FEASIBILITY STUDY AND FINANCIAL ANALYSIS IN PHARMACY PRACTICE

FINANCIAL ASPECTS OF INVENTORY
MANAGEMENT
Learning objectives
·        Describe the cash conversion cycle and its importance to inventory management
·        Identify and understand the four main costs of inventory, including purchase, ordering, carrying, and stock-out costs
·        Understand the importance of avoiding stock outs and maintaining safety stock
·        Describe and develop the economic order quantity and reorder point, then understand their importance in optimizing inventory control
·        List and explain inventory management considerations


Introduction
Pharmacy managers face unique challenges when it comes to the proper management of inventory, with balancing inventory levels that satisfy patients’ needs while minimizing costs the primary goal. This goal is not met when inventory is managed without careful planning and analysis – for example, just ordering substantial quantities of each formulary medication in an institutional setting. While this method of controlling inventory may result in meeting the objective of appropriate patient care, it will also result in excess levels of inventory sitting on the shelves and represent a significant use of cash. The second major consideration for pharmacy managers is to decide the appropriate
level of resources (cash) to be committed to inventory. Recognizing that inventory is included on the balance sheet as a current asset, it is less liquid given its little value to the pharmacy operation until it is dispensed, billed for and payment/reimbursement collected, which is known as the cash conversion cycle. Recently in large chain/grocery chain/mass merchandise pharmacies, inventory control has become automated using barcode technology to provide identification of inventory and track transactions in real time as they occur.

Other types of buying agreements can include competitive bidding or bundling the purchase price of one product with the amount of an additional product’s purchase quantity. In many institutional or large warehousing chain practices, market share contracts are offered by various manufacturers. Under a market share contract, additional discounts or rebates are awarded if the percentage market share of all purchases within a certain category exceeds a contracted level. These contracts recognize the importance of individual retailers’ professional purchasing decisions on manufacturers’ market share.
However, in most larger chain settings, pharmacy managers are not the individuals who negotiate these more complicated purchasing contracts.

Pharmacy managers may, however, be asked to contribute information to the contracting, bidding or accounting department where these kinds of negotiations occur. The next basic inventory cost is ordering costs, which are those costs associated with placing an order and processing the corresponding payment. Any costs associated with receiving the goods and getting them to the shelves for dispensing can also be included. For simplicity’s sake, ordering costs are usually not separately identified, as most pharmacy environments place daily orders with their wholesalers and payment is made through the accounting department. Putting the order on the shelves is also considered part of routine daily duties of the pharmacy staff; although, if significant, these costs could also be identified separately. Though, if an institution wishes to make bulk purchases of intravenous supplies and these orders require additional outlays, such as offsite storage and labor to unload and re-distribute when needed, these costs should be added to the overall purchase price when placing orders.

Not all items in inventory generate the same level of profits. Further, some items require more inventory space than others. This is where the third basic inventory cost, known as carrying costs, comes into focus. The capital investment, or the inventory’s actual purchase price, is the major and most easily identifiable component of carrying costs and the primary factor in relation to the cash conversion cycle. Inventory service costs, such as handling, insurance, and taxes are another component. Thirdly, storage costs outside of the actual pharmacy contribute to carrying costs of inventory. Finally, there are the risk costs, which are made up of obsolescence, damage, and shrink.

Therefore, good inventory management is often a trade-off between the costs associated with keeping inventory on hand (e.g., carrying costs) and the benefits of having the inventory in stock (ability to sell the inventory and convert it into cash). In other words, the carrying costs of maintaining higher levels of inventory must be balanced with the less easily measurable costs of stock outs, lost sales, poor patient care/satisfaction and even the business’s or institution’s reputation.

Case-in-point 6.3 Inventory loss
Product obsolescence, theft (shrink), and natural disasters occur in all businesses. The impact of these events is obvious. However, for most retailers, there are more subtle risks that can impact inventories. For example, medications that need to be refrigerated can be placed at risk when power outages occur. Flooding and other types of water damage, such as that from a broken pipe or water heater, can also create inventory losses. Losses can also occur as a result of poor inventory storage, such as when inventory is improperly stored, e.g., boxes stacked too high and they become unstable and there is breakage. While some level of risk is inherent, proper management can reduce these kinds of risks
to a minimum. Considering all medications have an expiration date after which the value
is substantially reduced, obsolescence is a major consideration in inventory management. Proper rotation of stock is essential, as is regular monitoring of expiration dates. Many wholesalers allow for a return of inventory items based upon their expiration dates, and effective pharmacy managers will keep a close eye on individual inventory items and their expiration dates to take full advantage of any return programs, given the magnitude of potential losses. Damage to inventory is possible at any time, just by the existence of the inventory on the shelves. Although damage is usually accidental, pharmacy managers should strive for proper housekeeping of inventory to minimize such occurrences.

