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Opinion: The Future of Pharmacy Care Services, Post-Pandemic

MHE PublicationMHE July 2020
Volume 30
Issue 7

Senior Vice President and Chief Pharmacy Officer for Optum Rx and member of the Managed Healthcare Executive® Editorial Advisory Board, David Calabrese, provides his commentary on the future of pharmacy care services after the coronavirus pandemic.

Pharmacy care has always played a critical role in supporting patients’ access to needed services and overall health. At the onset of the COVID-19 pandemic, pharmacies’ ability to proactively engage and monitor patients became even more important as we saw a significant drop in the number of prescriptions filled, an increase in provider and pharmacy access challenges, and a greater need to monitor and protect high-demand medications.

As restrictions are lifted across the country, I anticipate many pharmacy care services that evolved to meet market needs brought on by COVID-19 will continue. Digital platforms, home care services, prescription home deliveries and behavioral health support tools have helped pharmacies provide more affordable, higher quality, more efficient care.

Digital health shift

Digital health services, including telehealth and remote monitoring, quickly transitioned from a “value add” to a “must-have” during the pandemic. Nationally, consumers of all ages appear more comfortable and willing to engage digitally than before. We’ve seen this among Optum members, with an 86% increase in first-time users of OptumRx virtual capabilities, such as digitally transferring chronic medications from retail to home delivery. In addition, nine out of 10 of our community pharmacies serving patients with mental health, substance use
disorders and other complex, chronic health conditions are using telehealth to provide more care.

David Calabrese

David Calabrese

As users’ comfort level and experience grow, virtual engagement and empowerment tools will continue to advance. Although some providers previously did not offer telehealth options, many are now incorporating it permanently into their practices, creating a more integrated e-pharmacy experience that supports ongoing patient monitoring, enhanced medication adherence and reduced risk of viral transmission.

The rise of home care

Analysis of medical claims data shows marked reductions in both physician office- and clinic-based outpatient visits during the pandemic, which has led to a substantial decrease in provider-administered drug utilization. The value of in-home services, such as home infusions, has become apparent. They are a potentially safer, less disruptive and more cost-effective alternative to provider-administered medications, particularly for individuals at higher risk.

Home care was already growing, partly as a precaution against infections acquired in hospitals. COVID-19 accelerated the trend. Home care’s flexibility and convenience will keep that momentum going. It can prevent infection, and research has shown home care can also cut medical and pharmacy costs in half compared with hospital outpatient clinics.

Focus on mental health

The COVID-19 pandemic and its subsequent social and economic effects have taken their toll on the mental well-being of our society. Data suggest that the incidence of mental health and substance use disorders is increasing. OptumRx analytics show that in March the number of prescriptions for anti-anxiety medications increased 15%; for antidepressants, 14%; and for sedative hypnotics, 5%.

Virtual services will continue to be a powerful support tool for those requiring more high-touch care, including patients with mental health, substance use disorders and other complex, chronic health conditions. OptumRx has leveraged its Genoa Healthcare footprint to provide support through telepsychiatry, our Optum Emotional Health line, virtual visits and complimentary, on-demand emotional support via the Sanvello mobile app.

In this new healthcare environment, pharmacy benefit managers are uniquely positioned to help protect continuity of care, given the vast and diverse resources at our disposal. Our collective goal should be to build upon what we have learned during this time. We should continue to deploy and refine tools that will yield positive clinical and financial value while also improving care and service in a post-pandemic environment.

David Calabrese, RPh, M.H.P., is senior vice president and chief pharmacy officer for Optum Rx and a member of the Managed Healthcare Executive® Editorial Advisory Board.

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