Patient care model a long, patient climb

Drug Store News, March 25, 2002

Is there a future in the business of pharmacy care? Walgreens pharmacy leaders think so, but they're not prepared to stake the company's future on it.

Instead, Walgreens is applying its "crawl, walk, run" approach to the development of a pharmacy care or disease state management business model. "We can never take our eye off the ball" of Walgreens' core pharmacy mission, which is "being able to be efficient, productive and fill a lot of prescriptions at a low cost," said Dennis O'Dell, vice president of health services,

That said, Walgreens is pressing ahead with efforts to establish patient-care activities--and to gain reimbursement for those efforts from health plan contractors, corporate plan sponsors and cash-paying patients themselves. The chain has opened roughly a dozen "community care centers" in Walgreens stores in Gainesville, Fla., Indianapolis and other test markets, and is developing a range of patient-care activities that can be delivered by some of its pharmacists and other staffers for a fee. But in most cases, the payment levels for those services--and the source of those payments--have yet to be determined, according to company sources.

Charged accordingly

"The one thing we have figured out is that it can't be free," O'Dell said in a recent interview. "We need to be able to demonstrate some of those [pharmacy care] values and look at the big picture, combining patients' medical information with their pharmacy information to show that pharmacy does make a large contribution to lowering overall health care costs."

Most patients, O'Dell told Drug Store News, "are willing to help support the economic valuation of face-to-face contact" with pharmacists--provided that Walgreens offers its pharmacists "the tools and the support" to provide disease management services.

That support will be strongest and offer the most chance for a successful disease management program if it comes from a whole coalition of health care partners, said O'Dell, including pharmacy schools, third party payers and drug manufacturers. Along those lines, the chain has advanced its pharmacy care concepts farthest in markets like Las Vegas--where the chain is working with local HMOs to provide preventive health services for women by its pharmacists--and in its community care centers, where it is slowly building recognition among payers for its management of patients with diabetes and other conditions.

Testing residency programs

Walgreens also is working increasingly with pharmacy schools to cosponsor jointly funded residency programs for post-graduate pharmacy students. In exchange for a practice site to meet residency requirements, those students provide the chain with a clinical-care resource within its community care centers.

In Gainesville, for instance, the chain's residency program was the first in the United States to gain full accreditation for its disease management efforts from the American Pharmaceutical Association and the American Society of Health-System Pharmacists, according to the University of Florida School of Pharmacy. The resident checks patients' blood pressure, cholesterol and blood glucose levels and provides those patients with counseling on diet, exercise and medications. Results of the tests are sent to patients' physicians.