Managed Care Innovator: TJ Parker, PharmD - Part 1

PillPack—an overarching name for the company’s revolutionary pharmacy model, pill delivery system, and mobile medication management app—was recently launched by TJ Parker, PharmD, after years of development and fine tuning. Mr Parker’s company aimed to reinvent the way patients manage their medications, which involved rebuilding pharmacy distribution as we currently know it from the ground up. The system combines mail-order pharmacy with a novel delivery/storage device that allows patients to access their daily medications in small, sealed packages that have been meticulously customized for their specific pill regimen.  

Now, after 2 years, PillPack is servicing around 4,000 patients and growing. The company’s delivery system is having a positive impact on adherence and safety, while also helping to curb misuse—a combination of successes that could make PillPack the pharmacy of the future. 

Can you tell me a little bit about what inspired the development of the PillPack?

I’m a second-generation pharmacist, and grew up working at my family’s pharmacy in New Hampshire. Because of that, I’ve spent most of my life watching people struggle with managing their medications—dozens of pill bottles, weekly trips to the pharmacy and time-consuming do-it-yourself organization. Meanwhile their pharmacists, while well-intentioned, had limited resources to help. The entire system was complicated, confusing, and did little to support health or wellness.

I decided to go to pharmacy school and become a pharmacist so I could solve this problem. In speaking with health care professionals, patients, and colleagues it became clear that no app or smart pillbox could truly make a meaningful impact. What was needed was a totally reinvented pharmacy focused on making life easier for the 1 in 10 Americans who take 5 or more medications daily. That reinvented pharmacy is what we’ve built with PillPack.

Can you give a brief explanation of what the PillPack is?

PillPack is the only independent pharmacy that delivers medications to customers nationwide. Our mission is to make it easy to manage medications. Our customers are people that live with chronic conditions, like diabetes or MS. We package medications by date and time, so that they arrive from our pharmacy to you already pre-sorted and organized by when you take them. We also offer personalized pharmacy service, including pharmacist counseling, customer education, monitoring of drug therapy and interactions, and prompt and accurate delivery of your medications.

Behind the scenes, PillPack tracks down refills and makes sure insurance is in place. And, our online tools let customers manage over-the-counter meds, vitamins, and prescriptions all in one place. Together, these products and services that remove the stress and hassle that often get in the way of taking meds as prescribed, helping our customers stay adherent and healthy. 

How does the pharmacy portion of the PillPack system work, does PillPack have its own pharmacy staff?

Yes, our main pharmacy in Manchester, NH is staffed by pharmacy technicians, customer experience associates, and licensed pharmacists.

Can you outline the App/software aspect of PillPack? It seems to automate nearly every aspect of the prescription process—but also allows for patient customization on the fly? Was the App portion of the PillPack’s development equally as important as the physical portion?

There are two components to the digital PillPack experience: the customer-facing Dashboard and PharmacyOS, the software that powers our pharmacy. The online dashboard is a hub for all of a customer’s prescription and over-the-counter medication. It includes all billing, medication, and account information so it’s easy to see what’s in your PillPack, when the next one will ship. The dashboard is designed to give our customers effortless control over their medications, a transparent view into their billing history, and a glanceable dashboard for all information related to their immediate and future medication plan.

PharmacyOS powers our pharmacy and is a reinvention of the entire backend system for how a pharmacy works. Before, with off-the-shelf tools (the ones that every other pharmacy uses) we were really limited in how much we could automate and the kinds of service and quality tools we could introduce. These systems depend on a certain amount of faxing, calling, and manual look-ups just to function. Now, with PharmacyOS, we’ve been able to automate a lot of the manual tasks of pharmacy—including checking when a refill is due, confirming insurance, and finding out someone’s copay—so that we’re always ahead of any problems and so that this information is available to the customer anytime they want to check on it. 

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Does the PillPack improve adherence? Are there any data available showing positive results?

Peer-reviewed research has shown that the approaches we’re using now—multi-dose packaging, clear information and support, behavioral nudges—all make a difference. At some point in the not-too-distant future, we’d like to partner with an institution to do a clinical study of our own.

Similarly, does the PillPack help to curb misuse? Are there any data or anecdotal evidence to support this?

Anecdotally, we’ve heard from customers that PillPack’s pre-sorted packs do help with misuse, both because it’s easy to see when packs have been ripped open and because the dated, time-stamped packets act as a mental nudge to only take the pills when prescribed.

What kind of barriers have you run into during the real-world adoption phase?

Pharmacy is (and should remain) a highly regulated industry, so it took some time to get licensed in every state. 

From the point of view of a payer, a system that cuts misuse and improves adherence seems like a win in terms of cost-savings. Do you see the PillPack as a managed care/cost-savings tool?

Absolutely. We have received a lot of interest and are having conversations now about how to integrate with payers and care systems.

Fundamentally, adherence drives significant cost savings and revenue opportunities to payers. PillPack simplifies the pharmacy experience and customer report that it improves adherence, so it is a clear way to reduce high-dollar claims like ED visits or readmissions that are due to non-adherence. PillPack can also help payers hit high-value STAR Measures which allow them to realize performance-driven bonus dollars. Additionally, plans are increasingly focused on member experience and looking for unique services that help their members positively engage with the health system. PillPack’s customer satisfaction scores (as measured by net promoter score) are roughly three times higher than our peers in the industry, so partner companies see value in their members using PillPack for their chronic care medications.

Lastly, as we look at our evolving offering to payers we are incredibly excited about the possibilities. PharmacyOS opens up many intriguing possibilities because we’re able to create APIs and build products that wouldn’t have been possible when we were using third-party tools. With PharmacyOS we can provide unique insights about plan members’ pharmacy experience, which is an incredibly exciting prospect. Initial reaction from the payer community is quite positive, so we look forward to further exploring with additional partners.