![pharmacist talking to a woman](/sites/default/files/styles/vertical_slide_956x675/public/2023-10/Sara%20Roszak%20231005.jpg?itok=Xo7T4_8P)
Poor nutrition is estimated to kill 10,000 Americans every week and cause 21,000 new cases of diabetes per week, cutting lives short, increasing suffering, and reducing quality of life.
Pharmacies are uniquely positioned to bring scalable solutions to the forefront. Nearly 90 percent of Americans live within five miles of a pharmacy, and both high-risk Medicaid and Medicare beneficiaries visit pharmacies significantly more than primary care providers annually (35 vs. 4 visits and 13 vs. 7 visits, respectively).
At the National Association of Chain Drug Stores (NACDS), we’re committed to exploring the intersection of pharmacy and nutrition, with the aim to equitably reduce the impact of diet-related diseases, particularly with populations experiencing food and nutrition insecurity. According to a Morning Consult poll commissioned by NACDS, 80 percent of adults support pharmacists helping patients prevent chronic diseases—and separately, also understanding their nutritional choices.
Future nutrition and health efforts should consider pharmacies as a partner to improve population health.
Last year, NACDS pledged a commitment to the White House Conference on Hunger, Nutrition and Health to undertake a nationwide public education campaign to communicate the growing proof of the connection between the foods you eat and your health and well-being. What has since transpired is #NourishMyHealth, a collaboration with partners including the American Cancer Society, the American Diabetes Association®, and the Food is Medicine Institute at the Friedman School of Nutrition Science and Policy at Tufts University. Nourish My Health encourages the public to ask your pharmacist how to check your baseline health numbers; use this information to understand your risk for diet-related disease; and work with your health-care provider to make a plan to reduce your risk, as appropriate.
Here are a few considerations for engagement of pharmacies in Food Is Medicine (FIM) initiatives:
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Pharmacies are a trusted, equitable source of care. The risk for food and nutrition insecurity and diet-related diseases is higher in historically underserved populations. Consider that Black households experience food insecurity at more than triple the rate of White households. A localized approach to prevention is needed. Pharmacists are among the most trusted providers of care, and pharmacies have been touted as stigma-free destinations to receive care. Even though half of American adults live with diabetes or pre-diabetes, there is still a need to identify individuals requiring nutrition services and refer them into care. Pharmacies are expert at doing so for a variety of interventions. There is vast opportunity to channel and translate such a model to FIM interventions.
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The pandemic underscored a proven ability to deliver just-in-time and scalable services for the public. Since the COVID-19 vaccine became available, more than 307 million doses have been administered at 41,000 pharmacies. When considering vaccinations, testing, and treatment services, and using conservative estimates, pharmacists and their teammates averted more than 1 million deaths, 8 million hospitalizations, and $450 billion in health-care costs. Experts are now considering how this network could be leveraged to address other disease states, such as hypertension. Taking this line of thinking further, imagine what applying this network could mean for FIM interventions.
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Since pharmacies are not incorporated into formal and compensated care models, they are limited in their ability to offer key care services. Were a new model to be established that fully recognized pharmacists, FIM, nutrition security, and other preventive care services could be managed more effectively for Americans. While pharmacies offer the trusted scalability and clinical expertise to provide FIM interventions across diverse communities, reliable sustainability is missing. Unlike other health-care professionals, pharmacists have limited opportunities to be compensated for the clinical care they provide. The Equitable Community Access to Pharmacist Services Act (H.R. 1770/S. 2477) would help to fill this gap to address certain health threats like influenza and COVID-19, building on the effectiveness and equitable reach of pharmacy-based care during the pandemic. Some states have made gains to address sustainability. For example, in Virginia, pharmacist care services are now covered by Medicaid, but Medicare seniors are still left out.
Additionally, value-based transformation may help create new opportunities to sustain FIM interventions. For example, the CMS Innovation Center has prioritized addressing health-related social needs within their models. Integration of pharmacies into value-based care models may support improved opportunities for pharmacies to scale and sustain FIM interventions to broaden the reach and impact of these interventions.
Pharmacies can be part of the solution in reducing the majority (85 percent) of health-care spending in the US that is related to the management of diet-related diseases. A renewed focus on nutrition will have meaningful results on our nation’s health. Future nutrition and health efforts should consider pharmacies as a partner with an aligned mission to improve population health.