Women's Health and Community Pharmacies
Representing 50 percent of the population, women have unique needs that require unique products and services that DME pharmacies can provide. That said, pharmacies must also strive to provide knowledgeable, top-shelf care. What goes into accomplishing that?
- By David Kopf
- Apr 01, 2021
Photo © Rawpixel/depositphotos.com
The primary business imperative for today’s DME
pharmacies is ensuring that they diversify their
revenues and services and reinforce their status as
a healthcare hub for communities. Moreover, they
can’t properly execute on those initiatives without providing the
right mix of women’s health products and services.
Pharmacies must create a business that strives to provide
top-shelf care and products for patients and referral partners
alike. And that means laying a solid foundation in terms of market
understanding, staff expertise, customer care and resources.
To help us take a closer look at what’s involved, Nikki Jensen,
vice president of Essentially Women (www.essentiallywomen.
com), the division of VGM & Associates that providers education,
networking and group purchasing for businesses that provides women’s healthcare products, shares
some insights and expertise.
IDEAL MARKET POSITION
To begin with, DME pharmacies are in a
unique position to serve women’s DME/HME needs. Assuming a community pharmacy
has a good reputation for providing
DME and HME products and services, they
already have established a solid connection
with the women in their local market.
Now they just have to follow through and
be that primary resource for women.
“More than anything, women are seeking
a trusted resource,” Jensen Says. “They want
a compassionate, educated person who will
listen and help them understand options.
Women are also looking for one place to
serve all their needs; they don’t want to go
to several different locations if they can get
everything they need on one stop.”
There are a variety of customer constituencies
that pharmacies can better
service by catering to care and product
needs, such as those for mastectomy, maternity
and women’s compression needs.
For starters, DME pharmacies are
“uniquely positioned” to offer assistance
to women before and after mastectomy
surgery, according to Jensen.
“It’s possible these women are
already customers using pharmacy
services,” she says. “One in eight women
will be diagnosed with breast cancer in
her lifetime, which sadly, is not expected
to change anytime soon.”
Bearing that in mind, a pharmacy
looking to help these clients should aim
be a one-stop-shop for post-mastectomy
patients. Now that the patient has found
a friendly, reliable, supportive resource,
the last thing she wants to do is have to
go somewhere else for one single item.
Simply by providing the full spectrum of
post-mastectomy products, you are establishing
your pharmacy as a resource.
The more “central” products related
to this group include post-mastectomy
bras and prosthetics, but there is a wide
variety of products and issues related
to breast cancer patients that women’s
healthcare providers should stock.
Because those patients can be exposed
to radiation treatment, there are various
skincare product lines available to those
patients. Wigs, hats, scarves and other
head coverings are also important to
patients undergoing chemotherapy.
“As women prepare for mastectomy
surgery, there are items she should have
in advance to help make her recovery
more comfortable,” Jensen says. “Items
such as the Contour Flip pillow are very
useful since women who’ve had mastectomy
surgery will have limited range of
motion using her arms or using her arms
to get in and out of bed or rising from a
seated position for several days.
“There’s also a need for wound management,”
she adds. “Women may need
to resupply bandages and dressings for
their surgical areas.”
Obviously, new and expecting moms
need a variety of products and services
ranging from pregnancy support products
to breast pumps and everything
in between. So, this is a cornerstone
women’s health category.
Furthermore, it represents a solid retail
reimbursement category with a wide
variety of products. And that list gets even
larger if you factor in items such as infant
nutrition. A pharmacy aiming to specialize
in women’s healthcare should offer these
items along with a wide array of other
maternity- and baby-related products.
It’s worth noting that one of the more
expensive maternity items, breast pumps,
is a key maternity offering, but it is one
that might trend increasingly toward retail
purchase due to softening reimbursement
rates. (Of course, new moms have been
opting to purchase breast pumps when
insurance hasn’t covered them for years.)
“Over the past few years, we’ve heard
some of our members tell us the reimbursement
has been declining for breast
pumps, so they wonder whether they
want to continue offering them,” Jensen
says. “For those people, I urge them to
reconsider and call Essentially Women so
we can help you identify where you can
make adjustments to your business model
for breast pumps business. There are opportunities
to be successful in this area.”
Compression products, such as hosiery,
socks and arm sleeves, are used for many
reasons, from relieving pain to helping to
prevent severe varicose veins and deep
vein thrombosis (DVT). Compression is
also used in the treatment of lymphedema
and in wound care.
Moreover, compression is a key
women’s health offering with women representing
the lion’s share of the market.
And compression needs are often related
to the previous categories, mastectomy
and maternity. In fact, Jensen notes
that as many as 40 percent of women
who have experienced breast cancer will
develop secondary lymphedema following
“Women who’ve had lymph nodes
removed as part of their treatment will be
at higher risk,” he says. “Lymphedema
can appear weeks, months or even years
later. Treatment with prescribed gradient
compression therapy will be needed.”
“Pharmacies are uniquely positioned
because many patients, before they know
what they lymphedema is, may be coming
to your stores seeking wraps or sleeves to
help control the swelling,” she adds.
It’s important to add that women
buying compression products might
need custom compression garments, or
they might be prescribed overnight vs.
daytime compression items. Also, most
patients will be recommended to replace
compression garments every six months
since garments can get stretched out
with use over time, Jensen adds.
