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Episode 11 – Employers Health Pharmacy Residency Program

Learn how employers will benefit from Employers Health’s new pharmacy residency program from Director of Pharmacy, Matt Harman, along with Kevin Wenceslao, pharmacy resident. They’ll share the benefits of an on-site flu clinic, trends in pharmacy benefits and more.

Marcas Miles (0:09)

Hello, and welcome to the Employer’s Health HR Benecast, your source for clarity on health benefit trends and strategies. I’m Marcas Miles, your host, as usual, for the podcast. And in this episode, we’ll talk about a number of new communication efforts that have been underway and some new resources that we want you to check out.

We’ll also talk about our upcoming Learning Opportunity Networking Opportunity Agenda, which includes our third annual Health and Wealth Administrator Workshop coming up this month in August. And then I’ll introduce you to a new program that we have here at Employers Health, a pharmacy resident program. So you hear from Matt Harmon and our new resident in that space.

To start this podcast, I’d like to remind you to listen for a keyword that we include in each episode, and you have the opportunity to become a lucky winner if you simply respond back after listening to the podcast with the keyword, and we’ll enter you into a contest to win a $50 Visa gift card simply by submitting the word. So I’ll give you that word a little later in the podcast, and then all you have to do is click on the submit question button on the landing page here for the podcast.

So a number of new things that we’ve been working on for you and excited to share is one being a new website.

So we recently launched a brand-new website at employershealthco.com. It had been a number of years before we had done a real overhaul or refresh, and boy, did we do it this time. So I would love for you to check that out, especially noting some new areas on there. One is a number of resources and tools under our Connect tab.

Under there, you’ll find things like our most recent magazines. You’ll find this HR Benecast. Past editions of that are posted there as well.

And what we call Benefits Insights, or really a stable of articles, white papers, things that are important to you that we’ve either written on or posted or published in our magazine. So would love for you to check that out. We also, under the Programs tab, we post meeting materials from our latest conferences, webinars, and other things that are learning opportunities that you could either look back at, or if you missed, have an opportunity to download the materials that would have been presented at a particular program.

Under the Programs tab, we also have our events calendar and some other things there for you to take a look at. Some other things, we recently published an RX Annual Report or a look back at our PBM program over the last year, also posted out on the website. And our latest Employers Health Annual Report that you’ll want to take a look at.

We really went with a theme of In Your Words. So we took words that we hear from you, especially quotes that some of you have given us, and included those and peppered some different words throughout the annual report. So give that a look when you do have some time to check that out.

So I mentioned our upcoming Employer Health and Wealth Administrator Workshop. This is the third one that we’ll have hosted, and it really has become a signature event for us. It’s one that’s very popular, even though the topic in general and the different sessions tend to be a little heavy in information.

It’s very relevant, very helpful information, and that’s the feedback that we get from you after the previous two editions of this particular conference. So it’s going to be in August this month, on August 21st, in Columbus, Ohio again. This year it’ll be at the Columbus Hilton at Easton Town Center, and the time is 8:30 until 3:30 p.m. Really great lineup of speakers that really are experts in compliance from places like the United States Department of Labor, Cornerstone Capital Advisors, Thompson Hein, and the topics range from DOL investigations, unemployed benefit plans, HIPAA, what employers need to know to protect their company, aiming for the retirement bullseye, making friends with the FLSA, new employer-friendly changes on how you should comply, and then even a session on Back to Basics, documentation and recording for health and welfare plans.

So you’ll definitely want to get that on your calendar, make sure you register. The registration is up and available. We have gotten approval for five hours of continuing legal education through the Ohio Supreme Court, so bring your legal friends, bring those colleagues on your team at your company that are responsible along with you for compliance, any vendor that you work with to help you with compliance and legal issues, please feel free to bring them along with you.

And we also will be providing recertification credit hours towards PHR and SPHR, so you’ll want to be sure to get on the registration list for that plan to attend on August 21st.

On August 27th, we’ll be hosting a webinar, Suicide Prevention and Awareness, in the Workplace, something that is very important, something we all have got to be talking about. Our friends at Comp Psych will be providing that webinar and I’ll be also providing a little bit of information around the work that we do around depression at the workplace, so certainly an important one that you won’t want to miss on August 27th from 3 until 4 in the afternoon.

And then, as always, you can find all of the other upcoming events on our website that we are always trying to put together to meet your needs and really comply or meet the needs that you’re faced with, the challenges you’re faced with on a regular basis, so please take a look at those.

