Pharmacy-perceived consumer preferences: A survey of community pharmacies in Macau

Abstract

This study aims to analyze the community pharmacies’ perceptions of preferences of local residents and tourists towards community pharmacy and pharmacy products by a questionnaires survey to 135 community pharmacies in Macau. The survey report indicated that local residents take price level as the most important factor in choosing community pharmacy and pay more attention to the product efficacy and quality in choosing products. Tourists take more consideration of the product category and convenient location in choosing community pharmacy and pay more attention to product origin in choosing the product. Compared with tourists, local residents paid more attention to price and pharmacy history, whereas, tourists emphasized product origin and product packaging. The result is not only expected to help the field of service management of community pharmacy but also help understand consumer preference.

Keywords

Community pharmacy consumer preference tourist resident Macau

Introduction

Community pharmacies around the world are playing increasingly important roles in both medical and social fields.¹ Different from traditionally single role of drug dispenser, community pharmacies, currently, have to experiment to serve varied functions to satisfy the diversified consumers. Specifically, community pharmacy today needs to serve not only local residents but visiting consumers who come from outside of the community. The dramatic changes of consumer composition force community pharmacy to face the challenges of diversifying demands from different types of consumers.²

Community pharmacies seek to satisfy their consumers from different places. However, consumer satisfaction with pharmacy is an integral component of the quality of systematic service.^3–5 Moreover, consumer satisfaction with community pharmacy is one kind of subjective perception, which is dependent on individual judgment about the extent to which a product or service provides a pleasurable level of consumption-related fulfillment in the community pharmacy.⁶ The diversification of consumers means consumers have different assumptions, values, and beliefs about judging community pharmacy.⁷ The distinguished background of local residents and visiting consumers like tourists signifies that they have different preferences towards community pharmacy. Understanding the differences of consumer preferences are important for community pharmacy, which is less addressed in literature. Particularly, past studies paid little attention to the pharmacy’s perceptions of consumer preference though pharmacy’s own perceptions which are more important for instructing management practice of community pharmacy.

Therefore, the aim of this study is to obtain community pharmacies’ perceptions about local residents and tourists preferences towards community pharmacy and pharmacy products. This study is expected to contribute to not only the field of service management of community pharmacy but also help understand the consumer preference.

Literature review

Along with the dramatic changes of market environment, the challenges for the survival and development of community pharmacy are becoming more and more obvious. In the past years, scholars indicate that different forces are changing the environment for community pharmacies.⁸ Such kind of impacts exist in not only developed countries but also in developing economies.^9,10

The researchers conducted survey study on the increasingly competitive sector of “community pharmacy industry”, where independent pharmacies must compete with national and multinational chains for market share. Each pharmacy seeks to differentiate and earn customer trust. Their study reveals that sincerity and competence have the most significant impact on building customer trust.¹¹ Other research also suggests that independent pharmacies need to differentiate themselves by developing a brand personality that is competent and sincere, thereby earning the trust from their customers.¹²

In addition, the growing intensity of competition from non-pharmacy retailers in the non-prescription medicine sector has increased concerns of community pharmacy.¹³ In the past decade, many researchers have argued about the importance of community pharmacists towards patient care in addition to their traditional role as drug dispensers.¹⁴ Pharmacy is thought to be a dual market industry that combines retailing services with professional services.¹⁵ Thus, community pharmacy should improve professional service quality to enhance its competitiveness.

However, the strategic actions of community pharmacy depend on their correct understanding of consumer preferences, which could be categorized into two aspects: factors related to community pharmacy as a whole; and factors related to pharmacy products.

Among the factors related to community pharmacy as a whole, product category is the most significant factor, which determines the potential choice width of consumers. The main activity of community pharmacies throughout the world is dispensing.¹⁶ Dispensing is always carried out by pharmacists, or under their direct supervision.¹⁷ However, besides drug dispensing for prescription drugs, community pharmacy is experimenting to provide more and more diversified products, not just medical and health products but other products as well.¹⁸ But the appropriate scope of product category is unknown or uncertain for community pharmacy.¹⁹ Whether different types of consumers will prefer different scopes of product categories still needs exploratory study.

The convenience of location is often regarded as the most influential determinant for consumer’s choice of community pharmacy.²⁰ History of community pharmacy can also function as one important factor in influencing consumer’s decisions. Location and history of community pharmacy cannot be changed easily. Therefore, community pharmacy has to pay attention to other more controllable factors, especially its internal management. Mostly, the internal management factors of community pharmacy include price level and service quality, which are interactive to some extent.²¹ Nevertheless, these factors may be differently preferred by consumers of community pharmacy.

