\u201cEveryone is, so to speak, reading from the same page,\u201d said Jennifer Donovan, PharmD, vice president of clinical services at Shields, in an interview with AJMC. \u201cThat allows us to have this integration and prevent the fragmented care that often is seen outside the health system.\u201d<\/p>\n
The work begins before the first fill. Pharmacy liaisons run benefits investigations, complete prior authorizations, and arrange financial assistance, steps Donovan said are \u201coften barriers that prevent patients from starting therapy.\u201d Patients are often on therapy within 48 hours, she said. At the same time, a pharmacist calls the patient to walk through which adverse effects to expect and when, the dose titration schedule, and how to administer and store the medication.<\/p>\n
That first call is also where pharmacists learn patient preferences, which matter more now that oral GLP-1 RAs have joined injectables. Some patients don\u2019t want or have difficulty with injections, while others prefer a once-weekly shot to a daily pill. Frequent travel with medication that needs refrigeration can also factor in.<\/p>\n
\u201cAt the end of the day, we want the patient to get the right med that they\u2019re going to take consistently,\u201d Donovan said.<\/p>\n
One-Month Follow-Up Targets Adverse Effects and Titration<\/p>\n
About a month after the first fill, the pharmacist checks in on how the patient is managing adverse effects and may suggest practical changes, such as eating smaller meals, so gastrointestinal symptoms don\u2019t push the patient to stop therapy.<\/p>\n
\u201cIn some instances, the patients really can\u2019t tolerate that next dose titration,\u201d Donovan said. \u201cSo we\u2019re able to work with the prescriber and change the dose back down to a more tolerable dose. And I think that\u2019s a great example of the integrated care.\u201d<\/p>\n
For patients with T2D who also take insulin or sulfonylureas, pharmacists monitor closely for hypoglycemia. Check-ins continue through the rest of the year to keep patients on therapy and catch problems early.<\/p>\n
Shields Reports 19.7% Discontinuation at 1 Year<\/p>\n
Shields\u2019 2025 Clinical Outcomes Report<\/a>, which added diabetes, obesity, hyperlipidemia, and rare diseases for the first time, draws on nearly 80 health system partners.3 The report found that 19.7% of Shields patients discontinued GLP-1 RA therapy at 1 year. Adherence reached 92%, which Donovan said is measured by proportion of days covered, and patients lost 9.8% of total body weight at 6 months, compared with an industry benchmark of 5% cited by Shields.<\/p>\n The figures reflect Shields\u2019 own partner network and were not compared head to head with the national data.<\/p>\n \u201cI think it\u2019s a good illustration of that high-touch care and that relationship that allows patients to continue,\u201d Donovan said.<\/p>\n She also pointed to a pharmacist care coach program at one Shields partner site, where patients with diabetes had 30% fewer emergency department visits, lower costs of care, improved hemoglobin A1c, and sustained weight loss.<\/p>\n Medicare Bridge Runs Through 2027 as BALANCE Stalls<\/p>\n The Medicare GLP-1 Bridge, which launched July 1, gives eligible beneficiaries GLP-1 RAs for obesity at a $50 copay and now runs through the end of 2027. CMS\u2019 BALANCE model, designed to pair GLP-1 coverage with lifestyle support, will not launch in Medicare Part D as scheduled on January 1, 2027, after plan interest fell short, according to KFF<\/a>.4<\/p>\n The stakes for Medicare are large. Part D spending on GLP-1s rose 68%, from $11.4 billion in 2022 to $19.1 billion in 2023, the most recent year of CMS data, as the number of beneficiaries using the drugs grew from 2.9 million to 4.5 million, according to the MedScout analysis of the CMS Part D Prescribers by Provider and Drug public use file.<\/p>\n Donovan said she couldn\u2019t speak to specific policies. Based on her observations, patient engagement lets care teams anticipate coverage changes and address barriers that affect whether patients start and stay on therapy. Health systems that own their specialty pharmacy, with liaisons running benefits investigations and pharmacists working with both prescriber and patient, keep patients from \u201cgetting left behind with a fragmented system,\u201d she said.<\/p>\n \u201cWhen relationships are formed, patients share information that allows the pharmacist to engage with the provider and ensure patients\u2019 needs are being met,\u201d Donovan said.<\/p>\n References<\/p>\n Rodriguez PJ, Zhang V, Gratzl S, et al. Discontinuation and reinitiation of dual-labeled GLP-1 receptor agonists among US adults with overweight or obesity. JAMA Netw Open. 2025;8(1):e2457349. doi:10.1001\/jamanetworkopen.2024.57349GLP-1 patient journey data. MedScout. Accessed October 27, 2026. Shields Health Solutions demonstrates industry leading clinical outcomes. News release. Shields Health Solutions. March 3, 2026. Accessed October 27, 2026. https:\/\/shieldshealthsolutions.com\/shields-health-solutions-demonstrates-industry-leading-clinical-outcomes\/<\/a>Cubanski J. CMS extends Medicare\u2019s short-term Bridge program for GLP-1 obesity drug coverage. KFF. April 23, 2026. Accessed October 27, 2026. https:\/\/www.kff.org\/quick-take\/cms-extends-medicares-short-term-bridge-program-for-glp-1-obesity-drug-coverage\/<\/a> <\/p>\n","protected":false},"excerpt":{"rendered":"\u201cEveryone is, so to speak, reading from the same page,\u201d said Jennifer Donovan, PharmD, vice president of clinical…\n","protected":false},"author":2,"featured_media":667648,"comment_status":"","ping_status":"","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[33],"tags":[103,61,60,371],"class_list":["post-667647","post","type-post","status-publish","format-standard","has-post-thumbnail","category-medication","tag-health","tag-ie","tag-ireland","tag-medication"],"_links":{"self":[{"href":"https:\/\/www.newsbeep.com\/ie\/wp-json\/wp\/v2\/posts\/667647","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.newsbeep.com\/ie\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.newsbeep.com\/ie\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.newsbeep.com\/ie\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/www.newsbeep.com\/ie\/wp-json\/wp\/v2\/comments?post=667647"}],"version-history":[{"count":0,"href":"https:\/\/www.newsbeep.com\/ie\/wp-json\/wp\/v2\/posts\/667647\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.newsbeep.com\/ie\/wp-json\/wp\/v2\/media\/667648"}],"wp:attachment":[{"href":"https:\/\/www.newsbeep.com\/ie\/wp-json\/wp\/v2\/media?parent=667647"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.newsbeep.com\/ie\/wp-json\/wp\/v2\/categories?post=667647"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.newsbeep.com\/ie\/wp-json\/wp\/v2\/tags?post=667647"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}