Case-in-point 6.4 Damages/damage reports
Throughout the work day or week, medications are spilled, IV bags are broken or pills are crushed, leading to damaged inventory. To handle these situations, managers can keep an exact report/log of all damaged products and adjust the inventory accordingly, or properly dispose of the damaged product and let it exist as shrink on the year-end inventory. Either way, the inventory was purchased but not able to be sold and, at the least, recoup the associated cost. Pharmacy managers must diligently stress to the staff the negative impact damaged inventory can have on sales and work to reduce damages and, therefore, maximize sales potential. The final risk cost included in inventory carrying costs is shrinkage, or simply “shrink”. When the final calculated inventory value in a company’s accounting records is compared with the final valuation from the physical inventory, any shortage is referred to as shrink. Inventory shrink is expressed in the actual dollar amount difference, or as a percentage of the total inventory balance. Usually, theft is attributed to the existence of shrink, both by customer shop lifting and employee theft. Proper controls over access to inventory and good housekeeping by pharmacy managers can contribute greatly to keeping inventory shrink to a minimum.

Case-in-point 6.5 Employee theft
Theft of inventory, also referred to as “shrink,” occurs across all industries. It may be particularly troublesome in pharmacy since medications have such significant implications when used improperly or abused. Shrink can be caused by shoppers or employees. A rule of thumb is that nearly one-half of all shrink occurs at the hands of employees. Employee theft occurs just like shoplifting, when an employee conceals merchandise and removes it from the business. Theft can also be the result of an employee allowing others to steal from the business. Regardless of how the theft occurs, the result is inventory loss. Ideally, there would be some way to identify a dishonest employee. Unfortunately, dishonest employees are found in all work settings and it is impossible to identify these individuals by some demographic or physical characteristic. Careful screening of employees (e.g., character, honesty, and integrity) and corporate policies (e.g., lockers for personal items such as coats or purses, clear policies that all theft will be prosecuted and result in termination) that reduce opportunity are the best defense against employee theft. Not having a medication in stock, in any pharmacy arena, has expensive costs associated with it. These costs are the final basic inventory cost, stock out costs. For example, if an extreme emergency requires that the out-of-stock item be procured overnight, a non-discounted price with additional overnight shipping charges is often paid. While these costs are readily quantifiable, sometimes they are not. Consider the case of an extremely upset customer at the independent community pharmacy. The lack of availability of the item may cause them to take their entire prescription business to a competitor, or worse, customers who are close friends of the irritated customer may sympathize and change pharmacies as well. This lost opportunity may exist for only
A few weeks, or forever. Therefore, prevention of stock outs is a goal of proper inventory management. Stock outs may be avoided by maintaining a safety stock, or minimum amount to always be on hand. It is determined in relation to expected usage as well as any delivery lead times. Although there are carrying costs associated with safety stock, the potential cost of damaging customer relations and future business usually exceeds them and justifies having a cushion of safety stock.

Case-in-point 6.6 Stock outs
JB is a 40year old diabetic who uses insulin 500units/ml. This concentration is convenient and saves JB from having to give multiple injections because of his high insulin dose requirement. Even so, his insulin dose has remained relatively constant over time. He has recently changed pharmacies because the pharmacy he had been patronizing required him to call a day ahead so the insulin he needed could be ordered, rather than stocking it routinely. The pharmacy maintained that having this concentration was not desirable since it could be accidentally sold to a patient who might inject it as if it were the 100-unit concentration. JB was accepting of this, but, on several occasions over the past year, the insulin was not available from the wholesaler on short notice and JB had to resort to multiple injections. This prompted him to switch to a pharmacy willing to keep the 500-unit concentration in stock. In fact, the new pharmacy manager decided to order JB’s supply after each purchase so that a safety stock could be maintained and JB’s needs would be sure to be met.

