An independent pharmacy-led pneumococcal immunization campaign led to an immediate and sustained increase in vaccine uptake, according to a poster presented virtually at the American Society of Health-System Pharmacists (ASHP) 2020 Midyear Clinical Meeting & Exhibition.

Tiana Tilli, PharmD, RPh, ACPR, director of pharmacy innovation and professional affairs at Whole Health Pharmacy Partners, discussed the results of the program, known as the “Did You Pneu” campaign, across independent community pharmacies in Canada, in a virtual presentation on December 6, 2020.

“Although the scope of practice of Ontario pharmacists has expanded to include pneumococcal vaccines, little research exists of pharmacy-led immunization programs,” Tilli said in the presentation.

The Public Health Agency of Canada’s National Advisory Committee on Immunizations recommends adults 65 years and older receive pneumococcal conjugate vaccine followed by the pneumococcal polysaccharide vaccine. Canada’s vaccination coverage goal is to reach 80% immunization coverage; however, uptake of at least 1 dose is only 58% in this targeted population, according to Tilli.

Pharmacists practicing in Ontario, Canada, received the authority to administer pneumococcal vaccines in December 2016. Two years later, the “Did You Pneu” campaign was developed with the intention to address barriers to vaccination uptake, including lack of awareness of pneumococcal disease and lack of strong recommendations by health care providers.

“The ‘Did You Pneu’ adult immunization campaign aimed to address these barriers by providing community pharmacy teams with the necessary education and tools to increase pneumococcal vaccine uptake,” Tilli said in her presentation of the results.

The first month-long campaign was introduced in November 2018.

Pharmacist education materials (adult immunization webinar, immunization manual)

In-pharmacy marketing materials (posters, countertop displays, staff buttons, prescription bag attachments, pamphlets)

Pharmacy operational supports (prescriber recommendation templates)

Following the launch of the first campaign, pharmacists collected feedback via telephone interviews to inform updates to the program to be rolled out in the second month-long campaign in November 2019.

Re-focusing the webinar to be on pneumococcal disease specifically

Developing social media marketing materials

Enhancing operational supports to include a section for patient self-screening for pneumococcal immunization in the banner’s influenza vaccine consent form and developing pneumococcal vaccine counseling guides.

According to Tilli, the investigators then performed a retrospective observational analysis that looked at pneumococcal vaccine purchase data from a convenience sample of 10 pharmacies from January 2017, before campaign implementation, to December 2019, after 2 campaigns had been held.

Overall, pneumococcal vaccine purchases increased by 23% during the first campaign and another 213% during the second campaign. Sustained vaccine uptake was observed in subsequent months as well, with a 47% increase in the mean number of pneumococcal vaccines purchased per month by the pharmacy banner. Tilli suggested that campaigns should be repeated over several years to further increase uptake.

“This suggests that pharmacists have a role in promoting pneumococcal immunization and can contribute toward reaching Canada’s pneumococcal vaccination coverage goal,” Tilli concluded.

She noted that barriers of the campaign included vaccine cost and out-of-pocket costs for some patients, as well as campaign materials not reaching the entire pharmacy team.

Given the success of the program, Tilli indicated that the next steps include developing adult immunization campaigns for additional vaccine preventable disease, such as herpes zoster and meningitis.

1. Tilli T, Faggioni M, Wong R. “Did You Pneu?”: Impact of an Adult Immunization Campaign across Independent Community Pharmacies. Poster presented at: ASHP Midyear 2020 Clinical Meeting & Exhibition; December 6, 2020. Virtual. Accessed December 6, 2020. 

https://www.eventscribe.net/2020/midyearposters/posteragenda.asp?m=nobucket&pfp=Schedule

Articles

ASHP

A poster presented at the ASHP 2020 Midyear Clinical Meeting & Exhibition highlighted the success of an in-pharmacy pneumococcal immunization campaign. 

Independent Pharmacy-Led Pneumococcal Immunization Campaign Improves Vaccine Uptake

AmerisourceBergen has reached an agreement with the U.S. Centers for Disease Control and Prevention (CDC) to include 

 and Elevate Provider Network members in the Federal Pharmacy Partnership Strategy for COVID-19 Vaccination.

To support access, AmerisourceBergen will serve as a network administrator and place orders with the CDC on behalf of qualified and eligible 

 and Elevate Provider Network members. AmerisourceBergen will receive a direct allocation of COVID-19 vaccine for independent retail pharmacy customers once there is adequate supply of COVID-19 vaccine to support broader inoculation efforts and vaccination is recommended for individuals beyond the initial critical populations. COVID-19 vaccine will be distributed by the CDC’s central distributor.

“Independent community pharmacies have been fearless and have risen to every challenge that COVID-19 has presented this past year. Independent pharmacies are critical sites of care in their communities year-round and many Americans turn to their local pharmacy for a variety of immunizations annually,” said Brian Nightengale, President of 

. “We are beyond proud to help our independent pharmacies gain access to COVID-19 vaccine. They are already poised to join this next phase in the fight against the coronavirus and continue to support their communities.”

This effort will help jurisdictions augment access to COVID-19 vaccine when supply increases. With more than 90 percent of people living within 5 miles of a community pharmacy, pharmacies have unique reach and ability to provide access to COVID-19 vaccine and support broad vaccination efforts. This program will provide critical vaccination services for the U.S. population, with vaccine administered at community pharmacy locations at no cost to recipients. The program will be implemented in close coordination with jurisdictions to enable optimal COVID-19 vaccination coverage and vaccine access nationwide.

 is AmerisourceBergen’s independent community pharmacy network. As part of the network, thousands of independent community pharmacies across the nation leverage the unsurpassed industry knowledge of AmerisourceBergen business coaches, sales executives along with data and actionable insights to optimize their practice. Core programming within 

 focuses on augmenting an independent pharmacies’ in-store experiencing, marketing, managed care contracting and overall business performance. Elevate Provider Network is AmerisourceBergen’s pharmacy services administrative organization (PSAO). As a PSAO, Elevate Provider Network negotiates the most effective payer contracts for pharmacy members, helping them improve operational effectiveness and enhance patient care. The Good Neighbor Pharmacy Network, which includes Elevate, represents more than 4,100 independent community pharmacies nationwide.

 and Elevate Provider Network, please visit: 

https://www.amerisourcebergen.com/solutions-pharmacies/independent-pharmacies

ThoughtSpot

AmerisourceBergen has reached an agreement with the U.S. Centers for Disease Control and Prevention (CDC) to include Good Neighbor Pharmacy and Elevate Provider Network members in the Federal Pharmacy Partnership Strategy for COVID-19 Vaccination. 

