During a recent virtual conference sponsored by the Northeast Business Group on Health (NEBGH), our CEO, Karthik Ganesh, led a panel discussion about the outlook on vaccines and game-changing treatments for COVID-19.
The insightful conversation got us thinking about the role that employers and sponsors can play in COVID-19 vaccine strategies. So, I sat down with Polina, our Chief Pharmacy Officer, to continue the conversation. Here are some of her thoughts:
Question: Why is a value-based and holistic approach to medication management especially critical to the success of COVID-19 treatment and prevention efforts?
Polina: We may feel like we’re dealing with COVID-19 overload sometimes, but we can’t forget that it’s a brand-new disease in humans. Every day we learn more about the virus and more about the populations at highest risk. So, it’s critical to look at the big picture right now. To arrive at the best clinical outcomes, we must first accurately gauge who’s at the highest risk. We have to consider both clinical and social factors, which requires complex risk stratification—not just looking at conditions in isolation. At the same time, we need to analyze the data to see which interventions deliver the greatest value and outcomes across each population. That’s the only way to arrive at treatments that work clinically and practically.
Question: What opportunities do you see for pharmacy leaders to work together with employers and sponsors to create COVID-19 vaccine strategies—especially once several different vaccine products become available?
Polina: First of all, it’s important for people to understand that we’ll have multiple COVID-19 vaccine options at some point. Not initially, of course. But in relatively short order, there will be several vaccine products, each with different safety profiles and guidelines. Pharmacists and clinically focused pharmacy benefit managers like EmpiRx Health are in a great position to lend their medication management expertise by reviewing and identifying the safest and most effective options to guide clients and their members.
Question: How can employers help build confidence in a COVID-19 vaccine?
Polina: Employers are absolutely crucial to successful vaccination efforts. Not just because they offer healthcare benefits coverage, but because of the trust factor that exists between employers and their employees. As EmpiRx Health we assist employers with education efforts by answering questions such as: Who’s most at risk for COVID-19 and how do we know? How are vaccines created? Employers can play a big part in combating misinformation and educating their employees about the importance of COVID-19 vaccines.
Question: What is the #1 thing employers and sponsors should be doing right now, as we wait for a COVID-19 vaccine to be approved?
Polina: Good question, but I’m not sure there’s a #1. Really, several things should be done in tandem. First, we should analyze existing data, and use that analysis to educate employees and members. Look at their current flu vaccine patterns, for example. We could reasonably assume that COVID-19 vaccine patterns might be similar. So, education aimed at easing whatever qualms employees have about flu vaccines is a good way to proactively address potential COVID-19 vaccine concerns as well. Employers and sponsors also should be thinking about how they’ll cover COVID-19 vaccinations. Do they prefer to cover the vaccines on the pharmacy side or medical side of the benefits, for instance? Even without knowing cost details, we should start those strategic discussions now. It will make it that much easier to hit the ground running once a vaccine is approved.
Question: What role will data and analytics play in COVID-19 vaccine plans?
Polina: An enormous one. COVID-19 is showcasing the benefits of data and predictive analytics in healthcare. EmpiRx Health was utilizing risk stratification powered by the Johns Hopkins ACG® Model, alongside other tools and algorithms, long before COVID-19 emerged. We’ve seen such applications generate tremendous insights for improving health outcomes, particularly when paired with other data sources such as social determinants of health (SDOH).
Where people work and where they live, their socioeconomic status, their age, their race, their gender—all of these factors impact COVID-19 risk. We can’t manage COVID-19 effectively if we don’t incorporate SDOH into our analytics. Because of this, COVID-19 has awakened many others in the PBM space to the idea that the riskiest, most vulnerable populations must be managed differently. It’s through artificial intelligence, risk stratification and predictive analytics that we can proactively manage the populations at highest clinical and financial risk to help keep them well.
Question: What should PBMs be doing to help employers and sponsors deal with COVID-19 in the short- and long-term?
Polina: I think our assistance must be as practical as possible. PBMs should offer value-based, data-driven risk management strategies. We should be helping employers and sponsors find COVID-19 therapies that improve health outcomes first and foremost, but that also deliver overall financial savings.
What’s clear from today’s discussion is that while there is uncertainty around when a treatment or vaccine will be in place, there are concrete steps that employers and plan sponsors can take now for when one is in the market. By being proactive, employers and plan sponsors can help reduce the burden and uncertainty that their members feel as they navigate the next phase of the pandemic.