Take 5: Pharmacy insights with Jamie Reuter
"Take 5" is a series in which we pose five questions to a Blue Cross and Blue Shield of Minnesota leader and learn more about who they are, what they do, and how they help our members live their healthiest lives.
This edition of “Take 5” features Jamie Reuter, Vice President of Pharmacy Solutions.
Can you tell us about your background?
I'm a pharmacist with 30 years of experience across clinical practice, health systems, and startups. After some early work in retail pharmacy, I earned my PharmD and completed a critical care residency, spending a decade in inner-city Baltimore in intensive and trauma care. I ran a residency program, taught for three schools of pharmacy, and published more than 40 pieces focused on improving quality, outcomes, and cost across health systems.
For the past decade, I've worked primarily in startup and turnaround roles, building and scaling retail pharmacies and Pharmacy Operations for health plans. Today, I bring all of my experience and insights to focus on stability, sustainability, and continuous improvement for Blue Cross members.
Are there any new ideas you’ve brought to Blue Cross that you want to share?
During my time in the startup world, I worked with a few people who created a smartphone-connected ultraviolet light emitting device called Zerigo. It's a handheld phototherapy device for treating chronic skin conditions like psoriasis and eczema.
After a few months of use, Zerigo users typically can transition off of expensive specialty drugs for treating their conditions. That means no more needles, no specialty co-pays, no side effects, and patient’s can treat themselves on their time. It’s really gratifying to advance solutions that empower people while also helping their healthcare dollars to go further.
The use of GLP-1 medications are on the rise. What do you want Blue Cross members to know about them?
GLP-1s have been around for more than 20 years to treat diabetes. But now, the expanded use of GLP-1s to treat obesity - along with years of inflation - has caused prices to skyrocket.
I think people should know that just because GLP-1s have been approved to treat obesity, they are not a silver bullet for weight loss. Available data has shown that only about 60 to 70% of users are still on the medication at the 9 to 12 month mark. Also, up to 40% of people taking GLP-1s experience side effects, which can be a barrier to staying on the medication.
Overall, I would say that while GLP-1s can be very impactful for those who have struggled with weight loss in the past, it is important to also consider the high costs and other factors like side effects and long-term commitment to diet and exercise for these drugs to work.
Are there any benefits to using Artificial Intelligence (AI) in the Pharmacy space?
Absolutely, yes! AI can be a game-changer in terms of helping us use data and analytics in more predictive ways. For example, I mentioned skin conditions earlier. Our data can show when psoriasis patients gradually move from a $12 dollar cream, to a $300 cream, and then a $8,000 injection. Clearly that course of treatment is not working. Before a doctor considers the next step of expensive specialty drug injections, we can step in and talk with that doctor about recommending a lower cost and more convenient home therapy alternative, like Zerigo.
The cost of healthcare continues to rise – do you have any advice for members to help manage pharmacy costs?
Pharmaceutical costs are increasing between 2.5 to 5 times the rate of inflation. This rapid increase in drug costs translates directly to higher out-of-pocket costs, including premiums. That is why we are working to manage rising costs in multiple ways on behalf of our members.
Of course, generic medicines and biosimilars for biotechnology drugs are affordable and equally effective alternatives to brand name drugs. So that's one proven way we can help make your healthcare dollar go farther.
I also think it’s important for members to know that there are tools available to calculate how much a prescription medication is going to cost in advance. You can use Blue Care Advisor to check your formulary and find coverage information.
Members should also know that if their doctor is prescribing a specialty medication that requires an injection, sometimes patients are able to administer those on their own at home That eliminates the need to pay for an office visit for every injection. It’s always ok to ask your doctor what your options are.
Learn more
Find in-network pharmacies and search for covered medications based on your plan here.
