A pharmacy's layout tells its history

By walking through a pharmacy's physical inventory, you can tell a lot about the operator of that pharmacy.

Among the more niche topics that I enjoy debating with pharmacists is “what is the right way to lay out a pharmacy’s inventory?” You can tell a lot about the history of pharmacy from shifting trends in how pharmacies lay out their inventory.

When my dad started working in the pharmacy, the inventory was laid out by manufacturer. This was the Pfizer shelf, that was the Upjohn shelf, the Lilly shelf, the Smith-Kline shelf, etc. This was before pharmacy computerized, and before wholesalers took over the world of distribution. Pharmacies had accounts with all of the manufacturers directly. So you laid out your inventory to facilitate each staff member managing the “Lilly account” or the “Smith-Kline account.” They’d set par levels and place orders directly with each manufacturer.

When I started working in 2004, our pharmacy was laid out by Brand name, with the generic equivalent sitting next to the branded product. The sertraline was sitting in the Z’s under Zoloft, the atorvastatin was in the L’s under Lipitor. I carried around a little blue book published by Mylan that listed brands and their equivalent generics in the front, and generic names and their equivalent brands in the front. Without that, I was lost trying to fulfill prescriptions or even just putting up inventory on the shelf when the order arrived. The shift from shelving by manufacturer to shelving by brand name occurred as the wholesalers gained more prominence. In 2004, generic drugs were less than half of prescriptions filled, so shelving things by brand name made sense.

Ten years later, I started pharmacy school and worked at Gateway Apothecary in St. Louis. They shelved their inventory mostly just by the straight alphabet of the bottle, but they had a “fast mover” area next to the bench where prescriptions were physically filled. This made sense to their workflow - by 2014 the overwhelming majority of prescriptions filled were for generics, so keeping sertraline in the Z’s didn’t make sense anymore.

While I was there, they purchased a Parata MAX robot, which added a section of inventory for “stuff that goes in the robot.” The owner explained to me a metric of “% of prescription fills satisfied by the robot or with a unit dose bottle.” We selected which items should go in the robot by looking at fill volume and trying to put the fastest moving items into that robot.

A few months ago, I modified our shelf layout from the “straight alphabetical” (which still has some subsecitons - liquids and creams are in one section, birth control another, oral solids in another, otic, opthalmic injectables and inhalers in their own areas). I added a section for “branded products.” Today, ~10% of prescriptions are filled with branded products, but that 10% of prescriptions accounts for ~70-80% of the total inventory value of the pharmacy. Keeping the branded products in their own section allows the pharmacy to easily and visually tightly manage the vast majority of the inventory dollars with only a single bay of shelves. If I’m pulling products for return to our wholesaler, I could walk the entire 100 shelves of inventory to return $30,000 of product, or just the 5 shelves that hold branded products and easily return $25,000 of the total $30,000 that I would pull off in 5% of the time and effort. There’s an aphorism among pharmacy owners: your money is either on your shelf or in your bank account. Technicians don’t accept their pay in Eliquis tablets, so keeping the inventory down is essential to maintain a pharmacy’s cashflow. Keeping a tight inventory (in dollar terms) is a lot easier when all the dollars are in one section.

I’ll also add here that to make learning the shelving system easier for new employees, I have our computer system print the shelf number on our labels. It looks like this:

When I was in pharmacy school, my pharmacist sister told me that as she learned about various drugs, she would visualize where that product sat on the pharmacy’s shelf to help her categorize the information she learned. I found this a useful mnemonic too.

I’d be interested to hear stories from other people of how they lay out their inventories - pharmacy or in other industries - what’s the logic that drives how you lay out your inventory? You could lay out your inventory by color (moving your levothyroxine and warfarin across the entire pharmacy), by NDC number (please don’t), by bottle size (our old RxSafe 1800 did this), by therapeutic class, by route of administration, by disease state treated or in any myriad of other ways. How do you lay it out?