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Diabetes Roundtable: Lessons of the pandemic for diabetes care

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Among the many changes wrought by the pandemic has been the heightened focus on diabetes management, given the increased risks to people with the condition. The implications for diabetes care from mass vaccinations and the waning of COVID-19 are discussed on the following pages by chain drug retailers and diabetes product suppliers.

CDR: With so many people getting vaccinated, how can the diabetes care community ensure that lessons learned about the need for careful management of diabetes will not be lost?

Kenneth Snow

Kenneth Snow

SNOW: One of the lessons learned during the pandemic is the importance for people with chronic illness, especially diabetes, to continue to receive ongoing care. The dramatic adoption of virtual health care provides an incredible opportunity to meet people where they are, making health care both more accessible and affordable. It is important that this new approach to care continues to be available even as people get vaccinated.

SHAH: The pandemic has shone a light on what things are and aren’t working for people, and many are using what they’ve learned from this crisis to make improvements in their lives. We continue to meet our customers and patients wherever they’re at with services that help them take an active role in managing their health. Our health equity diabetes program helps patients connect with our pharmacists to get information surrounding clinical guidelines, recommended lifestyle changes and general tips to better manage their diabetes. Through comprehensive, personalized consultations our pharmacists can uncover any gaps in diabetes care and barriers to adherence and offer tailored solutions leading to improved health outcomes.

Rina Shah

Rina Shah

Beyond our pharmacists’ relationships with patients, Walgreens Find Care provides resources that centralize critical health information and offer access to state-of-the-art health monitoring devices such as Dexcom’s and Abbott’s continuous glucose monitoring (CGM) systems, giving patients real-time glucose data. We also provide a 24/7 Pharmacy Chat option through our mobile app and website, giving patients easy access to personalized care and advice from Walgreens pharmacists.

LYONS: The pandemic taught us so much. We saw COVID-19 lead to poorer outcomes in individuals who have chronic diseases, including diabetes. As we move forward, we need to apply what we learned during the pandemic to make a proactive plan for the future. This includes increasing efforts for both prevention and management of diabetes. Community pharmacies can and will play a huge role here.

I want to challenge every pharmacist administering the COVID-19 vaccine to use the assessment time to educate patients about ways they can help them manage their condition to live healthier. Even if the pharmacy isn’t actively providing diabetes services, a great place to start the conversation is by reviewing medications, making referrals to other health care professionals and assisting with self-care ­recommendations.

WILLIAMS KERLEY: Pharmacists are a tremendous resource for community health — whether helping end the pandemic through vaccinations or helping manage chronic conditions like diabetes.

Due to accessibility and the frequency with which they see patients, community pharmacists are available to counsel, educate and increase awareness of diabetes — thereby helping their patients lead healthier lifestyles. Pharmacists are one of the first resources customers engage with questions, and they can direct customers to their primary care provider or resources if diabetes is a concern.

Summer Williams Kerley

Pharmacists and pharmacies are uniquely positioned to offer resources to help to successfully achieve these lifestyle goals through services and product offerings at the pharmacy — including comprehensive medication reviews and identifying risks for developing diabetes or signs of prediabetes. We also utilize an immunization questionnaire/annual review form that can help lead to a broader discussion with the patient.

FRANK: In addition to encouraging patients to remain up to date with their vaccines, pharmacists should educate patients with diabetes that appropriate management of diabetes and other comorbidities can help reduce the risk of severe symptoms and complications from COVID-19 and other viruses.

Elaine Anderson

Elaine Anderson

ANDERSON: Whilst the pandemic has posed a great challenge for everyone, and it is encouraging to see vaccines forging a path towards a post-pandemic world, the challenge has been particularly difficult for those managing chronic conditions, such as diabetes, many of whom have felt the need to shield and have had at times reduced access to the traditional face-to-face health care and medical advice for their diabetes management that they had been used to in the past.