AmerisourceBergen Reaches Agreement with CDC to Support Independent Retail Pharmacies’ Access to COVID-19 Vaccine

The upcoming webinar event “Get to Know Good Neighbor Pharmacy & the Four Core Values” will help independent pharmacies optimize their business and secure their position as a vital source of care in the community. 

The event, which will be held on Tuesday, November 17, will provide actionable insights to help independent pharmacists strengthen their defining attributes by enhancing their current practices. Brought to you by AmerisourceBergen and 

 (GNP), the webinar will equip independent pharmacies with the information they need to improve their performance, develop deeper patient relationships, and secure their legacy within their communities.

Jennifer Zilka, group vice president of GNP’s Field Programs and Services, will introduce viewers to the GNP network and discuss the 4 core value centers pharmacies should focus on:

 Leave a positive impression on every person who walks through your door by using proven tools and expert guidance to deliver the kind of experience your patients are craving.

: Attract more patients and build loyalty by executing proven marketing strategies that showcase your unique brand and extend your reach within your community.

 Maximize profit margin and minimize profit leakage with solutions that combine analytics, technology, and professional services to ensure you get the reimbursement you deserve.

 Perfect how your pharmacy operates with the help of a dedicated business coach who will combine deep industry knowledge with data-driven insight to improve your profitability.

The program aims to provide support where it’s needed most and help pharmacies simplify business operations, amplify brand and identity, and protect their independence.

Independent pharmacists should tune in to this webinar event to learn how Good Neighbor Pharmacy's 4 core value centers can help them optimize their business. 

Get to Know Good Neighbor Pharmacy and the 4 Core Values

®. Welcome back to our ThoughtSpot 2020 series in partnership with 

In this episode, we're welcoming guest host Brian Nightengale, president of GNP, who will be joined by Rich Tremonte, executive vice president and president of community and specialty pharmacy at AmerisourceBergen, as well as Doug Hoey, chief executive officer of the National Community Pharmacists Association (NCPA).

Brian, Rich, and Doug will be discussing the biggest opportunities and headwinds facing independent pharmacies in 2021. Thanks for listening.

 Hello everyone and thank you for tuning in to our ThoughtSpot 2020 podcast in partnership with 

®. I'm Brian Nightengale, president of GNP, and I'm joined today by Rich Tremonte, executive vice president and president of community and specialty pharmacy at AmerisourceBergen, and Doug Hoey, chief executive officer of NCPA. Thank you both for being here today. Really appreciate you joining.

 You're welcome, Brian. Pleasure to be here.

 There’s a lot going on for sure. Today, we're going to be discussing the year ahead, 2021, and some of the biggest opportunities and headwinds facing independent pharmacies.

It's hard to believe that 2020 is almost over, but I think we're all probably relieved to be able to say that. We'll talk about how the industry is working to help independents address some of these challenges, and certainly take advantage of opportunities that lie ahead and continue providing accessible care to patients across the country.

So we’re really looking forward to the conversation. Doug, I think I'll start with you. When you think about entering into 2021, what are some of the primary issues or headwinds that that you and the team at NCPA are planning for?

 Yeah, Brian, well, first of all, thanks to GNP and ABC for the opportunity to talk with you today. But yeah, 2020 has made a huge mess for the world and for pharmacy, so there's going to be a lot of cleanup going on in 2021.

Some of those issues that NCPA has been focused on is changing the pharmacy payment model. And when we say that, we are talking about the prescription reimbursement, but we're talking well beyond that as well. We're talking about the payment system that's confusing, it's complex. And it's very covert for patients as well as for pharmacy.

So we'll be focused on pharmacy DIRs, those continue to ravage independent pharmacies, and close not only independents, but also chain pharmacies, so pharmacy DIRs will be a primary focus.

Reform to Medicaid managed care, because we're seeing that a lot of states are not getting a good deal with their PBMs, and so those dollars could be better spent by the state to barely pay the pharmacy and do other things with those dollars: repair some roads, build some bridges, fight a pandemic. Those are 2 of the headwind issues.

The list could go on Brian, but the third one I'll mention is the administration of the [COVID-19] vaccine. We believe or I believe that some of that will begin in this year, but the widespread administration of the vaccine will largely take place, I believe, in 2021.

And the role of pharmacists in the administration of that vaccine is crucial. We've said many times to the CDC, and to the Health and Health and Human Services (HHS), that if independent pharmacists are not playing a central figure, a central role, in the administration of the vaccine, then the rollout will not be successful. Adversely it will be successful if independents are playing that central role. I'll pause there, Brian. There's plenty to do in 2021.

 Yeah, that's for sure. And we'll talk a little bit more about vaccination and COVID-19 in a minute as well, spend a little bit more time on that. But Rich, from your perspective, anything to add?

 Thank you, Brian. And through our membership with NCPA and other associations, ABC, we continue to collaborate with the pharmacy community on key legislative issues, so I just wanted to acknowledge that partnership and thank Doug for that collaboration.

Very similar and aligned with many of the things Doug mentioned, as we look into 2021 DIR fees are the top of my list and that was something we see firsthand, Brian, as you know, through our business coaches and through our relationships with our customers. It's a struggle, it's a struggle, because it's unpredictable. And it's very covert.

