Building value over volume: Calgary’s Meadows Mile is proving that when care comes first, patients follow

Across Canada, shrinking pharmacy budgets, increasing clinical expectations and pressure on pharmacists to do more and more for patients, has some questioning what a sustainable pharmacy of the future really looks like these days. In Calgary, Meadows Mile Pharmacy & Compounding is offering one viable answer.Opened in 2020, this hybrid pharmacy and clinic model features pharmacist-led ‘hubs’ focused on addressing therapeutic gaps in patient services. For example, the Iron Hub—which manages IV and oral iron therapy—was developed when the pharmacy team noticed patients’ surgeries were being delayed due to untreated anemia. Similarly, the COPD/Asthma Hub, which was launched this year, is a partnership with AstraZeneca and local respirologists to ensure patients receive proper device training, spirometry testing, and proactive follow-up to prevent hospitalizations. There is also a pain management hub in the works.“We identify where there is a need and then build programs around it so we can offer patients more value and become an integral part of their care, as opposed to just a transaction point,” says Pharmacy Manager Michael Kani, who joined Meadows Mile in 2024. When patients see that the pharmacy team has helped solve a problem no one else could, he says they’ll drive 45 minutes from other communities to keep coming back. “The focus is not on prescription volume but the value you create with patients, many of whom we continue to follow regularly.”Pharmacist owner Dan Curle explains that Meadows Mile came to fruition thanks to his long-standing relationship with some local dermatologists, who offered him an opportunity to open a pharmacy in the same building where they were setting up their practices. In two previous pharmacies he owned, Curle was focused on compounding and supplying compounded medications to other pharmacies. He wanted a new venture where he could put the focus back on patient care, procuring customized compounds as needed that were filling gaps in treatment.In addition to the dispensing and clinic area within the pharmacy, patients who try to book with the physicians in the building—who are often scheduled months in advance—are automatically offered an appointment with a clinical pharmacist when appropriate who can prescribe within scope. “If the patient [is under the care of] one of the physicians, we have access to the EMR and can later enter our clinical notes and prescriptions,” says Curle, adding that he is grateful to the physicians who designed the building format as they were very intentional about creating shared spaces (they even share a lunchroom).“It means we can easily learn what each other’s pain points are and collaborate on programs,” he says. “When you have a relationship with providers and are regularly talking to patients, you can quickly learn how to address their barriers from a pharmacy perspective and ultimately drive better outcomes.”In looking for a partner for this latest venture, Curle reached out to Kani because of his extensive past experience in consulting and operating his own pharmacies. “What drew me to Michael was his commitment to innovation…while being able to connect with patients and staff,” says Curle. (Kani was a featured innovator in Pharmacy Practice + Business in 2018.) “He’s been doing a great job in helping our visions come to life.”Kani says joining the Meadows Mile team was a “no brainer” for him given the pharmacy model. “I’d visited before several times and saw the setup with the physicians next door and knew we could create a lot of value for patients here,” he says.Rather than just layering services on top of dispensing, he says the pharmacy culture and workflow is geared to continuously promoting clinical offerings. He points to vaccinations as a prime example. “So many patients who are qualified for vaccinations aren’t receiving them as no one is doing the assessment, so we’ve literally built that into the workflow,” he says. That entails checking the vaccination status of every patient coming into the pharmacy. “We have a cheat sheet of recommendations depending on age and current conditions and we flag those right off the bat, which has resulted in us doing way more vaccinations than we’ve ever done before.”A strategic focus on billingThere is a similar flagging system for all other pharmacy services as well, he notes. Those who don’t see the pharmacist right away at the time of intake and are flagged for certain conditions are followed up later by phone. Like physicians, Kani says he and his team are very strategic about billing, focusing on one condition at a time and then booking up a follow-up appointment for other conditions based on their urgency. They also assist patients with special authorization of medications not covered by provincial plans or private insurance.In fact, the team has recently added a “specialty hub” focused on helping patients access effective but often expensive specialty medications. “We’re constantly looking to partner with biotech companies and others to get products to patients in a timely manner,” says Kani.With a staff of six (including two on-site pharmacists, a technician and pharmacy assistants), Kani focuses on the day-to-day operations, while Curle is geared towards business development and building relationships with physicians and other healthcare providers via in-person visits. “As we build more programs, I can certainly see adding more pharmacies in our future, eventually housing different specialities within different pharmacies,” says Curle.Though revenue has been increasing by double digits year over year, Curle stresses that creating a sustainable pharmacy model requires constant “revision and pivot” to improve efficiencies. “We don’t have this robust dispensing model creating revenue to fall back on.” But on the other hand, he says the physicians they’re working with are realizing more and more just how valuable the pharmacist can be in improving their practice. Kani says another challenge is finding pharmacists with the right skills sets and desire to follow the pharmacy’s vision.In addition to finding like-minded pharmacists to join Meadows Mile in future endeavours, he encourages pharmacists across the board to seek opportunities (whether that be at multi-disciplinary CE sessions or other healthcare events) to talk to prescribers outside of pharmacy. “Identify an area or issue where you could provide a pharmacy program and go to a specialist or prescriber to see about working together,” he says. “When you offer creative services that can benefit prescribers and patients it becomes such a strong value proposition you don’t have to oversell it.”In looking at the current Canadian healthcare landscape, both Curle and Kani say the potential for pharmacy to fill gaps in patient care is enormous. “It’s about thinking outside of the box and outside of prescription numbers, and finding the opportunity to add real value,” says Kani. “If pharmacy wants to survive, we have to stop being at the back end of the healthcare system and join partnerships that ensure patients are being taken care of.”Rosalind Stefanac is a Toronto writer specializing in pharmacy, retail and business journalism.

Building value over volume: Calgary’s Meadows Mile is proving that when care comes first, patients follow

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