Expert interview

Where do you see the greatest promise and opportunity in oncology today?

As an industry, we’re starting to shift our focus to prevention, and that gives me hope because there is a big role pharmacists can play in early screening and detection. COVID-19 may have set us back a bit, unfortunately, and we’re playing catch-up to make sure patients are getting the cancer screenings they missed. But overall, I believe we are making progress.

Because Walgreens often interacts with people before they’re patients, we’re in a great position to have conversations about prevention. I want to make sure that Walgreens is a place where people can come and learn about cancer prevention — and take important steps such as getting the human papillomavirus (HPV) vaccination.

You specialize in oncology and fertility. Why is it important to look at both?

I truly have a deep personal connection to my work in oncofertility. With a family history of ovarian cancer and my own experience with in vitro fertilization (IVF), I bring expertise, empathy and passion to my work. Like me, a lot of people are either directly affected by these issues or know someone who is.

Walgreens is unique in that we specialize in both oncology and fertility, and I’ve seen it make a real difference to patients. We recently had a 27-year-old patient who was diagnosed with cancer and scheduled to start her oncology treatment in two weeks. At first, she didn’t realize that two weeks was just enough time to get one fertility preservation cycle. With our team’s help, she was able to freeze 14 eggs before starting her chemotherapy treatment. And it came at no additional medication cost thanks to the exclusive relationships we have with manufacturers offering financial assistance.

What are the biggest challenges you’re seeing for oncology providers?

In my experience, aside from drug shortages, keeping up with changing clinical guidelines is one of the biggest challenges for oncology providers. Not everyone has the resources to provide the latest in evidence-based care. A provider at a large academic institution, for example, may have access to the latest diagnostic testing and treatment methods, whereas a community oncology center in a rural area may not.

Considering Walgreens nearly 9,000-store footprint, we can help advance health equity across the country. Part of my role at Walgreens is to ensure that our patient management programs are evidence-based and clinically reviewed so we can help deliver the most up-to-date care to all patients, regardless of their ZIP code. Our pharmacists intervene every day on drug interactions and other medication barriers, such as inappropriate therapy.

Oncology medications are notoriously costly. How can we keep this from being a barrier to care?

The high cost of oncology medications puts a heavy financial burden on patients, also known as financial toxicity. Financial toxicity ultimately affects patient outcomes. Research shows that nearly a quarter of patients enrolled in copayment assistance programs didn’t fill their prescriptions, 19% took less medication than prescribed, and between 4% and 7% spread out or missed clinic or chemotherapy appointments.¹ Oncologists should be focused on helping patients get better; they shouldn’t also have to worry about whether the therapies they prescribe are covered or if patients can afford the copay.

A big part of what we do every day at Walgreens is helping our patients afford their medications. In 2022, we helped secure $681 million in financial assistance for eligible specialty patients across all disease states,² working with advocacy organizations and pharma partners to help patients pay for medications as well as things such as medical bills and rent.

What does better oncology care look like, and how can pharmacies help?

I believe it’s our responsibility as community pharmacists to treat patients holistically, as individuals. This year, I was fortunate enough to present to the White House on the Cancer Moonshot initiative with that message. If my 70-year-old aunt and I are both diagnosed with cancer, our journeys will be completely different — including our insurance, health status, educational backgrounds and even our goals of therapy. That’s why it’s so important to use tailored interventions.

As for treating the whole patient, one way we do that at Walgreens is through services such as Feel More Like You®, a unique team approach to help patients manage both internal and external visible side effects of oncology treatments. We also screen for depression and connect patients to resources, such as Imerman Angels, for mentorship and support.

What makes Walgreens specialty pharmacies unique?

The combination of local access and speed to therapy is really what makes us different. When I was the specialty pharmacist at the Walgreens location inside Howard University Hospital, we were just down the hall from the oncology care center. Whenever we received a prescription, we could finish the prior authorization in literally hours, not days, because of our proximity and close relationships with health plans. We have an industryleading turnaround time of 48 hours, on average, and often sooner for firsttime oncology therapies.³

Additionally, patients are always welcome to come into the pharmacy and have one-on-one conversations with our pharmacists to talk about anything related to their condition or medications, such as injection training. We believe that healthcare is local, and one size does not fit all.

What’s next for oncology care?

There are a few important issues I see going forward.

Health equity will continue to be at the forefront of everything we do. We are actively working to improve patient outcomes and narrow health equity gaps by increasing accessibility and education. We do this through collaboration and localized, patient-centered pharmacy and healthcare services.

We have a shared responsibility to support patients by addressing social determinants of health, especially for underserved populations. Access barriers related to transportation, language and health insurance, among other factors, can affect medication adherence and healthcare utilization. So if there’s a transportation barrier, for instance, we can set patients up with automatic refills and mail their medications to them directly before it becomes an issue.

In the research space, there simply isn’t enough representation in clinical trials, which can hinder our ability to reduce health disparities for the patient populations we serve. Walgreens Clinical Trials ensures that clinical trials include people from diverse backgrounds — by race, ethnicity, gender and age, among other factors. Our goal is to use the Walgreens footprint to bring clinical trials to areas that have been historically underrepresented or underserved, such as rural areas, and to educate patients about the benefits of participating. Investing in these efforts will allow us to build trust with patients and advance equity within the research space.

I’m also excited about the promise of cell and gene therapy. Walgreens is building a new facility to handle these complex new therapies, recognizing that innovative approaches and solutions are needed to better serve patients who are affected by chronic health conditions, including some cancers.

Ultimately, everything we do is about patients — making sure they have holistic support and access to medications.

That’s why I come to work every day.

As director of Clinical Pharmacy Strategy in oncology and fertility, Laly Havern is dedicated to creating offerings that benefit patients. She has extensive experience as a field pharmacist, with specialization in cystic fibrosis, HIV, fertility, oncology and more. We sat down with Laly to talk about the state of oncology care, how community and specialty pharmacies can play a valuable role, and her own experiences with oncology and fertility care.

“I believe it’s our responsibility as community pharmacists to treat patients holistically, as individuals.”

— Laly Havern PharmD, MS, BCACP

1. Zafar SY, Peppercorn JM, Schrag D, et al. The financial toxicity of cancer treatment: a pilot study assessing out-of-pocket expenses and the insured cancer patient’s experience. Oncologist. 2013;18(4):381–390. doi:10.1634/theoncologist.2012-0279 2. Combined data across all disease states for Walgreens specialty pharmacy and AllianceRx Walgreens Pharmacy. 2022. 3. Walgreens internal data. Specialty Pharmacy Operations. Stauffer D. September 2021–September 2022.

©2023 Walgreen Co. All rights reserved. RS054-OR-0823

This article is sponsored and supplied to myamericannurse.com by Walgreens and is not peer-reviewed. The views, opinions and information expressed in the content of this resource center are those of the authors and do not necessarily reflect the opinions or recommendations of the ANA, the Editorial Board members or the Publishers, Editors and staff of American Nurse Journal.