The Digital Health Guy Gets The Expert Opinion:
Brad Fluegel, Former Senior Vice President, Chief Health Care Commercial Market Development, Walgreens Company
In years past, most people viewed drugstores as nothing more than prescription-fillers. Patients took in handwritten prescription requests from their doctors, came back a day or two later to pick up their bottle of pills, and never visited again until it was time to refill the prescription or fill a new one. Perhaps that model was not entirely accurate, because customers also bought bandages, braces, deodorant, and maybe the odd bottle of witch hazel.
Today as you know, all that has changed. People are going to large pharmacy chains to not only get their prescriptions filled, but get flu shots, blood pressure checks, and advice from pharmacists. And those changes, while highly visible to anyone who has visited a pharmacy recently, are only the beginning. Retail pharmacies, which once occupied a position on the sidelines of health care innovation, are moving to play a wider and more important role in helping people lead healthier, more connected, lives.
Brad Fluegel currently advises health care organizations, entrepreneurs, and other participants in health care. He was most recently the senior vice president – chief healthcare commercial market development officer for Walgreens. Brad was responsible for all commercial healthcare activities, including sales and contracting, biopharma relationships, retail clinics, clinical affairs, new service development and market planning. Previously, he was Chief Strategy and Business Development officer for Walgreens, responsible for corporate strategy and business development.
Prior to joining Walgreens in 2012, Brad was an executive in residence at Health Evolution Partners. He also worked at WellPoint, where his responsibilities included long-term strategic planning, government affairs, corporate communications, corporate marketing, corporate development, international expansion, innovation and new business ventures. Earlier, Brad was Senior Vice President of National Accounts and Vice President, Enterprise Strategy at Aetna, Inc. where he was responsible for developing and executing strategies that expanded Aetna’s position as a leader in the large employer market. Brad earned a master’s degree in public policy from Harvard University’s Kennedy School of Government and a Bachelor of Arts in business administration from the University of Washington. He is currently a lecturer at the University of Pennsylvania’s Wharton School of Business and serves on the boards of many organizations, including the Metropolitan Jewish Health System (New York) and Performant Financial.
Kevin Pereau: How would you summarize your experience for our readers?
Brad Fluegel: I was at Walgreens for a little more than five years. I joined in October 2012. And before that, I spent most of my career working in health plans and health insurance. I headed strategy for Aetna, I ran strategy and external affairs for Anthem. I also was with the Harvard Community Health Plan, and then before joining Walgreens, I spent a year and a half or so in private equity.
Kevin Pereau: What big trends have you seen emerge over the course of your career?
Brad Fluegel: I think one of the things that is definitely a trend, but which has taken longer to be adopted than I would have expected, is the movement to focusing first on the patient as part of the health care journey. Historically, the focus has been built around physicians and their needs. It now needs to be built around patients.
That helps explain one of the reasons I joined Walgreens. I believe that the ability of consumers to have more convenient access points to care is a trend that people have been watching—one that everyone realized was going to happen everywhere. It is taking a bit longer to materialize than I anticipated, but I think that having patients served in convenient locations is a trend that is accelerating. That is why a number of pharmacies, including Walgreens, are becoming places that allow customers to do much more than just pick up pills.
Regarding other trends, let me mention telemedicine. People’s ability to access care using their phones, laptops and tablets has been around for quite some time. I would have thought that it would have taken off earlier than it has. But it is now definitely accelerating.
Kevin Pereau: Do you think that thanks to telemedicine and other tools, individuals now feel they are more in control of their care—more in the driver’s seat?
Brad Fluegel: Yes, I think that’s true for most people. Customers’ ability and interest in reading certain symptoms, in having access to more transparent information online, and to research their conditions is accelerating. And increasingly now, customers will be able to use their phones to schedule physical appointments and perform other functions. At Walgreens, we have a Pharmacy Chat function; if people have questions about any medications they are taking, they can chat with our pharmacy staff.
Kevin Pereau: How is a company like Walgreens using the growing amount of individual data that is available?
Brad Fluegel: There are a few issues to mention. We need to better aggregate the data that we have, the pharmacy data that we have, with other data related to what’s happening with that patient.
When a customer comes into our store, for example, we know what medicines they are taking, whether those medications were purchased from Walgreens or from another pharmacy. But there are other things about the patient that we don’t know. We might know that he or she has a chronic condition, because we know what drugs are taken. But if the customer is, say, diabetic, we don’t know their glucose scores or A1C test results. And we don’t know if they are having other medical issues that the pharmacy might be able to help with.
That is consistent with one of the questions that is being asked everywhere in the larger health care system, which is, how can we get and use a view of everything that is happening with that patient, so that any care provider, including the pharmacist, will be able to help that patient take better care of him or herself?
Kevin Pereau: Are we on the cusp of connecting patient data to pharmaceutical companies who make the drugs?
Brad Fluegel: Currently, I don’t think that everybody in the system – whether it’s an insurance company or a doctor or a pharmaceutical manufacturer – has enough information to know what’s happening with a patient who is using a particular drug.
There are a fair number of programs, typically around specialty medications, that gather and relate information back to the manufacturer about what is happening for patients who are taking their drugs. I think that represents an opportunity for everyone in the chain of care to have more information about how those drugs are impacting on individual patients. But overall, I don’t think that gathering that kind of information is something that’s of great enough interest to health plans and manufacturers.
Kevin Pereau: Do you think we are moving toward a time when people and their insurers might not have to pay for drugs that have not helped them? That’s kind of a thunderbolt.
Brad Fluegel: At first it will start with payers and insurance companies, but ultimately it may get down to individual patients as well. If I am dealing with a thousand-dollar deductible for a drug that doesn’t work for me or my insured members, why should I be paying for it?
Kevin Pereau: Boy, that’s a wonderful thing to say. To turn the discussion back to what Walgreens is doing, can you tell me how you are helping customers in the increasingly competitive environment of retail pharmacies?
Brad Fluegel: Both we and other retail pharmacies are going to become more full-service health care destinations where people can have a variety of things taken care of. We now have retail clinics in approximately 400 of our stores, and we are setting up urgent care clinics in about a dozen locations with physicians and nurse practitioners on staff. Lab services are being tested in our stores, so people can have blood drawn or urine samples taken.
Kevin Pereau: Patients’ ability to go to Walgreens and have diagnostic tests taken is a very big thing.
Brad Fluegel: Our advantage is that we are already located close to where people live, work, and drive. We are better integrating delivery of medications to the end consumer, and to the health plan. The result will be an integrated experience, so patients will receive better care.
Brad Fluegel is former Senior Vice President, Chief Healthcare Commercial Market Development for the Walgreen Company, where he was responsible for all commercial health care activities, including sales and contracting, biopharma relationships, retail clinics, clinical affairs, new service development and market planning. You can follow him here on Linkedin and by watching the boards of: @AdhereHealth –
Thank you Brad, it was truly an honor to have you included as one of our valued Thought Leaders for Kevin’s new book:“The Digital Health Revolution” – sign up here for updates and to get your copy today.