The pandemic has acted as a catalyst for the growth in online tools, information and educational resources and virtual consultation platforms developed to help people living with diabetes optimally self-manage their condition. What’s important now is that, as we come out of the heat of the pandemic, everyone in the diabetes care community takes stock of those tools and resources to identify which will continue to be useful going forward, and establish how to build these into the day-to-day care of people living with diabetes and the support that health care professionals and others provide them.

DESAI: COVID vaccinations are extremely important, but patients must remember that they are over and above what is still required for their diabetes care and management. Shoppers pharmacists are continuing to perform A1c testing, provide support and counsel to patients with their medication and offer prescription delivery. We are working hard to ensure that patients continue to get the care they need in addition to our vaccination effort.

We know that A1c testing is particularly important for the management of diabetes. Our pharmacists continue to administer these tests to patients and use results to perform a medication review and develop a management plan that includes things like dietary and lifestyle goals. We have several stories from pharmacists who were able to help their patients successfully manage their condition and lower their A1c level after following a plan spurred from an A1c test.

Matt Jewett

Matt Jewett

JEWETT: In many ways, the COVID-19 pandemic accelerated opportunities for innovations in diabetes care. Remote care and telemedicine continue to grow and be well accepted and valued. Our mySugr diabetes management app now has over 3 million users. The last year also exposed significant health care disparities. We are working — independently and with partners like the ADA, JDRF, Beyond Type 2, employers and pharmacies — toward a “new normal” that includes high-quality care that is accessible to all people with diabetes.

RADIN: Therapeutic inertia remains a significant problem, as many people with diabetes are not receiving optimal care or reaching their treatment goals. COVID-19 has served as a call to action for patients and health care providers, providing a compelling reason for diabetes management and good glycemic control. In addition, people living with diabetes are at higher risk for severe infection should they become infected with COVID-19 compared to those without diabetes. This sense of urgency to get people with diabetes under better glycemic control is something we don’t want to lose.

Although many are getting vaccinated, we still have a while before the end of the pandemic. Therefore, the diabetes community still has an urgent opportunity to reinforce the importance of good glycemic control. Reducing the risk of severe COVID-19 infection in a person with diabetes is only one of the numerous reasons to aim to achieve good glycemic control, however.

At Novo Nordisk, we believe it is critical for patients to understand the importance of good glycemic control to help reduce the risk of complications and terrible outcomes associated with diabetes. These include retinopathy and resulting blindness, end-stage kidney disease and the need for dialysis, and peripheral neuropathy and risk for lower extremity amputations. To improve care for patients, we offer health care providers educational materials and support they need to help care for patients with diabetes.

CDR: How can chains leverage pharmacists’ accessibility and people’s trust in them — as reinforced during the pandemic — to play a greater role in diabetes care?

SHAH: With our pharmacy team members embedded in communities and having more than a decade of experience providing immunizations, we have the expertise for working with series-based vaccines, vaccines that require cold storage and administering in various settings including in stores and off-site clinics. Throughout the COVID-19 pandemic, Walgreens has been a vital partner in testing and community education, and our trained immunizers have administered over 15 million COVID-19 vaccines in stores and through dedicated clinics.

As shelter-in-place orders went into effect, we reached out to patients with multiple medications or complex conditions to ensure they had everything they needed, including those with diabetes. It’s this relationship that makes pharmacists a critical part of care. Coupled with our telehealth offerings, Pharmacy Chat and prescription delivery options, we are focused on connecting patients to the care they need.

We also continue to evolve our suite of services for those impacted by diabetes in partnership with health plans and employers, educating patients on preventative measures. Walgreens is prioritizing high-touch consultations for those living with diabetes by offering personalized solutions, addressing any barriers to taking medications and making recommendations for health screenings and immunizations.

Ashesh Desai

Ashesh Desai

DESAI: Throughout the pandemic pharmacies and grocery stores are one of the few retail services that have remained open. Over the last year we’ve demonstrated that we are accessible and trusted, and we have made every effort to ensure that patients continue to have access to the care they need. In addition to in-person consultations with pharmacists we have leveraged digital tools such as virtual care services, the PC Health app and digital pharmacy so patients can do things like interact with health care providers such as nurses, dietitians and pharmacists, complete health programs or renew prescriptions online.

