The PHARMer's Market The Charitable Pharmacy is piloting a program that prescribes food as a drug to help patients with diabetes

Cheryl bursts into tears.

The elderly woman is sitting in St. Vincent de Paul’s Charitable Pharmacy as assistant pharmacy director Rusty Curington slides a large, non-descript box in front of her. This, he says, may save your life.

Cheryl is diabetic. Her A1c level is more than nine percent, a dangerously high level that puts her at risk for severe complications—heart failure, stroke, loss of limbs. She came into the pharmacy for insulin but is told that alone isn’t enough for her extreme condition.

For two hours, pharmacists educate her on diabetes, what’s happening in her body and what will probably happen if she doesn’t make some changes. They fill the prescription from her doctor for the insulin, but also fill their own self-written prescription for another drug that is going to help her as much as the medicine: food.

Not just food—healthy food. Curington lifts the lid of the box and starts pointing out its contents: low-carb tortillas to replace bread, low-fat turkey bacon as a protein, Greek yogurt, sweet potatoes and 24 other items. It also includes 27 recipe cards—three meals a day for nine days—that can be used with the food.

Cheryl stares through teary eyes at all of the food that is being given to her in an effort to make her healthier. In May, the pharmacy initiated a unique program called the PHARMer’s Market in which it is giving out healthy food to 50 of its high-risk diabetic patients in order to help them return to good health and document the impact of food as a drug. The concept is a result of a grant from CVS Pharmacy and the National Association of Free Clinics.

“The idea of food as a drug is not new,” says Curington, “but it’s certainly trending at the moment, which is sad because it should have always been a consideration because all disease states are impacted by food. In my vision, all pharmacies would be dispensing food as drugs—here’s your medicine, here are your over-the-counter products and the salad is over there. What would make that so great—and what makes this so appealing—is that it’s a multidisciplinary approach. You have your doctor, your pharmacist and your social worker involved. It’s coordinated care.”

That’s also what helped CVS pick St. Vincent de Paul for the grant. CVS previously took a giant step toward changing the idea of what a pharmacy should offer when it stopped selling cigarettes—a huge moneymaker but contradictory to promoting good health—in its stores.

“I began my career selling cigarettes at Walgreens,” he says. “Why is a pharmacy selling cigarettes?”

Without getting into the economics or business models of pharmacies, Curington points out that freestanding pharmacies still don’t sell healthy foods, or pharmacies in grocery stores are always located on the other side of the produce.

The PHARMer’s Market is also a coordinated effort with St. Vincent de Paul’s food pantries, which is trying to change its focus from strictly addressing the issue of hunger to a more informed approach of addressing both hunger and health. Not all of the PHARMer’s Market food is currently available in the pantry, so Curington uses the grant money to purchase what’s needed to fill the boxes.

“People just don’t donate low-fat turkey bacon or Greek yogurt to the food pantry,” he says.

St. Vincent de Paul is planting gardens in an effort to supplement its food pantries with fresh produce, something that is becoming more and more common. Curington points to Boston Medical Center, which has a food pantry that receives 60 percent of its produce from the hospital’s rooftop garden. Doctors send patients to the pantry.

For St. Vincent de Paul, says Curington, a similar approach is a good fit. While nine percent of Americans have diabetes, 56 percent of those who come to the Charitable Pharmacy have diabetes.

“This means a lot to them,” says Curington. “People who come here don’t have the options that others have or often don’t have the educational background to know what healthier options are. We survey the people in the program, and most don’t report a food insecurity. They just don’t have healthy food options in their homes. They don’t understand that they are killing themselves with what they are eating. And if they make all of this at home instead of eating out, they can afford it. That is the critical element. A head of lettuce is 90 cents, and it can make three salads.”

Participants like Cheryl can bring their food boxes back every two weeks to be refilled. After three months—the time it takes for A1C levels to completely change—they rotate off the program. The whole program ends in October.

“If we get good outcomes, perhaps it can lead to different donations of food to the pantry, or maybe it can lead to other grants for the teaching kitchen so we can do this on a bigger scale,” he says. “It’s all about education—what food to have in home and how to make good meals.”

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