As Doug said, provider status is something else that Doug mentioned. This is something we fight for every day. But we need to have these pharmacies recognized under Medicare Part B, especially during a pandemic, and all that they're doing. And frankly, they're being looked upon to be the front line and be the number 1 place to go for our entire community, our entire population, so that's something I'm hoping that through this pandemic, we can continue to push.

And then overall, I mean, I think it gets lost on folks, every day, our pharmacies are getting reimbursed underwater for products, and sometimes that could be 2 dollars, and sometimes that could be hundreds or even thousands of dollars. And they're being put in a position where they may have to send a patient away, because the reimbursement is just putting the pharmacy out of business. So that continuity of care for that patient is really being jeopardized through reimbursement. So really looking forward to making strides in all these different areas of reimbursement moving forward.

 Yeah, take the DIR situation, for example, and kind of drive that home a little bit. We heard from 1 of our member pharmacies last year, when they got a retroactive DIR fee, and that particular fee for that particular quarter was more than that pharmacy’s entire payroll for a month. That's the kind of impact these things have in terms of not knowing when they're going to hit and not knowing how much they're going to be. And all of a sudden, it's the equivalent of payroll for a month or more. It's real problem that has to be addressed sooner rather than later for sure.

Let's talk about really a very historic argument that's being considered right now in the Supreme Court, that Rutledge v. Pharmaceutical Care Management Association (PCMA) that was heard on October 6. And Doug, I know that NCPA hosted a prehearing and post hearing update, which hopefully is still available on your YouTube site, because it was really insightful.

I have to say that when I listened to it, at first, I was listening to the hearing, and I was a little bit discouraged until the experts got on and said how well it went. I'd love to hear your perspective on that and how you think it went and, what it means for pharmacy.

 Yeah, the Rutledge v. PCMA case. I mean, when we look back at the history of pharmacy, and this may sound hyperbolic, but when we look back at the history of pharmacy, the Rutledge v. PCMA will be in the annals of the pharmacy history books, hopefully coming out the right way, which the right way from NCPA's perspective, and I think for most of pharmacy’s perspective, just very few exceptions—the magic word that we're all looking for is the word “reversal.”

What the Supreme Court case would do would be to reverse the lower court's rulings that said that states did not have the authority to regulate PBMs. And the Supreme Court case, if it reverses the lower courts, it would allow states the ability to have more oversight of PBMs, which largely they go unregulated right now.

I really picked up on, as far as the hearing itself, it's just hard to gauge. I mean, it was back and forth. There were times when I was really excited about the line of questioning from the justices, and then a few times I thought, “Oh, that's trouble.” I thought that the Nick Bronni, the Solicitor General from the state of Arkansas, did a great job. Also arguing with the state of Arkansas was the United States government. One of the assistant Solicitor Generals of United States, Fred Lewis, also argued in favor of the Arkansas state of Arkansas supposition and I thought he was superb.

Editor’s note: This podcast episode was recorded prior to Associate Justice Amy Coney Barrett’s swearing in to the Supreme Court on October 27, 2020.

But we won't find out how the justices weigh in on this until probably almost certainly next year. They have to rule by June 30, because that's when the session ends. Adding even more complication to it is that there are only 8 justices, at least for the moment, although a ninth one is very likely, very soon, but that ninth justice won't have heard the case, so they'll have to decide, if there's a tie, if they have to rehear the case. That could complicate things.

One way or the other, we'll find out. We'll get an answer. We’ll get some clarity whichever way the justices rule. And 1 of the things we know with that clarity is that the PBMs are arguing that, “Hey, states can't regulate me because I'm a health plan.” Well, if you're a health plan, then you have a fiduciary responsibility to your clients. And PBMs have argued forever that, “Oh, no, no, no, we don't have a fiduciary responsibility.” So 1 way or the other, either as a fiduciary responsibility or more regulation from the state, there's going to be additional clarity from the Supreme Court case. So we're optimistic and like everyone, excited and waiting with bated breath to hear how the justices rule.

 Yeah, that's the case for sure. Rich, what are your thoughts?

 I won't predict the president here, either. But I will tell you, this is something that I think we all agreed that with Doug, this is a landmark case. And at the end of the day, the only thing I can add is as ABC, we really want this to head in the place of transparency. That's what this is all about.

We know that there's bipartisan agreement, that this is something that needs to be addressed. We continue to look at the lack of oversight, having just real repercussions for small business, and this Supreme Court case, we're all hoping and praying will really be able to launch us to where we've been trying to go forever. We've, through various initiatives within our business, Brian, as you know, have tried to push for independent pharmacy to make sure that they're treated fairly, and we do the best we can.

But this is this is something that could transformational and put us in another level. We're all looking forward to this. And it will be interesting, and hopefully it will come before June. But I know we'll stay on top of it.

 Just to add to what Rich said, you talked about things for 2021. And whichever candidate wins the White House is likely to be a sprint in 2021 and 2022. Because if President Trump wins, he'll be termed out after 4 years, so he has 4 years left. If Vice President Biden wins, a lot of people speculate, because he’ll be 78 years old when he takes the office, if he should win, that he may only be in for 1 term in speculation. But there's a lot of signs that there will be a lot of push those first couple of years for things like drug pricing reform, which affects pharmacy DIR, and which also the Supreme Court case ruling will have a bearing on. 2021 and 2022 are in particularly key years for pharmacy because of all of these different variables lining up.

 Yeah, I totally agree. Totally agree. And before we jump fully into 2021, Rich, as you reflect upon this last year 2020, certainly pharmacies have been on the front lines of fighting the pandemic, what are you most proud of? What have you seen with our customer base that really just makes you proud to be able to support them?

 Yeah, I think we talked about it a little bit earlier, Brian. We couldn't be proud of our customers or our manufacturers and you think about what we do is connecting our manufacturers to our customers.