In partnership with Diabetes Canada, we recently launched diabetes health programs on the PC Health app to better support Canadians living with diabetes.

Debbie Weitzman

Debbie Weitzman

WEITZMAN: The pandemic has reinforced the importance of the retail pharmacist as a trusted health care advisor for diabetes patients. Their role will become even more important later this year when the first insulin biosimilars with an interchangeability designation from the FDA come to market. Interchangeability will allow pharmacists to fill prescriptions with biosimilars without consulting a prescribing physician, in order to help expand access and reduce the health care expenses of diabetes patients.

WILLIAMS KERLEY: Since they are among the most trusted and accessible health care providers, pharmacists are an essential resource when it comes to information and education — including information about diet and other factors that can have a big impact on how our customers with diabetes manage their condition. Pharmacists can also help monitor adherence to medication and, when needed, offer suggestions for how to get help paying for medication.

Rite Aid’s Medicine Support Team enables Rite Aid to reach patients who may not frequently visit our pharmacies to fill their medications. This type of outreach allows Rite Aid to remain connected to these patients and support behaviors that lead to better disease management and healthier lifestyles.

Dr. Michael Radin

Dr. Michael Radin

RADIN: It takes a team of health care providers working together with patients and their families to help optimize diabetes care — and pharmacists play a very important and valuable role here. Since many patients develop trusting relationships with their pharmacists, pharmacists have incredible opportunities to educate, particularly in regard to medication management and helping ensure they understand how to properly take their prescribed medications.

Pharmacies can encourage their pharmacists to adopt a more proactive role in engaging and educating patients. This begins with developing meaningful relationships and gaining their trust. At Novo Nordisk, we provide educational materials to pharmacists on our medications specifically designed for this use.

ANDERSON: One, two or four medical visits per year — in a best-case scenario — is insufficient for individuals living with diabetes. This reinforces the important role that everyone in the health care ecosystem, including pharmacists or practice nurses, really do play in supporting people with diabetes’ self-management efforts. Over the last 18 months this has been further exacerbated, as many consultations have been in a remote setting, leading to pharmacists sometimes being the only person a person with diabetes has physically and regularly seen in relation to their condition, positioning them well to provide advice and support on various aspects of diabetes care.

In recognition of this, Ascensia, like many other companies in the diabetes care sector, has invested time and resources into developing a series of educational tools and informative materials to help to enhance pharmacists’ continued learning and understanding of diabetes. This in turn hopefully empowers those who have had access to these materials to help simplify and improve the lives of those living with diabetes.

Nancy Lyons

Nancy Lyons

LYONS: Every community pharmacy, including the independently owned and operated pharmacies that are a part of the Health Mart family, stepped up in significant ways during the pandemic. I was never prouder to be a pharmacist than when I saw these essential, frontline, health care workers increase home deliveries of prescriptions and other needed items as well as offer curbside and drive-thru services that included COVID-19 test collections, to the people who needed them.

Patients will benefit when they discover that the health care provider who helped them through the pandemic can also offer them convenient diabetes care and education services. To be sure this can happen, pharmacists must be able to easily access adequate payment for diabetes care and education services. Barriers to billing need to be removed to ensure pharmacies can offer sustainable services.

JEWETT: As a focus on the need to deliver equitable access to health care increases, chains can leverage their pharmacists’ ability to build diversity and inclusion in diabetes education and awareness, an area in which we have sharpened our focus. Another important way chains can continue to play a greater role in diabetes care is by taking advantage of new technologies, such as the Roche Diabetes Care Platform, that harmonize data, improve insights into diabetes management challenges and enable improved, satisfying consultations with their customers living with diabetes.

