In this episode, we interview Hetal Patel, PharmD and RFUMS COP Alumni, regarding her career path that eventually led her to open Lebanon Family Pharmacy in TN in 2021. We discuss the challenges and opportunities of starting a new independent pharmacy and what the future of independent pharmacy looks like. Key Concepts Starting a new, independent pharmacy requires substantial planning 8 to 12 months before the pharmacy’s doors even open. New pharmacy owners need to consider a variety of factors such as location, type of building, a business plan with financial analysis, a variety of building and pharmacy inspections, paperwork and government approvals, and so much more. PSAOs (pharmacy services administrative organizations) can be helpful, especially for new pharmacy owners, to serve as a liaison between the pharmacy and PBMs (pharmacy benefit managers) to negotiate reimbursement contracts. As owners gain more experience, there may be financial advantages to not using PSAOs and negotiating with PBMs directly. Companies like “Health Mart” have a franchise-like model to provide products, services, documentation, policies and procedures, and more to independent pharmacies. These companies reduce the workload associated with running a pharmacy so that the pharmacy owners can focus their time and attention on the business itself and providing exceptional customer service. There are a number of challenges to independent pharmacies – some of these challenges involve PBMs (DIR fees and MAC pricing) as well as unrestricted dispensaries in primary care clinics. References Lebanon Family Pharmacy. https://lebanonfamilypharmacy.com/