‘Big box' companies and public health

Whether it’s because of a shortage of primary care physicians, impatience at the length of time it takes to see one, or simply increasing costs, the so-called big-box companies are getting more involved in health issues. Steven Burd, CEO of Safeway, told attendees at the World Health Care Congress (WHCC) in March that 70% of healthcare costs are driven by behaviour and he called for introducing market forces into preventive medicine and drug compliance.

Safeway has attracted a coalition of more than 50 other companies in promoting healthful behaviours. At Jefferson Medical College ‘s Department of Health Policy’s 17th annual Dr. Raymond C. Grandon Lecture, Dr. John O. Agwunobi, a senior vice president at Wal-Mart, spoke about bridging the worlds of business and public health. And also at WHCC, Stanley B. Blaylock, president of Walgreens Health Services, described his company’s healthcare initiatives.

In an interview with HOC, Blaylock noted that Walgreens has more than 6200 retail pharmacies, and that 146 of these have “Take Care” in-store clinics that the company is adding to at the rate of one a day. In March, Walgreens became the exclusive specialty pharmacy provider for Prime Therapeutics, a pharmacy benefit manager collectively owned by 10 Blue Cross and Blue Shield plans, which together serve more than 20 million health plan members.

Medmark, a Walgreens specialtiy pharmacy of which Mr. Blaylock, a former investment banker, was a cofounder, will provide Prime Therapeutics with medication fulfilment and complement Prime’s existing patient education and clinical support services. Its pharmacists and nurses will counsel patients on the importance of medication adherence and on managing side effects.

Blaylock describes the company’s new employer on-site clinics as “Take Care on steroids.” He notes that in the US more than 7000 employers have over 1000 employees, and 200 of these, including Sprint, BMW, and Disney, are Walgreens clients. Taking healthcare to the workplace, he says, increases productivity and accessibility while decreasing absenteeism. It’s also more user-friendly, he believes. The next step for Walgreens, says, Blaylock, is to integrate the company’s health services more fully in an attempt to provide something closer to the so-called ‘medical homes’ – comprehensive, community based primary care.

While Safeway, Wal-Mart, and Walgreens may all serve different client bases and adopt differing strategies to serve them, there is clearly a growing trend towards store-and work based healthcare delivery as we try to come to grips with the increasing challenges of cost, access, quality, and efficiency.