Service management are becoming increasingly crucial for the survival and development of community pharmacy.^6,21 Quality of service will influence trust, commitment, satisfaction, conflict, and communication between pharmacy and consumers.¹⁸ Quality of service of community pharmacy is mainly related to service attitude and professionalism, both of which are highly dependent on staffs, especially pharmacists.^22,23 The pharmacists play an important role in community pharmacy. Consumers rely on the pharmacists’ knowledge to buy the product and to build up the long-term relationship with pharmacies or to increase consumer loyalty.²³ Past research has shown that the pharmacists’ willingness and ability to provide an expanded pharmaceutical-care service are two separate but related factors.²⁴ The interactions between consumers and pharmacists are dynamic, which implies that different consumers may have different opinions on the service quality of community pharmacy.

Product management is another important aspect that will influence the preference of consumers. Community pharmacy has to make a series of decisions related to its products, including product packaging, brand, efficacy and quality, and product origin.²⁵ This information of pharmacy product may be preferred differently by different types of consumers.²⁶ Although community pharmacies can apply different practices regarding business and management, they need to understand the consumption preference of different types of consumers beforehand.

In current literature, the preference differences between local residents and visiting consumers like tourists have not been addressed. Moreover, little efforts have been taken from the perspective of community pharmacy though most scholars study consumer directly. Therefore, the following research is designed to fill the gap by targeting community pharmacy’s perceptions about consumer preference of local residents and tourists.

Methods

Research setting

Macau is a Special Administrative Region of China with a small population of 550,000 people. As an international city depending on the development of tourism, it is attracting an enormous number of tourists from the world. Especially, after its return to China, it has attracted a great number of tourists from the mainland of China. Merely in 2011, more than 30 million tourists have visited Macau and shopped widely in the community pharmacies. Community pharmacies in Macau have to adapt their product and service portfolio to serve both types of consumers.

In 2008, the Department Pharmaceutical Affairs of Health Bureau of Macau decided to abolish the regulation of restrictions in opening of new community pharmacy within 300 m distance. Since then, there has been a rapid increase of community pharmacies, from only 71 community pharmacies in 2008 to 135 community pharmacies in 2011. Because of the small geographical space of Macau, all the community pharmacies will serve local residents and tourists at the same time. Therefore, the community pharmacies in Macau have much experience of understanding the preference differences between local residents and tourists.

Data collection

A written survey study with questionnaire was conducted at the community pharmacies in Macau. Ethical approval for this study was granted by Research Committee of University of Macau. Questionnaires were sent to the leaders of all the 135 community pharmacies in Macau by mail and 67 valid questionnaires were returned with a 49% response rate. The final sample consisted of community pharmacies from five different types of locations of Macau: tourism area, residential area, near hospital area, custom border area, and Taipa area. Among the sample community pharmacies, 42 community pharmacies were franchised pharmacies belonging to several business groups and 25 community pharmacies were independently private. The geographical location and ownership of sample community pharmacies are summarized in Table 1.

Table 1.

Location and ownership of sample community pharmacies in Macau

Location	Ownership		Total
Location	Franchising	Independent	Total
Tourism area	8	4	12
Resident area	15	15	30
Near hospitals area	4	1	5
Custom border area	10	2	12
Taipa (Island) area	6	2	8
Total	42	25	67

The founding year of sample community pharmacies is shown in Table 2. Among the 67 community pharmacies, there were 12 pharmacies established before 1999, implying long history and awareness to local residents. There were 37 community pharmacies that were established after 2008 when the Health Bureau of Macau abolished the regulation of “300 Meters Prohibition” restrictions in opening of community pharmacy without geographical limits.

Table 2.

Founding year of sample community pharmacies

Founding year	Before 1999	2000–2003	2004–2007	2008–2011
Number	12	10	8	37

In the questionnaire, each respondent was first asked to answer according to his experiences in his own community pharmacy to what extent local resident (tourist) paid attention to the following factors when selecting community pharmacy: product categories, price, service quality, location convenience, and pharmacy history. Secondly, respondent was asked to answer according to their experiences in their own pharmacy to what extent local resident (tourist) paid attention to the following factors when selecting pharmacy product: product packaging, product brand, product efficacy and quality, and product origin. Each respondent was asked to choose among a Likert measurement (1 = not at all; 5 = very much).