A great example is the federal government looking to us to work directly with the care in the community to make sure we get product to where it needs to be. And We Are GNP, I talk about it all the time. But just like there's great resources on NCPAs website, there's great resources on We Are GNP’s website. We talk about Fearless Pharmacy and we have so many great examples, inspiring stories on Fearless Pharmacy that you can go and check out and it ranges everywhere from compounding hand sanitizer, to helping get lunch to people who are out there on the front lines every day.

We really are proud of how agile – so our pharmacists never had a chance to stay home, right? They had to go to that pharmacy every day. And they found ways to service their patients, whether that was sending them through the drive thru or delivering more than they ever had to in the past.

We’ve been able to get closer to our customers, which sounds almost crazy during this time, but we were able to get closer to our customers and maybe not be there physically, but we've communicated with them more than ever. We've had over 10 town halls over the past 6 months. And we've seen how they've worked with their patients, and it's just been amazing.

From the ABC side, all the investment we've made over the years to make sure that our network is resilient, and there's over 800 million dollars invested over the past 10 years. And I always talk about our Olive Branch, Mississippi facility having to be shut down for a week because there was an associate that came down with COVID.

In the past, those pharmacies that were serviced out of that Olive Branch, Mississippi facility would not have gotten product. 

Because of all the work we've done over the years, we were able to transition those lines to other DCs literally overnight, and that's just 1 of the examples to see how we were able to help and how our manufacturers were able to help get care into the communities

 and no one does it better than independent pharmacy. And we see that every year with JD Power, and obviously, GNP, just doing a great job servicing those patients and always doing really well in the JD Power scores.

 Yeah, thanks, Rich. And Doug, you mentioned earlier about 2021, being the cleanup of the mess that’s been 2020. When you reflect on 2020, what good has come out of it for independent pharmacy?

There's a saying that was popularized by Rahm Emanuel, who was the chief of staff for Obama. And he said, “Never let a good crisis go to waste.”

And I feel a little hesitant to use that phrase during a pandemic, because no one wants to take advantage of the negative things that have happened this year, but it has opened doors and as Rich had said, pharmacies have really shown what they can do, how creative they are.

And by the way, the actual person who said that phrase was a guy named Dr. Myron Weiner, who was talking in Medical Economics. He's the 1 who actually coined that phrase, “don't let a crisis go to waste.”

And we've seen the creativity from pharmacies, we've seen the point-of-care testing. We've seen pharmacists being authorized to order and administer tests, and now vaccines, including childhood vaccines. It's an enormous opportunity to accelerate what's already happening in community pharmacy.

And when we talk about changing the pharmacy payment model, as I mentioned, it is about part of it is about getting paid fairly for the product, but another enormous part of it is getting paid for the services that pharmacies provide. And because in March and April and May, a lot of primary care offices, physician offices, were closed because of the pandemic. And once again, pharmacies stepped forward to fill the gap in many situations.

There are, through point-of-care testing, through the vaccine administration, through really just relying on pharmacies and pharmacists to be able to help manage chronic conditions. And I think as a country, we're figuring out that we may have to do health care differently. And so being able to manage those conditions.

And related, and I just want to make sure I mentioned, and Rich touched on this. But a real shout out to GNP and ABC and the whole supply chain, to help pharmacies while we're on the front line. We're on the front line, but I didn't hear any complaints from members, I'm sure they existed, but I didn't hear them as far as not getting orders, or not being supported. Not only during the pandemic, but during the hurricanes and the fires that have taken place this year as well, so pretty amazing job for ABC, GNP, and the whole distribution channel to make sure we have the products we need to be able to serve patients, so shout out there.

 Yeah, thanks, Doug. And I think another positive that has come out of this is our ability to educate people on the ability for pharmacists to do more, whether we're talking to the CDC, I know NCPA has been been in direct communication, as have we, around access to vaccines when they're available, and ensuring that independent pharmacies are at the forefront in being able to vaccinate. It is amazing how we've been able to educate policymakers and members of the administration and elsewhere around all that pharmacy can do and hopefully that will stick around and last long.

So I'll stick with you on that theme, Doug, in terms of the future and building upon that momentum. Anything to share in terms of the discussion around being compensated for services and the community pharmacy enhanced services network? There seems to be a lot of momentum there and growth, and what's your outlook there and any updates to share on where this will go and how close can we get to changing that that payment model?

Yeah, it's a great question. It's a great point, Brian, that the awareness surrounding people in general about pharmacists, and the role of pharmacists has really been magnified. It wasn't that long ago that you didn't hear pharmacists even on just a commercial. Now you hear commercials for vaccines and it says, “Talk to your pharmacist or doctor.” And that's a fairly recent evolution. CPESN, which is the Community Pharmacy Enhanced Service Network, as you mentioned, it has over 2600 pharmacies and growing and the pandemic has helped payers, employers, realize that they need pharmacists. It's just reemphasized the importance of pharmacists that can help control chronic conditions or help manage chronic conditions.

It's also helped with employers who are looking for testing. And there's several opportunities for testing networks with CPESN. The ability for a payer, an employer, a plan sponsor to sign up a network of pharmacies to provide services is increasingly important. Having that single signature. That's 1 of the challenges, Brian for independents, is that - and we're seeing it with the vaccine, where government can suddenly do have one signature and get 10,000 pharmacies. And that's the easy button for them. So that's a real challenge for independents is how do we make it easy to work with independence? Whether that's CPESN, or Elevate or other networks, how to make it easy to work with independents? That's going to be 1 of the most important things for independents in the future, for our future survival and success, because if we can't make it easy, the chains have a definite competitive advantage.

 That's great. And Rich, I know where we're coming up on end of our time here. But when we talk about enablement and clinical services, I know you and I have talked about this a lot, and you've supported our strategy here very strongly. What are your thoughts around how we're supporting independent pharmacies and expanding their ability to provide services?

