NCPA, NACDS Underscore Role of Community Pharmacists in Fighting COVID-19

In a published letter to Vice President Mike Pence, the National Community Pharmacists Association (NCPA) highlighted the importance of community pharmacists in combatting the COVID-19 pandemic.

“Over 10,000 locally-owned pharmacies provide home delivery services and over 5000 have the ability to compound necessary medications and preventative needs, such as hand sanitizer,” NCPA CEO B. Douglas Hoey, pharmacist, MBA.

However, in order for small-business neighborhood independent pharmacies to continue providing access and care, Hoey urged for immediate suspension of all pharmacy direct and indirect remuneration (DIR) fees. In addition, Hoey requested several allowances in order to continue to provide life-saving medications to patients, such as waiving requirements for patient signature or other delivery verification requirements that put individuals at increased risk of coronavirus exposure.

NCPA is also urging for the availability of COVID-19 tests and protective equipment to small business pharmacies, as well as the ability for pharmacists to compound commercially available prescriptions if there are drug shortages and dispense early refills and emergency refills for maintenance medications.

Other requests include:

• Instructing pharmacy benefit managers to allow 90-day prescription refills at any network pharmacy with commensurate reimbursement.

• Authorizing pharmacists to conduct therapeutic interchange without physician authorization if drug shortages exist.

• Allowing pharmacists to deliver any medication to patients’ homes.

Because community pharmacists are on the frontlines of patient care, expanding their roles can help further assist in fighting the pandemic.

Measures such as allowing all pharmacies to administer vaccinations, as well as offer point-of-care testing, can be particularly helpful in alleviating some of the pressures off of physicians. In Florida, for example, Governor Ron DeSantis (R) recently signed a bill into law allowing pharmacists to test and initiate treatment for influenza and Group A Streptococcus.

“The bill will improve convenient access to quality care while removing avoidable pressures on hospitals and acute settings–a meaningful benefit at all times, and a benefit that is top-of-mind amid demanding public health situations ranging from flu outbreaks to the current coronavirus concerns,” NACDS said in a press release.

Currently, 44 states allow for pharmacist point-of-care testing, according to NCPA.¹

NCPA also recommended to “use local pharmacists to give the COVID-19 test, as availability of tests and versatility of available tests develop.” Pharmacy chains such as Walgreens, CVS Health, and Target have already said they will start providing COVID-10 testing in their parking lots.

Other ways that community pharmacists can help, as outlined in the letter, include prescribing medications via collaborative practice agreements, education, relief of symptoms, compounding hand sanitizer, and providing home delivery services.

"Community pharmacies are open and ready to assist with ongoing efforts to fight the coronavirus pandemic," Hoey said in a statement.² Unleashing our capabilities and utilizing our relationships with patients are the best ways to communicate and engage with rural and underserved communities in particular, as independent community pharmacists are trusted, well-established health care providers. We urge Vice President Pence and members of the Coronavirus Task force to tap into the full potential of community pharmacy as part of the administration's response to this national emergency by empowering pharmacies to realize their full potential and allowing them to shed administrative burdens restricting patient care."

NACDS President and CEO Steven C. Anderson, IOM, CAE also issued a letter to the Administration and Congressional leadership. In alignment with many of NCPA’s recommendations, the organization called for necessary policy changes that related to pharmacy services and staffing, credentialing, operation, and workflow. Such measures include provider status, point-of-care testing authority, and remote capabilities that would improve social distancing requirements.³

“Pharmacies can provide additional services and resources that can be utilized to further strengthen national emergency response capabilities as a trusted health care provider which provides unparalleled access to those populations that need assistance the most,” Anderson wrote.³ 

The American Pharmacists Association (APhA) expressed similar sentiments in a letter sent to Vice President Pence on March 13, which included a number of immediate actions the Task Force can take in response to the outbreak.⁴

"APhA urges the Task Force and the HHS Secretary to use the full authority of Section 1135 to maximize the use of pharmacists to prevent, treat, and respond to the coronavirus," Thomas E. Menighan, BSPharm, MBA, Scd, FAPhA, executive vice president and CEO of APhA wrote in the letter. Under Section 1135 of the Social Security Act, the HHS Secretary may temporarily waive or modify certain Medicare, Medicaid, and Children's Health Insurance Program requirements to ensure that sufficient health care items and services are available to meet the needs of individuals enrolled in Social Security Act programs in the emergency area and time periods.⁴

In addition to the above requests, Menighan also stressed the importance of providing appropriate and effective protective equipment, such as N-95 masks, to pharmacists and other providers who are in direct contact with patients. 

References:

1. Hoey DB. RE: Community Pharmacists’ Recommendations to the President’s Coronavirus Task Force. NCPA. http://www.ncpa.co/pdf/ncpa-coronavirus-letter-recommedations-031720.pdf. Accessed March 17, 2020.

2. NCPA Sends Small Business Community Pharmacy Recommendations, Needs to Administration’s Coronavirus Task Force [news release]. NCPA’s website. https://ncpa.org/newsroom/news-releases/2020/03/17/ncpa-sends-small-business-community-pharmacy-recommendations. Accessed March 17, 2020. 

3. Anderson SC. Letter to Vice President Pence, Leader McConnell, Minority Leader Schumer, Speaker Pelosi, and Minority Leader McCarthy. NACDS' website. https://www.nacds.org/pdfs/pharmacy/2020/NACDS-federal-COVID-pharmacy-services-3-16-2020.pdf. Accessed March 17, 2020. 

4. Menighan TE. RE: APhA Recommendations to the President's Coronavirus Task Force to Maximize the Use of Pharmacists to Prevent, Treat, and Respond to Corona virus. APhA's website. https://www.pharmacist.com/sites/default/files/APhA_Coronavirus_Comments.pdf. Accessed March 18, 2020.