Case-in-point 6.7 Stock outs large chain pharmacy perspective
Most large-chain pharmacy district managers continually monitor ordering levels, especially for items typically available from the store’s own warehouse. As discussed above, emergency overnight purchases through a wholesaler are made at much greater costs than from the chain’s warehouse. District managers want to see as low a percentage of emergency/non-warehouse purchases as possible.

Inventory record keeping methods
There are two basic ways to keep a record of inventory values and quantities, known as perpetual and periodic methods. The perpetual inventory system is most commonly used, and, as implied by its name, this system can provide details of the inventory quantities and values whenever they are needed. When using the perpetual inventory method, each purchase is recorded along with individual sales when they occur. Since a beginning balance for any time period is available, this period activity is recorded and an ending inventory balance is shown as illustrated in Figure 6.2. Note that both dollar and quantity details of purchases and sales are shown.

The perpetual recording of activity produces both the inventory recording method’s name as well as inventory details. When this process is replicated many times over for each individual item (referred to as SKUs, or stock keeping units), the sum of all SKUs will produce the final inventory amount, which is shown on the balance sheet. In theory, the actual inventory quantities on the pharmacy’s shelves should exactly agree with the values shown in the perpetual inventory record keeping systems. Discrepancies between recorded quantities and actual quantities are a result of various factors, such as counting or recording errors.

Case-in-point 6.8 Perpetual inventory
When a retail pharmacy operation places an inventory order, either from a full service wholesaler or a company owned warehouse, the inventory received in each order must be added to the quantity on hand, to accurately reflect new inventory levels. This is usually done by “applying” the order to the existing inventory maintained in the pharmacy computer system. Applying the order serves to increase the inventory count of the products received. Invoices are then provided to the accounting department for collating and payment, as well as inventory auditing.

Perpetual inventory
Plavix 75 mg tablets
100 count bottles
Date
Purchases
Sales Balance on hand
No.
$
No. $ No. $
4/1/20xx 300
500.00 per
bottle 300
1,500.00
4/5/20xx
60 300.00 1,200.00
4/17/20xx
90 450.00
750.00
4/29/20xx
60 300.00 90 450.00
4/30/20xx 300
390 2025.00
525.00 per bottle
240
150
Perpetual inventory example for single item.

The second inventory record keeping method, the periodic inventory system, is less often used because it provides fewer details. As one can imagine from the name, the inventory value is determined on a periodic basis. Since the periodic system is less sophisticated, many details regarding prices and quantities are not maintained as shown in Figure 6.3. Under this system, at the end of various operating periods, the inventory account is updated to reflect the actual value of the ending inventory on the balance sheet and the corresponding amount to be recorded as COGS. During the period, all of the inventory purchases are recordedonlyinthetotaldollaramountofpurchases.Attheendofanoperating period, the ending inventory value is determined by taking a physical inventory. A physical inventory is a labor-intensive process and each inventory item is physically counted on a specific date. Owing to the nature of taking a physical inventory, there are various vendors available for hire by companies to complete a physical inventory. By employing personnel trained in counting pharmacy inventory, a physical inventory can be completed quickly and efficiently with the appropriate preparation. Completing the actual physical count is only half of the process. After obtaining details of all SKUs and their corresponding quantities, the appropriate cost information must be assigned. The extension process begins whereby the actual quantity on hand is multiplied by the current cost, which yields an extended inventory. The extended inventory provides the final dollar value of the inventory and is shown on the balance sheet. There are benefits, as well as drawbacks, to each of these two inventory record keeping methods. If simplicity is desired, the periodic system functions very well, although there is much less timely information available for pharmacy managers.

Description
Balance in $
Beginning balance
0
Add
: April purchases
600,000
Total available
600,000
Less
: 4/30/20xx physical count
390,000
Quantity sold during April 20xx 210,000
Figure 6.3
Periodic inventory example for single item.

Since only dollar amounts of purchases need to be reflected in the accounting records, summary entries can be made. In contrast, the perpetual system requires more recording effort; however, computers and automation have greatly reduced this impact with much of the information being provided electronically from wholesalers and other vendors. The periodic system has a significant limitation in being unable to provide COGS on a regular basis, thus preventing the preparation of a consistent income statement.

