Mital Thakrar, head of private services at Well Pharmacy, and Surrey contractor Sunil Chandarana spoke at this year’s Pharmacy Show on the growth of weight loss services – and how to run them successfully
Focus on retention
Mital Thakrar set out Well’s approach to the service, telling the audience: “It's understanding the true unit price of that service. A lot of focus goes into growth margin, and actually having an understanding of the full costs is really key.
“The second thing for me is to focus on retention. Retaining patients is really important, and we obsess over it. We spent a lot of time on trying to acquire patients, and the energy and the effort devoted to retaining them must be at least equal, if not more.
“And I think the third one for me is to remember that we're a pharmacy offering additional services. Right now we've probably got patients walking into our pharmacies for weight loss consultations. The next natural step would be offering a flu or Covid jab.”
How does Well retain patients? “I think it's having a recognition of who those patients are, and keeping close to them. It's a really competitive market, so giving them a reason to want to come back is super important.”
Sunil Chandarana said that while it’s “debatable” whether NHS services are profitable, “a private service has to be profitable,” adding: “Every consultation needs to be covered. There's the prescriber's costs, rent, rates, that all has to be covered.”
That means it can’t be sold cheaply, Sunil said. He offers an introductory five-minute conversation to establish a patient’s ability to cover the costs of the service, as well as their motivation for wanting to lose weight and any possible contra-indications to GLP-1s.
Through these measures, “we've basically got our patients to be ready to start the journey and that's when we start to have our 45-minute minimum consultation... by doing that we end up having a higher retention rates”.
He said a “holistic approach” has worked well for the pharmacy: “For us it always has to be patient first and then you build a plan backwards for that patient.
“You want to inform them, and more importantly listen to them, find out their triggers, discuss the diet, exercise, hydration, vitamin supplements… it has to be realistic with their target and their goals.
“It's not just about the weight loss consultation, here's the medicine, and see you again next month. It's about all of those different things we do to help our patient achieve their goals.”
Approach to pricing
“There are so many overheads,” said Mital. “Staff costs, platform fees, merchant fees, then equally the costs to actually acquire that have to be considered as well.
Sunil added: “From our point of view, you have to be financially responsible. There’s no point just trying to undercut competitors. We have to look at our rents, our rates, and our staff costs.
“This is very individualised, and that's something you should do to build a model that works for you with a good profit margin – because if not, you’ll struggle later on.”
Maximising return – why teams matter
Sunil said: “If a pharmacist cannot get the return they need, you have to look for their model, you look at your staff, do they know what you are doing, are they educated?
“The journey for a patient walking in has to be seamless. That means your counter assistants, your dispensers need to understand the service."
Advertising is crucial too, he says. “Do your patients know you offer the service, and if so how do they know?”
Mital says that from a multiple’s perspective, if a branch is underperforming “the key is making sure the team are involved – a lot of the interactions with our patients and with our counter staff.”
Commenting on the use of technology, he added that a good customer relationship management (CRM)system that connects to the appointment booking system can help “keep the patient”.
Patient recruitment
Sunil focuses strongly on local advertising, including fliers for private services in prescription bags and advertising them on TV screens in the pharmacy. He said: “The patients are fully aware of what we do in-house for those that come to us.”
Mital commented: “Staying within the Advertising Standards Authority guidelines is important,
We spend a lot of time advertising on social media. It's getting that message out there on the ground that we offer this service in all of our pharmacies.
“Again, probably the biggest advertising opportunity for us is with our teams. If our teams are informed and they're able to talk to patients about the service, that's key.
Word of mouth referrals are also beneficial, he said: “We can see a lot of people coming because of that.”
And media reports of a new weight loss drug coming on the market drive up queries, he said, adding that teams should be trained up to answer questions on topics such as administration or side effects.
Sunil said: “The team really need to know exactly what you're offering. It could just be a conversation where somebody's taking someone's blood pressure, and they're here to have a conversation.”
Create returning customers
Asked how to convert a once-off interaction into a returning service user, Sunil said: “It all comes down to service quality. From a patient's perspective it's the environment that our pharmacy team creates. The patient's coming in to have a conversation on a sensitive topic, so we need to make them feel welcomed, non-judged and give them a reason to come back.
“It’s also about focusing on the value that we can add, not just weight but supporting them no other parts of their journey.”
Mital added: “You need to understand everything about the journey, using key metrics. So, how many enquiries are you getting, and how many of those follow up with a consultation?”
Well’s service centre checks in with branches to ask if they are following up with those patients who haven’t come back within a month, he said.
“The fact we offer face-to-face is great,” he said. “It's the same prescriber who knows you, who's seen you last time and given really good advice.”
Contractors should also “think really hard about their website,” the audience heard. “You compete against so many online retailers – how many clicks does it take to really make a booking? It should just be a couple of clicks.”
Commercial versus clinical
Where is the balance the commercial growth and clinical responsibility? Sunil said: “First and foremost, we're all clinicians, we have a responsibility for the patients' welfare. That is the most important thing.
“We've all been in situations where a patient comes to the pharmacy and they're going to a wedding or on holiday and they're trying to push you for higher strength. That may not be in their interest and we have to push back. Those conversations happen early on.
“You have to say no, and if we don't say no, we're essentially just a shop – and we're not a shop, we're a pharmacy.”
Mital said: “When I think about clinical responsibilities it's making sure that the patient knows exactly what they need to do, because if they don't you can find yourself in a different situation where the topic is about making it viable.
you can find yourself in a place of having to reissue the drug, which adds financial burden because it's at your own cost.”
He encouraged pharmacies to signpost patients who do not meet the BMI thresholds for treatment: “Those patients are still looking for treatment to lose weight, how do we ethically and correctly refer them and advise them? It’s our duty to do that.”
When weight bounces back
GLP-1 users often see their weight bounce back after stopping medication. Sunil said: “We want to create a strategy that accounts for that, and that's why lifestyle is just as important.
“Our system should support them along the journey and we have seen many patients over the over the last couple of years who've done really well because they've invested so much time with the staff.”
Mital added: “I think wraparound is a big part of our conversations whether that's online or in store. There’s been the emergence of providers out there that are now offering that lifestyle support, coaching them and helping with diet. That’s equally important if you want to play a big role in the market.”
Market potential
Asked how he expects to see the market take shape in the next five years, Sunil said: “It’s difficult to know, but – and I won't say this lightly - it could probably be bigger than AI.
“It's huge. I think it it could be a really, really important step for a lot of people out there.”
Mital added: “Because of the emergence of new molecules, there's going to be so many new products that are out there – it can get confusing.
“As pharmacists and pharmacy teams, we'll need to help our patients start picking the right molecule that's suitable for them and their goals.”
