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Chasing health inclusivity

The industry is tackling pharmacy-access inequities with a variety of strategies.
Mark Hamstra
september cover

The COVID-19 pandemic shone a spotlight on the concept of health equity, as the disparities of the disease’s impact among different demographic and ethnic groups was on full display.

This has led to an increased focus on the differences in access to healthcare among various communities and highlighted the practices of companies throughout the healthcare ecosystem, including retail pharmacies.

Often these companies are taking a holistic approach to enhancing equitable access to healthcare, both in the sense that they tackle the issue from several different angles, and also in the sense that they leverage the various resources that their entire enterprises can provide.

A Holistic Approach at CVS

Joneigh Khaldun, vice president and chief health equity officer, CVS Health, said making meaningful improvements in health equity requires an integrated, company-wide effort on the part of CVS.

“Our health equity approach requires the holistic and constant refinement of our organization’s internal processes,” she told Drug Store News. “We bring intentionality about applying a health equity lens to every aspect of our policies, protocols, data, quality and routine decision making.”

The company develops and implements specific action plans that seek to address disparities among the company’s patient populations, Khaldun said.

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holistic health

Among the company’s pharmacy initiatives are Project Health, a program that provides free biometric screenings, with no insurance required. These screenings—measuring conditions such as body mass index, blood pressure, glucose levels and cholesterol—can help identify chronic conditions before they become life-threatening illnesses, the company said. They can also include professional consultations, smoking cessation counseling and diabetes resources.

[Read more: What shopper expectations do first aid manufacturers need to meet?]

The company’s holistic approach to health equity is also reflected in efforts such as its Health Zones initiative, through which the company invests in local, high-risk communities to reduce health disparities and advance health equity. The Health Zones effort focuses on some of the key social determinants of health, including housing, education, labor, transportation and access to food and health care.

Khaldun said CVS’ Aetna insurance division is particularly focused on overcoming barriers to care in mental and heart health. For example, the company’s Aetna Medicare and Medicaid
teams developed an initiative that pairs its members with community-based health workers, aka CHWs.

“These CHWs help our members understand their covered benefits, book transportation to appointments, access social services, fill out necessary paperwork and navigate the healthcare system so they ultimately receive the care they need,” Khaldun said.

The company’s Aetna Medicare team also works to identify which of its members face digital health literacy challenges and what specific challenges they face, which has led the company to launch solutions to help address those gaps.

“Through our work with CHWs, we’re learning from those who understand communities best,” said Khaldun. “This allows us to build trust and create locally tailored solutions that make an impact.” Because the needs vary from community to community, national initiatives are most effective when they include a local element and perspective, she said.

Data and analytics will continue to be integral to the future of health care, Khaldun said, noting that the company leverages these tools to advance equity and inclusivity. “This includes being inclusive in how we define and develop solutions to our patients’ health needs by actively listening, leveraging both quantitative and qualitative data and incorporating patient and customer feedback into the design of our programs,” she said.

“I really see this as ground zero to do a lot more in our communities across Cincinnati.”
— Emmanuel Ayanjoke, owner, Altev Community Pharmacy
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Altev Community Pharmacy
Altev Community Pharmacy

McKesson Targets Pharmacy Deserts

Access to pharmacies is one of the most visible aspects of inequities in healthcare. Nearly a quarter of all neighborhoods in the United States can be classified as pharmacy deserts, according to research from The University of Southern California, in partnership with the National Community Pharmacists Association. Many of these underserved areas tend to have high Black and Latino populations, the research found. The research defines a pharmacy shortage area as one where the distance to a pharmacy is greater than 10 miles in a rural area, two miles in a suburban area, one mile for urban areas and a half mile in low-income neighborhoods where vehicle ownership is low.

[Read more: 50 Most influential people in retail health]

The problem is exacerbated by the closure of independent pharmacies under pressure from the drug-pricing practices of pharmacy benefit managers, according to the NCPA.

One example of an effort to tackle this problem is McKesson’s Project Oasis, which seeks to improve access to care and advance health equity for at-risk populations in underserved communities. This initiative has manifested in the form of Altev Community Pharmacy in the Cincinnati neighborhood of Avondale.

McKesson said it evaluated pharmacy deserts in communities around the country before selecting Avondale as its pilot location. The company helped Emmanuel Ayanjoke, a pharmacist focused on building strong ties with the local community, open the store.

Avondale is the largest neighborhood in Cincinnati, yet it lacked a retail pharmacy, said Rousseau O’Neal, VP, inside sales, Masters Drug Co., McKesson, in a video describing the project.

altev

“We wanted to not only put together a plan to bring a pharmacy, but to allow somebody who could touch the community, who understood the community, who we could invest in, and we found one,” he said.

