At Medly Pharmacy, our job is to make the prescription process painless. The physicians we work with, of course, are an essential part of that process. In this installment of our ongoing series highlighting various practices and practitioners who’ve partnered with Medly, we’re introducing you to Dr. Barry Jacobson, a physician specializing in Obstetrics & Gynecology who also runs Osteoporosis centers, with over 40 years of experience in the medical field.
Osteoporosis is a unique specialty because, as Dr. Jacobson explained, “telemedicine is ideal because we don't touch the patient. We look at density scans and lab work and recommend treatment, but we really don't interact physically with patients.” For this reason, coronavirus did not have much of an impact on the practice when it began to hit the US in March.
What it did impact was Dr. Jacobson himself, who was hospitalized from coronavirus twice. “I've been not seeing patients, although I'm involved with every patient because I sign up charts, but we've been doing telemedicine,” he said. In early July, his osteoporosis practice began seeing people again, and he estimates about 75% of his patients are now in-office, with the rest still on telehealth.
Though an OB/GYN by trade, Dr. Jacobson developed an interest in the world of osteoporosis in the mid-nineties. “After 10 years of OB/GYN, I got very interested when Fosamax came out in '95, I guess, '95, '96. I had a really great Fosamax experience,” he said.
“I got to spend some time with some researchers and I got fascinated by the condition, because there was really no treatment. Once you get involved in it, it becomes an interesting world. I became a speaker for Lilly in late '98 when Evista came out. As time went on, I just did more and more osteoporosis."
Dr. Jacobson explained that there is no fellowship especially in osteoporosis, which means that different specialties will take it on, from endocrinologists to rheumatologists and gynecologists. “Really, nobody owns the specialty. What happens in most places is that there's one person that grabs it. In my system, I was that person,” said Dr. Jacobson.
Dr. Jacobson also runs a Fracture Relation Service, in which anybody in the local hospital system who has a fragility fracture in their hip, humerus or pelvic area and is over 50 is referred to his Osteoporosis Centers for a consult. The service is ongoing but has slowed down dramatically due to the coronavirus pandemic.
In terms of innovation in the space, Dr. Jacobson said, “There's really nothing out there, which is sad.” According to a Merck speaker at a conference he attended, Dr. Jacobson said that “‘except for what's in study, there'll be no new drugs for at least 10 years, because the market's not big enough.’”
About 95% of his patients are on one of four drugs: “During the height of the pandemic, we used basically three drugs, actually four drugs in osteoporosis. The drugs we have are either anabolic, which is either a Forteo, Teriparatide, or Abaloparatide which is Tymlos, Tymlos being preferred by most insurances and less expensive,” Dr. Jacobson explained. “The other drugs we use are basically zoledronic acid, which is an infusion in the office, which we delay because it is not timely. It lasts a long time, so delaying it was not going to hurt people. We're actually ramping up to try to get caught up.”
For other drugs that require a more timely schedule, such as Prolia and Evenity, Dr. Jacobson had a set routine to assist those patients with their injections.
"We would basically meet people in the parking lot and give them a shot, and they'll go their merry way, Prolia being twice a year, Evenity being every month for 12 months. Now we're back in the office for those things,”
Many patients use anabolic therapies, which is where Medly comes in. “It does a great job in terms of getting supplies to the patient and keeping the patients honest,” said Dr. Jacobson. “We've used many different specialty pharmacies over the last, well, I've been doing this since a long time. Forte has been there since 2001, I guess, which is 19 years, but we use many different specialty pharmacies. Medly has been probably the best we've used in terms of service. Again, the communication with the patient has been excellent… Everything has been absolutely perfect, which is what we want.”
“It's just been a very seamless process which is what it has to be, in order to facilitate what we do,” said Dr. Jacobson continues. “Again, we are very happy to tell your praises to anybody because we've had really no problems.”