We’ve all watched and commented upon how the Walgreens drugstore chain has developed unique strategies, from prescription price negotiations to bringing pharmacists and customers closer together. Now, the chain is exploring ways its stores can better distribute and educate their customers on medical devices and the emerging world of mobile healthcare. In this post, I share highlights from my interview with Dr. Jay Rosan, VP of Health Innovation at Walgreens.
Is Walgreen’s moving into mobile health?
Most people view Walgreens as the community pharmacy—we have nearly 8,000 such stores. About two-thirds of Americans live within three miles of a Walgreens. We also have more than 350 retail clinics. We are one of the top specialty pharma retailers in the country, and the largest provider of workplace health and wellness centers in the U.S., with about 360 locations including many Fortune 500 companies. We are the closest place to home (for many Americans) so we have a lot of opportunities to facilitate personal health.
When your technology group looks at supplies and devices for diabetes, for example, are there devices that are covered that you provide but do not necessarily promote?
We have a large distribution channel. We have 27,000 pharmacists, and in our new pilot format stores we’re taking them from behind the counter and putting them in front. So we are going to take pharmacists away from the production aspect of filling prescriptions and have them interact more directly with patients. We don’t cover devices, but these pharmacists will help distribute and educate customers about almost all the devices for diabetics that are out there since we carry most of them. We review devices all the time, and we promote those we feel are appropriate for the patient.
If a device were to be used by someone with diabetes, I would send it to individuals in our innovation, purchasing, diabetes and our mhealth teams for their opinions. I think that the Holy Grail for diabetes devices is a noninvasive glucometer; when that is successful, that will change the world. There are a few companies who are getting close to this. They are small companies and not necessarily the larger ones.
Do you see trends in reimbursement with regard to telehealth and remote monitoring?
Insurers see these technologies as more of a value than they had before, but for the right types of patients. It is beginning to shift. No question they are starting to reimburse, but they are cautious; appropriately so, because the technologies are not exactly perfect.
Is a lot of reimbursement tied to outcomes?
Yes absolutely. That reflects the general trend in health care and the efforts under health care reform. Today, payers, providers and health plans are all focusing more and more on outcomes and how treatments can lower overall health care costs and improve care.
What would tip their view on reimbursement?
Reimbursement depends on the device, so for instance with continuous glucose monitoring, certain criteria need to be met before reimbursement will occur. Devices can be consumer or medical. Consumer items are not reimbursed by insurers. Medical devices are prescription-based but also based on what the device does. So if someone wants a Jawbone Up, which is an activity sensor; there is no real medical indication for it and it is not reimbursed by insurers. But if someone wants a glucometer, that is a medical device because you are relying on a specific number to make treatment decisions. So it is reimbursable. But could any device help a patient with type 2 diabetes who is overweight? Certainly, to some extent. However whether it is reimbursable is a question because there might be people who would abuse the situation.
So, now, what do you think: Are digital health devices becoming more “insurer-friendly?” Or do we have a ways to go before non-invasive devices are reliable enough health delivery instruments? Should mobile health delivery be in the hands of pharmacists, or somebody else? Share your thoughts with us below.