Jessica Frank

Jessica Frank

FRANK: At OutcomesMTM, we heard from many pharmacy partners that patients were so appreciative that their pharmacist called to review their medications and discuss their health. Pharmacists can build on the deeper relationships their staff has formed with patients during the uncertainty of the pandemic. For example, when talking to a patient with diabetes about the benefits of a COVID-19 vaccine, discuss other services offered by the pharmacy that could support them in managing their diabetes. We believe the expanded role of health care advisor will continue, so OutcomesMTM has been working on a suite of disease state-specific interventions, including diabetes, that are designed to leverage pharmacists’ health expertise, reinforce the role of medications in managing chronic disease and empower patients to make informed health decisions.

SNOW: Pharmacists are a trusted resource for many people. In addition, they have the added benefit of having regular relatively frequent interactions with many patients, especially those with diabetes who are on medications. Pharmacists can help assess whether a person’s care plan is working, identify challenges people are facing in controlling their diabetes, provide accurate information on diabetes and available technology as well as serve as a link between the patient and their provider. Multiple studies have demonstrated that pharmacists, working under a collaborative practice agreement, can provide excellent diabetes care in a more convenient setting.

CDR: How can the digital media and social networks deployed during the outbreak continue to have a paramount role in diabetes management?

WILLIAMS KERLEY: COVID-19 has prompted many customers with pre-existing conditions to rethink how they seek health care advice. Rite Aid is here to meet our customers where they are most comfortable, whether that means protective measures in-store or telemedicine options and delivery of prescriptions and other essentials. In some cases, technology can offer additional helpful options for tracking diabetes and facilitating remote collaboration of the patient’s care team.

DESAI: Canadians are becoming more and more comfortable with digital health care engagement especially since the start of COVID 19. While we’ve used social and digital channels for education on COVID testing and vaccination, there is an opportunity to pivot to other areas, such as diabetes education. Via digital channels such as social media or e-mail communication we hope to keep our customers informed about the introduction of new programs or services and share resources for things such as diabetes care and management. We know that many Canadians turn to their pharmacist first for support with their health care needs and we want to continue to ensure that communication channels remain available to them, whether in person or digitally.

ANDERSON: During the pandemic there has been a real evolution in the role of technology in diabetes management. For example, the rise of telehealth has enabled people with diabetes to connect with health care professionals during times of lockdown and social distancing, at a time everyone across the globe has adopted new social media, video and collaboration tools to stay in touch.

This ability to stay connected digitally has also really shone a light on the importance of the online community in diabetes, and the role it has played in peer support that has helped people with the condition to stay positive, healthy and social throughout the pandemic. The diabetes online community is very engaged, and its use of social networks has proliferated over the last year, with many people finding new ways to manage their condition and new people to turn to for guidance and peer support.

I would expect these connections and new methods of self-management to long outlast COVID-19.

JEWETT: The ability to connect was so important during the outbreak. Digital media and social networks were especially valuable, and will continue to be platforms for human exchange — the experience of listening, sharing and learning from health care professionals and people with diabetes. We continue to add educational resources on our Accu-Chek website, such as the Moms & Diabetes hub, and support online and in-real life educational programming with the American Diabetes Association, JDRF and Beyond Type 2, among others.

LYONS: During the pandemic, we saw systems used in new ways, including to maintain business operations and even to deliver patient care. Use of technology to break down barriers needs to continue. Patients living with diabetes face challenges and successes every day. Giving them the ability to connect with health care professionals and others facing the same challenges, even remotely, can increase support and improve outcomes.

SNOW: Digital media has allowed people to obtain information about many aspects of their lives, including information on health. This process can and should continue to allow people to access information that they find important. Through ongoing curated content people will be able to leverage the power of these resources to obtain useful knowledge in a manner that is readily accessible at times of the person’s choosing.

RADIN: Many people turn to digital media and social networks for information. This provides another great channel to educate patients on diabetes and the medications they use to treat it. In order to maximize educational opportunities of digital media and social networks, it’s important for the diabetes care community to establish trustworthy places for people to visit for accurate information, especially considering misinformation that can be published in these venues. It’s about ensuring accurate information is out there to educate people and directing people to the right places to seek this accurate ­information.

