Enhancing diabetes prevention and care services
A number of major retailers are stepping up to the plate to support diabetes prevention and care with expanded services and programs.
The list of services includes medication therapy management, point-of-care testing and screenings, personalized interventions, product demonstrations, on-on-one coaching, video webinars and education. Retail expansion into diabetes care comes at a time when it is sorely needed.
According to the American Diabetes Association, in 2019, 37.3 million Americans, or 11.3% of the population, had diabetes. Every year, 1.4 million Americans are diagnosed with diabetes. In 2019, 96 million Americans aged 18 years old and older had prediabetes.
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While numbers for the diabetes category are hard to come by, Chicago-based research company IRI pegged annual sales of the home health care/kits category to be around $4 billion, glucose testing kits to be over $347 million and lancet/devices to be almost $39 million in U.S. multi-outlets for the 52 weeks ending May 15, 2022.
Key players
One of the experienced players in diabetes care is Walmart. The retailer serves 14% of its customers who have diabetes via its pharmacies, Walmart Health centers and telehealth programs.
Following the debut of ReliOn insulin in 2000, last year Walmart introduced ReliOn NovoLog, the first and only private analog insulin. The ReliOn brand also includes affordable blood glucose monitors, lancets and other diabetes management essentials.
“Insulin affordability is a major issue, and we know many people with diabetes struggle to manage their disease because of its financial burden,” said David Carmouche, senior vice president of omnichannel care at Walmart Health & Wellness. “That’s why Walmart offers a suite of low-cost diabetes products that provide customers with choices when it comes to their diabetes management.”
Yet another innovation, The Walmart Health Virtual Care Diabetes Program, was developed in collaboration with the American Diabetes Association. It is available as a standalone or as part of a comprehensive medical and behavioral telehealth program for employers to offer employees and their families, and it allows members access to personalized diabetes management in their homes.
“We are working to help customers better manage their diabetes through convenient, affordable products, including access to fresh foods and workout clothes, in addition to our primary care offerings at Walmart Health centers,” Carmouche said. “We operate more than 4,600 pharmacies nationwide, many of which serve the heart of rural America. Our pharmacists can provide education on monitoring glucose levels, help patients with medication management and offer counsel on diet and exercise.”
Walgreens also is on the cutting edge when it comes to providing diabetes care.
“We start with our pharmacists receiving enhanced diabetes management training and completing regular continuing education to keep up to date with current guidelines,” said Stacey Emmons, director of pharmacy and retail operations at Walgreens. “These tools help our pharmacists empower individuals living with diabetes with the information they need to manage their health. We take a holistic approach with patients to educate and support nutrition, exercise and ensure they get regular checkups and screenings, such as kidney screenings, diabetes eye exams and foot exams.”
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Building strong relationships with patients in their communities to support medication adherence is a key focus of Walgreens’ pharmacy team. “We use smart analytics to power personalized interventions that help improve adherence and patient outcomes by identifying patients who are most in need, then triggering interventions through the most appropriate channels, which enables personalized conversations,” Emmons said.
Additionally, Walgreens provides a 24/7 Pharmacy Chat option through its mobile app and website, giving patients easy access to personalized care and advice from Walgreens pharmacists.
Stop & Shop is another formidable player in providing diabetes care. In the spring of 2020, the retailer began offering free monthly virtual diabetes and prediabetes webinars year-round. The webinar content, and patient educational takeaways, are created by a team of clinical pharmacists and registered dietitians.
During American Diabetes Month in November, a more in-depth weekly series is offered. Participants receive a 40-plus page resource document that includes educational handouts along with dietitian-approved product choices and recipes, and an appointment for a complimentary medication review with a pharmacist and a consultation with a dietitian.
“As retail dietitians, we play a vital role in ensuring that our customers are equipped with the knowledge that they need to succeed in managing those conditions since it is so closely tied to food and medication management,” said Emily Hayes, a dietitian on the nutrition team. “Since we are a retailer with two strong heath expert teams, we can best service our customers by teaming up to provide this valuable education for patients.”
Stop & Shop’s pharmacists also provide demonstrations of how to use blood glucometers and on specialty pen injection techniques.
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Brittany Orlando, a clinical pharmacist on the team, explained that many patients are prescribed injectable diabetes products, which often requires dialing up a dose on the device. “There are certain techniques patients should follow, such as attaching a new needle to the hub of that injection device with each use, making sure the area is cleansed appropriately and rotating injection sites to reduce the risk of injection site reactions or potential infection,” she said. “Our pharmacists can walk you through step by step how to use them.”
Stop & Shop pharmacists also help patients understand how to use glucometers that sync to a smartphone, enabling patients to upload data to their medical records, and they are proactive in flagging a new prescription so that they can ask patients if they have questions.
“Pharmacy takes the lead on why it’s important to manage blood sugar levels, to improve health outcomes and on how to achieve success with any medications the patient may be prescribed,” Orlando said.
