Pharmacists: filling in
Attention continues to build among the traditional mainstays of adherence: physicians and pharmacists. Employers are becoming
much more engaged as well, willing to place a bet on care solutions that have shown success.
Increasingly, pharmacies are asking pharmacists to step out from behind the counter to assist in educating and engaging the
patient and collaborating more readily with physicians to ensure effective management of chronic conditions. As Sue Ewing,
senior vice president of business development and strategy at Walgreens highlights, "The opportunity for pharmacists to address
adherence lies in the fact that they see patients more due to their monthly need to refill medications, whereas a doctor may
only see patients three or four times a year."
Walgreens' Well Transitions program is one such opportunity. Here, a pharmacist consults a patient on disease-specific information
accompanied by advice on managing their drug regimens after they are discharged from the hospital. The pharmacists interface
with primary care providers to share information on the patient and to make sure the patient's current and new prescriptions
do not conflict. In assuring quality and effectiveness, Walgreens works with the patient to produce a monthly joint outcome
report. The overarching goal of the program is to reduce hospital admissions and to foster a sense of medical community where
the patient can feel a sense of familiarity and trust.
McKesson has also shown success with their Pharmacy Intervention Program (PIP), which uses motivational interviewing techniques
to provide patients with one-to-one coaching focused on addressing personal adherence barriers. The platform focuses on newly
diagnosed diabetes patients, using five minute, face-to-face interviews upon initial fill and additional follow-up sessions
for future refills. "The goal is to use any motivational barriers to adherence the patient might have to develop a personalized
plan for success," explains Stacy Irving, VP of strategic marketing at McKesson Patient Relationship Solutions. The program
relies heavily on training the pharmacist to ask the right questions and implement health behavior changes. Since its inception
in 2008, PIP has been implemented in over 3,000 pharmacies, both chain and traditional.
Payers embrace new platforms
Also recently, healthcare insurers have rolled out various co-pay reduction programs, mostly for medications for chronic conditions
such as diabetes, coronary artery disease, asthma, and hypertension. But payers have since looked beyond new value propositions
to get patients to stock up on their meds. Now they seek to reinforce adherence by analyzing the data they have for insight
and enlisting the help of mHealth companies to create interactive platforms to help subscribers to manage their overall health
and encourage them to actively take and refill their prescriptions.
United Health Care, in working with its Pharmacy Benefit Manager (PBM) subsidiary OptumRx, created a comprehensive online
dashboard to help enrollees manage their prescriptions, with a built-in SMS-based reminder system. Aetna is currently leveraging
data on prescriptions, conditions, and treatments from its 18.2 million subscribers to generate insights that keep patients
healthy and reduce their costs. Additionally, Aetna selected a team of companies that developed an array of health apps, including
FLOR'NCE's web and mobile-based reminder mHealth Coach, to be a part of its CarePass™ program. The platform allows for seamless
data-sharing across each app to create a versatile, user-friendly health management system.