Frequently Asked Questions

Once a Tik Tok phenomenon, weight-loss drugs now have the attention of mainstream America. In many ways, they could be the answer to shrinking pharmacy margins. HLA summarizes several ways in which pharmacists can pivot towards the opportunity ahead.

Semaglutide Demand is Only Beginning to Ramp

America's fascination with body image transcends socio-economic and cultural differences, enabling companies like Novo Nordisk and Eli Lilly to capitalize on the trend.

Semaglutide drugs are projected to increase GDP by hundreds of billions of dollars across 70 million users in the next four years. In fact, these predictions are limited only by supply chain constraints and payor coverage.

In addition, limited research to date indicates a wider range of potential health benefits, including significantly reduced risk of heart problems.

Build Trusting Patient Relationships through Education

Although payor programs vary across states, many pharmacists already serve as diabetes specialists, offering education and management, including glucose monitoring.

Nutrition counseling also is a natural extension of a pharmacist's role in patient care. Patients of all ages seek pharmacy advice on vitamins and homeopathic remedies.

In both capacities, pharmacists have the most natural and frequent touchpoints with the patient population who may benefit from the use of semaglutide drugs.

Accordingly, even if a pharmacist does no more than educate herself as to the safe use of these drugs, that investment will foster trusting relationships with those patients who may be unsure whether semaglutide is right for them.

Enhance Provider Relations with Collaborative Practice Agreements (CPAs)

Nearly all states permit pharmacies to execute collaborative practice agreements (CPAs) with physicians to participate in the care and management of various disease states and medication therapy management. As we have written about extensively, compliant referral relationships are critical in today's marketplace, and CPAs help facilitate these partnerships.

Semaglutide drugs are important to manage a number of different disease states that may be included in a CPA protocol, including diabetes. Ultimately, it is likely that payors will be obligated to cover these drugs for a wider range of indications at some point. Accordingly, pharmacists should position themselves now to participate in this inevitable scenario.

Subscribe to Semaglutide Telehealth Platforms

We all understand that semaglutide drugs may be compounded, but it takes significant time and effort to launch compounding operations, particularly sterile compounding. Nonetheless, for those pharmacies looking for more immediate cash flow, there are a number of telehealth platforms that provide turn-key solutions.

In exchange for an onboarding fee and subscription pricing, pharmacies can use these services to fill semaglutide prescriptions for patients. Because these services focus on cash-pay patients, insurance and PBM concerns typically do not arise.

Remote Patient Monitoring (RPM) & Chronic Care Management (CCM) Programs

In today's digital universe, patient health is monitored by an increasing number of medical devices that operate over the "internet of things" to transmit health information and data on a minute-by-minute basis. The hope is that one day patients in need of immediate intervention can be identified through automatic analysis of this vast data "lake."

Given the number of touchpoints that pharmacists have with their patients compared to physicians, this area represents another opportunity for collaboration across care providers. Although CMS reimbursement guidelines vary, pharmacists generally may provide billable RPM and CCM services through collaborative practice agreements for eligible disease states.

Launch Compounding Operations

Because semaglutide will be short-supplied for at least the next year, copies of FDA-approved versions may be compounded. That said, compounding risks are higher than those associated with the opportunities described above. For example, the regulatory environment lacks clarity and manufacturers will aggressively defend what they perceive as their "turf."

In short, if you were already positioned to compound drugs, semaglutide was a windfall. For those moving in this direction, there is still some opportunity ahead for those inclined to invest.

Legal Partners in Pharmacy Innovation

Health Law Alliance enables pharmacies to capture business opportunities while protecting them from PBM abuse and regulatory risks. Using decades of legal healthcare expertise, we help clients leverage innovative partnerships, compliant contracts, provider programs, and other scope-of-practice opportunities. You focus on growing your business—we focus on safeguarding it.

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