 I think it's a lot of bringing all the strategy into execution and our business coaches every day in the pharmacies, as you know, Brian. Whether it's helping them through the attainment of a CLIA waiver, everything they need to do to make sure that they're taking the right steps to get into areas where they maybe are not comfortable or just haven't had experience in in the past.

And we do that in many different ways. But if we stick to the theme of vaccines, I think it's very important and just timely, as well as many other things that can be done in the pharmacy or a pharmacy in general. We know there's thousands of pharmacies today that are already performing CLIA waived test. And the flu test is obviously the easiest example. I go to a pharmacy to get my flu vaccine every, every year. We know, over the past 3 years, that it's up over 20% through data. So, long and short, people are very custom comfortable and want to go to a pharmacy to get their vaccines.

This is something I think flu has proven; it can be done, and can be done really well and can be done affordably. I'm really, really hopeful that one of the key things coming out of this pandemic, and regardless of who wins the presidency, or what direction we go in, is that pharmacy and independent pharmacy specifically, is the best place right now to go to get care for many, many things. And that's something that we stand behind.

 Yeah, thanks, Richard. And I'll just add 1 piece as well. There's a newly launched program that NCPA and the Innovation Center, and CPESN have launched this year, and that's the community pharmacy fellowship. And, Doug, we're certainly honored to be able to sponsor that for the Innovation Center and CPESN. And really looking forward to see what comes out of that. In terms of a 12-month training program to really help practicing pharmacists make that transition to a much more of a clinical services model. And we really do look forward to working with CPESN USA and the NCPA Innovation Center to see how that goes. And I'm really excited about that. If there's anything you want to share on that, but we're excited to see what happens with that.

 I do I'm super excited by that. I mean I I'll be honest with you, I’d like to say that was my brilliant idea and I thought of that, but that was not true. And actually, my team didn't have to twist my arm, but they had to tell me more about this fellowship program and how it's going to work. And will people really sign up?

As a matter of fact, almost 30 people signed up the first year. That was twice what we expected, and we think that's going to continue to grow. And this fellowship program, like you said, Brian, it's for practicing pharmacists. It's not a residency, which residencies are great, this is not to replace them at all.

But it's for practicing pharmacists who are in the pharmacy. Most of these pharmacists are going to stay in the pharmacy, and the skills that they've learned, the exposure that they have to some of the brightest minds in the industry, they're going to take back to their practice.

I practiced for about 5 years before I came to NCPA. And I think if I could go back in time and a fellowship program like this was available, my mouth would be watering. It would be ideal for someone who wants to be able to accelerate their practice. And so we really appreciate GNP’s support of this. And I've gone from somewhat skeptical to 1 of the biggest cheerleaders for the fellowship program.

 Yeah. And you tie that with reimbursement reform. I mean, you only get 1 swing at the bat in this case. Certainly, with changes that may happen with the Supreme Court ruling, the momentum that we're making with payers, our pharmacies need to be ready when there is that ability to provide care and get paid fairly for it.

We need thousands of independent pharmacies ready to go ready to jump in and ready to prove that we are key players in the health care ecosystem and that we are not a cost of the ecosystem. We are a benefit and a driver of savings to health care within the United States because of that high touch, white glove treatment that our independent pharmacies are able to provide. They have the time to care for those patients, they have the commitment, and certainly they have the support of companies large and small and industry partners like NCPA and certainly Good Neighbor Pharmacy.

We covered a lot of ground today. There's certainly a lot more to do and I love the way you mentioned it Doug, 2021 will be the cleanup of the mess that was 2020. And we are excited to continue working on that cleanup with NCPA. And Rich, thank you for your support of independent community pharmacy as well. And hopefully we can continue this conversation, perhaps after the June time frame with the Supreme Court.

Podcasts

Guest host Brian Nightengale, president of Good Neighbor Pharmacy, is joined by Rich Tremonte and Doug Hoey to discuss the biggest opportunities and headwinds facing independent pharmacies in 2021.

ThoughtSpot 2020 Series: 2021 Opportunities and Headwinds Facing Pharmacy

Zilka: Hi, I'm Jenni Zilka with AmerisourceBergen. I'm the senior vice president for Good Neighbor Pharmacy (GNP) Programs & Solutions.

Digital marketing provides a vehicle to reach patients that's timely, it's cost effective, it's very inexpensive, and you can really target your patients and your community surrounding the pharmacy.

Tip 1: Develop your content marketing strategy

If you're an independent, I think step 1 is to develop your content marketing strategy.

The first thing you need to do is think about what content you want to promote and make sure that you reach your patients with it. 

It also really showcases the pharmacist and the staff as medical experts, which we all know our pharmacies are - they play such a critical role in the care of their community - that helps build a loyal following. Your patients and consumers will check back with you to learn more and to find out more about what's happening with the pharmacy. And it really encourages engagement.

Whether it's a blog, or a YouTube video, or Facebook Live, which I know are all very uncomfortable spaces to be in. It's a wonderful way for you to get out there and really engage with your patients, especially when they're at home and they're on their devices and were quarantined and spending more time at home and not in the pharmacy. Develop that strategy and make sure you're showcasing all of the wonderful care that you provide.

Secondly, consider Google. Whether we like it or not, Google is still the number 1 reigning website.

Through Google, you can really serve up relevant info right at your patients’ fingertips, which is amazing because they're searching for you and searching for that information. And as a pharmacy owner, you can do that. You can be super targeted, it's low cost, and you can use really hyper-specific words.

If a patient is looking for delivery or home medical equipment or things like that, you can really target in and help that patient find you and learn about the services that you as a community pharmacy provide.

And then thirdly, engage with social media. You can update your communities so quickly on anything that's changing within the pharmacy.

As you think about COVID and everything that had to change so quickly from a workflow perspective, our pharmacies were able to very quickly alert their patient base and their communities that were doing drive thru, were offering delivery, here's what you do, when you pull up to the curb, all of that information that they were able to provide very timely to a very sizable audience.