Now, I have an opportunity to chat with Matt Harmon, our Director of Pharmacy Initiatives, and Kevin Wenceslao, who is our new resident here at Employers Health. Joining me to talk about a new initiative that we have here at Employers Health, a residency for managed care pharmacy program, are Matt Harmon, our Director of Pharmacy, and Kevin Wenceslao, our new resident.

Welcome both Matt and Kevin.

Matt Harman (6:36)

Thanks for having me, Marcus.

Kevin Wenceslao (6:37)

Thank you.

Marcas Miles (6:38)

Sure. So, we’ll start with Kevin. Matt will have you tell us a little bit about the program in general but really want to just introduce Kevin into the picture here.

And Kevin recently graduated from The Ohio State University College of Pharmacy. So, Kevin, that was just recently, right? You just graduated.

Kevin Wenceslao (6:58)

Yep.

May of 2018, so brand new.

Marcas Miles (7:01)

Okay. And so, as with other medical programs, I think, you know, I ultimately think of doctors or physicians, you know, whether in a hospital setting, I guess I didn’t realize that there was a residency for pharmacy.

Tell us a little bit about that in general, and what the requirements are.

Kevin Wenceslao (7:16)

Yeah, more and more pharmacists are being pushed to help on the clinical side of things. Traditionally, there has been a residency program one to two years for the hospital side, but more recently things have started to expand to the community side with retail pharmacy residencies, as well as managed care, which is working with health plans and pharmacy benefits managers.

Currently, right now, a lot of managed care pharmacy residency programs are one year long, and it helps just provide that intro into what managed care is all about, and really provide the experience at an accelerated rate.

Marcas Miles (7:55)

Nice. And so, obviously, you’ve been in Columbus for a while, but where do you hail from?

Kevin Wenceslao (8:00)

I’m from the suburb of Chicago, Illinois, Arlington Heights, for those that are familiar.

Marcas Miles (8:05)

Gotcha. All right. Well, Matt, this is obviously a new area for employers health, and we continue to evolve and grow, and you’ve been here for a little while now, but just curious to know, you know, why we did this, or what we expect, or even what our members can expect to benefit from such a program.

Matt Harman (8:28)

Sure. So, yeah, I’ve been with the coalition now for five years, over that time, we’ve doubled in size, both from, you know, total lives and employers and staff. So, really, that growth of the coalition was a primary motivation to expand our clinical resources.

So, you know, I’d love to be at every meeting on every call, but since it’s a little tougher to do that when you have over 200 employers, I saw the opportunity to expand our clinical team, and I thought a good way to do that was to have a residency program similar to, you know, we have internship programs for other positions. I think this is a good training ground to, you know, immerse a pharmacy graduate into the managed care field, and also, you know, the unique setting that our coalition provides, and really trying to, you know, we pride ourselves on being that independent clinical resource for our members, and I think this is, you know, a way to expose the students to, base graduates to the PBM industry, since it’s not really taught a lot about in pharmacy school as much as we’d like to see, and, you know, I think that also, you know, the pharmacy benefit has just become a growing importance to our HR benefits folks, including that, you know, we have CFOs now attending meetings to get…

Marcas Miles (9:53)

Which is good. I mean, we’ve wanted that for a long time, so that’s good that they’re involved.

Matt Harman (9:57)

Exactly. So, we have that, you know, that heightened awareness of the pharmacy benefits, so we want to have, you know, those resources to be able to establish our expertise as a, you know, a clinical coalition.

Marcas Miles (10:10)

So, can our members expect to see Kevin? Will he tag along to meetings with you? Will he be joining account managers? What’s the plan as far as interacting or engaging with our clients or members?

Matt Harman (10:22)

Absolutely, yes.

So, we’re about to kick off the mid-year review season with our PBM, so right now, I think that Kevin will be going to a lot of the meetings with me, tag along, to kind of see how we operate, how, you know, we have, you know, different roles with, depending on, you know, the size of the employer. So, some, we are the face of the clinical team, and some, we are more, you know, that partner with our PBM vendors. So, kind of see how we interact on both sides, and then hopefully for annual review season next year, we can just split up those.

Marcas Miles (10:57)

Well, yeah, or kind of share the love, right, with those different.

So, Kevin, you’ve only been here, is it a month? Not even, maybe?

Kevin Wenceslao (11:05)

About a month.

Marcas Miles (11:06)

Okay, about a month. So, I imagine that Matt has lined up some projects or things that even that you probably have requirements, right, for the residency.

