As Director of Commercial Channels for Pfizer Canada, Gordon Cooper is always looking for opportunities to drive business and create a win-win for patients and the pharmacy profession.
by Jane Auster
Photography by Brandon Gray
Through his work he focuses on the various sectors of the healthcare industry – retail, business to business, and private payers – constantly searching for new strategic approaches. A prime example is negotiating and supporting the pickup of the EpiPen in restaurants and recreational facilities to have on site in case of emergency. A big part of his work involves the pharmacy world, where he sees huge opportunities for big gains in patient care. Mr. Cooper is a proud Newfoundlander who sees distinct advantages in his Down East approach.
PharmacyU.ca. How does your personal background inform the way you approach your work?
Gordon Cooper. I grew up in a family of seven and my dad was a fisherman. We were all overachievers who looked at unique ways of getting things done because we did not have the resources. I grew up in an environment where we were almost forced, in a good way, to find a better way to get things done. So, yes, the way I grew up, the way my parents raised us in a family, certainly influenced how I work.
My father was a seasonal fisherman in the summer who did other things the rest of the time. He left school when he was 12 because there were no more teachers, but went back to school in his 40s to become a fishing captain. He spent several years as a sea captain, then became an instructor in the fishers’ college in Newfoundland. Again, it’s an example of learning to do things for yourself. I can often see things where others don’t; I may not have all the solutions, but I believe in doing things differently.
PHU.ca. Medication non-adherence is one of your big issues. Do you think pharmacists fully understand the issue and its impact?
Pharmacists believe the facts about non-adherence; they see the impact on patient care. But I believe the biggest issue is change. Adopting and facilitating change is challenging at best, so that is a significant part of the reason non-adherence didn’t improve significantly decades ago when we first started talking about it. Why is the resistance to change different now? Everything happening in healthcare and the pharmacy world is being forced to change. Governments are trying to reduce their healthcare budgets, so pharmacists need to look at healthcare in a new way – quantitatively demonstrate their value to patient care, improve medication adherence and support new revenue streams.
PHU.ca. Why the enhanced focus on appointment based (adherence) models (ABM) as a solution?
Fifty per cent of patients are non-adherent; they don’t take their medications as prescribed, or not at all. ABM sets up a process to be in touch with patients and puts in place a model to improve the adherence rate. Non-adherence represents $12.5 billion in lost revenue and is a burden to the healthcare system. Studies in the U.S. found that with the ABM model there was an uptake in the adherence rate of approximately two to three months of additional medication therapy. The result was that long-term healthcare improved, costs went down, revenues went up, and patient health improved.
The appointment-based adherence model was developed in the U.S. by a pharmacist in the 1990s named John Sykora. In 2009, Pfizer USA became involved in supporting some early work on a patient-centred model. In 2012, the team worked with key pharmacy associations in helping to drive the rollout and research effort on this model.
PHU.ca. ABM seems almost a personal crusade for you.
I am always asking the question, how can you give back and still drive business so that it’s a win win win all around – good for patients, healthcare and business. Part of my interest is the visionary side, but I also see it as an opportunity for Pfizer. It’s a way to show leadership in partnering with pharmacy to improve patient care, while supporting our business. Earlier in my career, I worked with another pharma company where I led a major disease management initiative in asthma. We saw that if you standardize the care, you achieve a positive outcome in patient health. The concept with asthma was being used by a couple of hospitals which got the company to support it. We developed partnerships with hospitals across Canada, standardized care and measured outcomes. As a result of this model, the standard of care improved in the institutions around medication management. It’s the old adage of teaching someone to fish, as opposed to feeding them. It’s a model to help you manage your healthcare better.
PHU.ca. Are pharmacists the key to making these models work?
I have two pharmacists in my family, so I respect their day-to-day world. This concept is changing that day-to-day world to make it more efficient. Not just adding on to their day-to-day, but changing the way they deal with patients on chronic medications. The challenge is getting pharmacists to see how that change will make their practice more efficient.
We started our ABM model project (called C.A.R.E. – Collaborating on Adherence in Retail Environment) by working with pilot project pharmacists, but the model has gone much broader at this stage and expanded to the corporate chain and banner level.
Everyone is seeing the benefits and looking to how they can incorporate it. We provide an implementation guide, expertise, the US experience and learnings from other Canadian pharmacists. The objective is to raise knowledge and awareness to enable implementation of the model in more Canadian pharmacies.
Patients will begin to ask for this service. As pharmacists roll out these models, they are putting out ads and flyers, promoting the new service and its benefits. Already patients are saying, “This is great, I have more valuable interactions with my pharmacy…I like this service.” The satisfaction rate from patients is in the high 90s, so they will begin to look for the model over time and want to be supported with something like this.
Several pharmacy groups rolled out the model in 2016, and the feedback from patients has been very consistently positive. Pharmacies are seeing the benefits, they believe in the model, and it’s the right thing to do for the patients, their pharmacies and healthcare. Patients will need to be enrolled in the program a good 6-12 months for pharmacists to see the change. We’re not quite there yet from a data perspective. We are hearing anecdotally of an improvement in adherence, but we need to wait for longer term results.
PHU.ca. Where do you go from here?
There’s still a lot of work to be done. Only a limited number of pharmacies (500-600) are doing it (ABM) at this stage, and a lot haven’t even discussed it. Pharmacists are the key to focusing on better medication management. Our job is continuing to support them and creating more awareness until ABM becomes one of the standards of practice. We are currently looking at the pharmacy sector but also expanding discussions to the pharmacy associations and provincial ministries of health to keep them in the loop. The more that people hear it day to day, the more they may get on board: Make some noise so people start asking about it, patients think they should be part of it, and then it becomes a tipping point.