SHAH: Digital media provides valuable information to patients who are unable to see their doctors or pharmacists. Along those lines, we post articles on Walgreens.com to help address interest from our customers and patients in learning more about diabetes management. As people return to normal activities, we believe use of digital and online resources, like our website, will last, as they are convenient and many have come to enjoy using these offerings in new ways.

CDR: What are the prospects for continuous glucose monitoring and newer technologies, and how can retailers and suppliers help promote them?

WEITZMAN: Pharmacists continue to serve as key resources of health information for diabetes patients, and it is vital that they have access to new technologies, methods for disease monitoring and other future innovations. Over the past several years, more patients have embraced CGM devices, and we expect further adoption based on the increased adoption of digital health tools during the pandemic. Cardinal Health offers retailers access to some of the leading CGM devices on the market, with significant growth expected over the next several years. Future CGM devices could include innovations such as closed-loop systems that link glucose monitoring and insulin pumps together, requiring less effort for the patient.

Community pharmacies are highly accessible for the vast majority of patients, and manufacturers are expected to view the pharmacy as a key distribution channel for these devices, allowing patients wider direct access. As additional products and innovations enter the market, we will continue working closely with our manufacturing partners to provide a variety of options for community-based pharmacists to assist their patients in selecting the CGM device that is right for them.

SHAH: We continue to expand what we offer through our digital health platform to help patients access in-person and virtual health care expertise from the comfort of their own home. Through this online marketplace and our stores, patients may purchase two different blood glucose meters that transmit results via a smartphone app, allowing both doctors and patients to monitor their blood sugar. Our goal is to make CGM available to all customers who need it, no matter how they pay for it (commercial insurance, Medicare, Medicaid).

JEWETT: Integration of digital technologies and solutions will continue to dramatically improve coordination among health care providers, work flow and patient care. Together with telemedicine, these advancements will produce more effective care models for all patients under any circumstances, even in the event of the next health crisis.

Retailers and suppliers can help by emphasizing the benefits of these technologies. While some people with diabetes may not feel comfortable with technology, perhaps we could encourage them through gradual steps. Offering a free diabetes management app like mySugr can help make daily diabetes challenges less burdensome by keeping track of sugars, medication, meals and moods all in one place. An added benefit of the mySugr Pro app is the ability to create and share with their health care team a detailed report of their aggregated diabetes data from Accu-Chek blood glucose meters, blood sugar levels, carbohydrate intake, stress levels, insulin dosages, medication and estimated HbA1c. This efficient overview of information helps health care providers recognize patterns and individualize guidance.

LYONS: The evidence for improved control of diabetes through CGM is growing. Besides the convenience that patients can get in not having to stop and perform a fingerstick, CGMs allow health care professionals to spot trends more quickly and to adjust activity, foods and medications to achieve better overall control. In addition, the alarms, connectivity to mobile applications and other automation that are available can improve patient safety, especially in pediatric patients or in anyone who lives alone. Retailers and suppliers should focus on highlighting the features of the available products and matching the benefits to the populations they serve. The next step is to ensure all health care professionals have the right tools to be able to make the right recommendations to their patients. Community pharmacists interact with patients who could benefit from CGM every day and should ensure they have the right knowledge, products and price points to serve these patients.

RADIN: We’ve seen newer technologies — in particular CGM — play a critical and increasingly important role in helping people with diabetes manage their blood glucose levels during the COVID-19 pandemic. With CGM, people living with diabetes have the ability to check their blood sugar levels at any time and gain an awareness of their glycemic control that was never before possible.

Additionally, people with diabetes can use this technology to share their blood glucose levels with their health care providers. This was critical during the pandemic — especially early on –— when face-to-face office visits were limited. My hope is that retailers and suppliers recognize the value of CGM and work with the diabetes care community and will continue to increase awareness of this technology. This way, more patients and health care providers will become aware of the benefits of CGM and adopt the use of the technology.

