BEYOND MCO: COMMUNITY PHARMACIES IN THE NEW NORMAL
Written By: Jack Shen Lim
As we enter into what is hopefully the end of the recent episode of the movement control orders (MCO) and its subsequent Conditional MCO (CMCO), businesses nationwide are faced with a harsh reality of a nation that has been on a standstill for weeks and an economy interrupted.
Community pharmacies, although allowed to function as an essential healthcare service, is also adversely impacted in this period together with other private healthcare facilities. In a recent interview, En Amrahi Buang, the president of the Malaysian Pharmaceutical Society (MPS) stated that despite a surge in sales of face masks, sanitisers and gloves in the initial phase of the MCO, by the third phase of the MCO revenue have dropped by at least 50% leading to severe economic distress.
However, as community pharmacies are a key component of the health system, it is important that community pharmacies must continue to operate and remain in business in order to serve and contribute to the community. That being said, as a business, community pharmacies need to plan and manage a new harsher economic and social environment that will become the new normal.
A recent Bernama news article published in major local dailies on the 15th of April highlighted the issues faced by the wider retail market that also afflicts community pharmacies. As the MCO continues, industry experts are revising growth forecasts downwards and most businesses will face further losses due to operational shutdown. In the article, based on the data gathered by an online retail data analytics platform called SYCARDA, it was surmised that although different retail sectors show different sales results during the MCO period, almost all is suffering through a major decline in revenues and this is forcing businesses to downsize or shutter. In the same article, small and medium enterprises are advised to focus on cash flow, innovate and to take advantage of the liquidity made available by the government Prihatin Rakyat economic stimulus package, requesting the extension of credits and rental reduction.
Global advisory firm EY also echoed the sentiments outlined in its recent Take 5 for business issue on the 26th of March. Titled ‘The resilient enterprise – COVID-19 preparedness’, they outlined four actions that enterprises need to undertake as part of their crisis response in order to mitigate the adverse impact of this challenging period.
PRIORITY AREA #1: PUT PEOPLE SAFETY FIRST
People, be it your floor staff or additional pharmacists, are the key assets of your business and needs to be protected. As a frontline community primary healthcare facility, pharmacies need to have steps taken to prepare your team for the continued fight against the disease and also infection prevention and control in case of exposure to COVID-19 cases. These steps are outlined in the MPS’ April 2020 ‘COVID-19 Pandemic Guidance Document for Malaysian Pharmacists that can be accessed from the MPS website or from the FIP COVID-19 resource center.
On top of the immediate occupational health and safety issues, community pharmacies as good employers needs to practice empathy and assist employees to deal with the personal impact of the crisis. Steps include setting mechanisms for responding to employee’s health concerns (such as insurance coverage, mental well-being); regularly communicating positive and assuring messages; creating channels for regular check-ins and updates and reminding employees of the common purpose of the company. These measures are necessary to steady the ground at this time of crisis.
In addition, with the impact of the continuing MCO, there exists a need to transition staff into new ways of working. This is particularly true for the back-office team that is not required to be at the shop floor. Key steps to do this is to establish clear company direction based on the changing situations on the ground, set clear expectations on work priorities and responsibilities as well as advising employees to stay flexible and if possible, provide remote working opportunities. You can stay connected to the MPS Area Committees, social network and communication channels and the MPS website for the latest information and initiatives.
PRIORITY AREA #2: PROTECT BUSINESS CONTINUITY
Business continuity comes naturally to most community pharmacies, but the situation is changing with the continuing MCO and the subsequent restarting of non-essential businesses. The situation during MCO is relatively stable but supply chain networks are increasingly disrupted.
Community pharmacies must assess their supply chains to identify gaps in the supply especially for pharmaceutical products. Consider a diversification of suppliers if possible but for single-source medications, rational use of medicines by limiting dispensing may be needed to ensure that only those who need the medications get them. If need be, recommend to your patient, after consulting their medical doctor (if required), a substitute medication in the same therapeutic group.
As part of preparedness, community pharmacies must define an alternative plan (Plan B) with a clear decision-making process to respond to disruptions. One clear example is staff preparedness facing the presentation of a suspected COVID-19 positive patient. The community pharmacy needs to plans in place to refer the patient, ensure staff safety and disinfect the premise at the shortest possible time to minimise disruptions to the business.
Lastly, please consider the available tax, financing and other steps made available to the business as part of government stimulus measures.
PRIORITY AREA #3: BUILD AND SECURE LIQUIDITY
Liquidity or cash flow will be an immediate problem for almost all sectors of the economy due to the prolonged MCO. Whilst it may not impact essential services such as pharmacies as hard as other sectors, steps need to be taken to ensure continued cash flow.