Hy-Vee also is taking a lead in providing diabetes care from its pharmacists and 50 dietitians across its eight-state region.
Over a decade ago, the retailer began to offer programs that have evolved throughout the years. Programs take place in-store in some locations and are virtual in others.
“Hy-Vee pharmacists work collaboratively with our dietitians to provide knowledge, disease state counseling and MTM,” said Angie Nelson, senior vice president of pharmacy at Hy-Vee. “Our pharmacists refer diabetes patients to the Hy-Vee dietitian team if they are requesting or needing additional support to help with diet and food selection.”
Hy-Vee pharmacists also counsel and show newly diagnosed diabetes patients how to monitor their blood glucose, and refer them to the dietitian team for additional support.
A1C screenings also are part of Hy-Vee’s focus on diabetes. “In partnership with several of our supplier partners, we administered 1,000 free A1C screenings to customers across dozens of our stores in April, with a record number of customer signups,” said Elisa Sloss, vice president of HealthMarkets and dietitians at Hy-Vee. “Following the screening, our dietitians shared tips on how individuals could better manage their blood sugar.”
The Hy-Vee dietitian-led virtual diabetes store tours, which are live and on-demand, help customers navigate the grocery aisles and learn the basics of following a diabetic-friendly meal plan. They also offer product recommendations and tips on how to add more nutrition into individuals’ lifestyles. The tours integrate with the Hy-Vee Aisles Online grocery ordering service via a shoppable link that makes it easy for customers to quickly shop products online as they’re touring the store and view product nutritional information.
“The virtual tours also are available in Spanish, allowing us to broaden our customer reach,” Sloss said.
Additionally, each month, Hy-Vee dietitians lead virtual Freezer Meal Prep Workshops to help customers learn how to save time on meals using nutritious ingredients. In April, Hy-Vee’s dietitians focused on carb-conscious recipes to help those with diabetes learn how to better manage their blood sugar levels. Customers who enroll in the workshops receive a step-by-step guide, recipes, a shopping list and a Hy-Vee Aisles Online shoppable link to make the experience of prepping, shopping and cooking convenient.
What’s more, Hy-Vee’s team of registered dietitians are available to consult one-on-one virtually or in person with customers to discuss their lifestyles and conditions, and develop a meal plan tailored to their personal health goals.
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Additionally, Hy-Vee recently launched WholeLotta Good, a national ship-to-home website. “WholeLotta Good offers an array of dietitian-approved food and supplements, including products for individuals with diabetes. The website also features a blog offering expert advice and healthy recipes,” Sloss said.
Hy-Vee also provides a line of sugar-free OTC items and a team of pharmacy technicians who can advise patients.
The Giant Company, based in Carlisle, Pa., also is a leader in helping patients tackle diabetes.
At Giant and Martin’s, all pharmacies have a specially trained diabetic care pharmacist who helps patients with questions on medications and diabetes management.
Tim Kaylor, clinical pharmacy specialist at Giant, said that by offering information from experts focusing on both medical and nutritional factors, “we can address diabetes from all angles. We also can prevent the severity of the disease if customers are given the tools for early detection and management of their weight, health and diet. Our pharmacists are involved in all of the programs we offer, from teaching the diabetes classes to being a great in-store resource. They also are available to support our customers in managing their diabetes and answering their questions about label reading, portion sizes or medication.”
In addition, the pharmacy section of the retailers’ website and Rx app offer prescription management to customers. The Rx app also includes a health library section with high-level information on various topics, including diabetes.
Giant also partners with local community organizations and employers to screen individuals for diabetes. “When detected and treated early, people at risk for diabetes or prediabetic patients can reduce the severity of the disease long-term or even prevent it entirely,” Kaylor said.
Additionally, all of Giant’s stores with pharmacies have Higi Health Stations, enabling customers to engage with the “Know Your Risk for Diabetes” program. “Based on their responses, their risk score will be calculated as high risk or low risk and shared with them on the station, and they receive a follow-up email with recommended next steps,” he said.
Giant’s dietitian team also offers guidance for those struggling with diabetes or prediabetes. “Customers can expect advice on better-for-you options to add to their shopping carts and time- and money-saving tips to bring balance to their lives while making the best decisions for them and their families,” Kaylor said.
As more retailers seek to tackle social determinants of health, offering diabetes care is a win-win for retailers and patients.
Noting that 4,000 of Walmart’s stores are located in HRSA-designated medically underserved areas, Carmouche said: “Through our pharmacists, Walmart Health centers and telehealth services, we are in a unique position to reach more people with care and resources that they need. By using all of our existing assets together — from fresh food to pharmacies to telehealth to clinics — we are able to care for our customers when and where they need care, in the way that works best for them.”
In Chicago, where there is a large population of patients with diabetes, local customers and associates have access to HabitNu, a diabetes management program developed by the CDC. “Our locations also emphasize programs that address the social determinants of health, including behavioral health needs,” Carmouche said.
