Q&A: LTC Pharmacy Crucial in Supporting Challenges Across Aging Populations

With new, groundbreaking health care innovations seemingly unveiling on a daily basis, healthier patients and longer lifespans have become normal. However, for older adults reaching the later stages of life, managing medications and keeping up with their well-being becomes increasingly difficult.

“It’s such a unique time for the aging population because you’re seeing this unprecedented growth and this tilt in our population that is going to be aging and aging longer,” Esmé Grewal, JD, president and CEO of the Senior Care Pharmacy Coalition (SCPC), told Drug Topics®. “We’ve always talked about the baby boomer population just being large and vast, but then you have to think about the fact that there’s all of these terrific health care innovations that are allowing people to live longer.”

With these phenomena at play, Grewal presents the case that long-term care (LTC) pharmacies are uniquely positioned to address growing issues among the country’s aging population. As seniors have the dual challenge of navigating both their medications and insurance, among a plethora of other issues, LTC pharmacies—as Grewal will explain later—are key in putting the focus on the US’ most vulnerable populations such as senior patients.

Read through part 1 of our chat with Grewal as she breaks down the evolution of senior care in the US and where she hopes LTC pharmacy can fill in much-needed gaps.

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Drug Topics: What would you say are some of the most pressing issues facing older patient populations in the US today?

Esmé Grewal: It’s such a unique time for the aging population because you’re seeing this unprecedented growth and this tilt in our population that is going to be aging and aging longer. We’ve always talked about the baby boomer population just being large and vast, but then you have to think about the fact that there’s all of these terrific health care innovations that are allowing people to live longer. Lifetimes are longer. People are managing their senior time in a longer trajectory. On top of that, you’re dealing with a lot of changes because of a lot of innovation in the pharmaceutical space, where maybe there were conditions that were more terminal that are now becoming more chronic, which is a great outcome from what we’ve seen in this innovation space.

When I was with BrightSpring, worked in the oncology space, and you would see that over the course of many decades, a lot of cancers went from being terminal to being managed through medication therapy. [This] is really, really wonderful, but I do think it creates a challenge for folks to be able to manage their medications for a longer amount of time and aspire to have the quality of life that they really want. I think you partner that with the complication of when you enter the Medicare program, and maybe you’re even covered by Medicare and Medicaid. Seeing this from the family perspective, how complex that system is, it’s really, really difficult to maneuver. You want to have your medications covered, you want to get the right medications, but then you’re also trying to figure out how to get that paid and how to do it over a long duration of time because your life expectancy is longer.

To me, that’s really a core issue for folks; you’re getting into 65, and now we think of 65 as so young. A lot of folks are living so much longer. I’m celebrating my dad’s 90th birthday next year, and he’s doing great. You really are seeing more of these 90s, 100s. How do you make sure that those individuals are able to not only get the medications that are making that possible, but then having them covered by the system? To me that’s a very complex dance.

Drug Topics: What are your hopes for the greater LTC pharmacy community as well as the general aging population as a whole by the time your tenure with SCPC has concluded?

Esmé Grewal: My answer for this is different than it had been in previous roles where I’d worked on issues that were really about driving inclusion, fixing issues, and stepping away. I always used to say, “I hope I’m not needed in 10 years,” and that these issues are resolved. It’s a bit different for SCPC. My main hope is that LTC pharmacies are no longer health care’s best-kept secret. I really hope that we can get out education about what they’ve been doing for decades and what they’re able to do as we move into the future.

As we look at this aging population growth, I’m actually really excited about the opportunities it gives us to do it right. We often look back in health care policy and think, “Oh, we should’ve done it this way,” or, “We could’ve done it this way.” We have a real opportunity now to do it right, and I think that LTC pharmacies are at this perfect point of providing solutions, not only for that aging population, but I do think that they can solve a lot of our health care issues.

My true hope is that in a decade that is recognized, seeing these uplifted and how we can create a system where LTC pharmacies are a before thought, not an afterthought. Not only is that generating great quality of life for the beneficiaries—I think that’s really the core goal—but real clear sustainability for the LTC pharmacies and overall savings for the programs. I think there’s so much to be had there and [so many] reasons for everybody to get involved in this mission to uplift the LTC pharmacy. That’s my core hope, and I’m really excited to be a part of it.

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