AS CASES OF coronavirus disease 2019 (COVID-19) continue to spread throughout the United States, health care providers have moved to remote working conditions to ensure the safety of their staff and patients.

For Nancy Crowell, PharmD, senior vice president of operations for Senderra Specialty Pharmacy, one of the advantages of specialty pharmacy is the ability to work remotely without compromising the care that pharmacists give to their patients. Crowell noted that specialty pharmacies are different from retail or community pharmacies because communication with patients is largely by phone.

“We don’t have to do anything really differently in [the] specialty pharmacy world to address the needs of the crisis other than activating a few of our part-time pharmacists to come in and help us handle the call volume,” she told Directions in Specialty PharmacyTM. “It is important that the strains and barriers, financial or otherwise, are addressed and handled up front to allow pharmacists to continue caring for patients who are vulnerable at this time.”

Specialty pharmacists play an integral role in preventing disease contraction in vulnerable patients, largely those who are over the age of 65 years or immunosuppressed with comorbidities. These patients have a higher risk for contracting the virus, so Senderra is emphasizing to their staff the importance of sheltering in place to limit exposure until a vaccine is available to prevent the spread.

According to Sheila Arquette, RPh, executive director at the National Association of Specialty Pharmacy (NASP), specialty pharmacy is uniquely positioned by virtue of its established operational model to help protect vulnerable patients across the United States against COVID-19.

“Specialty pharmacies utilize technologies that allow remote patient education and management and deliver medications via the mail or courier promoting patient and pharmacy team member safety. Specialty pharmacies currently possess the operational infrastructure and capabilities to ensure patients can continue to receive their medications and essential support services without interruption and remain adherent to their prescribed drug regimens,” Arquette said to Directions in Specialty PharmacyTM.

In addition to establishing their own COVID-19 resource section on their website, NASP is collaborating with broader pharmacy, drug delivery system, and supply chain communities. They are also working with the Trump administration, Congress, the Centers for Medicare & Medicaid Services, the FDA, various state boards of pharmacy, and state and local officials. This effort is to ensure that patients continue to receive their medication without interruptions, that members have access to the personal protective equipment they need to limit exposure, and that management restrictions for payer-pharmacy benefit managers are relaxed. NASP's efforts also ensure that off-label treatment and recognized medication experts have the support to address inappropriate prescribing and prophylactic use, according to Arquette.

To help their vulnerable patients, Senderra’s pharmacists are given up-to-date information on COVID-19 and are easily accessible to speak with patients directly during the pandemic.

“Our pharmacists can offer valuable lifesaving information and tips for staying healthy as well as working with people to boost their immune system, especially with the medications that we work with,” Crowell said. “It’s imperative that we protect our pharmacy staff, keep them safe and healthy, so that they remain an active part of the health care team during this time. So, we monitor all our staff for sickness, making sure that they stay home if they don’t feel well, [and] follow guidelines for social distancing. …We’re [also] disinfecting counters as well as desks.”

Carmine DeNardo, RPh, president and chief executive officer of ReCept Pharmacy, said that his pharmacy has been committed to the unique role that specialty pharmacists play in providing customized services that enhance patient outcomes.

“As this ever-changing health care landscape of COVID-19 shifts and unfolds, we believe that the communication and empathy we have established with our patients will cultivate an environment of clarity and cooperation for them rather than one of confusion and panic. Our patients know us and trust us–they know we will be there for them to help make them feel better however we can,” DeNardo told Directions in Specialty PharmacyTM.

DeNardo noted that ReCept implemented an infection disease continuity plan early on in the COVID-19 outbreak.

“We have clearly defined the measures needed to safeguard our seamless continuity of care. By following the CDC guidelines and protocols from public health officials, our pharmacy teams have taken precautionary and preventive actions to make the working environment as clean and protected as possible,” DeNardo said.

In addition to counseling patients to boost their immune system by getting plenty of sleep, sticking to a normal schedule, eating healthfully, and limiting the intake of processed foods and alcohol, Senderra is prepared with a business model that allows them to support patients remotely and deliver medication via the mail at no cost. Crowell said this promotes shelter-in-place guidelines, limiting patient and pharmacy staff exposure risk.

According to Crowell, medication adherence may be affected by the current COVID-19 pandemic and stopping medication can be just as or more life-threatening than the virus itself. Senderra’s pharmacists want their patients to discuss a plan of action with their health care provider and to not stop their medication unless they have had a consultation. Medication adherence is vital, so pharmacists should help to ease their patients’ concerns and keep them from stopping important treatments.

“As an essential service, our pharmacy has been solely focused on our patients, assuring them that we are here, we are open. Whether it means bringing their medications out directly to their car or offering free delivery right to their doorstep or advocating for uninterrupted accessibility to their medications, ReCept puts our patients’ needs above all else. Our staff has risen up to face this challenge on behalf of our most valued asset, our patients,” she said.

Crowell noted that it is incumbent on specialty pharmacies to manage their staff members’ and patients’ mental health as well, by working to calm their fears and to assuage their concerns surrounding COVID-19.

“For our industry to continue to provide all of these services to our patients, we’ve got to keep our staff and our pharmacist team healthy and educated so that we can be there for the patient, to reassure the patient, and to give them sound advice,” she said. “Without that, we can’t create the sound business that can be here for those patients. This crisis will come to an end at some point, and it’s very important that we are able to maintain that sound business structure, so we’ll be there just as we’ve been here for so many years taking care of patients.”