Data analysis

All the data was input and analyzed by SPSS 18 software. In addition to descriptive analysis, independent T-test was applied to examine the significance difference between local residents and tourists. p-Value of less than 0.05 was accepted as statistically significant.

Results

Perceived preferences towards selecting community pharmacy

According to community pharmacy respondents, the perceived preferences of local resident towards selecting community pharmacy are summarized in Table 3. Community pharmacy respondents thought that price level was the most important factor that influences local resident’s choice of community pharmacy, with 49.25% of respondents choosing “great” and 37.31% of respondents choosing “much”. Service quality was also highly emphasized, with 25.37% of respondents choosing “great” and 41.79% of respondents choosing “much”. Product category and location convenience had similar preference choices, totally 41 (61%) respondents thought they were seriously considered by local residents when selecting community pharmacy. Comparatively, only 37 (50%) respondents chose pharmacy history as one significant factor and 8 (12%) respondents even thought it had none or little impact on local residents’ decision of selecting community pharmacy.

Table 3.

Preferences of local resident towards selecting community pharmacy

	Not at all	A little	Moderately	Much	Great
Product category	1 (1.49%)	2 (2.99%)	23 (34.33%)	29 (43.28%)	12 (17.91%)
Price	0	2 (2.99%)	7 (10.45%)	25 (37.31%)	33 (49.25%)
Service quality	0	0	22 (32.84%)	28 (41.79%)	17 (25.37%)
Location convenience	0	4 (5.97%)	22 (32.84%)	30 (44.78%)	11 (16.42%)
Pharmacy history	2 (2.99%)	6 (8.96%)	22 (32.84%)	22 (32.84%)	15 (22.39%)

According to community pharmacy respondents, the perceived preferences of tourist towards selecting community pharmacy were summarized in Table 4. Community pharmacy respondents thought that tourists emphasized product category mostly when selecting community pharmacy, with 29.85% of respondents choosing “great” and 37.31% of respondents choosing “much”. Location convenience was another factor that influences tourist’s choice of community pharmacy, with 29.85% of respondents choosing “great” and 32.84% of respondents choosing “much”. As far as the service quality is concerned, 38.81% respondents thought it was much considered and 19.40% thought it was greatly considered. Besides, less than 50% respondents thought tourists paid much or great attention to price level. Particularly, only 23 (42.69%) respondents thought tourist regarded pharmacy history as one important factor.

Table 4.

Preferences of tourist towards selecting community pharmacy

	Not at all	A little	Moderately	Much	Great
Product category	1 (1.49%)	4 (5.97%)	17 (25.37%)	25 (37.31%)	20 (29.85%)
Price	0	5 (7.46%)	27 (40.30%)	17 (25.37%)	18 (26.87%)
Service quality	0	2 (2.99%)	26 (38.81%)	26 (38.81%)	13 (19.40%)
Location convenience	1 (1.49%)	10 (14.93%)	14 (20.90%)	22 (32.84%)	20 (29.85%)
Pharmacy history	6 (8.96%)	11 (16.42%)	27 (40.30%)	15 (22.39%)	8 (11.94%)

The comparison test of preference of local residents and tourists towards community pharmacy was conducted (Table 5). It showed that, compared with tourist, local resident significantly emphasized more on price level (p < 0.001) and community pharmacy history (p = 0.007). There was no significant preference difference between local residents and tourists towards product category, service quality, and location convenience of community pharmacy.

Table 5.

Comparison of consumer preferences towards community pharmacy

	Consumer type	N	Mean	SD	p-Value
Product category	Local resident	67	3.73	0.845	0.342
Product category	Tourist	67	3.88	0.962	0.342
Product price	Local resident	67	4.33	0.786	<0.001
Product price	Tourist	67	3.72	0.950	<0.001
Service quality	Local resident	67	3.93	0.765	0.189
Service quality	Tourist	67	3.75	0.804	0.189
Location convenience	Local resident	67	3.72	0.813	0.858
Location convenience	Tourist	67	3.75	1.092	0.858
Pharmacy history	Local resident	67	3.63	1.027	0.007
Pharmacy history	Tourist	67	3.12	1.108	0.007

Perceived preferences towards selecting pharmacy product

As shown in Table 6, 47.76% and 43.28% community pharmacy respondents reported that local residents paid great attention to product efficacy and quality and product brand respectively, both of which were highly valued by local residents. In terms of product origin, 35.82% reported great attention and 43.28% reported much attention paid by local residents. Comparatively, only 37 (50%) respondents in total thought local residents paid obvious attention to product packaging.

Table 6.

