Flu season wreaks havoc on suppliers
It was the cough, cold and flu season that wasn’t. The percentage of patient visits on account of influenza-like illnesses never eclipsed the 2.4% baseline that typically marks the beginning and end of a flu season. According to the Centers for Disease Control and Prevention, the closest the 2011-2012 flu season came to materializing was the week ended March 17, when 2.384% of all office visits were attributed to ILI symptoms nationwide.
According to IMS Consumer Health, the South Atlantic region had seen the greatest decline in ILI rates through March 31 as compared with last season, down 80.5%. That decline in ILI rates wasn’t as pronounced in the Pacific region or the West North Central region, however.
The never-materialized 2011-2012 flu season not only impacted quarterly results across many of the pharmacy retailers, but that impact also may extend into next season.
“General respiratory from a flu perspective [was down this year and crested] significantly much later than normal,” said Scott Hanslip, IMS Consumer Health director of sales. “You would normally see some activity rising in the Thanksgiving time period, but you didn’t see any lift. It was extremely flat throughout most of the season until just recently.”
In the past, the season following a particularly slow influenza season had meant significant excess in cold remedy inventory throughout a retailer’s supply chain.
Retailers would typically buy heavy at the top of a season, when incidence was low, and look for an exit strategy for that excess inventory just as a season was peaking in the first few months of a new year. After a down season, any significant excess in inventory was held over to the fall when they wouldn’t buy as heavy as they did in the prior year.
That kind of ebb-and-flow buying process wreaked havoc among production flow plans for suppliers.
“[But] you don’t have to do like we did in the old days, which is load up and hope [for a strong season],” Hanslip said. Best practices for managing cold remedy inventory entail maintaining a steady base throughout the year, and triggering order and replenishment as illness trends across a region.
Career drivers target of health programs
Several health-and-wellness programs targeting professional drivers have been gaining traction in the past few months. And for the consumer packaged goods industry, professional drivers represent a crucial cog in the whole supply chain. But it’s a cog that happens to be heavily indexed across many chronic disease states (e.g., obesity, diabetes, heart health) — and for a simple reason. There just aren’t that many healthy choices for those drivers putting the hammer down on the big road.
According to statistics published by the Heavy Duty Trucking trade journal, as many as half of all long-haul drivers smoke tobacco; 28% suffer from hypertension; 25% had high cholesterol; 10% had diabetes mellitus; and almost 15% had sleep apnea. And only 58% are covered by health insurance.
As many as 55% of truck drivers are obese, compared with 33% of U.S. men, and the life expectancy of a commercial driver is 16 years shorter than the norm, the trade journal reported, referencing data from the Centers for Disease Control and Prevention.
Reaching this population represents an opportunity for community pharmacists and clinics to close an important gap in health care with an at-risk population that numbers in excess of 3.5 million. “But it’s not just the 3.5 million drivers,” noted Bob Perry, president of Rolling Strong, one of several organizations making a concerted effort to reach drivers with health information. “It’s the 3.5 million drivers plus their [families].”
Rolling Strong has teamed with several national healthcare-fused companies. Kroger pharmacy is the preferred provider for on-site health screenings, for example. Kroger pharmacists provide on-site biometric readings for drivers at Rolling Strong’s trucking clients and also on the road throughout their truck- friendly Kroger stores. Rolling Strong and Kroger also are working together to embrace professional drivers and their families by creating wellness educational materials designed specifically to help them stay healthy where they live — on the road.
The Healthy Trucking Association of America last month launched its HTAA Driver Vitality Program in partnership with the Vitality Group. “So many ‘wellness programs’ are really just weight-loss diet plans,” said Bill Gordon, HTAA executive director. “[The Driver Vitality Program] is a universal platform that all drivers can use — an industry standard that can benefit every driver and every fleet.”
In addition to its health-and-wellness program, HTAA this past season partnered with Walgreens on improving professional driver access to immunizations in communities across the country, whether that be through one of Walgreens’ points of care or at a fleet-sponsored, on-site flu clinic managed by Walgreens clinicians.
And the Truckload Carriers Association earlier this year partnered with Lindora Clinic on a weight-loss competition across the industry. Prizes will be awarded in May to the fleet and individual achieving the greatest percentages of weight loss. “For the past year, we’ve been increasing our emphasis on health in an effort to educate our members about the negative effects that obesity, sleep apnea and other medical conditions are having on the trucking industry’s work force,” stated Chris Burruss, TCA’s president.
