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Monday, November 1, 2021

Healthcare: Inequalities | Strategies | Promoting Equity

Healthcare Equity Gaps Equity Healthcare Image with healthcare professionals discussing equity gaps

Specialist says insights into the conditions of specific millions of cases can help.

Equity could also be a popular term in healthcare currently. A panel discussion at Asembia's 2021 Specialty Pharmacy Summit explored how to convert well-meaning promises about addressing gaps into real efforts. Health education, pharmacy access, and income disparities were just a few topics discussed.

The three-part panel on Wednesday included Mike Valenta, MBA, VP of Strategy and Government Relations at Merck; John Wigneswaran, M.D., Chief Medical Officer at Walmart; and Lilian Ndehi, Pharm.D., MBA, BCPS, VP of Pharmacy Clinical and Specialty Operations at Humana. George Van Antwerp, a managing director at Deloitte who focuses on pharmacy and PBM clients, moderated the discussion.

Van Antwerp began the discussion by recounting a conversation with a patient who needed three separate deliveries in one day to receive her medications. "Those kinds of complications make it difficult for someone to stay compliant and improve their condition," he said.

Specialists explored how pharmacies can step up and address care gaps. Wigneswaran explained how Walmart, in collaboration with Cleveland Clinic and the American Diabetes Association, is tackling diabetes disparities by focusing on at-risk patients and providing continuous glucose monitors (CGM).

"A diabetic patient earning under $25,000 a year faces increased risks of mortality or poor outcomes," Wigneswaran said. "For Medicare patients, far fewer African Americans and Latinos are even offered a CGM device."

Understanding the specific conditions of individual patients improves outcomes and paves the way for personalized care, the specialists emphasized.

"We always need to focus on truly delivering patient-centered, whole-person care," Ndehi added. She stressed that capturing data from pharmacies on factors such as medication non-adherence can help payers, like Humana, identify and intervene for patients. However, these efforts must involve longitudinal follow-up.

Wigneswaran also shared Walmart’s initiatives to address HIV in Georgia and reduce disparities through similar means. "We are also conducting behavioral and social engagement training for our pharmacists so they can have targeted conversations with specific populations, especially LGBTQ individuals," he said.

Screening patients and determining which treatments are most effective for specific cases not only reduces waste but also helps improve treatment adherence, the panel concluded.

However, the complexity of the healthcare system presents challenges for patients who may not have access to the internet or the time to spend hours on the phone trying to navigate their health plan.

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