Some pharmacy managers have operating environments that are able to function effectively in this manner, namely the independent owners of community pharmacies. They are often very skilled at understanding their pharmacy’s operations and can estimate operating results through cash flow and visual inspection of inventory levels. On the other hand, the perpetual inventory system provides pharmacy managers and others with much more timely inventory details. Additionally, each accounting period may be closed and COGS be calculated along with the corresponding net income. One of the major strengths of the perpetual inventory system is the ability to perform individual item analysis and identify, assess, and correct inventory shrink.

Inventory valuation methods
As previously mentioned, the physical flow of inventory is implicit – oldest items are sold first, and then replaced with newer items. In pharmacy practice, this means medications with earlier expiration dates are dispensed first and normally replaced with medications that have much later expiration dates. When a company determines an inventory value at the end of any accounting period, there are three inventory valuation methods which may be used. It is important to emphasize that these inventory valuation methods are obtained through the accounting system information flow from detailed transactions of company activities. Therefore, the physical flow of inventory will not match the assumed flow of the accounting data. Under each inventory valuation
Method, assumptions must be made regarding the flow of inventory costs. As a result, COGS are different under each inventory valuation method, which in turn will yield different ending inventory balances, gross profit and net income amounts. Regardless of the inventory valuation method chosen, the flow of the actual physical inventory dispensed should always be based upon the earliest expiration date of individual inventory items. A detailed discussion of each of the three inventory valuation methods follows, using the detail of purchases for one month as shown in Figure 6.4. It is
important to note that regardless of the inventory valuation method used, the inventory purchases are recorded in exactly the same manner. Perhaps the easiest inventory valuation method to understand is the one that simulates the actual physical flow of inventory throughout a company.

Therefore, the first-in, first-out method , known as FIFO, reduces inventory value for dispensed inventory in the same order in which shipments are received. Since the FIFO inventory valuation method results in the remaining inventory items being those most recently purchased, it is sometimes also referred to as last-in, still here or LISH. The advantage of the FIFO inventory valuation method is shown on the balance sheet, where the ending inventory value reflects the most recent purchase costs. Under FIFO, the cost of goods sold (COGS) is based upon the cost of material bought earliest in the period, while the cost of inventory is based upon the cost of material bought later in the period. This usually results in inventory being valued at a higher level. During periods of inflation, the use of FIFO will result in the lowest estimate of COGS and higher net income.

As the name implies, the last-in, first-out (LIFO) inventory valuation method is the direct opposite of the FIFO inventory valuation method. The earliest inventory items purchased are the last inventory items sold, therefore LIFO may be referred to as first-in, still here
, or FISH. Accordingly, since the last inventory items purchased are assumed to be the first inventory items to be sold, there is a better matching on the income statement with COGS reflecting the current cost of inventory items. Under the FIFO inventory valuation method, the income statement reflects earlier inventory acquisition costs, which may or may not reflect current inventory replacement costs. The importance of the closer matching of current inventory costs on the income statement under the LIFO inventory valuation method is critical in periods of inflation or rising costs. In essence, LIFO will produce the highest estimate of COGS and lowest corresponding net income estimate when compared with
FIFO.

Any Hospital Name
Detail inventory sheet
March 20XX
D5W, 1 liter bags, 12 count cases
Date
Cases
received
Per case cost Total cost
3/8/20XX
60
$15.25 $915.00
3/16/20XX
80
$14.93 $1,194.40
3/28/20XX
90
$15.37 $1,383.30
Total
purchases
230
$15.19 (average
case cost)
$3,492.70
Figure 6.4
Sample inventory purchases.

The effect of these two methods can also be seen on the balance sheet. LIFO will understate the inventory values on the balance as compared with the FIFO inventory valuation method. Some firms may use a LIFO approach for the tax benefits during periods of high inflation. When firms switch from FIFO to LIFO in valuing inventory, there is likely to be a drop in net income and a concurrent increase in cash flows (because of the tax savings). The reverse will apply when firms switch from LIFO to FIFO.
The weighted average cost (WAC) inventory valuation method is a compromise between FIFO and LIFO. The WAC per unit is calculated by taking the COGS available for sale and dividing this by the total number of units for the period. At the end of each accounting period, this weighted average cost per unit of inventory is determined and reflected in both the balance sheet and income statement as COGS. The WAC valuation method levels out the effects of market fluctuations in inventory prices, as seen with the FIFO and LIFO inventory valuation methods in periods where prices are rising. Therefore, in periods of fluctuating prices, the effects on both the balance sheet and income statements can be minimized through the use of the WAC inventory valuation method.

