RxGenius

Bucking Bronco Health News – Part 2NPA & Manufacturer Formulators Provide the Cushion

Back in April (I can’t believe so much time has gone by!), I wrote about consumers’ confusion wrought by media’s coverage of health issues, particularly on the use of supplementation.  Well, I’m just back from the Natural Product Association's (NPA) annual meeting, conference and trade show, where I listened to a presentation about “Navigating Sensational Reports and Conflicting Claims” by Neil E. Levin, CCN, DANLA.  It was chock full of science, showcasing a variety of studies on Vitamin E; Vitamin D3 and D2; soy safety including efficacy of biotech soy versus conventional soy; supplement versus food effectiveness and safety; GMO’s; and organic versus conventionally grown ingredients.  I must admit that I didn’t understand a lot of the scientific jargon, but I got the point and learned some very interesting facts as a supplement consumer.

But first, about the NPA:  Founded in 1936, the Natural Products Association is the largest and oldest non-profit organization dedicated to the natural products industry.  It represents more than 10,000 retailers, manufacturers, wholesalers and distributors of natural products, including foods, dietary supplements, and health/beauty aids.  It’s been through a metamorphosis over the years, most recently changing their name from Natural Nutritional Foods Association to NPA.  In our industry, the NPA is an important education and lobby organization, with an office now located in Washington DC. 

Any pharmacist who is interested in transitioning into a wellness center with a more integrative medicine approach would do well by investigating and joining the NPA.  They have a number of resources for members and, more importantly, provide support for quality manufacturing standards (such as their TruLabel GMP program) and credible research that helps protects us from too much government and pharmaceutical industry intrusion, supports quality assurance and consumer choice.

Neil is a member of the Scientific Council of the national Clinical Nutrition Certification Board and a 2008 recipient of the NPA’s Industry Champion Award, one of several the NPA gives out annually to recognize scientists, business people and activists in our industry.  He’s also a formulator at Now Foods in Bloomingdale, Illinois, a highly reputable, quality manufacturer of a line of 1,600 affordably priced nutritional supplements in multiple categories.  Neil has been writing a blog called Honest Nutrition, since 2006 from an informed science point of view, which I encourage readers to visit.  You will appreciate his annotated, referenced commentary in articles on over 460 topics.  Check out the Labels list on the left hand column for a quick view of the subjects.

Neil didn’t get the time to finish his presentation; after all, there were 102 slides in his presentation.  But in the time allotted, I took away these key messages:

Most negative reports on nutritional supplements come from meta-analysis, in which the statisticians may not have the thorough understanding of the science behind the substances and more importantly, a thorough understanding of the original research.  Consumers don’t understand the difference between meta-analysis, gold standard, double blind placebo research in independent university settings and manufacturer sponsored proprietary studies.  When the media print it, it becomes the gospel driven by word of mouth, poor follow-up on subsequent studies, and ubiquitous internet links.  Better informed researchers invariably look at the same data and come to different conclusions, but by then the press flurry is over and consumers are never exposed to published studies that refute original conclusions.

Secondly, if we look at the trail of publishers and the influence of the pharmaceutical companies on the media, specifically on scientific and peer review journals, it’s clear that drug advertising influences scientific journals to publish fewer and mostly negative articles on nutritional supplements.  We’ve wondered about this for years, especially during the rise of direct-to-consumer advertising during the last two decades.  But to have a published article out of the University of Florida and School of Medicine at Winston-Salem, North Carolina, is tangible confirmation, not just rumor and speculation.

I also learned that antioxidants are synergistic.  As a consumer, that fact was an eye-opener that helps me continue my own personal education about the value of nutritional supplementation, especially in an aging baby-boomer body.  I wonder how many of your patients know this fact.

I asked Neil what independent pharmacists can do if they want to go beyond their traditional sources of information and reach into the integrative medicine world to get credible science about nutritional supplements.  His short answer is to join professional, science-based organizations that focus on supplements including the American Herbal Association, the American Botanical Council, and the NPA among others, and get beyond the media by accessing information online.  Neil has a short list of these sources, government, university and non-governmental organizations, on the left column of his blog.

So how can we counter the national media bias?  One solution is for independent pharmacies to create relationships with their local newspapers and feed the reporters articles with the full facts.  Your credentials go a long way in understanding the research and, more importantly, providing newspaper publishers and readers the full truth and not just the partial truth we often get today.