And I think consumers - the stats are out there, and I'm probably guilty of some of these. But we're spending 3 hours per day on our phones. And of those 3 hours, 2 hours are typically spent on social media. It's really important that our pharmacy owners meet their patients where they're at, which is on their phone.

Expert Interviews

Jenni Zilka, senior vice president of Good Neighbor Pharmacy Programs & Solutions, AmerisourceBergen, offers 3 tips for independent pharmacies looking to improve their digital marketing strategies.

Three Digital Marketing Considerations for Independent Community Pharmacies

 Three key takeaways that are really important for independent pharmacies to keep in mind:

Number 1, more Medicare patients than ever before are turning to digital marketing channels such as Google and social media to find information about local businesses and stay connected to their friends and family.

The second most important key takeaway for independents to remember is that their strategies may look different this year than they have in the past. It's important for independents to modify their communication strategies based on any modified services that they may be offering, such as curbside pickup or pharmacy delivery.

The third key takeaway to remember is that print marketing still has a role to play. Even in a digital world where people are connecting online, there are still touch points, such as handing off a prescription and including a bag stuffer, or in-store signage that make a big difference when communicating with your patient.

Jordan Cupo, web and media specialist at Good Neighbor Pharmacy, AmerisourceBergen, offers 3 key takeaways for connecting with patients in the pharmacy amid COVID-19 and Medicare Part D open enrollment.

Three Key Takeaways for Connecting with Patients During Medicare Part D Enrollment

®. I'm Gabrielle Ientile, and welcome to our ThoughtSpot 2020 podcast series.

As part of our partnership with Good Neighbor Pharmacy (GNP) and AmerisourceBergen, we're welcoming guest host Susan Lorenz-Fisher, vice president of Corporate Citizenship at AmerisourceBergen, who will be interviewing Gina Clark, president of the AmerisourceBergen Foundation, and Nicolette Louissaint, executive director and president of Healthcare Ready, on the topic of supporting marginalized communities amid the coronavirus disease 2019 (COVID-19) and natural disasters.

We hope you enjoy this special edition of 

Hi, everyone, I'm Susan Lorenz-Fisher. I'm the vice president of Corporate Citizenship at AmerisourceBergen and the program officer for the AmerisourceBergen Foundation.

I'm very excited to be hosting our 2020 ThoughtSpot podcast today with a couple of my colleagues, both from AmerisourceBergen and the AmerisourceBergen Foundation, Gina Clark, who's our president, and Nicolette Louissaint, who is the president and executive director of 

, which is 1 of our main nonprofit partners.

We're going to talk a little bit today about what's happening with the pandemic, how we're responding to natural disasters, as well as healthcare disparities. I'm excited to dive right in and see what we can learn from each other.

Thanks for joining us today, Gina and Nicolette. Why don't you start by sharing a little bit about yourself? Gina, can you provide a little bit of your background?

Clark: Sure. Thanks so much, Susan, and very, very happy to be sharing this podcast time with Nicolette, a great partner and friend.

I have been in healthcare for my entire career, which is about 35 years now. I've been at AmerisourceBergen for almost 15 years, it will be 15 in January. I also am very proud to represent our foundation. AmerisourceBergen created its independent foundation about 5 years ago, and I took responsibility for about 4 years ago. And we are very committed, as is AmerisourceBergen Corporation, to creating healthier features, so I'm very proud to lead this foundation.

Susan is our program officer and does an amazing job with a small but mighty team. And we have a terrific board of directors, both external and internal, who helped us make good decisions. So it’s a pleasure to be here with you, Susan and Nicolette.

Louissaint: Thank you, and so great to be with you both. My name is Nicolette Louissaint. I guess I can both introduce myself and the organization. I've been in various parts of science and healthcare for my entire career. I'm really transitioning as a clinical scientist biomedical researcher into health policy, and then really the disaster preparedness and response world a number of years ago. My background is really as a clinical pharmacologist and I have long been interested in infectious diseases, so really starting my career around HIV prevention, moving into other infectious diseases, and lately responding to pandemics as a part of Healthcare Ready.

I’m very proud to serve as the executive director of Healthcare Ready, which next year will be 15 years old. It was created really as an informal coalition that became a nonprofit organization after Hurricane Katrina, recognizing that there needed to be better coordination across the supply chain and with the public sector during disasters. Specifically, recognizing that the issues of healthcare access, continued access to medicines, and continuity of care for individuals most impacted by disasters, needed a dedicated and focused approach.

And so that's what we do, that's where we serve, and very proud to continue to respond to disasters. I think we're now around 200 disaster responses over that 15-year time period.

Lorenz-Fisher. Thanks so much, Nicolette. Well, why don't we dive right in? So Nicolette, I'll pitch this first question over to you.

I will never forget last year's ThoughtSpot conference back in 2019. You were presenting to a team of AmerisourceBergen associates, and you mentioned that the world was due for a pandemic. I remember thinking, “wow, that's, that's interesting. I hadn't thought about that before.” And now here we are, living through month 6 or 7 now of COVID-19. What kind of brought you to saying that, and feeling like we were due, and if you could offer some perspectives there?

Louissaint: Sure. We tend to see small-scale disease outbreaks that have pandemic potential about every 5 to 10 years, and we've had some what we would consider near misses in the way of H1N1 really being widespread, but really a less virulent virus than it could have been. We had MERS-CoV, which was I think the last large-scale coronavirus, the Middle East Respiratory Syndrome, but again was contained. We had the Ebola outbreak, that had the potential to be a catastrophic outbreak, but was able to be contained largely in West Africa.

When you look at all of those things from my lens, and also think about the fact that the climate is changing. When we're thinking about climate change, and what it means for the environment, we often forget that it also changes biodiversity, or just the bacteria that may be accessible, bacteria that we might not have previously been exposed to and may not have immunity towards.

From my lens, just thinking about the convergence of all of those factors. I just thought it was time that we that we would see a pandemic.