Figure 6.5 compares the various ending inventory valuations and corresponding COGS shown on the balance sheet and income statement when the three inventory valuation methods are used. This example assumes there was no beginning inventory balance and a periodic inventory system is used. A physical inventory count resulted in the ending inventory quantity remaining for March 20XX of 75 cases. Pay close attention to the variation in both the COGS and ending inventory values under each inventory valuation method. It is important to note the selection of which inventory valuation method is
employed by a particular company, especially in the chain and hospital setting, is often made by upper management or the accounting department, not pharmacy managers.

Any Hospital Name
Affects of inventory valuation methods
D5W, 1 liter bags, 12 count cases
Method
Ending
quantity
Ending inventory
value
COGS
FIFO
75
$1,152.75 $2,339.95
LIFO
75
$1,138.95 $2,353.75
WAC
75
$1,139.25 $2,353.45
Affects inventory valuation methods. (See the chapter glossary for an explanation of the abbreviations.)

The ending FIFO inventory value of$1,152.75 is determined as if all of the remaining 75 cases were part of the last purchase of 90 cases at a cost of $15.37 per case. The COGS amount is calculated by the formula:
Beginning inventory
Using the LIFO inventory valuation method, the remaining 75 cases are valued at $1,138.95, the cost of the initial 75 purchased [(60 cases @ $15.25)
Þ (15 cases @ $14.93/case)]. WAC produces an ending inventory value of $1,139.25 and uses the average cost per case for the period to value the ending 75 cases (75 cases @ $15.19/case).

Managing inventory turnover
Other than physical facilities, inventory represents one of the largest uses of cash within a pharmacy. Once purchased, inventory must be sold and the funds from the sale received before the firm’s cash can be used for various aspects of the pharmacy operation. In institutional and chain settings, pharmacy managers may not be directly responsible for the cash flow of the business, but these managers are acutely aware of the impact high inventory levels can have on operating efficiency. Inventory is perhaps the most carefully
controlled of all operating costs and an expected function of all pharmacists involved in dispensing in any way.

Financial ratios (discussed in Chapter 5) are routinely used to assess the effectiveness of a pharmacy operations inventory control techniques. The most common of these ratios is the inventory turnover ratio. The inventory turnover ratio is a benchmark used by pharmacy managers to assess inventory control and measure how many times the inventory of a company is used up during a period, usually a year. The expression “turns” or “turn days” is calculated by dividing 365 by the annual inventory turnover. This number is used to estimate the number of days of inventory available for sale.
The inventory turnover ratio is calculated by the formula:
Inventory turnover
¼
Cost of goods sold
=
Average inventory
Average inventory is calculated by averaging the beginning and ending
inventory balance (from the balance sheet) and given by the equation:
Average inventory
¼ð
Beginning inventory
þ
Ending inventory
Þ = 2

In general, an inventory turnover ratio of approximately 12 turns per year is considered optimal for most pharmacy operations. This means, on average, the pharmacy will operate with about 30 days, or one month, of inventory on hand. Some items may have higher turnover rates than the overall operation. These items, usually referred to as “fast movers” in the pharmacy environment, vary by area and represent the most commonly used medications. Fast movers may be purchased in larger quantities, turnover more frequently and can have a significant impact on profitability. Thus, it is important to price these items carefully, which is discussed in Chapter 8. Using the information shown in Figure 6.6, the pharmacy’s actual prescription inventory turnover of 10.5 for the year is determined by dividing the prescription COGS by the pharmacy average inventory.
Inventory turnover (IT) ¼
COGS/Average inventory
Inventory turnover (IT)
¼
$1,678,407/$159,848
¼
10.5
A separate turnover can be calculated for other sales (OTC, etc.):
Other sales IT
¼
COGS/Average inventory
Other sales IT
¼
$536,748/$65,716
¼
8.2
Accordingly, the overall inventory turnover ratio for the entire pharmacy business would be:
Overall IT
¼
Combined COGS/Combined average inventory
Overall IT
¼
$2,215,155/$225,564
¼
9.8
For the year ended December 31, 20XX
Description
Actual Budget Last year
Average inventory
Prescription sales
$159,848 $150,980 $140,844
Other sales
65,716 56,624
52,130
Total
225,564 207,604
192,974
Cost of goods sold
Prescription
$1,678,407 $1,670,545 $1,575,241
Other sales
536,748 411,002
331,105
Total
2,215,155 2,081,547 1,906,346
Inventory turnover ratio
Pharmacy
10.5
11.1
11.2
Front end
8.2
7.3
6.4
Combined
9.8
10.0
9.9
Figure 6.6
Sample inventory turnover analysis report.
Financial aspects of inventory management