So, what are some of the things that you’ll be working on?

Kevin Wenceslao (11:19)

Yeah, so currently, day-to-day, I’ve been helping out with some of that clinical advising role. So, with our account managers coming to me, asking about questions about trends or things that they want me to take a look at. I’m really excited.

This week, we’re going to have our first rotation student from Ohio State. So, I’m going to be assisting and helping with the preceptor roles, helping guide that student, and just make sure that when Matt’s busy with some of the other work with Employers Health, that that student’s accounted for to help provide that learning experience for them. Throughout the year, we’ll be doing flu shots this coming couple of months.

First couple of them, I’ll be-

Marcas Miles (11:56)

It’s a popular season. Matt is very popular during that time.

Kevin Wenceslao (12:01)

So, I’ll be with Matt for a couple of them, the first few sessions, and then we’re hoping to send me on my own to try and help tackle the state and really get those finished quickly.

Hopefully-

Marcas Miles (12:12)

Let me interrupt. How many shots have you given so far?

Kevin Wenceslao (12:15)

I’d say, if I had to estimate, around 200. So, I’ve done one where it was rapid fire at an employer, and we just kind of had them line up, but nearly not as much as-

Marcas Miles (12:26)

So, you’re pretty confident then? You’re pretty confident?

Kevin Wenceslao (12:28)

Maybe.

We’ll see.

Marcas Miles (12:29)

Okay.

Matt Harman (12:30)

The average between us would be about 6,000 total that we’ve given.

So, if we add up all of them.

Marcas Miles (12:33)

Yeah, sure, sure.

Kevin Wenceslao (12:35)

That’s Matt-heavy there.

Marcas Miles (12:36)

Yeah, right, right, right. So, what are some other things, anything else that you have top of mind that you’ll be working on or want to do, I guess?

Kevin Wenceslao (12:44)

Yeah. So, for the Academy of Managed Care Pharmacy, which is our big organization that handles managed care pharmacists, there is a conference in the spring that I’m hoping to prepare a research project on.

I’m not sure what the topic will be just yet. I’m going to try and utilize something that might be useful for Employers Health to know, and hopefully I can present that poster at that conference to help spread that information and maybe use that to deliver better outcomes or improve some of our processes.

Marcas Miles (13:14)

I would imagine that you had other opportunities for your residency, and this is obviously a new one.

We’ve already discussed that, but what was attractive about this type of setting or opportunity for you over, say, a retail pharmacy environment?

Kevin Wenceslao (13:32)

Yeah. So, all through school, they teach the two main routes, which is retail or community pharmacy versus hospital. Having discovered managed care pharmacy, I really like the broad-level perspective it gives me with population health, especially with the way our economy is going.

It’s something that’s really important and becoming a bigger and bigger factor every day, especially with new medications coming out. So, in an effort to learn more about this field and try and understand more, I started looking for managed care residencies, and a pharmacist in a coalition is actually one of the newer roles I’ve seen, which provides me the experience to work with pharmacy benefit managers or PBMs but still continue to advocate for both employers and the clients. That’s something that’s really important to me.

I like to have that balance, to be unbiased when it comes to providing advice and also trying to healthcare as a whole to help improve not just cost but also getting patients the medicines they may need.

Marcas Miles (14:34)

We see it as important as well, and I think that’s why you mentioned it is an emerging space and something that we see value in as we enhance our services and do more of the things that maybe traditionally the PBM has done or just really to enhance the member experience that we pride ourselves on. Matt, talk to us about how our Employers Health members can expect to either benefit or, we already talked about it, interacting with Kevin, and ultimately what, you know, after doing this pilot or this residency program, what success looks like?

Matt Harman (15:12)

Sure.

So, our members should benefit from just having another set of eyes on their data, just our book of business data to recognize trends. You know, like Kevin talked about, we have another independent resource, so we were able to really refine our strategies and, you know, have him hopefully in person or on the phone for all of our meetings. You know, also, we’ll hopefully free up some of my time to be more strategic and less day-to-day operationally so, and I think it’s just, this is just the start of expanding our clinical team.

I think that, you know, I think that’s really what the, you know, the future of the coalition holds where we can have a pharmacist at every single opportunity, a meeting, and that we would have. So, I think success is where we are developing confident clinical advisors that are able to help our employers manage their drug spend and trend. You know, Kevin mentioned Academy Managed Care Pharmacy.

