Learning Curve

The diabetes landscape — where millions of lives and billions of health care dollars are at stake — is quickly changing.

Shifts in diabetes care are driven by:

• ➤Patient-focused consumerism, where the onus for health is on the individual.
• ➤Increased access to health care services through community-based, patient-directed models, including retail pharmacy and health clinics.
• ➤Innovative digital health technologies that broaden access and empower diabetics to take control.
• ➤New insulin drugs, formulations and combination therapies for better glucose control, with advances in delivery and monitoring devices.

All require the need for better education.

Supermarkets, where food is center stage and a critical component to diabetes health, have come to recognize the importance of the diabetic customer both from an economic and a community health perspective.

Food retailers have tackled the disease to various degrees over the past decade. Yet to stay ahead of the diabetes trajectory, they’re testing new concepts, including integrating the total store, and employing new technologies while focusing on lowering costs and providing easy access for patients.

“At retail, [where] you’ve got food and grocery, if you have other assets where you can build comprehensive solutions for the patient and really center those solutions around the patient, it just opens a phenomenal opportunity for innovation and hopefully bringing down that cost of [health care] GDP,” Alex Hurd, senior director of product development, growth and payer innovation, health and wellness at Bentonville, Ark.-based Wal-Mart Stores Inc., said last year during a webinar produced by dLife.

Walmart is driving health care across its store assortment, focusing on affordability and achieving better outcomes. The Live Well with Diabetes initiative expands into skin care, supplies and low-carb nutritional foods.

Dave Wendland, VP at Hamacher Resource Group, a consumer health care consultancy based in Waukesha, Wis., says getting the assortment right is a best-in-class practice for food retailers targeting diabetes.

“Not only ensure that the correct meters and related strips correspond with the health plans in the area, but look for additional product lines — OTC medications, medical supplies, lotions, food and exercise equipment — all relevant to shoppers with diabetes,” he notes. “Call attention to those products as part of the right mix.”

When it comes to promoting healthy eating habits, Walmart partners with health care plans that incentivize its members with discounts of 5 percent to 10 percent on Walmart’s Good For You nutritional foods.

The mega-retailer and its health care plan partners also discount health-related products for members who complete a health risk assessment at a Walmart Pursuant Health kiosk.

Further, the company is piloting a primary care clinic model that includes management of chronic conditions.

Besides national food retailers like Walmart, smaller regional grocery chains are testing new concepts.

Total Store View

According to Wendland, it’s important “to look at diabetes through the lens of the entire store and across all the aisles.” To that end, he recommends a total store makeover.

“Category managers in nonpharmacy areas of the store need to understand the value of the patient,” Wendland observes. “The story needs to be consistent across the spectrum of categories. Look for ways to create unique product bundles that meet the needs of diabetics.”

Wakefern Food Corp., based in Keasbey, N.J., has done this with the launch of the Diabetes Wellness Center, which features more than 100 items across seven categories, including pharmacy, dedicated to diabetes.

The center, developed in conjunction with New Brunswick, N.J.-based Johnson & Johnson, is strategically located next to in-store dietitians and pharmacists.

According to Chris Skyers, Wakefern’s VP HBC, those centers are being rolled out to stores as a one-stop shop for diabetes customers. The first one debuted last year at a ShopRite store in Flemington, N.J.

It’s been reported that the set has the potential to generate $1,000 in incremental sales annually for every new diabetes customer visiting ShopRite stores. Those customers are said to have a market basket five times larger than nondiabetic shoppers.

The retailer co-op has been expanding its health-and-wellness platform since 2006, when it began hiring dietitians to work with pharmacists as part of its Live Right program.

“We’ve always been focused on stocking all the [diabetes] products our customers need and want,” notes Skyers. “The difference now is that we are really trying to make it easier for our customers to find what they need and access all the other great services we offer, such as our retail dietitians and our pharmacists.”