“In underserved communities that we serve, we’ve observed a higher rate of diabetes and lower health outcomes. Our health equity diabetes program helps patients connect with our pharmacists to get information surrounding clinical guidelines, recommended lifestyle changes and general tips to manage their diabetes,” Walgreens’ Emmons said. “We’ve implemented this pilot program in Chicago-area stores, which takes a holistic approach to helping patients. Through comprehensive, personalized consultations, our pharmacists can uncover gaps in diabetes care and barriers to adherence, and offer tailored solutions leading to improved health outcomes.”
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To ensure guidelines are met to support prevention of common complications in diabetes, Walgreens also is piloting enhanced screening services, including HbA1C and blood pressure screenings. The retailer works with select payer partners to pilot comprehensive disease-state management interventions, offering personalized consultations to select patients to educate and motivate them, “to close gaps in care and resolve barriers to adherence,” Emmons said.
In addition, Walgreens offers a Prescriptions Savings Club that lowers prices on hundreds of prescription medications, including diabetes medications.
“By providing various programs and access to our pharmacists and dietitians, we are there to help these patients navigate their diagnosis,” Nelson said, pointing out that in many communities, Hy-Vee is the most accessible place for individuals to receive health care.
Perhaps Kaylor summed up best what retailers are hoping to accomplish in the diabetes space: “We are meeting our patients directly where they are in order to achieve the CDC’s goal of creating environments that promote attaining the full potential for health and well-being for all.”
Who’s helping the helpers?
These companies are coming to the aid of retailers that provide diabetes prevention and care.
Embecta, based in Parsippany, N.J., has a broad portfolio of injection devices complemented by education, training and support resources available across multiple channels and digital platforms. Formerly part of BD, embecta is focused on diabetes care, building on nearly 100 years of experience and a global manufacturing and distribution network, delivering about 7.6 billion units of diabetes injection devices to more than 30 million people in more than 100 countries.
Intuity Medical, in Fremont, Calif., is a commercial-stage medical technology and digital health company focused on developing comprehensive solutions to improve the health and quality of life for people with diabetes.
Intuity Medical’s POGO Automatic Blood Glucose Monitoring System is the only FDA-cleared automatic blood glucose monitoring system that lances and collects blood in just one step through its 10-test cartridge technology, ending the need to individually load lancets and test strips as required by other blood glucose meters. POGO Automatic delivers a simplified and discreet blood glucose testing experience that is less disruptive to the user’s everyday life.
i-SENS USA, located in Torrance, Calif., is a subsidiary of i-SENS, a South Korean manufacturer of blood glucose monitoring systems and 2.1-plus billion diabetes test strips per year.
In 2022, i-SENS launched the CareSens S Fit blood glucose monitor system, which is integrated with reliable NeuralSync sensing technology to deliver more accurate glucose readings. It has been serving customers in New Zealand and South Korea for more than a decade. Since 2012, the company has been the exclusive supplier of glucometers in New Zealand.
LifeScan, in Malvern, Pa., is a global leader in blood glucose monitoring and digital health technology. More than 20 million people and their caregivers around the world count on LifeScan’s OneTouch brand of glucose meters, test strips and lancing devices to manage their diabetes.
Used together, the OneTouch Verio Reflect or the OneTouch Verio Flex meter and the OneTouch Reveal app help manage a patient’s blood sugar. The newest OneTouch Solutions digital health subscription program integrates the product with premium wellness tools from Noom, Fitbit, Cecelia Health, Welldoc and more.
Medtronic, based in Northridge, Calif., cares about improving the lives of those within the diabetes community. “We’re passionate about our products that help people achieve their health goals, proud of our around-the-clock support and service and driven to innovate new diabetes solutions,” the company states.
Owen Mumford, in Marietta, Ga., is an industry leader in medical device design and manufacturing.
The company’s portfolio includes Unifine pen needles, Unilet lancets, Autolet lancing devices and Unistik safety lancets. Owen Mumford recently introduced a home-use pen needle, Unifine Ultra, which has innovative design features that help to enhance the injection experience and encourage patient compliance.
Simply Good Foods, a Denver-based company, makes the Atkins brand, rooted in the nutritional principles of reduced sugar and carbohydrates, with optimal protein and good fats.
Atkins offers nutritional bars; ready-to-drink shakes that contain calcium, vitamins and minerals; confectionary treats and snacks, including Atkins’ Iced Chai protein shake, which contains tea, vitamins, minerals, 15 g of protein, 5 g of fiber and 1 g of sugar per serving; and Atkins’ Nacho Cheese Protein Chips.
UltiMed, in Excelsior, Minn., has launched an exclusive product that combines 100 pen needles or insulin syringes with a sharps waste container and prepaid mail-back materials for proper disposal of sharps at a medical waste treatment facility. It’s available in all standard sizes for the same co-pay as pen needles or syringes alone. The 3-in-1 kit, which is compliant with California Senate Bill 212, can be purchased from AmerisourceBergen, Cardinal Health or McKesson.