Until the next time, visit our website, or email me.
Linda O’Hara

Pharmacists Should Hire Other Credentialed Practitioners

This is third in a Series on Transitioning from a Drug Store to a Wellness Store.

Last week I received an email from an independent pharmacist commenting on the shortage of pharmacists and his interest in hiring other credential practitioners.  Most of us know that the shortages are caused by increased demand (one-two punch of increased use of drugs and aging of the baby boom population), shortage of pharmacy schools, and the most intriguing reason, “increases in the volume and range of activities demanded of today's pharmacists”  – specifically patient counseling.  In fact experts are predicting a shortage of 150,000 pharmacists in 2020 in spite of 15 new pharmacy schools due to open by 2010.

For those who are looking for career security, a pharmacy degree is sure bet.  But in the meantime, for consumers need is growing and it’s the body of knowledge and the clinical license to practice that’s important to them.  So independent pharmacists would do well to expand their store staff to include practitioners in other modalities to help with expanding demands for patient information.  Here’s a list of potential modalities that could fit into an independent pharmacy.

Nurses – In spite of the nursing shortage, there’s a host of nurses in the market who are burned out on patient care in traditional settings and want to use their knowledge in a less stressful, more holistic way.  Nurses are super additions to an integrated pharmacy due to the scope of their license, knowledge of physical systems and science, familiarity with drugs and experience with patient communication.  Look for these kinds of nurse specialties: Licensed Practical Nurse, Nurse Practitioner, Nurse Educator, Primary Care Nurse, Clinical Nurse Specialist, and Registered Nurse.

Licensed Dietitian or Nutritionist – Often very valuable in health food stores, dieticians and nutritionists won’t have as much value to an integrated medicine pharmacy unless a large part of their retail floor is food.  Certainly special diets are a big part of many patients health and wellness concerns and weight management seems to be everyone’s issue; but when considering this modality, look for the dominate categories in your store and select the clinician to match the merchandise mix.

Naturopathic Physicians – The often overlooked modality of Naturopathy would be a good fit for an integrated medicine pharmacy.  Still only licensed to practice in 15 states, a naturopathic physician’s body of knowledge is extensive, especially in nutritional supplements and alternative therapies, having had four years of training in a residential naturopathic medical school.  One way to differentiate between a naturopathic physician and a traditional naturopath is to ask for a copy of their degree.  There are only six accredited colleges of Naturopathy in the United States, all other schools are short programs or correspondence schools.  One big advantage of this modality is they qualify to buy and resell professional lines of nutritional supplements from companies like Metagenics, Thorne Research, Standard Process and more.  These supplements could be merchandised behind a counter set up as a high touch personal counseling area.  Pharmacists would need to look into regulations governing scope of practice.

Homeopathic Specialist – Many pharmacists already are familiar with the discipline of homeopathy.  This modality, practiced more widely in Europe and Canada, is still a respected modality offering substantial clinical education.  Like Naturopathy, these clinicians can provide both customer/patient information and support the professional nutrition and therapeutic supplements part of the store.

Licensed Massage Therapist, Estheticians – Many licensed massage therapists and estheticians don’t end up making a living in these professions full time.  LMT’s are excellent for running the body care, therapeutic and medical device departments whereas Estheticians would be good for health and beauty categories in an integrated medicine pharmacy.  The added bonus is their hands-on license.  Sometimes a patient just need a little hand or neck massage to feel just that much better.  These modalities are also great for in-store demos and value-add high touch services like chair massage and natural hair and skin care – rapidly growing categories.

Oriental Medicine, Traditional Chinese Medicine & Herbalists – Of course, Traditional Chinese Medicine is a now a widely practiced primary care modality in the US, licensed in 44 states.  But one of the best integrative medicine pharmacies I saw was in Washington DC where compounding was performed in Oriental and Ayurvedic herbs as well as pharmaceuticals.  Consumers who use Chinese and other herbs would benefit from a more retail like environment where they can replenish their prescriptions and seek additional information. 

Certified Health Coach – These professionals are a hard to find group now, but I predict they will grow especially with respected Duke University’s launch of their Integrative Health Coaching training program.  Integrative medicine pharmacies that want to transition from a drug store to a wellness center would do well to incorporate such a professional into their mix and broadcast this unique service far and wide, especially as a way to compete against the rapidly growing trends to put primary care clinics in supermarkets.      