The one thing to keep in mind is that
even when prescribed, compression is
almost always a retail product, except in
some scenarios involving lymphedema.
“Currently, Medicare does not recognize compression garments
as eligible for coverage so this will be an out-of-pocket
expense,” Jensen says. “Check with local private payers as
coverage may be allowed.”
A RELIABLE REVENUE BLEND
Looking at revenue more broadly, the products serving these
groups represent a good blend of funded and retail revenue. Major
items related to procedures — breast prostheses, for example
— are billable, but they are connected to a range of other items.
“Pharmacies should keep in mind women’s health offers
much more than one billable item and the transaction is over,”
Jensen says. “Whether it’s a woman going through her breast
cancer journey, lymphedema or she’s a pregnant mom, all of
these offer an opportunity to help a woman with more than one
item and in many cases she will be a recurring patient.”
That represents an excellent opportunity for incremental
sales, Jensen says.
“In other words, a woman may come to you because you
initially because you can bill her insurance carrier or Medicare,”
she explains. “It’s the additional retail items you offer that may
offer a more pleasant or comfortable experience.”
Bearing the patient groups and blended revenue in mind, there
are multiple products that a DME pharmacy can stock to start
to better cater to women’s healthcare needs while drive a mix
of revenue. Jensen provides some great examples of product
categories, specific products, and their revenue type:
- Body pillows such as the Contour Flip pillow for positioning
and support, as well as seat-belt cushions – retail
- The Shower Shirt, a post-surgical, water-resistant garment
designed to protect chest surgery patients while showering,
including mastectomy patients - retail
- Post-surgical bras and camisoles – billable
- Off-the-shelf breast prostheses – prescription, billable
- Mastectomy bras – prescription, billable
- Custom breast prosthesis – prescription, billable or out-of-pocket
if not covered
- Hats and turbans – retail
- Mastectomy swimwear – retail
- Wound care management – billable and retail, depending on
the specific product
- Skincare for radiation burns - retail
- Compression garments for lymphedema – prescription, billable
- Breast pumps – billable
- Breastfeeding accessories such as replacement tubing – retails
- Pre and post-natal support bands
Obviously, some women’s healthcare needs are very personal.
How does a DME pharmacy ensure that they are serving those
needs with the privacy, respect, consideration, etc. required?
“Having a private area to consult with patients is important,”
Jensen says. “This goes beyond having a space at the counter for a
prescription pick-up. Having a specific consult room is necessary.”
Also, Jensen advises that DME pharmacies offering postsurgical
bras, breast prostheses, and mastectomy bras, should
have dressing rooms.
“Creating a warm environment is critical to making patients
feel welcome and comfortable during this very personal and
sensitive visit,” she explains.
When it comes to having the right expertise,
training, education, or certification
on the team so that a DME pharmacy
best serves women’s healthcare needs,
Jensen says a big focus is on post-mastectomy
patients and fitting prostheses.
That starts with completing courses
offered by breast prosthesis manufacturers
for mastectomy fitting.
“These courses are instrumental in
understanding the basics of off-the-shelf
breast prosthesis and mastectomy bra
fitting,” Jensen says. “American Breast
Care (americanbreastcare.com/abcuniversity/onlinetraining) offers a great
option for an online training option.”
Pharmacies that are accredited for
Medicare DMEPOS need to factor that
training into their accreditation, as well.
“With mastectomy fitting, if a DME
pharmacy is already accredited through
a Medicare-approved organization, let
your accrediting organization know you
are billing the mastectomy ‘L’ codes,” she
advises. “Depending on the organization
you’re accredited though, you may or
may not be required to have a certified
mastectomy fitter on staff. Check with
your accreditation provider to confirm.”
On the maternity side of the business,
breast pumps don’t require specific
certification to bill payers for them, but
Jensen recommends pharmacies do their
research and have a solid understanding
of what their local payers require for
breast pump reimbursement.
So, how can a community/DME pharmacy
get started in better supporting local
women’s healthcare needs? Jensen has
some pro-tips for DME pharmacies looking
to establish their market presence.
Starting with mastectomy patients,
pharmacies should reach out to local
“Ask to speak to a nurse navigator,”
Jensen says. “Most health systems have
nurse navigators who are assigned to
help patients by attending physician
appointments and helping patients understand
“Let them know you’re interested in
assisting local patients and ask if there
are any current unmet needs you could
help provide,” she continues. “Let them
know you’re wanting to become that
trusted resource their patients need so
the recovery process can be as comfortable
For mother and baby, Jensen says
pharmacies should communicate to their
local OB/GYN offices that they have solutions
for some of the challenges pregnant
“Let them know you can provide
compression stockings to help alleviate
swollen, achy legs and ankles,” she advises.
“You can provide pregnancy bands
and support pillows. That same Contour
Flip pillow I mentioned for post-surgical
mastectomy patients is also great for
women who’ve had C-section).
“Most importantly, you can provide
breast pumps and accessories,” she
DME community pharmacies looking
for more information can contact Essentially
Women at firstname.lastname@example.org or (800) 988-4484.
This article originally appeared in the DME Pharmacy April 2021 issue of HME Business.