergistically.

• The gut is the core of our bodies, and health.

• Inflammation is at the core of most, if not all, chronic disease.

Thank You!!Thank You!!

Jennifer Hughes, PharmD

Greenwood Compounding Pharmacy

Waterloo, IA

116th annual convention - ncpa · create a marketing plan to introduce your nutrition niche to your...

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