Twelve pharmacy organizations in the United States have jointly released a cohesive set of recommendations directed at policymakers that address the novel coronavirus (COVID-19) pandemic. These recommendations are aimed at expanding pharmacists’ role in combating the virus.1-4

“The COVID-19 pandemic continues to put an enormous strain on our nation's health care system, and the supply of qualified health care providers is increasingly limited,” the groups said in a joint press release.1,2

The 12 groups represent practice settings of nearly all pharmacists in the United States, including those practicing in hospitals, clinics, community pharmacies, long-term care, the medical home, and physician offices.1,5 According to the groups, 90% of Americans live within 5 miles of a community pharmacy, as such pharmacists are positioned to serve on the front lines and are able to help.1,2

According to the groups, action on the 4 outlined policy areas are designed to empower pharmacists to fully and effectively support the US’ COVID-19 response, and help to ensure patients get the treatment they need.1,2 

“CMS needs to recognize pharmacists on the pandemic frontline as providers,” said Chad Worz, PharmD, BCGP, Chief Executive, American Society of Consultant Pharmacists (ASCP), in an email to Pharmacy Times®. “These are unprecedented times, the pharmacist is a natural and comforting source of information and treatment. They need to be maximized to help people and support a strained system at its most critical time.”

According to Jillanne Schulte Wall, JD, senior director, health and regulatory policy, American Society of Health-System Pharmacists (ASHP), the recommendations are aimed at federal policymakers, as well as state associations and health officials, many of whom may not be fully aware of what pharmacists do.

“We’re at a point that we really need to move fast,” Schulte Wall said in an interview with Pharmacy Times®.7 “Pharmacy work seems to be invisible, but pharmacy sits at the nexus of a lot of therapy.”

The 4 measures recommended for immediate adoption are:1,2,4

Authorize Test-Treat-Immunize 
Allow pharmacists to order tests, collect specimens, conduct tests, and interpret results. When appropriate, allow pharmacists to initiate treatment for infectious diseases—including COVID-19, influenza, and strep—and interpret and discuss options with patients. Expand current state pharmacists’ immunization authority to include all FDA-approved vaccines, including the potential vaccine for COVID-19, for all indicated populations.
“Pharmacists, as they currently exist in the health care ecosystem, are vital, but they’re not being used in the capacity in which they’re fully capable,” Schulte Wall said. “We want to see our pharmacists fill these gaps the way they want to fill them.”

Ease Operational Barriers to Address Workforce and Workflow Issues 
Allow pharmacists and pharmacy technicians with valid licenses to operate across state lines, including telehealth services. Authorize pharmacists and pharmacy staff to conduct routine pharmacy tasks remotely as necessary, such as prescription data entry and script verification, including those licensed outside the state.

Address Shortages and Continuity of Care 
Authorize pharmacists to conduct therapeutic interchange and substitution without physician authorization when product shortages arise. The FDA should identify drugs that are in, or at risk, of shortage, and work with firms to extend expiration dates. Require manufacturers to provide the FDA with more information on the causes of shortages and their expected durations, and allow public reporting of this information.
Schulte Wall said pharmacists are knowledgeable about shortages of drug and personal protection equipment, and can be a vital resource in helping to mitigate them at any time, but especially during a time of crisis.

Reimburse for Services and Remove Barriers 
Provide coverage for services delivered by pharmacists if within the scope of practice and covered for other health care providers. Remove the specific day's supply requirement from co-pay waivers for essential life-sustaining medications to ensure continuous access when medication is in shortage or needs to be rationed. Remove restrictions and cover home or mail delivery. Assure access to testing, treatment, and pharmacist services for patients without adequate access to these services.
“We want to be able to provide these services, but it has to be self-sustaining over time,” Schulte Wall said.

According to Schulte Wall, the 12 pharmacy groups regularly collaborate on advocacy and policy matters, and many of them were already contacting the same people with recommendations. Among these correspondences were recommendations outlined in a letter written last week by the American Pharmacists Association (APhA), which called on the White House’s Coronavirus Task Force to enact similar recommendations to those jointly released.5 The ASHP also has been advocating for expanded scope of practice and payment for testing services related to COVID-19, as well as support for pharmacists and their families during the pandemic.3

“We were in agreement on a lot of the pieces,” Schulte Wall said in an interview with Pharmacy Times®. “Generally speaking, the idea was to advance pharmacists to fully engage in the [pandemic] response.”

In releasing these new recommendations on Friday, ASCP, APhA, and ASHP have been joined by the National Alliance of State Pharmacy Associations, the National Association of Chain Drug Stores, the Hematology/Oncology Pharmacy Association, the National Community Pharmacists Association, the American Association of Colleges of Pharmacy, the American College of Clinical Pharmacy, the National Association of Specialty Pharmacy, the College of Psychiatric and Neurologic Pharmacists, and the Accreditation Council for Pharmacy Education.4

For up-to-date information on COVID-19 for pharmacy professionals, visit Pharmacy Times' coronavirus resource center.

REFERENCES
 
  1. Pharmacist Advocacy Groups Call for New Action to Enhance COVID-19 Patient Care [news release]. Washington, DC; March 20, 2020: APhA [email]. Accessed March 20, 2020.
  2. Pharmacist Advocacy Groups Call for New Action to Enhance COVID-19 Patient Care [news release]. Washington, DC; March 20, 2020: ASCP [email]. Accessed March 20, 2020.
  3. ASHP, Pharmacy Advocacy Groups Issue Policy Recommendations for Addressing COVID-19 Pandemic [email]. ASHP. Sent March 20, 2020. Accessed March 20, 2020.
  4. Pharmacists as Front-Line Responders for COVID-19 Patient Care. Executive Summary. APhA, ASHP, NASPA, NACDS, HOPA, NCPA, ASCP, AACP, ACCP, NASP, CPNP, ACPE. https://www.ashp.org/-/media/assets/pharmacy-practice/resource-centers/Coronavirus/docs/Pharmacist-frontline-COVID19.ashx?la=en&hash=1A5827F821D22FD7C75DDEEF815326BDA88469FF Accessed March 20, 2020.
  5. Coppock K. APhA: Allow Pharmacists to Do More to Help Mitigate the Coronavirus. Pharmacy Times. https://www.pharmacytimes.com/news/apha-allow-pharmacists-to-do-more-to-help-mitigate-the-coronavirus Published March 19, 2020. Accessed March 20, 2020.