Blend of Services

St. Louis-based Schnuck Markets, with nearly 100 stores, has made diabetes a focus for more than a decade. It has also expanded the depth and breadth of services across the entire store experience, says David Chism, Schnucks’ director of pharmacy services.

More than 150 Schnucks pharmacists are American Pharmacists Association-certified diabetes specialists offering patient-centered management services. Pharmacy teams work with diabetic patients individually to provide customized medication therapy management (MTM) and comprehensive medication reviews. The program aims to eliminate duplicate therapies, promote medication compliance and lower out-of-pocket costs, adds Chism.

“Every diabetes patient has a unique set of circumstances, and these one-on-one sit-down conversations [with pharmacists] are crucial to helping people, from a holistic perspective,” he says.

As technology continues to evolve, Schnucks will strive to be at the forefront of the curve, according to Chism. As examples, pharmacists have employed a smartphone diabetes monitoring and smart-app system to help patients control their blood sugar levels.

“Enabling diabetic customers to test more conveniently at reduced cost will only drive adherence to medications and awareness of how well they are controlling blood sugar day to day,” Chism points out, adding that the retailer strives for “a unique blend of pharmacy and dietetic services, coupled with access to the newest products, that will allow our patients to achieve the best blood sugar control possible.”

Team Effort

While the pharmacists’ role is central to diabetes education and management, in-store dietitians play an equally important part on the food side.

Reasor’s, based in Tulsa, Okla., launched its Eat Right, Feel Great program last year in part to give its dietitians a greater presence in disease prevention and management. “We are part of the pharmacy department, and we look to strengthen the connection between pharmacist and dietitian in stores,” says Lindsey Ince, a registered dietitian at Reasor’s.

The retailer is leveraging pharmacy data to increase diabetes patient referrals to Reasor’s dietitians to improve their outcomes and medication compliance. Reasor’s began a partnership last year with IMWell Clinic, a Fort Smith, Ark.-based developer of primary care clinics for multiemployers. It opened a clinic in one of Reasor’s 19 locations and has another clinic off-site.

“ We have seen a shift to the patient-centered model, as well as a focus on employee-centered care,” notes Ince.

Through the clinic, employees get medical care and routine checkups with convenience and no out-of-pocket fees. “The coordination of care with an on-site medical facility, registered dietitian and pharmacy in one location puts us in a position to improve health outcomes and patient satisfaction,” explains Ince.

Complete Solution

Schenectady, N.Y.-based Golub Corp., which operates more than 160 stores under Price Chopper and Market 32 banners, launched Diabetes AdvantEdge in 2010 to serve as a platform for a comprehensive diabetes program.

“This program is a complete diabetes care solution that helps patients confidently manage their diabetes while providing access to free diabetes medications and supplies,” observes Kathleen Bryant, VP of pharmacy.

Under the program, which is free, patients receive diabetes medications, supplies, a blood glucose meter and discounted test strips with a prescription. Some of the most common oral medications for diabetes are included. In addition, patients have access to knowledgeable pharmacists who advise on blood glucose readings and proper medication administration.

As the retailer transitions its pharmacies into the Market 32 brand, Bryant says design changes are planned. “They will include changes that create a warm and welcoming atmosphere that is ideal for patient-centered care,” she notes. “This includes professional, private patient consultation offices and a convenient separate store entrance directly to the pharmacy and wellness area.”

Supporting the AdvantEdge platform are the NuVal Nutritional Scoring System for informed food choices; immunization checkups, which are important to maintain the health of diabetics; MTM services; and promotions at the pharmacy that include coupons on produce, seafood and lean meats, and blood pressure screenings.

New services include a specialty pharmacy program with Pittsburgh-based Aureus Health Services and the testing of Doctor on Demand telemedicine services at five Price Chopper locations.

“Every diabetes patient has a unique set of circumstances, and these one-on-one sit-down conversations [with pharmacists] are crucial to helping people, from a holistic perspective.”
—Dave Chism, Schnucks