DSN Industry Issues Summit panel addresses collaboration between pharmacy, medical community

Widmer cautioned that retailers who aspire to form collaborations, such as the one between J&J and Walmart, need to realize that these “are long programs and retailers need to have mutual values. Between J&J and Walmart we do,” she said.

Pointing out that if you are black and pregnant, throughout and after your pregnancy, you are three times more likely to suffer serious complications or die in the United States, Widmer said that values and complementary strengths between partners are essential. “Walmart has the wonderful access, the trusted relationship, and is close to every consumer and patient in the United States. They have incredible insight and knowledge about the population. J& J brings clinical and behavioral science expertise.”

Pointing out that one company can’t do it alone, Widmer said that Care Source, a local insurance provider also is a partner for the first pilot in Georgia.

The support of senior leadership also is crucial. “If you are going to go after something like this, even though there’s passion in the middle of the organization and in junior colleagues, if leadership doesn’t get behind it, it is destined to peter out because business priorities may change, and people may turn over. We make sure our teams don’t have to fight for resources and we consistently make sure this is a top priority,” Widmer said.

Moore chimed in, stating that understanding there are true inequities that exist and the willingness to move into action has to start at the top of the organization. “We want to do real world and not check the box activity," he said. "It has to be real. It comes down to how you resource.”

He also pointed out that as an organization you have to understand what is important to your organization and what your customers need. “In the end you want one and one to equal three. How do you maximize the potential for the work you do? We started in Georgia, which is the third largest black population and has the second worst maternal outcome,” Moore said, noting Walmart has over 215 stores and with SAMS and Walmart in Georgia, it has 10 distribution centers.

“What we do for our community we do for our associates, and what we do for our associates we do for our community,” Moore said. “How can we find moms going through this journey and then reward them for the right healthy behavior, such as healthy foods, lotions and care products? We wanted to make sure we talked to the community, we talked to hospitals and community based organizations to learn.”

The discussion proceeded with Watkins addressing how Kroger creates a holistic approach, putting the patient at the center of everything they do.

Watkins insisted that you need to meet people where they are and understand the friction that happens in communities. “At Kroger, for the past 25 to 28 years we’ve been on a journey to personalize delivery of our service through better understanding of customers,” Watkins said. “We do that through analytics, customer loyalty cards at the point of purchase. Forty-five years ago it was the voice of the consumer. We had a town hall meeting. Folks said they need access to care. We said, let’s get into the pharmacy space. Fifteen to 20 years ago, they said that they need access to care and convenience. They don’t have time to take off from work to see the doctor. They also want transparent pricing. If I don’t have insurance how much will it cost?”

Watkins continued, “As we merge our assets under Kroger Health, simplifying solutions to help people live healthier lives, connecting us with well being health and nutrition we can drive better outcomes. We can work to do something meaningful at the population health level.”

To that end, Kroger has made a commitment to address obesity. “We know there are too many nutritional related diseases driving the cost of care," Watkins continued. "For instance, diabetes and high blood pressure, which leads to cardiovascular diseases.  Seven out of 10 deaths are created by chronic diseases.  Addressing things like the ability to get healthy foods in a meaningful way is important."

Kroger asked its CPGs to help the retailer create a healthier assortment of food. "We want to bring $58 billion in savings back into the purchase ability of our customers," Watkins said. "Let’s not jack the price up because we stuck a healthy label on it. Let’s work together to offer nutritionally sound products but not at a higher price. We’re talking about a top down population health approach to really improve the lives of the communities we serve."

As the discussion shifted, Stefas said that there are four barriers that exist when formulating collaborations in order to meet the needs of the consumer, but they are not insurmountable.

[Read more: Panel weighs effect of COVID-19 on retail pharmacy on 2nd day of DSN Industry Issues Summit]

“One barrier is from a technological perspective, but there are ways we can integrate data,” Stefas said. “Two, how are we going to treat the patient? There’s enough evidence based medicine out there where we can collaborate on who’s doing what and how it’s going to occur. The third barrier is around financials. Today stakeholders aren’t aligned. The fourth barrier is healthcare information from a financial perspective. We all know there’s value to these things, but are we willing to share data? The biggest barrier is regulations, as we build out networks can we do that from a regulatory perspective? Can we share data? Does the patient want to share data?”