I would love for the AMCP to recognize this as a, you know, a premier residency program that pharmacists can attend outside of that community and hospital setting. So, that’ll take some years to develop as we, you know, we train more and more residents down the road. So, you know, I’m very excited at the opportunity that we have here.

So, you know, we mentioned flu shots. I’m happy to, you know, have Kevin on board for that to break up some of the travel and hopefully grow the program.

Marcas Miles (16:42)

Yeah.

So, while we’re talking about that, is there, you want to give a plug for that or what’s the, what’s the sign-up window or how, how does one of our members go about signing up to get you to come on site for that?

Matt Harman (16:53)

So, currently that is for our members in Ohio and Kentucky since that’s where I’m licensed, Kevin’s licensed here in Ohio and, you know, maybe as we have more pharmacists and license and more states, we could expand to, you know, the rest of the nation. So, right now, yeah, we are starting to schedule our membership for the seasons, kind of mid-September through early November and generally Tuesday through Thursday are the dates that we find best that had better uptake with our employers.

Marcas Miles (17:25)

Gotcha.

So, is that a simple reach out to you or Judy here in our Dublin office? What’s the best way to, to?

Matt Harman (17:32)

Either reach out to me or your Employers Health account manager.

Marcas Miles (17:35)

Right. Okay.

Matt Harman (17:36)

And so, we can talk, you know, we have, we tend to pride ourselves with its best in class pricing. We, you know, show up on site to give, give the flu shot. We’re pretty efficient, you know, my record is 55 in an hour.

Marcas Miles (17:48)

So, wow.

Matt Harman (17:49)

And we are, you know, about 30% less than what you would pay at a pharmacy and 100% less than when you pay at the doctor’s office. So, we, it is really a value-add program.

We joke about, you know, that like how it’s a profit driving program, but because it’s really not, it’s really set a friendly program for our members. Just, you know, we try to provide as many benefits to our membership that we can.

Marcas Miles (18:13)

Well, let’s switch gears just a little bit.

And I know that many of our listeners would, you know, if they knew they had your ear, they would ask you about trends, right? So, I know that’s something you talk about a lot and Kevin, feel free. You’re, you’re just coming out of looking at things like this, probably on a regular basis. So, what are some trends even through the end of the year or going into next year that, that you’re seeing or that, you know, we should all be aware of?

Matt Harman (18:38)

Sure.

So, I mean, specialty, it’s been the trend for, for quite some time and that’s not going to slow down. That’s where the manufacturers are focused on in the pipeline. We’ve seen some major drug approvals already this year, especially in the migraine space.

So, we’ve had the, for migraine prevention, a drug called Imavig was the first in its new class of medications called the CGRP drug class. So, that’s kind of the new potential blockbuster class that was approved back in mid-May and we should have two to three more approved over the next six to 12 months. And really, that’s, it’s a medication that has shown some value for those, for the patients it works with, and we just want to make sure we have controls in place to ensure that those members get it but make, and if it’s not working, then we would switch them off there.

Marcas Miles (19:29)

I feel like a few years ago there were, there was migraine medications or there was a push on migraine medications a few years ago and then I hadn’t heard much about it until recently. Is there a new approach, a new, a new drug that’s better than what has been in place before? Why, why the resurgence?

Matt Harman (19:49)

Really, because these are the first class of migraine medications that are for prevention.

Marcas Miles (19:55)

Okay, so, okay, so it’s not treatment, it’s preventing.

Matt Harman (19:58)

Yeah, that, so the other prevention drugs out there are, you know, maybe a blood pressure medication or an anti-seizure medication that, hey, then they found out this actually works for migraines. These were specifically designed for migraines. Now, there is some concern from a long-term safety perspective in my eyes since the drug, the CGRP in the body, helps have some kind of cardiovascular protective effects and migraine patients have a higher risk of cardiovascular outcomes.

So, I still think we really want to reserve these for those patients that have severe migraines until the data shows that it doesn’t reduce the risk, you know, it doesn’t hurt their cardioprotective benefits. So, that’s probably one of the bigger ones. And then from a non-specialty side of things, the dermatological class.

So, you know, there’s a lot of brand medications or, you know, when a patient goes to the doctor’s office, a physician might have a sample of a dermatological medication. If you think, you know, you take this sample and it clears up your skin, well, it kind of creates more brand loyalty. So, sometimes, while there’s a lot of generic that may act the same way or have the same efficacy and safety.

So, we might have there’s some new kind of step therapies that we want to kind of have in place for our members since a lot of focus of our payers have been on the specialty side. So, manufacturers have realized that and say, hey, well, let’s play around in the non-specialty space, which is where 99% of your prescriptions are. So, I think that’s one way to best manage your ability to pay for your specialty medications is to have those utilization management strategies for your non-specialty medications.

