Total Care

NEARLY 24 MILLION AMERICANS of all ages have diabetes, with 1.6 million new cases diagnosed each year. For most sufferers, it's a chronic condition that largely can be managed through lifestyle and diet — and until recently, supermarket retailers focused on the latter, by highlighting food products in their stores that were diabetic-friendly.

Now, this group of special-needs shoppers is being directed to the pharmacy, which is emerging as a comprehensive one-stop destination for medication, education and health products.

“You're seeing a lot of innovations take hold,” said Edith Rosato, senior vice president, pharmacy affairs, at the National Association of Chain Drug Stores, Alexandria, Va. “Supermarket chains are taking a look at the role of the pharmacist and testing these innovations to see how best to utilize the services and knowledge they provide.”

The developments come at a critical time in the country's fight to curb an epidemic of diabetes, and the health conditions that usually precede onset, namely obesity. Prevention efforts, led by First Lady Michelle Obama's “Let's Move” crusade, are top-of-mind with public health advocates, and nationwide awareness campaigns that promote testing have increased the number of Americans learning their status.

The strategic change has important implications on the retail side, where catering to such a population has been a mixed bag of medication from the pharmacy, food on the grocery side of the store, and occasional classes and tours.

The shift in the government's approach is now compelling many supermarkets to reassess their own efforts, and the result is a consolidation of several autonomous efforts into a single, all-inclusive umbrella that places the pharmacy in the center.

“We always focus on how we can be the ‘one-stop,’” said Publix Super Markets spokeswoman Maria Brous, about the company's Pharmacy Diabetes Management System introduced to stores in March. “As a grocery store we have that unique opportunity. It's very turn-key for our customers.”

Supermarkets find they have a chance to improve the profile of their pharmacists. Introducing programs like those for diabetes can translate into additional interactions between professional and shopper, beyond discussing medications.

“They look at the patient in a holistic way and they look at them from a disease state,” said Rosato. “It's no longer just about the medication; it's about the person, the patient and how you manage their disease state along with their medication.”

The centerpiece of the new supermarket approach to diabetes care is a number of management programs that allow retailers to tap the in-house expertise of the pharmacist while providing cost-saving benefits usually associated with loyalty card plans. Besides Lakeland, Fla.-based Publix, other chains leading the way include Price Chopper Supermarkets, Schenectady, N.Y., Giant Eagle, Pittsburgh, and CVS, the drug store chain based in Woonsocket, R.I.

“This diabetes program is meant to stand all on its own,” Brous continued. “With the increase in patients who face diabetes and need lifestyle changes, we were looking to provide the best resources for them.”

The Publix program offers free dosages of the common diabetes drug Metformin, in three strengths, an offer that saves the customer about $21 a month. Additionally, shoppers can sign up for automatic refills and receive educational materials online through the retailer's website.

“The online component continues to provide an information base, along with shopping ideas and recipes, and eventually we'll offer coupons,” noted Brous.

Medication, diet and lifestyle are also the focus of the Diabetes AdvantEdge program at Price Chopper. Here, the focus is on integrated care, with free medication, and a level of education and information that goes deeper than what nondiabetic wellness consumers look for, according to officials with the 128-store chain.

“The foundation of diabetic treatment is medication, so we've focused on those oral medications that are most commonly prescribed, and we've added free lancets and lancing devices, which are common needs, but costly at $5 a pop,” said Mona Golub, Price Chopper's vice president of public relations and consumer services. The retailer also includes automatic refills through its AdvantEdge refill system.

Giant Eagle has also joined the trend, offering five prescription medications for free in stores located in western Pennsylvania. Glimepiride, Glipizide, Glyburide, Metformin and Chlorpropamide were previously available for $4 under the retailer's reduced prescription plan. Since the introduction of the free initiative, which was tested in two Ohio markets, Giant Eagle officials estimate that type 2 diabetic consumers have saved more than $200,000 in prescription costs alone.

“Adding these five medications to Giant Eagle's free prescription program, while providing other ways to manage diabetes through the various healthy living solutions offered in our stores, reinforces our commitment to promote healthy lifestyles for all of our customers,” said Randy Heiser, the retailer's vice president of pharmacy operations.

Giant Eagle shoppers in search of assistance with their disease will also find specialists in the pharmacy who are trained in diabetes care. Beginning in September, they will also be able to attend nutrition classes in any one of 29 regional store locations.

Giant Eagle's program was created in conjunction with the American Diabetes Association's nationwide initiative, Stop Diabetes.

Creating a wellness umbrella to cover their diabetic customers demonstrates the deeper understanding retailers have about the disease and its connection with diet. It helps that supermarkets already have regular health and wellness programs in place, according to industry experts.

“People are going to have questions, and with food, one of the first places they turn to for information is the supermarket,” said Ted Taft, managing director of Meridian Consulting Group, Wilton, Conn. “You don't want to just show up and see products, and not have someone to talk to if you need some input.”

Taft notes that retailers have simplified the task of creating diabetes management initiatives by folding them out of their current loyalty card programs. Price Chopper ties into its existing AdvantEdge card, while CVS/Caremark relies on its ExtraCare program.

“Think of it as another category,” he said. “Being recognized as an expert in diabetes care is another one way of telling the shopper of the business you're in, and that has a halo effect on other choices they make down the road.”

The benefit of an umbrella program for those coping with the disease is convenience. Not only do they now have a reliable source of information and guidance outside of the medical community, they can immediately apply what they've learned on the pharmacy side of the store to the aisles.

“Gone are the days of a ‘diabetes diet’ and thankfully, we really don't even use the word ‘diet' anymore,” noted Kellie Rodriguez, director of patient education at the Diabetes Research Institute, Miami. “The word diet implies depravation. Our goal here is to create an informed consumer.”

The institute offers English and Spanish versions of a monthly class called “A Trip to the Supermarket.” Each two-hour session focuses on healthy eating and diet principles, using products purchased from local food stores.

Instructors emphasize label reading, and show students how to decipher the Nutrition Facts panel and the ever-growing number of health claims promoted on the front of every package. Deciding which information to believe is often the most important decision shoppers can make.

“We tell people to avoid the front of the package because it doesn't always tell you everything that's going on,” said Rodriguez. “We focus on getting people to read the food label itself, as well as the nutrition panel for the real story.”

The class covers much of the same ground as those inside many supermarkets, except there, the classes are led by dietitians and pharmacists. Rodriguez said that the need for specialized educational forums has decreased as supermarkets themselves have assumed a stronger teaching role.

“The situation has had to improve because, as consumers, they've demanded it,” she added. “Both grocers and manufacturers have realized they have an important role to play.”

GOOD ADVICE

• Review pharmacy sales records to determine the store's potential diabetic population.

• Check with service organizations such as the ADA to determine cooperative programs.

• Retailers who have folded out their loyalty card programs to cover purchases for fuel, etc., already possess a template for a diabetes program.

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SOURCE: Company press releases