So now you’ve got some ideas of the types of clinically trained health professions that would fit with an integrated pharmacy.  But who can help you with store merchandising, selling, ordering, and marketing?  And how can you find such a person?  Is a clinical person, such as a nutritionist or herbalist the right kind of person to hire?

There’s no single answer to those questions and there are a variety of considerations which sounds like the answers would be a good topic for my next post.

Until then, visit my website, or email me.
Linda O’Hara

Bucking Bronco Health News Requires Information to Cushion Consumers Landing

News headlines and industry emails last week compressed the usual see saw of news about drugs and supplements into a few days that felt like riding a bucking bronco.  No consumer could possibly keep up with the conflicting messages and sort thru the confusion without a lot of research time or – here’s where pharmacists come in – an easily accessible, knowledgeable clinician.  Without one, most consumers just get thrown off.

I read the electronic edition of the New York Times every day.  Last Sunday, I read news that pharmaceutical companies may be close to a legal shield from lawsuits if the Supreme Court rules so in a case involving Johnson & Johnson, makers of the Ortho Evra birth control patch, and over 3,000 women and families who have sued over claims that the drug caused injury and even death.  Called “pre-emption,” the legal argument is that since the drug was previously approved by the FDA, manufacturers cannot be sued, even if the manufacturer did not disclose to consumers correct information about the ingredients.  I wondered how pharmacists reacted to this news…

Two days later, Jane Brody, the NYTimes Personal Health editor, wrote a stinging article calling use of dietary supplements “substance abuse.”  In it she threw punches at the industry with oversimplified statements, a couple of extreme consumers examples and quotes and testimony from Center for Science in the Public Interest, a Washington DC based education (read lobby) organization known for it’s conservative views on nutritional supplements.  There were no balancing viewpoints from the Council for Responsible Nutrition, the Dietary Supplement Information Bureau, or the Natural Products Association, industry education (more lobby groups, but these are friendly to or created by the natural products industry).  This same story was respun the very next day for the television audience on CBS, this time using a nutritionist.

By Thursday, the biggest health headline in the New York Times and Pharmacist eTalk was the news that heparin, a blood thinner manufactured by Baxter International and approved by the FDA, was suspected in 62 deaths, most likely due from – yep, you got it, tainted ingredients from China.

The fact is that science, industry (both pharmaceutical and natural products), government and media have been creating wave after wave of conflicting information for decades that causes confusion and fear among consumers, especially those who do not have the time, the resources or even, perhaps the education, to understand the stories, put the information in context and make their own informed decisions.  Most consumers, just like I did for the first 30 years of my life, take doctors words and government regulatory proclamations as the “gospel.”  But when science and consumer experience is showing that doctors advice and government agencies are flawed, where can consumers go to sort things out?  Just take the 2002 hormone replacement therapy (HRT) revelations and the current responding backlash from pharmaceutical companies against bioidentical hormone replacement therapy (BHRT). 

Pharmacists are perfectly positioned to help us.  I use the word “us” intentionally, because as a leading edge baby boomer, I, my friends and my family, are all riding the same horse and we've been riding this bucking bronco for three decades.  To whom can we turn to help us? 

To walk into a integrative medicine pharmacy with professionals who have the knowledge, education and an unbiased viewpoint about both drugs AND supplements and herbs would be a blessing and here’s why:

• Community pharmacies are walk-in retail environments.  I don’t have to get permission from a doctor or an insurance company to talk to a pharmacist.  I could have more than 7 minutes to share my history and ask my questions.  I’m even willing to pay for this access to professionals and their time out of my pocket, like most integrative medicine consumers do.
• Integrative pharmacies that sell remedies across the spectrum demonstrate their acceptance of an integrative, whole health point of view, and therefore, acceptance of me.  I don’t have to worry that I am being judged, or that I have more education about health and wellness than the person to whom I am speaking.
• Many of the newer pharmacists are female, making personal, private conversations easier.  The older ones schooled in “weeds and seeds” decades ago start out with accepting the breadth and depth of available, affordable remedies beyond drugs.
• Pharmacists help explain what I need to pay attention to – from nutrient depletions caused by drugs to all the potential interactions – and can help me manage my own health in a more informed way.

And I’m not talking about Walgreens or CVS here.  Only independent, community pharmacies can deliver the kind of personal attention and information over my lifetime that will help cushion the jolts and bumps from the bucking bronco health headlines.

