PHARMACY

WAG unveils benefits 
of ‘Dimensions’ project

BY Jim Frederick

Pharmacists who intervene with diabetes patients are having a clear and positive impact on clinical outcomes, a new study from Walgreens found.


In a presentation last month, two Walgreens healthcare leaders unveiled the results of a groundbreaking pilot project on pharmacy-based diabetic care. Walgreens launched the project, called Dimensions, at its worksite pharmacies in 2008.


The two executives, Walgreens chief medical officer Cheryl Pegus and director of health outcomes and analytics Michael Taitel, unveiled the findings of the Dimensions pilot at the World Research Group’s Diabetes Prevention and Management Forum for Health Plans and Employers. The study, they said, established that diabetes patients who participated in a disease management program, leveraging face-to-face interactions with a pharmacist, demonstrated high levels of patient engagement — more than 90% — and significantly improved clinical outcomes.


“Chronic disease is arguably the most pressing area of concern for health care in the United States, and diabetes is one of the most difficult, and most costly, chronic conditions to manage,” Pegus said.


Dimensions centered on Walgreens working with employers at its worksite pharmacies. To that end, specially trained Walgreens pharmacists provided patients and employees diabetes education at the sites, including initial one-on-one consultations and monthly follow-ups.


The results of the program “showed significant patient improvement,” Walgreens reported, “as the percent of participants with combined HbA1C, blood pressure and cholesterol values at clinical guideline goals increased from 11.8% to 21.8%.” That marked an 85% improvement, Pegus noted.


Equally striking was the retention rate. At 18 months, more than 90% of patients stayed engaged in the program, according to Pegus and Taitel. Patients also had “exceptionally positive” reactions to the pharmacist interventions, the two execs said, reporting 100% overall satisfaction with the pilot.


The positive results of Dimensions led to the launch in four markets of the Walgreens Optimal Wellness program, which since has been expanded to five more markets as a self-care educational program for people with Type 2 diabetes.


In April 2010, Walgreens took the concept still further, partnering with UnitedHealth Group and the YMCA of the USA to launch the Diabetes Prevention and Control Alliance. Walgreens called that effort a comprehensive collaboration to treat and manage diabetes.

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PHARMACY

Retail pharmacy can rest easy with unequivocal AMP victory

BY Jim Frederick

ALEXANDRIA, Va. — It’s a battle that raged for more than three years. But in mid-December, the retail pharmacy industry was able to declare a clear, unequivocal victory.


We’re talking, of course, about the struggle to head off what would have been a devastating change in the way Medicaid pays community pharmacies to dispense generic drugs to low-income patients. On Dec. 14, the chain and independent pharmacy lobbies announced they had reached a landmark agreement with the 
Centers for Medicare and Medicaid Services that effectively ends the threat.


In short, the National Association of Chain Drug Stores and the National Community Pharmacists Association refer to the proposed changes as AMP, which stands for average manufacturer price. CMS had proposed AMP as a new method for calculating the market price of generics as a new basis for establishing the federal upper limit of reimbursements to pharmacies for dispensing those generics to Medicaid patients.


CMS unveiled the new reimbursement guidelines as a way to cut Medicaid costs in line with the Deficit Reduction Act of 2006. But pharmacy leaders have long argued that it’s a flawed approach to cost-saving by the government. AMP doesn’t reflect the true acquisition cost of the generic for retail pharmacies, they argued, since it takes into account the lower costs paid by other types of purchasing entities, such as hospitals and institutions. What’s more, the feds’ definition of a multiple-source drug itself was flawed, pharmacy 
advocates asserted.


Together with the low rate of markups CMS was proposing for generic Medicaid payments, the new AMP rule drastically would have cut pharmacy reimbursements and made it all but impossible to dispense medicines to low-income patients without incurring a loss, pharmacy leaders have long argued. To head off the change, NACDS and NCPA filed a suit in federal district court in 2007 to halt the new AMP guidelines from taking effect.


The resulting court-imposed injunction has kept AMP from taking effect, and it has saved chain and independent pharmacies an estimated total of $5.5 million a day ever since. Now that CMS finally agreed to withdraw its reimbursement plan and go back to the drawing board, NACDS and NCPA, along with their members, are breathing a sigh of relief. The fact that they’ve also agreed to drop the suit signals the end of a long — and ultimately victorious — battle for respect, and a decent return on their business.

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Travel clinics, immunizations take flight at Bartell Drugs

BY Alaric DeArment

SEATTLE — You can say Bartell is getting into the travel business.


Bartell, which had an estimated $353.4 million in sales in 2009, began operating travel clinics eight years ago and now has them at 10 of its 59 stores. They were the brainchild of pharmacists Jolene Kalmbach and Sharon Woodward, who got the idea after noticing that patients’ doctors often lacked necessary expertise in travel medicine and that commercial travel clinics were overbooked.


Customers can pay $50 for a consultation with the pharmacist and then pay individually for immunizations. In particular, Bartell’s clinics benefit from a provision in Washington state’s pharmacy regulations that gives pharmacists limited power to prescribe medicines and vaccines under special agreements with physicians.


“Seattle has emerged as a business-and-leisure travel hub to Asia, Latin America and Europe,” said Bartell Drugs clinical care coordinator Rachel Allen. “The international travel clinics have become a signature service that not only supports awareness of our overall vaccination program but [also supports] sales of travel-related items throughout the entire store.”

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