Preferences of local resident towards selecting pharmacy product

	A little	Moderately	Much	Great
Product packaging	3 (4.48%)	27 (40.30%)	25 (37.31%)	12 (17.91%)
Product brand	1 (1.49%)	8 (11.94%)	29 (43.28%)	29 (43.28%)
Product efficacy and quality	1 (1.49%)	7 (10.45%)	27 (40.30%)	32 (47.76%)
Product origin	0	14 (20.90%)	29 (43.28%)	24 (35.82%)

Table 7 summarizes the perceived preferences of tourist towards selecting pharmacy products. The community pharmacy respondents reported that product origin was extremely emphasized by tourist, with 58.20% of respondents choosing “great” and 34.33% of respondents choosing “much”. 44.78% respondents reported that tourist paid great attention to product brand. Similarly, 38.81% respondents reported that tourist paid great attention to product efficacy and quality. Comparatively, only 26.87% respondents thought tourists paid great attention to product packaging.

Table 7.

Preferences of tourist towards selecting pharmacy product

	Not at all	A little	Moderately	Much	Great
Product packaging	0	4 (5.97%)	16 (23.88%)	29 (43.28%)	18 (26.87%)
Product brand	1 (1.49%)	2 (2.99%)	12 (17.91%)	22 (32.84%)	30 (44.78%)
Product efficacy and quality	0	2 (2.99%)	11 (16.42%)	28 (41.79%)	26 (38.81%)
Product origin	0	1 (1.49%)	4 (5.97%)	23 (34.33%)	39 (58.20%)

The comparison test of preference of local residents and tourists towards community pharmacy product is summarized in Table 8. It showed that, compared with local residents, tourist significantly emphasized more on product origin (p = 0.006) and product packaging (p = 0.049). There was no significant preference difference between local residents and tourists towards product brand, product efficacy and quality.

Table 8.

Comparison of consumer preferences towards pharmacy product

	Consumer type	N	Mean	SD	p-Value
Product packaging	Local resident	67	3.69	0.820	0.049
Product packaging	Tourist	67	3.99	0.913	0.049
Product brand	Local resident	67	4.28	0.735	0.761
Product brand	Tourist	67	4.24	0.955	0.761
Product efficacy and quality	Local resident	67	4.34	0.729	0.181
Product efficacy and quality	Tourist	67	4.16	0.809	0.181
Product origin	Local resident	67	4.15	0.744	0.006
Product origin	Tourist	67	4.49	0.683	0.006

Discussion

Our research attempts to understand pharmacy-perceived consumer preferences, in order to put forward suggestions for community pharmacies that are seeking solutions to confront with the challenges of diversified consumers within a fierce completion market. From the perspective of community pharmacy, local residents and tourists not only have their own preferences, but also show significant preference differences in some aspects.

Compared with tourists, local residents regarded price level as a more influential factor that impacts their preference towards community pharmacy. Since local residents have the capability to observe the price level difference among community pharmacies, price level then becomes an important determinant for their selection of community pharmacies. In addition, local residents are more preferable to choose community pharmacy with longer history. Longer history may guarantee product and service quality.²⁷ It will help to establish credibility image that could influence consumer decisions of drug purchase explicitly.²⁸ Longer history of community pharmacy also means longer term interactions with local community by consumers, which facilitate them to perceive the organizational culture of specific community pharmacy.²⁹ All of these make pharmacy history to be regarded as one kind of brand asset for community pharmacy.³⁰ The preference of price level and history by local residents also implies the information transparency and reputation accumulation of community pharmacy, which is one kind of advantage for local residents rather than temporary tourists.

When choosing pharmacy product, compared with local residents, tourists had significant preferences of product origin and product packaging. Particularly in Macau, the majority of the tourists from mainland of China would like to choose drugs and other products from overseas, such as North America, Europe, or Japan, and so on. Consumers feel uncertain about pharmacy product when there is a lack of information clarity.³¹ The preference towards product origin means that tourists do not have exact information about products and would like to use product origin as quality assurance for their decision. Local residents are more familiar with specific products and aware of more information about the products, which led to less emphasis on the product origin. Similarly, the understanding of product led local residents to pay less attention to product packaging. For tourist professionals, packaging may attract their attention and increase their trust to product. All of these reflect the importance of information for consumer choice of pharmacy.³²

Community pharmacy perceived that there were no significant preference differences of location convenience, product category, and service quality between local residents and tourists. It implies that these three factors are basic criteria for both types of consumers for assessing community pharmacy. Product efficacy and quality and product brand are also decisive for both types of consumers to choose pharmacy product. Literature has called for more attention to pharmaceutical brand for community pharmacy.^11,33,34 Our study identified the brand effect empirically, implying that community pharmacy should consider more about product brand when they make their product choices.