SNOW: CGM and even newer technologies, such as connected insulin pens, provide powerful tools to help people manage their diabetes as well as new opportunities to interface with their health care providers. The ability to share this information between a patient and a provider remotely presents the opportunity for more frequent and better-informed interactions. One challenge that many people face in adopting this new technology is an awareness of its existence and how it might fit into their care plan. This problem is even greater among communities of color as studies have shown a decreased likelihood of this technology being made available to minority patients even when insurance coverage is not a barrier. Retailers, especially trusted retail pharmacies, have the opportunity to raise awareness among customers of the existence of this technology, the benefits of technology and how it might fit into their care plan.

ANDERSON: Developments in medical technology have played a significant role in improving the ability of people with diabetes to manage their condition. When you consider 20 years ago the FDA approved the first CGM system, which included a sensor that could be worn for 72 hours and took readings every 10 minutes, and today you have systems such as the Eversense approved for use for up to 90 days, which take readings every five minutes, you can see the speed at which technology has been evolving. For this reason I believe we are likely to enter a really exciting decade, with many innovative and interesting ways to measure glucose level being studied and developed, such as via contact lens and watches.

In order for retailers and suppliers to be truly empowered to help promote these new product developments in the context of a person with diabetes’ self-management, they need to have a solid understanding of how the technologies work, for whom they would be most suitable and what benefits they can provide. And it is up to the companies developing these new technologies to invest in educational and informational materials that provide that background and knowledge, so retailers and pharmacists are better placed to independently advise on different products.

FRANK: CGM devices are still relatively new and may be unfamiliar to patients. Therefore, patient education and training by a community pharmacist is essential for helping the patient use the device correctly to better manage their disease. Recently, our OutcomesMTM team deployed a targeted intervention prompting community-based pharmacists to educate eligible diabetes patients on the benefits of continuous glucose monitoring. The access to this information enabled pharmacists to have conversations with patients through medication therapy management ­interventions.

DESAI: CGM is extremely important for patients living with diabetes. We continue to educate pharmacy teams in this area so they are well equipped to inform their patients and provide care advice. CGM makes it easier for physicians and pharmacists to access and share a patient’s information, which means the patient will have a better connected and informed circle of care.

We also see opportunities to integrate glucose monitoring data into platforms like PC Health in the future, providing future visibility to patients and creating opportunities to integrate that data into health journeys, programs and related incentive structures.

WILLIAMS KERLEY: Recent advances in technology have made it possible to track blood glucose and other important information like never before. Since convenience is a key driver of behavior, these new tools can help patients monitor their disease more proactively.

Rite Aid pharmacists can help customers make sense of all that information and offer advice for how to act on the insights that new monitoring devices can provide.

CDR: How much more significant do you see telehealth becoming in diabetes care?

SNOW: So much of the care of somebody with diabetes involves the transfer of information — data from the patient to a provider and information back from the provider to a patient. Telehealth provides the opportunity for this exchange of information in a manner that is vastly more convenient for most people. The recognition that through Web-enabled devices allowing easy and secure transfer of information remote patient monitoring provides an opportunity to assure that people are staying on track in the time between visits with their health care provider rather than waiting for an in-person visit to identify a problem. In addition, the convenience in terms of time and the elimination of geographic barriers makes it highly likely that telehealth will play an ever-greater part in the provision of care.

ANDERSON: The current pandemic has fundamentally challenged the “old norm” for the delivery of consultations, with the increased rollout of virtual health care. Tele and remote health consultations to some extent may have increased accessibility to health care, particularly for those living in remote locations, which brings its benefits. That said, it may also have created a barrier, with people living with diabetes reticent to discuss the challenges they are facing when managing their condition, for example mental and emotional health conditions. At the same time there are some complications associated with living with diabetes such as retinopathy or foot neuropathy, that really require a face-to-face consultation to be properly assessed and treated.

So in short, whilst telehealth is almost certainly here to stay, at least in the short- to mid-term, health care professionals need to learn how to recognize and identify where there is a need for face-to-face consultations, and offer them where appropriate to ensure the person with diabetes receives the optimal care and support.

