There is a conversation I have had dozens of times with pharmacy directors across the country. It usually starts the same way: "We handle our own inventory counts. We have a good team. We do not think we need outside help."

By the end of the conversation — after we walk through the numbers — the question is rarely whether to outsource. It is why they waited so long.

I am not saying this to sell a service. I am saying it because the math is consistent enough that it has stopped surprising me. Facilities that bring in a specialized inventory team almost always recover more than the cost of the engagement — often significantly more. Here is why.

When pharmacy directors calculate the cost of an internal inventory count, they typically think about staff hours. A team of three pharmacists and two technicians, working over a weekend, at their blended hourly rate. That number is real, but it is the smallest part of the actual cost.

The larger costs are harder to see:

Accuracy variance. Internal teams counting their own inventory face a structural disadvantage: familiarity. When you work with the same shelves every day, your brain fills in gaps. You see what you expect to see, not necessarily what is there. Professional counting teams using barcode scanning and structured methodology consistently achieve 99%+ accuracy. Internal counts at most facilities run between 92% and 96%. On a $3 million drug budget, that 3–7% gap represents $90,000 to $210,000 in unresolved discrepancies.

Missed return windows. Near-expiry medications have a narrow window for manufacturer returns — typically 6 months before expiration, sometimes less. Internal teams focused on completing the count rarely have the bandwidth to simultaneously identify, segregate, and process return-eligible stock. That window closes quietly, and the credit disappears.

Staff disruption. A full physical count pulls your best people off their primary responsibilities for days. The downstream effects — delayed order verification, reduced clinical support, overtime to catch up — rarely show up in the cost calculation but are very real.

Compliance exposure. Controlled substance reconciliation, DEA documentation, and 340B record-keeping require specific expertise. Errors in these areas do not just create financial exposure — they create regulatory exposure. The cost of a DEA audit or a 340B compliance finding dwarfs the cost of any inventory engagement.

When IMC Pharma sends a team into a facility, we are not just counting faster. We are counting differently.

Our teams use barcode scanning technology that cross-references every item against current NDC databases, manufacturer return policies, and DEA scheduling in real time. That means we are not just telling you what you have — we are telling you what it is worth, what can be returned, what needs to be destroyed, and what your system records say versus what is actually on the shelf.

That last piece — the variance report — is often where the most immediate value surfaces. A facility that has been purchasing against inaccurate system data is making every buying decision with a distorted picture. Correcting that baseline does not just recover value from the current count. It improves purchasing decisions for the next 12 to 18 months.

I want to be specific here, because vague claims about "significant savings" are not useful to a pharmacy director trying to make a business case to their CFO.

Across the facilities we have worked with, the pattern is consistent:

A community hospital with an annual drug spend of $4 million brought us in for their first professional count in four years. The count identified $280,000 in near-expiry stock still within the manufacturer return window. Reverse distribution processing recovered $190,000 in credits. The variance between their system records and physical count was 5.8% — representing $232,000 in unresolved discrepancies that had been distorting their purchasing decisions.

Total recovery from a single engagement: well above the cost of the service.

A health system with six campuses and a combined drug spend of $12 million had been running internal counts annually. When they brought us in for a parallel count at two facilities, our accuracy rate exceeded theirs by 4.1 percentage points. Extrapolated across the system, that gap represented over $490,000 in unresolved inventory variance.

These are not exceptional cases. They are representative of what we see when a facility transitions from internal counting to a specialized team.

"Our staff knows our formulary better than anyone outside could."

This is true, and it is also irrelevant to the accuracy question. Formulary knowledge helps with clinical decisions. It does not help with the structural biases that cause internal counts to underperform. A team that counts pharmacy inventory at 50 facilities a year has pattern recognition that no single facility's staff can match — not because they are smarter, but because they have seen more.

The analogy I use: you would not have your own accounting staff audit your own books. Not because they are dishonest, but because independent review catches things that familiarity obscures. Pharmacy inventory is no different.

Not all pharmacy inventory services are the same. Before you engage any vendor, there are a few non-negotiables:

DEA licensure for Schedule II–V controlled substances. This is not optional. Any vendor handling controlled substance returns without proper DEA registration is creating liability for your facility, not reducing it.

EPA compliance for hazardous pharmaceutical waste. Improper disposal of hazardous medications carries significant fines. Your vendor needs documented EPA compliance, not just a verbal assurance.

State licensure in your state. Reverse distribution licensing requirements vary by state. Confirm your vendor is licensed to operate where you are.

340B experience. If your facility participates in the 340B program, your vendor needs to understand the distinction between 340B-purchased and WAC-purchased inventory. Getting this wrong in either direction creates audit exposure.

Transparent credit reporting. You should receive itemized documentation of every return processed, every credit generated, and every item destroyed. If a vendor cannot provide that level of detail, find one who can.

If you are running internal inventory counts and you have not benchmarked your accuracy against an independent count in the last two years, you do not actually know what your variance is. You know what your team found. Those are different things.

The facilities that have made the shift to outsourced inventory management consistently tell me the same thing: they wish they had done it sooner. Not because the internal team was failing — but because they did not know what they were missing until they had a clean baseline to compare against.

If you want to understand what that baseline might look like for your facility, I am happy to walk through it with you. The conversation costs nothing. The data it produces is usually worth quite a bit more.

Michael Samojla is the CEO of IMC Pharma, a licensed pharmaceutical inventory and reverse distribution company serving hospital pharmacies, VA medical centers, and health systems nationwide.