Linda O’Hara
Visit my website, or email me.

Are You Reading Natural Product Trade Publications?

Transitioning from Drug Store to Wellness Center – Part 2 of a Series

In my last post, I invited independent pharmacists to jump into the waters of the rising tide of integrative medicine and “natural” health and wellness.  Generally people come into this market from one of either two directions – personal or professional. 

Most of the folks who have been in the business of integrative medicine for over 15 years came into it through a personal experience of some kind.  Their own health challenge or that of a close family member who couldn’t be helped with conventional medicine is a typical story.  Or they were early pioneers with strongly felt values about the earth and nature and concerns about modernization and chemicals on agriculture and medicine.  Paul H. Ray and his associate Sherry Ruth Anderson described these people and the phenomenon in their seminal book, The Culture Creatives:  How 50 Million People Are Changing The World.
 
In the last 15 years, though, a new trend developed where professionals in health and consumer packaged goods became attracted by the profits and the growing market.

When you are new to the movement and its associated industries, there’s a lot to learn and some of the best places to start are trade journals.  Here’s my personal list of favorites who have been contributing to the literature of the business of integrative medicine, wellness and the natural products industry for long enough to have credibility and a range of sources that can satisfy even the most discerning clinician.

On the science and business of integrative medicine, Innovision Health Media is a publisher of both consumer facing and professional peer-reviewed content.  The company acquired an array of leading publications from the late 80’s and 90’s including Alternative Therapies, Integrative Medicine and Advances in Mind-Body Medicine and brought them together under one roof.  The value of these publications to a pharmacists is that together they give a range of information from the most qualified traditional clinical sources and content review processes to the most consumer friendly health and wellness magazine with articles running the gamut from cardiovascular health and maintenance to stress reduction through mind-body and spiritual practices. 

A related professional and leader in reporting on the business of integrative medicine is John Weeks, whose print newsletter The Integrator from the 90’s evolved into his current online Blog and email newsletter.  A self described maven as defined by Malcolm Gladwell in The Tipping Point, Week’s range of contacts in the integrative medicine world stretches across multiple disciplines and for well over two and a half decades.

New Hope Natural Media is probably the largest producer of trade content as well as trade shows that straddle both the nutrition and the food worlds.  Privately owned in the late 80’s and 90’s, New Hope is now owned by Penton Media and has acquired a number of professional companies including The Natural Foods Merchandiser, focusing on natural food retailers from Walmart to small, community independents; Nutrition Business Journal, a research journal focusing on the macro trends affecting the nutrition and organic foods business; and most recently the NPI Center, an online portal and directory of information for professionals in the Nutraceutical, nutritional, dietary supplement, cosmetic, and food industries. 

Pharmacists do well when they look at the ingredient side of the nutritional supplement business.  They are especially well positioned to understand the science of ingredients that influence both the pharmacological and the nutrition and nutraceutical sides of the wellness spectrum and translate this information to consumers.  Functional Ingredients is one of three trade publications that cover ingredient and manufacturing issues from the science of R&D to issues affecting distribution.

Another of these is Natural Products Insider, published by Virgo Publishing.  Jon Benninger, a founding editor in 1990 of one of the early Virgo trade publications targeting nutrition retailers, has helped guide their expansion to include trade shows, conferences and a new entry in the health and beauty category Inside Cosmeceuticals.

There are other publications such as Nutritional Outlook, owned by Canon Communications out of LA, but the people involved in the InnoVision, New Hope and Virgo groups have long histories and deep roots in the industry and understand how the lines have blended over the last two decades between conventional and alternative medicine to become integrative medicine.

To get a good dose of the “natural health and wellness” trends and the continuing challenges to professionals and consumers alike, I would start with these.  Then send me your comments.  I’m interested to hear different views on these publications. 

Next time:  Going to the Trade Shows to Swim with the Big and Little Fish

Linda O’Hara
Visit my website, or email me.

Transitioning from Pharmacological to Integrative Medicine, from Drug Store to Wellness Center

Introduction:
Jump In!  The Natural and Wellness Business Environment is Warm, Friendly and Growing

It’s hard to describe to people who don’t live the LOHAS lifestyle just what has happened over the last two decades, what is happening now, and what we believe is going to happen in the future in the world of health and medicine.  We’re the folks who have embraced alternative medicine and turned it into integrative medicine, have consumed natural and organic products and turned them into a world wide movement including USDA rules and regulations, and are spending more discretionary dollars on health and wellness because a) we have the money and b) we want to live a long and healthy life.