Lorenz-Fisher: So we'll pivot over to Gina. As president of the foundation, how has the foundation strengthened its giving and partnership practices to support the needs of communities during this terrible pandemic?

Clark: Well, first very important lesson we've learned is always listen to Nicolette, because she tried to get us all ready ahead of time, so I will always always listen to Nicolette.

The other things that we have learned really is that we do have to pivot quickly. We were very, very deep in terms of our foundation support, really in supporting communities around the opioid crisis, both with deterrent and with treatment, and with a number of other initiatives around that, and we are still doing that.

But we did pivot a lot of our services and funding over to meet the pressing needs of these communities during COVID. We do believe that philanthropic organizations have a responsibility and have a unique opportunity to address these global health emergencies. And I think that by their very nature, by their definition, they do that very collaboratively.

And we choose our partners, such as Healthcare Ready, and others because of their desire and willingness and expertise that collaborating for solutions. So with Healthcare, Ready, Direct Relief has been a major partner for us. And they've allocated emergency support to us and community centers: these serve those most vulnerable populations. They've also shipped that all important protective gear to health care organizations all over the world.

Americares is an important partner of ours and Americares is really focusing right now on a lot of the mental health needs. But just broadly mental health needs, which have, I think, always been underserved. Part of my career was in serving in that community, and I believe it continues to be underserved. And then they are specifically providing webinars for trained professionals who were treating COVID patients. They have their own specific and very challenging mental health issues, the families caring for them do. I'm very proud of the work that America is doing really in addressing those mental health needs. And then they too, are also providing PPE and protective equipment for frontline workers really all over the world everywhere from right up the coast in Connecticut to all the way over to Colombia, El Salvador and other places, so there’s a broad amount of support coming from them.

And I would just add that from the AmerisourceBergen perspective, really making sure that our associates understand the work that our nonprofit partners are doing is something that's just really, really important to us as a foundation and broader corporation. So we’re excited to have opportunities like this and some that Gina mentioned, to make sure that our associate population really understands the on-the-ground work that our partners are out there doing.

So with that, we'll turn over to Nicolette and start talking a little bit more about health care disparities. Over the past 6 months, as we highlighted during this year’s ThoughtSpot, pharmacies play a critical role in providing access to care to underserved communities.

Nicolette, would you mind talking us through how you think we can go about supporting the role of pharmacists and addressing healthcare disparities?

Louissaint: Absolutely. Pharmacies have been, for many years, a very important part of our disaster response coordination.

When we look at most disasters, oftentimes, there tends to be a focus on hospitals. But really, if we're thinking about, especially for patients that have chronic care needs, continuity of care, that question of how people who have medical needs without getting to medical crisis are getting care, pharmacies are a critical part of that solution. And with that in mind, we've long been supportive of pharmacies as well as pharmacists having the ability to have what we call expanded scope of practice: the ability for them to be able to vaccinate during a pandemic.

When we really think about the range of things that pharmacists are trained to do, and the fact that 93% of Americans are within 5 miles of a pharmacy, they're the closest type of health care in the United States to most people, especially those who are in rural or traditionally underserved communities.

For us, they're a critical part of all disaster responses. And as such, we have to make sure that first and foremost, they have the resources that they need to be able to continue to operate. That can be in the form of a business continuity plan or in an enterprise resilience plan, but what that really means is that not only do they have the training, but they have the resources and the coordination that they'll need to continue to operate.

And then, again, recognizing that they are a very critical linchpin, and being able to make sure that those communities that need that continuity of care have access, getting them the resources to be able to disseminate broader information.

And so that's been a big part of what we've done. For many years, I think it's about 12 years now, we've operated the Rx Open Map, which is a free service that allows for individuals to go online and see the status of pharmacies in their area. Thanks to the support from the AmerisourceBergen Foundation, we've actually expanded that to be able to include dialysis centers, which are another critical part of care for underserved populations. And we've been able to turn it on for the entire nation, for the entire pandemic.

When we're thinking about healthcare disparities, we want to make sure that first and foremost, we're understanding the needs of those populations and not treating it as a broad stroke, kind of everyone needs everything. But then also understanding that if we are actually focusing on avoiding medical crisis, the ability to continue the care that they're receiving, and possibly even improve the quality of the care that they're receiving, and the frequency of those touch points is critical.

Pharmacies are a big part of that. And 1 thing that I've actually seen pharmacies do, is actually engage in telehealth-based solutions and text messaging solutions that have also been able to increase the frequencies of those touch points. And so for those individuals who have access to technology, have access to broadband, that is an important part of how pharmacies have been a part of the answer for the last 10 months.

Lorenz-Fisher: Thanks, Nicolette. And it also seems like to a certain extent, we're seeing the pandemic actually escalate some of the technology utilization that maybe would have taken quite a bit longer had it not been for the terrible pandemic we're facing right now, so bit of a silver lining, but any thoughts on that?

Louissaint: Absolutely. I think one of the interesting piece of the stay at home orders for an organization like ours, our first thought was, “how are we going to get information out about emergency refills? How are we going to support pharmacies, in making sure that people understand, yes, you do not need 6 or 9 months of your medicines?” But let's get you that emergency refill, you can come in now and you can get that refill, and you can have an additional 30 or 45 days, and that that will be sufficient.

And that's actually I think where the role of technology started: really thinking about just how we're pushing out messages. And then in the interim, as you pointed out, the pandemic allowed for individuals to say, “okay, telehealth in the large scale, we're going to have this very dynamic web-based solution, that may not be what we need, right now.” We may just need a hotline. Or we may need a text based messaging system, where we're able to say, “we're going to be able to just text in a few questions and have kind of standard answers, or we're going to have something that's in between that, where you put in a request and someone calls you and then they determine if they need to get on Zoom or Skype to be able to examine you via video.”