Generally, pharmacy managers track inventory turnover year by year to assess the effectiveness of their inventory control efforts. Industry averages or benchmarks are often used to further assess pharmacy operations inventory policies. When the inventory turnover ratio is lower than the benchmark (12 turns per year), this can be an indicator that inventory is too high. Possible reasons for this might include deterioration, damage, obsolescence or over estimation of need. When the inventory turnover ratio is higher, it usually means pharmacy managers are using inventory more efficiently. Higher inventory turnover ratios indicate the purchases of new inventory items are replacing the inventory actually being sold and fewer inventory items are sitting idle on the shelves. This means less cash is tied up in inventory and is available for other uses, including increased profitability.

Other inventory control techniques
In today’s pharmacy business, inventory is often received daily and many pharmacy practice environments control inventory by ordering products to arrive just in time as it is needed for sale. This is known as a just-in-time (JIT) inventory control method. JIT is a quality-control process aimed at reducing inventory costs. This method can benefit a pharmacy business by reducing average inventory and even improving customer satisfaction when stock outs do not occur. JIT inventory control is generally not sensitive to rapid changes in demand, for example, during allergy season when there can be rapid increases in demand for certain allergy, cough, and cold medications. While today’s automated computer systems certainly facilitate a JIT system by maintaining a perpetual inventory, more information is needed to maintain an optimal inventory level and customer satisfaction. To assist the pharmacy manager in making purchasing decisions, the ideal inventory level is also needed. This is based on how much of a product a business uses, how fast they use the product and the costs associated with ordering and carrying the product. When a business places orders based on these variables, it can minimize total inventory costs (ordering and carrying costs). Using this information, a pharmacy manager can determine the most efficient quantity of product to order – known as the economic order quantity or EOQ. EOQ should be used as a tool to inform the JIT inventory process. Inventory models for calculating optimal order quantities, such as EOQ; have been available to business managers for many years. Computerization has automated the decision making associated with these kinds of models, and is an excellent tool for pharmacy managers to use in determining when to purchase and how much to purchase. Mathematically, the quantity is given by:
EOQ
¼ 2 ð
Annual usage in units
Þð
Order cost
Þ
Annual carrying cost per unit

Case-in-point 6.9 EOQ example
Pharmacy operations are frequently presented with special pricing and deals associated with purchasing larger quantities of merchandise. EOQ is a useful tool for the pharmacy manager to use in determining whether or not the deal actually makes good business sense. For example, if a pharmacy purchases 1,600 bottles of cough syrup annually with a unit cost of $4, order cost of $25 and inventory carry costs of 5%, the EOQ for this product would be
H (2
1,600
$25/($4
0.05))
¼
632 units per order. The total cost of inventory would be $4/unit
1,600 units
þ
$25 (1,600/632)
þ
0.05 (632/2)
¼
$6,479.05. If the
terms of the deal were a $3.75 purchase price if ordered in quantities
of 300 bottles at a time, the total cost of inventory for the purchase
deal would be: $3.75
1,600
þ
$25 (1,600/300)
þ
0.05 (300/
2)
¼
$6,140.50. This analysis would imply that even though smaller quantities would be purchased more frequently, the deal will lower total inventory costs.

Optimizing inventory decisions
Using modern computer systems, knowledge of EOQ and RP, and understanding the needs of one’s customers enables the pharmacy manager to make inventory management decisions that result in fewer out-of-stock situations and minimal inventory costs. Given the realities of modern day pharmacy operations, including lower profit margins, it should be clear inventory management is critical to the prudent pharmacy manager.