Here’s a quick example – a woman in her 30’s working in hospitals, has friends who are doctors, starts buying natural and organic foods in the early 80’s, has health challenges MD’s can’t solve, turns to diet and nutrition, acupuncture physician (MD) and mind-body center in Boston for solutions.  Her health improves and interest in chiropractic care, massage therapies and nutritional supplements grows.  Yes, emergency surgery for a true emergency, antibiotics when absolutely necessary; but now, at the age of almost 60, health is about staying well and feeling good with a wide range of nutritional supplements, organic foods, exercise and positive living. 

Ok, maybe this doesn’t give you the picture.  So try this:  In 2007, 81% of the US population1 consumed nutritional supplements, spending an estimated $20.3 BILLION2 on vitamins, minerals, herbal and dietary supplements.  Another $343.5 billion was spent on functional foods and beverages, where specialized nutrients are added to foods to provide a different distribution method for needed nutrients than traditional pills.  Growth of supplement sales alone was a healthy 6% in 2007, whereas growth of pharmaceuticals in 2007 was only 3.8%, the slowest rate of growth since 1961.  And this is in a period when 12,000 people are turning 50 every day and 70% of the nations net worth is in the hands of the burgeoning baby boomer population.

The fact is, so called alternative medicine is here to stay and it’s now considered mainstream.  More than half of Americans think combining alternative medicine with conventional medicine is helpful.  And with the frightening headlines about meat, produce and drug recalls and drugs found in 24 city’s drinking water, consumers are increasingly fearful of conventional foods and medicine and turning in droves to the newly labeled “organic lifestyle.” At the same time, cosmeceuticals and the organic and natural personal care category is growing faster3 than any other in the CPG industry, a healthy 11% - 13%, driven by youth and beauty seeking aging baby boomers.

Pharmacists should be elated at this news!  Wellness is the perfect safe haven from a shaky pharmacy market, restrictive government regulation, and shrinking Medicare reimbursement environment.  An integrative medicine pharmacy will have more customers, better margins, expanding categories, and enjoy steady growth due to the green movement and boomer tidal wave that are fueling growth of this market for decades to come.  All this, plus the fact that pharmacists are considered to be the second most authoritative source of information on health issues4, right after doctors, with 51% of supplement users saying that pharmacists are a very important or important influence on their purchase and consumption of nutritional supplements.

So, calling all pharmacists! Jump into the wellness market.  We welcome you, want you and need you!

How?  You may ask.  If you’re thinking about transitioning your drug store into a wellness center, here the first ten steps you can take to start the transition. 

1.  Read the “natural products” trade publications, especially those focusing on nutritional supplements and body care products.
2.  Go to industry trade shows & conferences
3.  Visit existing, successful integrative pharmacies
4.  Take courses in supplements, herbs and body care that are sanctioned and supported by the natural products industry
5.  Look for OTC and professional “natural” brands that a) conform to GMPs, and b) provide transparent, quality formulation information and third party efficacy research
6.  Join industry trade and lobby organizations
7.  Start shopping in natural product stores to get in swim with the market
8.  Establish business relationships with key industry distributors and directly distributed natural product brands
9.  Adjust branding, store decorating and merchandising to fit the needs and wants of the “natural consumer”
10. Hire other credentialed practitioners on staff

Now back to that woman in the second paragraph.  That’s me.  A consumer of alternative remedies, organic and natural foods, and a healthcare marketer for over 30 years.  And co-founder of Living Naturally. 

My next ten Blog posts will give you more details on each of the 10 steps listed above.  Or if you want the information faster, call Karen at 1-866-312-8324 or email us.

Linda O'Hara
Visit my website, or email me.

1 Nutrition Business Journal, 2008 Year Preview:  US Nutrition Industry
2 Natural Marketing Institute, The Health & Wellness Trends Database, Natural Products Association Presentation July 20, 2007
3 Hot Changes in the Organic, Natural and Supplement Markets, Expo West, March 13, 2008, Anaheim, CA
4 Natural Marketing Institute, New Consumer Research, Capitalizing on Trends in the Nutritional Marketplace, SupplySide West Presentation November, 2005