Based on our research findings, some suggestions can be proposed for management practice. First, community pharmacy should carry out different actions to satisfy consumers according to their origins. In the areas where residents are major consumers, community pharmacy can timely carry out price promotion or conduct “academic marketing” under the premise of assuring the quality of medicines and the awareness that price and service are the key factors affecting consumers’ preferences. Academic marketing does not mean simple door-to-door medicine delivery and free blood pressure and weight measuring. Instead, it means the omnidirectional medical service pattern, including pharmaceutical choice, purchase, usage as well as sound health assurance when faced with the closely classified consumer groups. It is also a systematic marketing project supported by professional skills, aimed at meeting consumers’ health care, disease prevention, and treatment.

In the areas where tourists are major consumers, the pharmacies should make full use of their geographical superiority to provide diversified products or change their layouts to attract the consumers’ attention, showing how vast the number of their product categories is. Meanwhile, the pharmacies can also make full use of external environment conditions and policy superiority, and consider multi-production site purchasing channels to enrich high-quality production line so as to gain profits.

Second, it is rather necessary for community pharmacies to carry out “service marketing”, which is in favor of community pharmacies to gain competitive advantage, increase medical products’ added value, establish the pharmacies’ brands and improve consumers’ loyalty. The services in pharmacies are classified into pharmacist services and regular services. The former mainly contain the whole demands concerning the patients’ pharmaceutical use. Except for traditional pharmaceutical dispensing, it also includes carrying out pharmaceutical information service, and health education. And the former mainly targets at professional pharmaceutical use, while the latter mainly refers to service attitude, for instance, guiding, cash registering, manner of dealing with people, and other daily performances. The pointed training and improvement of pharmacists’ service quality are viable, and are the important continuation since “academic marketing”.

Third, facing with complicated and dynamic pharmaceutical market environment and targeted consumers, the pharmacies need to apply a systematic strategy, so as to occupy the market and achieve the best economic benefits. To meet the consumer’ demands, it is important for community pharmacies to closely classify their consumer groups and establish their own marketing mix according to their location and product categories. Under the context of fiercely competitive pharmacy marketing, the pharmacies make quick responses when facing differentiated consumers, and meet the target consumers’ different demands, which will eventually improve whole competitiveness by carrying out diversified marketing mix.

Conclusion

Through a survey study of community pharmacies in Macau, this research found that community pharmacy perceived significant consumer preference differences between local residents and tourists. Through understanding different preferences of local residents and visitors, community pharmacy needs to adjust its strategy and internal management to meet the specific demands of the consumers they serve. In particular, community pharmacy should pay attention to product origin and product packaging preferred by consumers from outside of community. In the long run, community pharmacy also needs to invest into its own branding management to differentiate itself from other competitors through transforming its history into one kind of strategic brand asset.

The study was limited in some aspects and could be advanced in the future research. First, the small number of community pharmacies in Macau constrained the size of the sample. Although we have surveyed all the 135 community pharmacies in Macau, future research in a larger context could provide further information. Second, in this study, we collected information from community pharmacies, which provided a way to understand consumer preference differences in a reflective way. Future study could conduct direct investigation on local consumers and tourists. On the one hand, it could provide direct comparison between local residents and tourists. On the other hand, it could give a chance to compare the perception of community pharmacy with the ideas of consumers themselves, which may help each other to understand and improve community pharmacy practices.

Footnotes

Funding

This study was funded by the Research Committee of University of Macau (MYRG044(Y1-L1)-ICMS12-HH).

Conflict of interest

None declared.

Author biographies

Mao Yu Zhang is a postgraduate at the Institute of Chinese Medical Sciences, University of Macau. Her research interests focus on medical branding and marketing and industrialization innovation.

Wai Kuan Chong is a professional of community pharmacy at Macao. He got his master degree from University of Macau and is working on professional assessment of community pharmacists in Macao recently.

Hao Hu is an assistant professor at the Institute of Chinese Medical Sciences, University of Macau, China. His research focuses on Sectoral System of Innovation (SSI) in Chinese Medicine, road-mapping and commercialization of pharmaceutical technologies, industrialization innovation of health organizations.

Yitao Wang is a professor at the Institute of Chinese Medical Sciences, University of Macau, China. His research focuses on traditional Chinese medicine quality evaluation system and innovative drug discovery and development.

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