Stefas also pointed out that work needs to be done in the regulatory space and that it’s imperative that the industry work to support the patient in order to make sure we get the best outcomes and bend the cost curve from a health perspective.

Mammen addressed next what Walgreens does to close gaps in health care, noting that it’s clear that the role outside of the healthcare system is for all of us as partners to address community health needs.

“Walgreens has access to 80% of the population,” said Mammen, emphasizing that as we understand inequities in health care, it became abundantly clear during the pandemic that access to community based outlets “becomes inherently giant. We know that no one size fits all. Where we have the strength is we have our team members and patients who all come from the community. We look to them to identify the issues for that population. We then take data to look at our footprint across the country. Walgreens is able to offer services and access starting from the community.”

Mammen cited Walgreens’ recent partnerships with organizations like CareCentrix, which is post acute home based care; Shields, which is specialty care; VillageMD, which is primary care; and newly acquired Summit Health, parent company of urgent care clinic chain CityMD. “We’re setting the stage for bringing health care directly to the community. It starts with pharmacy. It serves to augment the other services while trying to allow everybody to work at the top of their field. We know no one house can do this alone.”

Mammen concluded that Walgreens has taken steps to say, "‘we see where the gaps have been in the past and where our patients need us more’ and we are building the system around their needs."

Emphasizing that collaboration is essential and that there is a great benefit in collaborating with pharmacy, Stefas said, “Having community pharmacists that are trusted that look like those communities becomes extremely important. When I look at retail based community pharmacies I see them as extensions. How amazing for us to send a message to Walgreens so when the patient picks up medicine, they ask, Do you know you are overdue for your physical or you have a lab due? How amazing for us to get a message into the community to contact the patient to adhere to wellness initiatives to make sure patients stay healthy?”

Commenting on the importance of addressing social determinants of health, Moore said that we know health starts in the home, in our schools and our communities. “The patient experience is an eye toward health equity at Walmart,” he said.

To that end, Walmart held two health equity summits to provide information to its front line associates. It also is deploying CE and CME to its pharmacists and front line providers, on how health equity can be addressed in the retail setting. “You want to reduce costs but still maintaining quality and that requires partnerships because no one has all,” Moore said.    

Moore cited one example: In June 2021 Walmart launched a private label ReliOn NovoLog Insulin. "We did it with Novo Nordisk to bring the cost down without reducing the quality. We need to make sure we take care of our providers and make sure they are motivated. That allows us to reduce the cost and improve population health.”

Burch addressed the topic of personalization, asking, How do we continue to find a better and easier solution for our patients and equip them with the right education during these critical touch points within their healthcare experience? “It’s all about collaboration to help the patients. At Embecta we’ve refocused our mission at the core of the patient. How do we get into their mindset? We focus on diabetes. The entire treatment pathway that goes across the board.”

Burch said from the time the patient is diagnosed, pharmacists are critical in their care because the diagnosis is overwhelming and life changing. “They rely on the pharmacist for education and for understanding. We focus on with our core partners how to get educational material to the patient at the point of contact. How do you get online tools for people so they can manage their disease? It’s about all of us coming together.”

Lastly, Burch said that the complexities of the system will continue to evolve and partnerships across manufacturers and retailers are crucial to educate and make people aware of the support available.

“Costs will continue to be a barrier so we have to find cost effective ways to seek better preventive health care so we can start that journey earlier,” she said. Together we remain focused on education and providing training and touching the patient at their point in the journey. It’s also about the caregiver and family because these chronic diseases impact everybody across the board.”

Lastly, Sanchez informed attendees that technology is available for personalized care. “The common theme we hear is how we help transition of care,” he said.

Sanchez cited when patients are discharged, how do we drive them into the retail setting? “There is a willingness for this to happen,” he said. “We can do all of this today, but there needs to be work done on the regulatory front. We have the ability to engage a patient, when and in what channel. We can guide them into the registry and inform patients that it’s time for your vaccination. Personalization is there. It’s breaking down the barriers and introducing processes like transition of care. Let’s transition patients from acute settings to retail with all of the information that a clinician needs to engage that patient.”