FRANK: For many diabetes patients and their caregivers, access to a local health care provider is limited. Diabetes prevalence is 17% higher in rural areas, and rural adults are more likely to report a diagnosis of diabetes than patients in urban areas. In the “diabetes belt,” which spans 15 states in the Appalachian region, nearly 12% of the total population has been diagnosed with diabetes. In “pharmacy deserts” such as these areas with no access to a pharmacy within a 10-mile radius, telepharmacy can be used to establish and restore pharmacy access.

Through technology created by TelePharm, a single pharmacist can supervise and review prescriptions remotely across multiple locations and conduct counseling virtually. As telepharmacy sites expand, we may see more of this unique intersection of in-person and telehealth services. Patients could potentially pick up prescriptions on-site and complete a video medication therapy management (MTM) consultation with a pharmacist based at another location in the same visit. With TelePharm, OutcomesMTM and mscripts merging to form Outcomes, we’re exploring ways to bring telehealth into our platform as another way to engage patients for clinical services.

RADIN: There is great poten-
tial for increased utilization of telehealth in diabetes care. Patients love the convenience of not having to make a trip to their health care provider’s office and instead visit their health care provider from the comfort of their own home. In many ways, chronic diseases such as diabetes are optimal to be treated via telehealth. This is because the provider spends most of the visit talking with the patient, gathering relevant information to understand their glycemic management, and then works with the patient to develop a plan on the next steps.

SHAH: The pandemic accelerated advances in health care and telehealth as we’ve never seen before, paving the way for patients to access at-home medical care for chronic conditions. Throughout the pandemic, many patients, including those living with diabetes, transitioned from meeting with their doctors in person to connecting with them virtually. We also saw this with our 24/7 Pharmacy Chat at the onset of shelter-in-place orders.

These factors contributed to our continued expansion of our digital health platform during the pandemic, helping customers access a broad range of providers offering services including diabetes care. Expansion of these services is important as the pandemic continues and both patients and practitioners seek to reduce exposure to COVID-19. For those who are medically or socially vulnerable or who do not have ready access to providers, it’s critical to provide remote access to health care services to help them address their health needs.

WILLIAMS KERLEY: We believe that the coordination of a patient’s care team is essential to improving health outcomes, particularly when managing a serious condition like diabetes. Telehealth is one tool that can help further connect care teams, so a patient’s physicians and specialists can stay connected with the pharmacists who see the patient more regularly, for example.

JEWETT: Diabetes care is well suited for remote care, and researchers predict that up to $106 billion of current U.S. health care spending could be virtualized by 2023. At Roche Diabetes Care, we are actively preparing for a future in which integration of digital technologies and solutions will lead to dramatically improved work flow and patient outcomes.

DESAI: Telehealth channels are a great tool through which patients can receive incremental support in managing diabetes care, over and above their primary physician or pharmacist. Through these digital channels, patients can access a variety of health care providers such as pharmacists, physicians, specialists or dietitians. This means even if a patient is not able to connect with a health care provider in person they are able to engage with them digitally, putting more control in the patient’s hands by giving them greater access to care.

LYONS: Telehealth can play an increasingly significant role in diabetes care, especially in the delivery of education and ongoing support. Eliminating time and distance barriers will have a substantial impact on patient engagement when managed in an organized way. To provide additional care, connected monitoring devices that link patient biometrics to the health care professionals who can assess and make care plan updates will be needed.

CDR: To what extent has the pandemic strengthened relationships between diabetes product suppliers and chain drug retailers?

LYONS: The pandemic caused everyone to stop and rethink the way we achieve our goals, in both our personal lives and in business. Diabetes product suppliers who can step back to look at the needs of every retailer and meet those needs, will become preferred partners.

WILLIAMS KERLEY: Throughout the pandemic, we’ve worked hard alongside our supplier partners to ensure that essential medicines and health care items are available for those who need them. We’re pleased that the supply chain has remained robust in the face of some unprecedented challenges. For our part, chain drug retailers have had to accommodate increased demand for the delivery of important medication and supplies to individuals who don’t feel comfortable coming in-store. We’ve stepped up Rite Aid’s ability to deliver both prescriptions and health care essentials to our customers, offering a way to provide what they need to stay healthy in a convenient, safe manner.