Marcas Miles (21:39)

Sure. And am I hearing a buzz around oncology medications or just the oncology space in general? What’s going on there?

Matt Harman (21:48)

So, that has been a big focus. That’s the largest, over half the pipeline in specialty is oncology.

Marcas Miles (21:55)

Wow.

Matt Harman (21:56)

And that a lot of it is taking these medications from, which are typically on the intravenous near hospital route and creating oral products. So, you know, we work with our employers under the pharmacy benefit and that’s where we’re going to start seeing a growth in the oncology spend.

So, we have, you know, just this other week, there is a, for acute myeloid leukemia, the first ever oral product came out for this class when it was traditionally an IV medication. So, we’re going to, you know, most of the oncology spend is under your medical benefit. And so, now we’re going to start seeing that shift to the oncology benefit.

So, you know, cancer is a tough condition. So, and in terms of management, you don’t, you know, you want to make sure you provide access. But if you look at the efficacy of these products, it’s generally maybe works for, you know, a quarter to a third of patients and maybe the overall survival rate is not as great.

And the quality of life sometimes may not be the best. So, but, you know, if you show 5%, everybody think, well, maybe I, you know, my relative or myself.

Marcas Miles (23:02)

You could be in that 5%.

So that, I mean, it sounds like we’re making some definite steps forward. Does this, I mean, bode well for a potential cure in our lifetime? Or are we just still looking at trying to, you know, treat, you know, existing conditions or illnesses?

Matt Harman (23:23)

Well, we have seen some potential cures. There’s in form of CAR T therapies.

It’s kind of a form of where they take a patient’s own cells and ship it to a manufacturer and then recharge them with kind of the fighting mechanism to attack a cancer and then ship it back to the patient and infuse really amazing technology. It’s a one-time injection. It costs a lot, roughly 400 something thousand dollars for that course of therapy.

But for the, you know, the pediatric version of the cancer, it was over 80% success rate. So we are starting to go down that path. Now each cancer is different.

So like there will never be a universal cure for cancer, just because of the different mechanisms that occur. So yeah, I think we’re approaching more personalized medicine.

Marcas Miles (24:15)

Okay.

Well, it sounds like this is good news in general, though, for that space. And as we wrap up our time here, I know that Matt, you are very accessible and our members can feel free to get in touch with you anytime, whether it’s related to their oncology benefits or flu shots at this point. So I just want to thank both of you, Matt, Kevin, for joining me on the podcast today.

Kevin, wish you all the best of success. And I think this is going to be a great program and a great benefit to our members. So thanks.

Thanks for joining me.

Matt Harman (24:46)

Thanks for having us.

Marcas Miles (24:49)

As always, we encourage you to submit questions regarding HR benefits and the value of membership in an employer-led coalition.

You can do so by completing the field on the landing page or clicking the link titled Submit your questions here. And also, if you’d like to be considered for the $50 visa gift card, the code word for this podcast is residency. See, it goes right along with the theme of today, with the theme of this particular podcast.

So residency is the word that you’ll want to submit along with your name and email address using the link on the landing page.

If you have any questions that you’d love for us to cover in future episodes, please do that. I’m happy to cover those or if there’s a certain individual or topic that you would like us to interview or pull into the podcast, I would be more than happy to explore that as well.

So that will conclude this particular episode. Thank you again for taking the time to listen, but more importantly, thank you for your continued membership and interest with us here at Employers Health. And don’t forget to submit your questions so that we can answer those in the upcoming editions of the podcast and get you included in the drawing for the $50 visa gift card.

Thanks.

In this podcast

Matthew Harman, PharmD, MPH

Employers Health | Vice President, Clinical Solutions

As vice president of clinical solutions, Matt works to monitor, evaluate and improve the pharmacy plan performance of the Employers Health $4 billion PBM group purchasing programs with CVS, Optum Rx and Elixir.

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Kevin Wenceslao, PharmD

Employers Health | Director, Clinical Solutions

Kevin works closely with the vice president of clinical solutions to serve as a clinical resource for our members’ benefit professionals on topics of new drugs, plan design recommendations and overall trends.

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Marcas Miles

Employers Health | Vice President, Industry Relations

Marcas Miles serves as vice president, industry relations at Employers Health, where he oversees efforts to strengthen connections with clients, partners and stakeholders.

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