In an interview with Pharmacy opening hoursAleata Postell, group manager of pharmacy business development and head of specialty pharmacy at Walmart, spoke about the new autoimmune disease specialty community pharmacies (SPOCs). Postell said these pharmacies bring high-caliber specialty pharmacies to local communities to serve patients with more complex needs.
Q: What is a community specialty pharmacy?
Aleata Postell: Absolutely. From my experience, I know that a centralized specialty pharmacy model provides intensive care for specialty pharmacies. Our local specialty pharmacy takes that care and brings it into our communities where we have a Walmart pharmacy. And we’ve trained our pharmacy teams — both our pharmacists and our pharmacy technicians — in the areas of focus for those communities. So we started with HIV and now we’ve expanded that to autoimmune diseases.
Q: What does this model look like for the pharmacists and technicians in these pharmacies?
Aleata Postell: Sure. So when you think about what the specialty pharmacy needs for a patient, whether it’s mental health support, nutritional support, or more, that’s what it looks like. But if we take it a step further and start from a centralized model in our on-site pharmacy, our pharmacists can actually administer injections as well. For example, you have a patient with rheumatoid arthritis who is experiencing a flare-up and is having difficulty giving themselves the injections, or just some caregiver training. We take it a step further by having our pharmacy teams actually be able to provide that service to patients, but also help them with their OTC needs that they may need to manage their flare-ups and also provide them with nutritional support. And when you come to Walmart, you can get all of those things in one place. So when we started working on our on-site specialty pharmacies, we wanted to leverage our assets and what we do well and bring them together to provide the services for our autoimmune patients.
Walmart Pharmacy | Image credit: The Toidi | stock.adobe.com
Q: What does the expansion of autoimmune-focused SPOCs mean for Walmart and its patients?
Aleata Postell: So an autoimmune patient is living with a complex, life-altering disease. A patient with Crohn’s disease has a number of things to think about when caring for their patients or when they’re dealing with joint pain. So when we look at rheumatoid arthritis, Crohn’s disease, ulcerative colitis, our goal was to bring the right services together to make sure that patients get all the care they need from our community specialty pharmacies and to make sure they can live better by providing them with those additional health outcomes that they may not always get. And 4,000 of our locations are in areas that have been identified as underserved. So when we were looking at where we would locate our community specialty pharmacies, it was important to us to meet that need, particularly in those underserved areas, especially given that over 50 million Americans have some type of autoimmune disease.
Q: How did Walmart recognize the need for these SPOCs?
Aleata Postell: It was important for us to put our sites in the right places. When we looked at COVID-19, we realized we had a number of patients who needed some kind of care, especially if their immune system was already compromised. And during COVID-19, we trusted the pharmacists who stepped up and immunized our patients across America. To take it a step further, when I think about autoimmune diseases, sometimes you have to titrate your dose, so that first dose is really important and you have to understand what’s behind it. And then you also deliver the medication to the patient and hope that they take it correctly or their caregiver can administer it correctly. So our goal was: How can we get this out of this? We’re taking the learnings and experiences we’ve had during COVID-19 and creating a program that can help our patients feel comfortable with their condition, be able to manage it, but also provide them with guidance and insight, whether it’s through a community health worker who can provide them with additional services outside of dispensing medications, as I mentioned, or through nutrition programs because we felt that was so important for the autoimmune diseases that we treat. When we identified our sites, we asked ourselves: could they meet the needs of this community? Was there a need in this community? Were there the services there that we can provide? We were very intentional in our approach, so I’m excited about expanding and taking everything we’ve learned over time about the role of the pharmacist and the pharmacy team in relation to COVID-19 and applying that to specialty conditions to take it a step further. And being able to actually administer that care was really important in our strategy.
Q: Can you explain the focus on autoimmune diseases? What does that entail and how does it impact the business of these SPOCs?
Aleata Postell: Absolutely. So when you think about autoimmune disease, the number of those diseases has increased significantly over the years. It’s increased 451% in the last 10 years. When I came to Walmart and looked at the number of patients coming into our pharmacies in our communities, we had a number of patients coming in for treatment. So when we looked at whether we should pause patients and move them into a centralized model or bring treatment to them, the decision was simple: bring treatment to them. And so we built on the program that we had already started in 2021 that was focused on HIV and added autoimmune disease to it. It was an easy decision when we looked at what support mechanisms we needed to put in place to really treat an autoimmune disease and what role our pharmacies can play in that. And as I said, when you look at the benefits: they already come to Walmart for groceries and everyday household needs. If we can combine that with your pharmacy needs, we have a model that can help patients live better lives. And that was the goal of the program when we started it.
Q: What impact do you think these SPOCs will have on their communities and Walmart Pharmacy?
Aleata Postell: These community specialty pharmacies are part of the community, right? It’s in the name. So our pharmacists live there. They’re part of it. They know the needs of their communities. They’re a trusted part of their communities. So I just see that as kind of a seamless relationship. Today, they might have a patient that comes in with a specialty condition, and they’re already treating them for other comorbidities that they may have. So it was also really important to enable them to be able to treat the whole patient because our pharmacists are already very skilled. I can tell you, just go into any of our pharmacies and talk to the pharmacy manager there or any of our clinical services managers. They know exactly what the needs are in that community, and they know the resources and tools that they need to be able to support (patients). And so I see us just continuing to expand and really doubling down on our efforts and making sure that we’re helping patients live their lives to the best of their ability.
Q: Is there anything else you would like to add?
Aleata Postell: I think one of the things I’ll share with you is that in my history with specialty pharmacy – I’ve seen different models – we’re watching specialty pharmacy evolve. And at Walmart, we’re positioned to make sure we’re meeting that need. And again, the lessons we’ve learned from COVID-19 and the confidence that pharmacies have in delivering care are feeding into our program. And I’m really excited to be here and to be part of this journey and make sure we’re using our resources in the best way possible to help patients on their journey to overall health.