Ayanjoke said local residents have been very supportive of the new pharmacy in their neighborhood. “The reaction from the community has been, ‘Wow we actually have a pharmacy,’” he said. “And not just any pharmacy—a Black-owned pharmacy that they feel they can open up to and talk about their health challenges to you.”

The store is helping fulfill a lifelong dream to serve the community, Ayanjoke said, adding that he hopes it is a springboard for additional initiatives around the city. “I really see this as ground zero to do a lot more in our communities across Cincinnati,” he said.

“Through our work with community-based health workers, we’re learning from those who understand communities best.”
— Joneigh Khaldun, vice president and chief health equity officer, CVS Health

CVS tackles inequity through housing investments

CVS’ housing investments seek to provide low- income people with affordable places to live combined with health services.

Among these investments, CVS this year said it invested $19.2 million to build 85 new units of affordable housing in Arvada, Colo., in a development called Marshall Street Landing. The development will provide permanent supportive housing for families and individuals experiencing homelessness, the company said. CVS will partner with local service providers to offer mental health and substance abuse counseling and other services to help the residents avoid returning to homelessness, the company said.

Similarly, CVS also recently pledged nearly $35 million to develop affordable housing in Hawaii, including a development in Lahaina, which suffered a devastating wildfire in 2023.

During the past five years, CVS’ housing investments have helped create nearly 2,500 permanent supportive housing units for veterans, LGBTQ+ individuals, those experiencing homelessness, single-parent households, victims of domestic violence, youth aging out of foster care, those with physical, intellectual, and/ or developmental disabilities, those in need of mental health or substance abuse support, Second

Chance participants, victims of human trafficking and other groups.

Technology also plays a role in McKesson’s multifaceted approach to health equity, as reflected in its stated purpose of “Advancing Health Outcomes for All.” In the company’s 2024 Impact Report, McKesson explains how its Prescription Technology Solutions, or RxTS, suite of services seek to enhance patient outcomes by helping overcome barriers, such as financial constraints and complex insurance requirements.

“McKesson is an impact-driven organization,” Nimesh Jhaveri, executive VP and chief impact officer, McKesson, told Drug Store News. “Guided by our purpose of ‘advancing health outcomes for all,’ we are committed to making better health possible, notably in improving healthcare access and equity.”

[Read more: 10 states ideal for retail pharmacy]

The company’s health equity efforts are focused on improving access, affordability and adherence to prescription medication, advancing health equity in oncology, and in removing barriers to quality care in its communities, he said.

Haleon Tackles Bias and Prejudice

Rachel Marler, chief customer officer, U.S., and head of Americas Commercial Excellence, Haleon, said health equity encompasses a range of initiatives at the consumer products company.

“At Haleon we have an enterprise-level focus and commitment to tackling the barriers that stand in the way of people’s better everyday health,” Marler said, citing efforts to empower self- care and investing in initiatives that seek to increase health literacy and accessibility and counter bias and prejudice.

Overcoming health inequity requires a multipronged approach, Marler said. Among Haleon’s recent initiatives was its Seeing AI application, which is a free app that scans the information on product labels and reads it out loud for more than 1,500 Haleon products.

“This is helping to make our brands more accessible for people who can’t read our packaging,” Marler said. Last year Haleon also launched the Advil Pain Equity Project, which is a long-term commitment to champion equitable and accessible pain relief, created by Advil and launched in partnership with Morehouse School of Medicine and BLKHLTH. The project’s first campaign, called “Believe My Pain,” focused on illuminating the issue of pain inequity in Black communities.

The brand provides resources for both patients and providers to help them understand the racial biases that can have a negative impact on the healthcare of Black Americans.

Marler said Haleon focuses on breaking down three of the biggest barriers to health equity:

  • Health literacy, which the company is tackling by leveraging its brands and its people to educate and empower healthy living and healthy behaviors;
  • Healthcare accessibility, which Haleon seeks to address by improving access to its products and services to support everyday health and meet the needs of underserved people, and
  • Bias and prejudice, which the company seeks to overcome by working to drive more inclusive policies and practices and challenge outdated norms.

Health equity is a complex goal that has several variables and stakeholders, Marler said.

“For it to have a meaningful impact, it needs to be intentional and address the challenges marginalized individuals and communities face,” she said. “A single organization cannot solve this issue on its own. At Haleon, we are doing our part and collaborating with like-minded stakeholders across the industry—including business, policy, academia, healthcare, non-government organizations, community and media for coordinated strategic action and measurable outcomes.”

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