SHAH: We’ve partnered more closely with diabetes suppliers in two ways: First, we’ve worked together to ensure that the supply chain does not get disrupted. Like many of our patients, those living with diabetes need continuous access to their medications and supplies to manage their condition. Second, we’ve found new ways to connect with and serve our customers. While many people are leaving their homes more often, it’s important to minimize exposure to COVID-19 by offering them options such as online prescription and retail ordering plus at-home and drive-thru delivery.

SNOW: During the pandemic people with diabetes had an even higher burden to manage their disease at home without the benefit, in many cases, of having an in-person visit with their health care provider. This need increased the already important role that diabetes products play in their lives. As such, it became more important for retail pharmacies to help support patients with their supply needs, resulting in tighter relationships driven by the availability of necessary supplies at retailers.

WEITZMAN: From the early weeks of the crisis until today, retail pharmacies kept their doors open to serve their communities, and Cardinal Health was there to support them every step of the way. Even with a pivot to work-from-home for office-based teams, the communication cadence was enhanced to ensure uninterrupted flow of life-saving medications and supplies despite the many challenges and hurdles being experienced by all involved. This level of cooperation has now become the standard in our relationships.

JEWETT: Roche Diabetes Care and chain drug retailers have a shared passion to help improve the lives of people with diabetes. From the beginning of the pandemic, we were in constant communication with our retail pharmacy partners to ensure that an uninterrupted supply of Accu-Chek products was available at an affordable price to get into the hands of people who need them. Our collaboration with retailers on savings initiatives was critical in our mission to ensure access to essential diabetes supplies, as well as a free mySugr PRO app offering — first made available during 2020 and the COVID-19 lockdowns, and now when paired with selected Accu-Chek meters. This work strengthened our relationship as we collectively support people with diabetes, our customers and fostered the health and safety of our communities.

DESAI: The pandemic has created an opportunity for us to find innovative ways to work with our vendors and partners. We’ve been able to identify new ways to support our patients throughout the pandemic specifically in the digital space. Here are a few examples:

Last year in partnership with League, we launched the PC Health app designed to transform how Canadians access and navigate health care. The app supports Canadians in their health care journey with free, real-time access to virtual chat and health programs and offers PC Optimum offer rewards to help Canadians make healthier choices over time.

In July of last year Shoppers Drug Mart partnered with Maple to launch free in-store virtual medical care across all British Columbia locations, providing British Columbians with access to safe and convenient medical care, in a way that fits their needs and schedules. Patients can connect to BC-licensed family or emergency medicine doctors, delivering high-quality and safe care virtually through video.

Now, through the PC health app, users can book appointments with Canadian-licensed general practitioners, and ­specialists are also available via Maple Virtual Care. Users can get a diagnosis, treatment and prescription directly through their device.

In February of this year Health Solutions by Shoppers partnered with Canada Life to offer health coaching programs targeting chronic disease prevention and management. Health Solutions by Shoppers is committed to helping employers and their benefits providers deliver more cost-effective and sustainable employee health benefits, with a focus on improving employee well-being and ultimately health outcomes. The health coaching program is delivered remotely by pharmacists, nurses and dietitians to make the program accessible from anywhere. This ease of access is especially important so employers can continue to support their employees during the COVID-19 pandemic.

ANDERSON: At Ascensia Diabetes Care our overriding goal is to simplify and improve the lives of people living with diabetes. This is why we have always recognized there is a valuable symbiotic relationship between us and pharmacists, and taken the time and effort to develop educational materials and tools as well as informational literature that enables them to have a better understanding of diabetes and the technology available to those living with the condition. During the pandemic, we’ve worked together to problem solve as consumer behaviors have changed. For example, we have developed new tools, programs and access resources to simplify and improve lives of patients living with diabetes during a pandemic.


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