In addition to partnering with Kroger, Rolling Strong has relationships with Snap Fitness, a 24-hour fitness center franchise with more than 1,200 locations nationwide. Rolling Strong soon will have 24-hour facilities in many Pilot Flying J travel centers. And the health-and-wellness program provider has partnered with Bayer Healthcare on providing diabetes education and meters. Rolling Strong also is exploring a partnership with Healthy Vending Management Co. on placing vending machines stocked with healthier choices across many of the truck stops and travel centers across the nation.
FDA debates expansion of switch paradigm
Get set for another decade of explosive growth throughout the over-the-counter category with the familiar switch as a catalyst.
The Food and Drug Administration public meeting that took place last month addressed a proposal to expand the switch paradigm by utilizing the latest in communications and diagnostics technology and/or incorporating the most accessible healthcare professional — the retail pharmacist — into the self-care decision protocol.
This would make prescription products available in the OTC space that go well beyond the latest series of complicated switches to hit the market — notably the emergency contraceptive Plan B One Step and Prilosec OTC. Both of those medicines were switched Rx-to-OTC with a dual prescription/nonprescription status. Plan B One Step is still prescription-only for women younger than 17 years, and Prilosec OTC is still prescription-only for a gastroesophageal reflux disease indication. The Drug Facts label on the OTC version instructs users to seek a doctor’s care if needed for more than two weeks.
But what the FDA and others heard over the course of that meeting wasn’t some kind of healthcare science fiction. The stage wasn’t being set for some future OTC Utopia where consumers appropriately self-select an OTC statin every time — the fact is the technology is already in the marketplace. In fact, just about everything needed is in place today, including the back-end infrastructure to support that technology and, on the clinical side, clinical skill sets among pharmacists who are proactively engaging their patients. Unlocking that technology could open up massive new OTC categories — it is projected that an OTC statin class could be worth $1 billion a year.
Market-driven technologies supporting compliance activities are the first to come to mind, suggested Chuck Parker, executive director of the Continua Health Alliance, when considering what tools are in place today that might facilitate a future complex switch. “That’s something that we already have in play in the marketplace,” he said. Something like cholesterol screening — a diagnostic tool that may improve appropriate self-selection of the aforementioned statin remedy — should become available in a retail setting, if not actually sold OTC, in the near future. “We have several companies that are working toward creating a standard to be able to capture that data in a relatively simple format, much like you would do with a glucometer,” Parker said.
The established back end of pharmacy communications also can help facilitate a future expanded switch model. “With the advent of SureScripts, we have a fairly robust and well-connected network now to track prescriptions and [to support] e-prescribing,” Parker said. “The evolution of that technology here in the United States is going to allow us to [engage] two-way communication much more effectively, not only to the physician who’s the prescriber but … [also] to the consumer level.”
In-store diagnostic tools that help improve compliance, contribute to a HIPAA-compliant health record and increase interception opportunities between pharmacists and patients are similarly in place. “We have a live [electronic medical record] today that’s actually sending patients data from the pharmacy directly into the patient’s health record at the physician’s office,” noted Ashton Maaraba, general manager and COO for PharmaSmart International. PharmaSmart has been featuring its Model PS-2000 With Connectivity, an in-store blood-pressure kiosk that integrates a “Smart Card” functionality to enable the transfer of blood-pressure and pulse readings through a secure HIPAA-compliant server and into an online patient health portal. “[This establishes] a link with the acute caregiver with a clinical specialist on-site,” he said. Already, supermarket pharmacies are incorporating that kiosk into their care protocol, Maaraba said, increasing pharmacist-patient interaction, augmenting that healthcare dialogue and then redirecting that patient to the dietitian across the aisle for additional advice on better health.
That pairing of Internet access with a patient identification tool could be a window into one potential future for pharmacy — a future where patients can self-identify a therapeutic need, sit down at a self-serve kiosk, identify themselves and proceed with an interactive online questionnaire to both improve appropriate self-selection and identify next steps. If blood pressure or pulse rates are pertinent, those tests can be administered at the kiosk. And if a patient has appropriately self-selected a therapy, that kiosk can generate a coupon receipt without which the therapy could not be purchased. It’s a self-selection tool that can both redirect a patient to a pharmacist consultation when necessary and pave the way to convenient access when not.
“Our kiosks are already programmed to do most of that,” Maaraba said, “including printing out the coupon.”