NACDS, AMA Spar Over Biden’s Test to Treat Initiative

The National Association of Chain Drug Stores (NACDS) is blasting back at the American Medical Association (AMA) after the physician’s organization criticized President Joe Biden’s inclusion of pharmacies in the administration’s COVID-19 Test to Treat initiative.

As part of the Biden Administration’s national COVID-19 Preparedness Plan ,¹ the administration will launch a nationwide Test to Treat initiative so Americans can “rapidly access treatment, including…visiting a 'one-stop’ location to get a free test and free treatment pills.”

These one-stop Test to Treat locations will be established at pharmacy-based clinics, community health centers, long-term care facilities, and. Department of Veterans Affairs (VA) facilities across the country.

“One-stop” sites will be operational by March, according to the plan.

While the AMA is “pleased” that the administration is ramping up supply of antivirals so in the near future they will be broadly available, establishing pharmacy-based clinics as one stop shopping for COVID-19 testing and treatments is “extremely risky,” said Gerald E. Harmon, MD, AMA president, in a statement.²

“Pharmacy-based clinics typically treat simple illnesses such as strep throat. Yet, COVID-19 is a complex disease and there are many issues to consider when prescribing COVID-19 antiviral medications. Leaving prescribing decisions this complex in the hands of people without knowledge of a patient’s medical history is dangerous in practice and precedent,” Harmon added.²

NACDS President and CEO Steven C. Anderson called the AMA’s criticism of the role of pharmacy-based clinics “extremely unfortunate, but also extremely predictable.”³

“The effectiveness of COVID-19 antivirals depends on patients’receiving them shortly after the onset of symptoms. When it comes to the patient journey for these medications, access and equity are critically important, and pharmacy-based clinics, pharmacies and pharmacists have essential roles to play,” Anderson said.

The Test to TreatInitiative relies on traditional prescribers, including nurse practitioners and others who practice in the pharmacy-based clinic setting, Anderson said.

“It relies on pharmacists to dispense the medications, as is appropriate given their extensive education and qualifications. If anything, the patient journey for these medications would benefit further from the inclusion of pharmacists as prescribers, consistent with the Ninth Amendment to the current declaration of the Public Readiness and Emergency Preparedness Act, or PREP Act,” Anderson added.

A poll commissioned by NACDS found that a majority of adults support pharmacists offering COVID-19 antiviral medications and prescribing the medications, according to Anderson.

“Respondents gave pharmacies the highest ratings for ease of access among healthcare destinations tested. Among entities working to address COVID-19, only hospitals received a higher rating than pharmacies,” Anderson said.

Up to this point in the pandemic, the AMA has lobbied against pharmacist-provided COVID-19 testing and has questioned pharmacist-provided COVID vaccinations, Anderson pointed out.

“Nonetheless, pharmacies, pharmacists and pharmacy teams have contributed to the effectiveness, equity, accessibility and convenience of the pandemic response on behalf of the American people,” Anderson said.

Pharmacies provide more than 2 of every 3 COVID-19 vaccine doses. More than 30% of children ages 5 to 11 who have received their COVID-19 vaccination have done so at a pharmacy, Anderson added.

In a later news release,⁴ Harmon added that the AMA is “reassured by Biden Administration officials' comments that patients who have access to a regular source of care should contact their physician shortly after testing positive for COVID-19 to assess their treatment options.”

Harmon was referring to comments from Cameron Webb, senior adviser for equity on the White House coronavirus task force and a physician. “People who can meet with a family physician shortly after testing positive should do so,” Webb told The Washington Post.⁵

The Test to Treat initiative is primarily focused on the one-quarter of Americans who do not have a primary care provider, Webb explained. Test to Treat locations will boost access to the lifesaving treatments for those who do not have such doctors, Webb said. “Now they have a path.”⁵

References

1. National COVID-19 preparedness plan. The White House. Published March 2022. Accessed March 10, 2022. https://www.whitehouse.gov/wp-content/uploads/2022/03/NAT-COVID-19-PREPAREDNESS-PLAN.pdf
2. AMA statement on administration’s test-to-treat COVID-19 plan. News release. American Medical Association. March 4, 2022. Accessed March 10, 2022. https://www.ama-assn.org/press-center/press-releases/ama-statement-administration-s-test-treat-covid-19-plan
3. NACDS statement on AMA criticism of pharmacy’s role in COVID antivirals. News release. National Association of Chain Drug Stores. March 7, 2022. Accessed March 10, 2022. https://www.nacds.org/news/nacds-statement-on-ama-criticism-of-pharmacys-role-in-covid-antivirals/
4. AMA Statement on test-to-treat COVID-19 program. News release. American Medical Association. March 5, 2022. Accessed March 10, 2022. https://www.ama-assn.org/press-center/press-releases/ama-statement-test-treat-covid-19-program
5. Shepherd K. Biden’s ‘test to treat’ covid plan draws praise, questions. The Washington Post. March 4, 2022. Accessed March 10, 2022. https://www.washingtonpost.com/health/2022/03/04/test-and-treat-covid-program-pharmacies/