The economic situation due to COVID-19 will disproportionately impact highly leveraged businesses or those with low cash buffers. As the economic situation worsens, there will be a tightening of cash flows in the market (partially due to a reduction in consumer liquidity as well) that will cascade from business to business and impact community pharmacies. Therefore, it is important to assess immediately the cash flow of your business and consider contingency funding.
As a business, community pharmacies need to immediately identify available cash and due payments – consolidating available cash and unutilised credit lines. Identify urgent payments and allocate cash reserves to cover upcoming payments. In addition, forecast cash flows in multiple scenarios (such as a drop of 25% and 50% store sales) to plan remedial action in each scenario.
In addition, consider additional sources of funding such as negotiating with suppliers on credit terms or peer-to-peer (P2P) financing. P2P financing is the practice of funding to individuals and businesses via online services that match lenders to borrowers. Some companies like Fundaztic have teamed up with a pharmacy alliance to provide community pharmacy specific initiatives to their members.
Another way to improve cash flow is to reduce overheads via austerity measures, rental reduction (or moratorium). For most businesses, the biggest overheads are staff and rental. Any savings in these areas will lead to an immediate liquidity boost.
PRIORITY AREA #4: ENGAGING STAKEHOLDERS
As in any business, community pharmacies are dependent on their stakeholders to be successful and it is crucial for community pharmacies to manage their stakeholder’s expectations amidst the COVID- 19 pandemic. As a first step, it is important for community pharmacies to identify and understand the priorities of each stakeholder at this time. Stakeholders for community pharmacies are the patients/customers (and their families), employees, investors, regulators, suppliers, other healthcare professionals and the community (public health).
Community pharmacies need to assess the needs and priority of each group so that a targeted engagement plan can be implemented. For example, looking at customers as a stakeholder group, their needs are generally to have continued supply of essential items at a reasonable rate with a good service level. As many is directly impacted by the MCO and their behaviour (demand) may have changed, it is prudent to engage them via clear communications – from something as simple as the store’s operation hours during MCO and how to get products and service at this time. In addition, you can start preparing post-MCO promotions and sales to engage them post-MCO.
Take this MCO period to plan, discuss and move on to other stakeholder groups and prepare a communication plan that address the priorities you identify for implementation. Ultimately, any engagement plan needs to be reassessed as conditions change and having considered it beforehand will allow you to respond proactively instead of reacting belatedly.
CONSIDER ALL OPTIONS & STAND UNITED
As we move on towards what may be permanent changes in consumer (or even societal) behaviour, it is important to consider all options from innovating the way community pharmacies do business, downsizing to manage costs and risks or even closing the business (in part or as a whole).
Another important consideration that all community pharmacies should explore is to end the ongoing unsustainable price war and unite as a profession for the sake of both the business and the patients. Unity and cooperation between community pharmacies may lead the way to create a better future for all pharmacists. Divided we stand alone but united we can all play an essential part in overcoming this unprecedented challenge to all pharmacists.
The writer is employed by Berjaya Pharmacy Sdn Bhd which is part of the Berjaya Group. Berjaya Pharmacy Sdn Bhd, through its subsidiary Berjaya Pharmacy Retail Sdn Bhd operates Tigas Alliance Pharmacy which is part of the MyTigas Alliance.
The opinions expressed in the article are the writer’s own and do not reflect the view of MPS YPC.
1) Pandemic Hits Malaysian Private Health Sector Hard, Code Blue 20/04/2020. Accessed April 20th 2020. https://codeblue.galencentre.org/2020/04/20/pandemic-hits-malaysian-private-health-sector- hard/
2) Data expert shares tips to empower SMEs in surviving MCO, The Malay Mail 15/04/2020. Accessed April 21st 2020. https://www.malaymail.com/news/money/2020/04/15/data-expert-shares-tips-to- empower-smes-in-surviving-mco/1856966
3) Pakar data kongsi panduan perkasa PKS semasa PKP, Bernama 15/04/2020. Accessed April 21st 2020. https://www.bernama.com/bm/news.php?id=1832319
4) The resilient enterprise COVID-19 preparedness, Take 5 for Business, Volume 8 Issue 3 26/03/2020. Accessed April 15th 2020.
5) COVID-19 Pandemic Guidance Document for Malaysian Pharmacists, Version 2, Malaysian Pharmaceutical Society 23/03/2020. Accessed April 25th 2020. https://www.mps.org.my/newsmaster.cfm?&menuid=37&action=view&retrieveid=7821
6) Fundaztic x Tigas Alliance, Peer-to-Peer Financing for Pharmacies. Accessed April 25th 2020. https://fundaztic.com/mytigas-alliance