Summary
Pharmacy managers should routinely use the financial information from their businesses, along with knowledge of the marketplace and customer needs, to appropriately control the inventory of a pharmacy operation. Proper inventory control starts with an understanding of the four basic inventory costs described in the chapter (purchase, ordering, carrying and stock out).  Applying the understanding of these costs, along with indicators such as inventory turnover, EOQ and RP, should result in optimal inventory levels which keep costs to a minimum while at the same time ensuring customer satisfaction. In managing inventory, a pharmacy manager must keep these principles in mind while routinely:

Monitoring the adequacy of inventory levels, balancing this with expected demand; this is especially important for products or services that fluctuate seasonally, such as Tamiflu for influenza

Taking full advantage of pricing discounts such as prompt payment discounts and other price incentives

Conducting a physical review of the inventory periodically, to look for slow-moving or obsolete items; this will reduce inventory carrying costs and improve cash flow

Maintaining an awareness of the average inventory level, keeping it to a minimum, since this is the source of carrying costs and can dramatically impact profitability

Keeping enough inventory on hand to ensure patients’ needs are met

Using the financial information to ensure inventory levels are providing sufficient profitability, in particularly by monitoring the financial ratios associated with inventory, EOQ, RP, and inventory turnover.

Suggested reading
Chisholm-Burns MA, Vaillancourt AM, Shepherd M.
Pharmacy Management, Leadership,
Marketing, and Finance.
Sudbury, MA: Jones & Bartlett Publishers, 2011.
Desselle SP, Zgarrick DP.
Pharmacy Management: Essentials for all Practice Settings, 2nd edn.
New York, NY: McGraw-Hill, 2009. Carroll NV.
Financial Management for Pharmacists: a Decision-Making Approach, 3rd edn.
Baltimore, MD: Lippincott Williams & Wilkins, 2007.
National Community Pharmacists Association (2008).
Managing the Pharmacy Inventory.
Alexandria, VA: NCPA. www.ncpanet.org/members/pdf/ownership-managinginventory.pdf
Blackburn J (2010).
Fundamentals of Purchasing and Inventory Control for Certified Pharmacy Technicians.
The Woodlands, TX: J&D Educational Services. https://secure.jdeducation.com/
JDCourseMaterial/FundPurch.pdf
McKesson Corporation.
Home Page.
San Francisco, CA: McKesson Corp. http://www.mckes-son.com
AmerisourceBergen Corporation.
Home Page.
Valley Forge, PA: AmerisourceBergen Corp.
www.amerisourcebergen.com
Cardinal Health, Inc.
Home Page.
Dublin, OH: Cardinal Health, Inc. http://www.cardinal-health.com

Review questions
The carrying costs associated with inventory management include:
A Insurance costs, shipping costs, storage costs, and obsolescence
B Storage costs, handling costs, capital invested, and obsolescence
C Purchasing costs, shipping costs, set-up costs, and quantity discounts lost
D Obsolescence, set-up costs, capital invested, and purchasing costs

The ordering costs associated with inventory management include:
A Insurance costs, purchasing costs, shipping costs, and spoilage
B Obsolescence, set-up costs, quantity discounts lost, and storage costs
C Purchasing costs, shipping costs, set-up costs, and quantity discounts lost
D Shipping costs, obsolescence, set-up costs, and capital invested

Shrink related to employees is not an issue to be concerned with in a
pharmacy business. True or false?

The result of the economic order quantity formula indicates the:
A Annual quantity of inventory to be carried
B Annual usage of materials during the year
C Safety stock plus estimated inventory for the year
D Quantity of each individual order during the year

In inventory management, the safety stock will tend to increase if the:
A Carrying cost increases
B Cost of running out of stock decreases
C Variability of the lead time increases
D Variability of the usage rate decreases

Calculate the EOQ for a chain pharmacy using 15,000 bottles of Lipitor 10mg per year at a cost of $100 per bottle. Assume carrying costs are 5% and it costs the pharmacy $50 to place a direct order from the manufacturer.

A JIT inventory can be used in conjunction with EOQ to optimize inventory control. True or false?

When the inventory turnover ratio is lower than the benchmark (12 turns per year), this can indicate:
A Inventory levels are too low
B Overestimation of the inventory needs
C Efficient use of inventory
D Increasing sales

Which inventory system provides the pharmacy manager with much more timely inventory details – periodic or perpetual inventory?

