Walgreens Launches Fertility Awareness Campaign in Support of National Infertility Awareness Week

Laly Havern, PharmD, MS, BCACP, director in specialty health solutions leading in oncology and fertility at Walgreens, discussed the company's Fertility Awareness Campaign that is being launched as part of National Infertility Awareness Week.

To find out more about Walgreens fertility program, please visit www.walgreens.com/fertility or call 800-424-9002.

Ashley Gallagher: Hi, I'm Ashley Gallagher from Pharmacy Times and today I'm speaking with Laly Havern, director in specialty health solutions leading in oncology and fertility at Walgreens, about the company's Fertility Awareness Campaign that is being launched as part of National infertility Awareness Week. So, what is this campaign and what are the goals?

Laly Havern: This campaign is a really exciting initiative that's really meant to show patients that Walgreens is here to support them through their fertility journey. We've actually timed the launch of it with national infertility Awareness Week, which is April 24, 2022, through April 30, 2022.

This is really a week dedicated to essentially raising our collective voices talking about the issues that patients are facing as they seek to build their families and really make sure that we continue to support those most in need.

So, research does show that there are health disparities in fertility, and so this week was created as sort of a movement to educate the public about these disparities, as well as to support those patients that really need it, whether they're seeking to build their families or they're going through fertility treatment for a myriad of other reasons.

How we do that at Walgreens is through our 11 local specialized fertility pharmacies, as well as our centralized solution, which is AllianceRx Walgreens Prime, and these offerings include access to pharmacies, 24/7, 7 days a week, supportive counseling, interactive educational tools, medication training, as well as navigating the complex world of insurance benefits and the cash discount programs that are available for these medications.

Ashley Gallagher: That's really great. Can you discuss the patient's journey with medication?

Laly Havern: I think the most important part here is that no 2 journeys are alike. So, when I was a pharmacist in the field, I actually had a unique perspective because I was also going through fertility treatment at the time. I really got to see how many different protocols there are as we had 7 or 8 clinics in my area. It's so interesting because it's actually called art, or assisted reproductive technologies, and so even though it's very scientific, it's very evidence based, there is certainly an art to it.

I would say that generally, most patients start with the oral therapies, whether it be clomiphene or letrozole, and then typically, we can even add a trigger shot or a medical procedure such as an IUI, which is intrauterine insemination. But again, every patient is different. Typically, they'll do that for a couple of cycles.

If there's no success, then they typically will move on to IVF, which is in vitro fertilization. Typically, this process involves about 8 to 12 days of varying stimulation, followed by an egg retrieval, and then the embryo transfer. Then typically that embryo transfer can be anywhere between 3 to 7 days, or it could be postponed for a future cycle. Again, highlighting no two journeys are alike.

Ashley Gallagher: What are some counseling tips for pharmacists to help patients who are on the treatments?

Laly Havern: First and foremost, we train our pharmacists to take into consideration what the patient is going through. So, I would say empathy and compassion are by far the 2 most important factors when supporting patients that are going through these treatments. Next is understanding that a lot of times you need that precise medication at that precise moment in the reproductive cycle, and we may need to accommodate in times of emergency.

It's really the difference between a successful cycle with a pregnancy and a failed cycle with nothing to show for it, but time, money, and that emotional and physical burden, can really come down to having that right medication at the right time when the patient needs it. So, really, the stakes are incredibly high, and we need to understand what is on the line when that patient calls out in a panic as can often happen.

Ashley Gallagher: How should a pharmacist set expectation for patients regarding fertility drugs?

Laly Havern: I think I'm going to put a little bit more of my personal spin to it, but I truly believe that being that beacon of hope is the best way that pharmacists can support fertility patients. So, at Walgreens, every journey does start with a personal fertility benefits and investigation and coordination of insurance since that in itself can be complicated. For example, a patient may have $25,000 in coverage, but that may include medical and drugs. It may be better to use it towards the medical procedures and then use our cash saving programs for the medications. Understanding that whole aspect is critical to the patient journey.

Once the patient's prescription has been processed, then our teams can have it sent to the patient or the patient can come pick it up that day, or they can wait to the start of their cycle. Then, again, being there for that patient at that moment when they're opening and seeing all these medications which needles go with which syringe which medications need to be refrigerated, which ones don't. Then, additionally, having those additional resources and also global support groups, for example, again, having been through it, I know firsthand the toll that it can take on your mental health, and I think as pharmacists, we are in the perfect position to be able to support the patients during that time.

Ashley Gallagher: So what kind of adverse events or precautions should pharmacists be aware of to further help their patients?

Laly Havern: So, generally, the medications used in fertility are relatively well tolerated, and because there's so many frequent blood work in clinic appointments, I think the clinics are pretty well aware of which patients are having issues. But, again, the important part point here is that the pharmacist needs to be aware of the symptoms and the treatments of potential adverse effects such as ovarian hyperstimulation syndrome, and, in the rare case that the clinic isn't aware of, making sure that if the patient does tell you that you make sure you loop in the clinic because these can become emergency situations.

Aside from that, I think there's always going to be counseling about injection site reactions. For example, I remember injecting one of the medications that contains sodium chloride for the first time, and it stung, and it got red, and I immediately thought I was having an allergic reaction and thought I need to stop all of this. So just having that expectation of little tips and tricks like that really put patients at ease as they go through the process. Then, additionally, things like when to ice or when to apply heat after injections, you know, progesterone and oil can be another tricky one because it is such a thick, viscous liquid. We have to use a wide gauge to retract the medication, but then swap out for a thinner gauge to inject. If the patient doesn't understand that process, you know, it is still not going to affect efficacy, but it can make the painful thing a little bit less painful. So it really is important that the patient understands all of the aspects of the medication administration process.

Ashley Gallagher: So more broadly, how has the treatment landscape changed over the past 10 years?

Laly Havern: The fertility landscape has evolved quite a bit in the last 10 years. For example, when I was going through it 10 years ago, egg freezing was a completely experimental procedure, and now it's standard of care. There have also been advancements in ovarian tissue freezing and fertility preservation surgeries for patients that are undergoing cancer treatments as well as even uterine transplants.

Our pharmacy teams undergo extensive training, not only to be up on top of or up-to-date on all of the medications and also in all the procedures, but also the involving emotional and cultural considerations for these patients. As an example, Walgreens just sponsored a partnership with family equality, that includes an LGBTQ+ diversity and inclusion training because we know that there's 3.9 million LGBTQ+ millennials that are going to be having families in the next coming years, and so we really want to make sure that every individual feels supported at Walgreens.

Ashley Gallagher: And lastly, to wrap up what are some future treatments that are in the pipeline that pharmacist should be aware of?

Laly Havern: So medication wise, there haven't really been any huge blockbuster drugs, but there is ongoing research about how artificial intelligence actually could potentially change the fertility landscape, as well as different methods to be able to find out which is the best embryo really to increase those pregnancy rates. But again, no matter the innovation or the treatment, our pharmacists will be there every step of the way, whether it's to be an educational and emotional or financial resource because all we want to do is make this really hard journey a little less hard.