And so I think what that did was it actually allowed for the concept of telehealth and the broad scale implementation to become practical in a way that actually increased the uptake. So now, my 82 year old grand aunt is telling me, “Oh, don't worry about me getting to urgent care, I'm just going to call my doctor, and I'm just going to get a telemedicine appointment.” And you know, she's 82, she barely texts me, but that is for her a very realistic way of being able to get care, and I think for most people, that's what we're seeing. It's no longer viewed as this access that's only afforded to some. It really has become a more accessible and more readily used solution because also people are already using these portals.

So they're already on Zoom. They're already on Skype. I think that's been a big part of it. And I know that a lot of pharmacists are working really hard to make sure that they are doing those routine touch points with so many of their patients, especially those that are older or have multiple comorbidities.

Lorenz-Fisher: Gina, would you mind sharing a little bit about how the foundation has worked to enhance access to care in underserved communities?

Clark: Absolutely. We have a series of safety net grant giving opportunities that we have activated to help provide patients with access to free charitable clinics. So these are for both the uninsured, but also the underinsured. That underinsured group, I think we sometimes jump over them, and they're very challenged in terms of they may not be completely uninsured and don't have access to some of those other federal products, but they don't have the money to pay for the care they need, particularly during a time like this.

We're really happy to have that opportunity to help fund those clinics. And even like an example that close to home, right in Chester County, Pennsylvania, we have a large migrant worker population, and we've been able to find access to care for that population specifically. I think it's so important to pay attention to those and look for those specific opportunities to give as well as more broad base giving, so the foundation will always be about access to care, and we will look for every opportunity to enhance and provide access to the best care possible.

Lorenz-Fisher: So we're gonna keep the conversation moving here and start talking a little bit about healthcare access amid natural disasters. So Nicolette, I'll go over to you.

A couple of minutes ago, you brought up the topic of climate change and how that is impacting the current pandemic. Well, we're also seeing impacts of climate change in natural disasters know intensity frequency have changed quite a bit over the past several years. And so as a healthcare company, we recognize that we have to be ready to respond no matter what, in any type of disaster. We're carefully addressing planning and taking bold steps to address climate issues. How is Healthcare Ready coping with this and helping communities to think about coping with this?

Louissaint: Sure. It's important that we're talking about this, we also think about what it means for the convergence of these events. We often remember 2017, we often think about Hurricane Maria. But often, we forget that 2 weeks before Maria, was Harvey, and Irma, and really some of the worst, at that time, California wildfires we had ever seen.

And so part of the challenge that we face is not just the intensity and the frequency of the events, but the fact that we are seeing more events happening at the same time, which is stressing our system and making it difficult for communities to prepare, because they're not clear on how much additional support they'd be able to get. That's been a big part of how we've been testing planning assumptions with communities, is to really look at what types of supports they will be able to pull together across their specific community, but then what they know they will need from the state or the federal government or external, national, or international partners, so that that can be very clear at the outset.

Also recognizing that when we are thinking about how we plan for events, we really have to take a step back and view it as a planning issue. And so a lot of our work has been around what we like to call resilience or community resilience based approach, which means that we have to work with local jurisdictions to actually incorporate their resilience plan into their cities plan. Urban planning, or community planning is really where it has to start.

We have to think about how we're building these communities and how we're building these systems, and then be able to prepare for the gaps that we know will inevitably fall from that because there will be gaps. And so that's been a big part of what Healthcare Ready has been doing over the last few years.

We've done quite a bit of work with cities like Baltimore, DC, Mobile, Alabama, some parts of Louisiana, really helping to think through how you incorporate planning into this perspective, recognizing that you're planning for the needs of your community, you're planning for the infrastructure that will be required to sustain their care, and then we'll be able to build a preparedness plan around it, and then we have to test it. But we have to test it in a way that really pulls in all of those vantage points. It's not about just how public health responds. It's about how the community is going to be engaged, how the faith-based organizations are going to be mobilized. Who's going to be able to go door-to-door and check on those who may have mobility challenges or access needs.

And so that is really how we've been going about it. And what we've seen even this year in California and Oregon and Washington is that it's really been the community that's been able to really stand in that gap. And so for our vantage point, everything we can do to bolster that is the appropriate response, we don't want to supplant it in any way. We want to make sure that they have what they need and that we're able to adjust and coordinate to bring in additional resources based on what insights they're sharing with us.

Lorenz-Fisher: Thanks, Nicolette, really great perspective there. And Gina, could you talk us through a little bit about how the foundation approaches natural disasters?

Clark: As a foundation, we again quickly pivot when these come up and the team is on it, the team does the research to understand where the need is the greatest. We are very conscious of where our associates are and where they're affected, and we have 2 to 3 vehicles via the foundation and our associate assistant fund to help them. But also in the vein of partnership and collaboration that I mentioned earlier, we partner with a number of organizations to respond. An interesting partnership is with the National Community Pharmacists Association (NCPA). We've partnered with them since 2019, with their disaster relief fund to ensure that community pharmacies that are affected by these are able to continue to give care and support community.

So just combine all of what we just talked about with Nicolette about the importance of pharmacies, and then understand that they're there under these dramatic disasters as well, and what kind of support can we give specifically to them, so they can continue to support the communities.

As tragic as the impact of COVID is, these natural disasters are tragic in and of themselves. I'm very proud that we, as a foundation, pay attention to all of those places where we can impact lives in a positive way.

Lorenz-Fisher: Thanks Gina. I would just close this out by saying thank you so much Nicolette for your time today and Gina for your time as well.

I think as a foundation we're so fortunate to have partners that are willing to talk about these really challenging issues with us, so we appreciate your perspectives and your time and ultimately all of the amazing work that Healthcare Ready does every day, Nicolette, so thank you for making the time.

And Gina thank you for your always fearless leadership of our company foundation. We've got a lot to be proud of and looking forward to bringing us all together again to see how things look in 2021. Hopefully it'll be a little bit different.

For our first episode in the ThoughtSpot 2020 series, experts from AmerisourceBergen and Healthcare Ready discuss how to support marginalized communities amid pandemics and natural disasters.

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