Discuss the impact of inventory management on customer service and store performance.

The statement is false.
As discussed in the text, inventory management, customer service and store performance are all interconnected. In a primarily product-driven business, a pharmacy manager must have adequate inventory on hand to meet customers’ needs. The main area where this becomes a problem and negatively impacts service levels and store performance is with partial fills and stock outs, especially with maintenance medications. A customer who has received a prescription for a new treatment just on the market, or one rarely used, can understand the product not being stocked and needing ordered. However, the same customer who comes to the pharmacy every month and gets the same three prescriptions will not appreciate having to make multiple trips to the pharmacy because you do not have enough or any of those medications. This decreases customer service and possibly negatively impacts store performance if that customer, and possibly many others, decides to patron another pharmacy.

Glossary
Capital investment Actual purchase price of the inventory, major and most easily identifiable component of carrying costs and the primary factor in relation to the cash conversion cycle. Carrying costs Expenses associated with having inventory, including the capital investment or actual purchase price of the inventory, inventory service costs, such as handling, insurance, and taxes, and storage costs outside of the actual pharmacy.
Cash conversion cycle (or cash cycle) The length of time, usually expressed in days, needed to return cash outlays for purchases of inventory (a use of cash) back into collected cash (a source of cash) after the sale of the inventory and the corresponding collection of the accounts receivable from the customer or third party payer.
Economic order quantity (EOQ) Most efficient quantity of product to order and should be used as a tool to inform the JIT inventory process.

First-in, first-out (FIFO) method
Inventory valuation method which reduces inventory value for dispensed inventory in the
same order in which shipments are received and results in the remaining inventory items being those most recently purchased. The advantage of the FIFO inventory valuation method is shown on the balance sheet, where the ending inventory value reflects the most recent purchase costs.

Inventory turnover ratio
A benchmark used by pharmacy managers to assess inventory control and measure how many times the company’s inventory is used up during a period, usually a year. “Turns” or “turn days” are calculated by dividing 365 by the annual inventory turnover, which is then used to estimate the number of days of inventory available for sale.

Just-in-time (JIT) method
A quality control process aimed at reducing inventory costs control inventory by ordering
products to arrive just before it is needed for sale. This method can benefit a pharmacy business by reducing average inventory and even improving customer satisfaction when stock outs do not occur.

Last-in, first-out (LIFO) method Inventory valuation method which is the direct opposite of the FIFO method. With LIFO, the earliest inventory items purchased are the last inventory items sold. Accordingly, since the last inventory items purchased are assumed to be the first inventory items to be sold, there is a better matching on the Income Statement with COGS reflecting the current cost of inventory items. Ordering costs Those costs associated with placing an order and processing the corresponding payment. Any costs associated with receiving the goods and getting them to the shelves for dispensing are also included, for example, putting the order on the shelves is also considered part of routine daily duties of the pharmacy staff. If significant, these
costs could also be identified separately. If an institution wishes to make bulk purchases of intravenous supplies and these orders require additional outlays, such as offsite storage and labor to unload and redistribute when needed, these costs should be added to the overall purchase price when placing orders. Periodic inventory Inventory maintenance method where a physical count of the inventory is performed at specific intervals. This method only keeps track of the inventory at the beginning of a period, the purchases made and the sales during the same period. Perpetual inventory Keeping book inventory continuously in agreement with stock on hand within specified time periods. In some cases, book inventory and stock on hand may be reconciled as often as after each transaction. This is useful in keeping track of actual product availability and determining the correct time to reorder. Product obsolescence Product condition that occurs when an existing product becomes out of date or obsolete. Prompt pay discount Discount offered by vendors to entice prompt, or even early, payment in order to help them maintain their own cash conversion cycle. Often quoted as, for example, “2% net 10”, meaning a 2% cash discount of the total invoice is taken if the entire balance is paid within 10 days instead of the traditional 30 days.

Shrink
Any shortage after the final calculated inventory value in a company’s accounting records is compared with the final valuation from the physical inventory. Weighted average cost
(WAC) method Inventory valuation method which is a compromise between FIFO and LIFO. The WAC per unit is calculated by taking the inventory purchases and dividing this by the total number of units for the period. At the end of each accounting period, WAC per unit of inventory is determined and reflected in both the balance sheet and income statement as COGS.

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