Study Shows Record Decline in US Drug Stores

HOT TOPIC

New Heat-Based Device Treats Evaporative Dry Eye

The FDA recently cleared a device called Tixel i from the Isreal-based company Novoxel for the application of localized heat and pressure to treat evaporative dry eye due to meibomian gland dysfunction.

The Tixel i system appears to use its proprietary Thermo-Mechanical Action rather than light or laser energy. One of the big selling points is that this unique mechanism of action allows the device to be used on all skin tones at any time of year, says Novoxel. It also claims to allow proper treatment of the meibomian glands in both upper and lower eyelids. The treatment regimen consists of only three sessions, each spaced 2 weeks apart.

Novoxel

According to the company, a multi-site clinical study demonstrated improvements in patient signs and symptoms. One of the doctors involved in the study, Gregg J. Berdy, MD, FACS, stated, “Unlike other systems, the procedure is simple: anesthesia is not required, no coupling gel is needed, there are no complicated applicators, and there are no bright flashes of light. The Tixel is simple and safe enough for my staff to perform the procedures. The upper and lower eyelids of both eyes can be treated in less than 2 minutes. Most patients say their eyes feel more watery during the actual treatment.”

My Two Cents

This seems almost too good to be true—especially as it’s seemingly coming out of nowhere. I’m surprised this company hasn’t made any noteworthy appearances at the optometry trade shows or to doctors with large dry eye centers. Perhaps it will make the mistake of only embracing ophthalmology, which has caused many product failures.

OUTSIDE THE LANE

US Retail Pharmacies on the Decline

A stunning new study found that nearly one-third of all US retail pharmacies have closed since 2010, leading to an “unprecedented decline” in neighborhood drug stores. The drop began in 2018 and was primarily caused by many store closures from chain pharmacies as the industry consolidated.

According to senior author Dima Mazen Qato, a researcher at the University of Southern California Schaeffer Center for Health Policy and Economics, “At the same time, many states are making efforts to expand the scope of pharmacy services beyond dispensing drugs to include the provision of preventative and emergency care. We found that fewer pharmacies are available to provide them for the first time in at least a decade.”

In the study, researchers tracked pharmacy closures between 2010 and 2021. But earlier, in 2018, significant pharmacy changes began to merge, and the locations that were not as profitable were shut down. This also put pressure on small local pharmacies, as these independent pharmacies were more than twice as likely as chain pharmacies to close due to the larger chains’ powerful benefit managers, according to the researchers. “A key factor contributing to the higher risk of closure for independent pharmacies may be their frequent exclusion from preferred pharmacy networks,” said lead author Jenny Guadamuz.

The study points out that between 2019 and 2021, the number of drug stores in 41 of 50 states declined, although I am curious to see just how much of an effect COVID-19 had on these results. The study also shows that the closures hit seven states particularly, including Illinois, Maine, Mississippi, New York, Pennsylvania, Rhode Island, and Vermont. In addition, Black, Latino, and low-income neighborhoods were hit disproportionally. Pharmacy closure rates were 38% in Black neighborhoods and 36% in Latino communities, as compared with 28% in White neighborhoods. (Read more here.)

My Two Cents

This isn’t shocking. As many areas of health care go through consolidation, pharmacies seem ripe for closure, as many, if not most, are owned by large corporate entities that never seem to balk at closing underperforming locations. I also wonder how many closures have been due to the COVID-19 pandemic during the years this study tracked. Regardless, the need for pharmacies, much like the need for optometrists, isn’t going away anytime soon. I hope the pendulum swings back toward independent pharmacies so that more mom-and-pop shops can open back up and offer the customized and caring service our patients deserve.

CAN YOU RELATE

Ahhhhhh Thanksgiving. My absolute favorite holiday. Every year, I take my son Brooks back to my hometown of Bay City, Michigan, and spend the week at my parent’s house. We visit old friends and family and check out the sights of my childhood. It’s both relaxing and refreshing. This year, we rode the original Polar Express train, which can be found in the small city of Owosso, Michigan (the engine’s real name is the Pierre Marquette—cool trivia question); visited the world’s largest Christmas store (Bronner’s); went out, found and cut my parents’ Christmas tree; and watched my beloved Michigan Wolverines beat their bitter rival The Ohio State University Buckeyes for the fourth straight year.

If you’ve been a regular reader of this column, you know I love to talk college football. Well, my Wolverines are having a terrible year after winning the national championship last year. Their record was 6-5 before the OSU game, and their two best players got injured and would not be playing in the year’s biggest game. It also meant that the Michigan defense would start two extremely inexperienced cornerbacks against Ohio State’s incredible wide receivers. Michigan’s putrid offense (statistically one of the country's worst), starting a quarterback who didn’t have any scholarship offers out of high school, was without its best weapon as well.

Meanwhile, Ohio State marched into the game at its home stadium on “senior day,” prepared to avenge its previous three beatings by the Wolverines after exiting the game all year. Las Vegas sports books put a 20+ “line” on the game, essentially saying it should be one of the most lopsided games in the history of the 100+ years of the rivalry, and the Buckeyes should easily win by 20 points. The teams were a mismatch. Ohio State started 5-6 “5-star” players on both defense and offense (meaning these players are considered the cream of the crop), while Michigan had only one on both sides combined.

Something funny happened, though. Michigan won. Again.

Some years ago, Michigan’s former coach, Jim Harbaugh, called Ohio State’s coach Ryan Day “soft” and said he “was born on third base.” Since then, Ryan Day has made himself a media spectacle by screaming how tough his team is and seemingly going out of his way to make his point. Instead of using his team’s impressive wide receiver and quarterback talent to pass the ball around Michigan’s depleted team, he tried to run the ball down Michigan’s throat. The problem is that Michigan has an incredible defensive line it’s pretty much the team’s only strength.

Ohio State’s coach was so focused on proving his toughness that he completely ignored his team’s apparent strengths and mismatches on the field and tried to fit a round peg into a square hole. Due to his arrogance and poor coaching, Michigan triumphed in a game they had no business winning.

As clinicians, we need to play to our staff and our strengths. If you don’t have a passion for a particular area of eye care, why not refer patients requiring that type of care to one of your OD colleagues and work to develop your practice into a patient base that you do have a passion for for? Play to your strengths; otherwise, you could lose a very easily winnable game.