Specialty Pharmacies Weather the Challenges of Hurricane Sandy

Considering the delicate nature of specialty pharmaceuticals, specialty pharmacies must take measures to ensure they have a crisis communication plan in place in the event of a natural disaster or an emergency.

Although many pharmacy customers stocked up on their medications in preparation for Hurricane Sandy, those who decided to stay in evacuation areas or who did not accurately plan for the length of the time they would be restricted from their homes are at risk of not having adequate access to their much-needed medications.

Getting prescriptions filled for even the most basic medications was also a challenge for many patients as a result of Hurricane Sandy, as many pharmacies had no power. For some, this meant contacting physicians to call in prescriptions at other pharmacy locations.

Getting prescriptions through specialty pharmacies may have proven to be an even bigger challenge, as many of these medications are have special instructions and rely on power for proper storage and refrigeration. In addition, reordering the medications that may have been lost due to power outages may be especially difficult, considering that many products distributed by specialty pharmacies have complex reimbursement procedures such as prior authorization that may prevent patients in need from refilling the products they need.

In preparation for the storm, some pharmacies set up services to ensure uninterrupted specialty pharmacy operations to their patients. Acro Pharmceutical Services set up an emergency “business continuity” plan per their parent company, Lincare Holdings. They set up business operations through Reliant Pharmacy based in Clearwater, Florida, and instructed patients that all calls and emergency shipments would be handled through that Lincare-owned business.

In response to the storm, Horizon Blue Cross Blue Shield of New Jersey stated they would “be working with its members and providers and will be modifying procedures” to make sure all members received all needed emergency medications. These modifications included the approving all prior authorization requests for covered benefits, approving all requests by providers to extend a previously approved authorization ending during the period following the storm, approving early prescription refill requests so that members would have access to needed medications, and expediting prior authorization requests for medications.

Aetna members who have been evacuated and were expecting shipments of specialty or biologic medications from Aetna’s specialty pharmacy will be contacted by the company, according to a press release. Aetna said that they will authorize and redirect replacement prescriptions to retail pharmacies or hospital outpatient pharmacies that are operational and will provide advice to providers at these locations on the stability of medications that may have been unrefrigerated for a period of time. In addition, Aetna said that they would be extending claim and appeal filing times and helping members who have evacuated find care outside their home areas. For more information, patients should contact Aetna Specialty Pharmacy Customer Service: 1-866-782-ASRX (1-866-782-2779).

Hurricane Sandy impacted USPS, UPS, and FedEx service in eastern areas of the United States, and therefore affected (and will affect) the delivery of many prescriptions. Due to service interruptions, Accredo held shipments of temperature-sensitive specialty products in 11 states. They noted that any patients affected would receive an automated call from Medco Pharmacy notifying them of the delay, although for many displaced patients, a call to their evacuated home or uncharged cell phone may not reach them. In this instance, patients have been encouraged to provide a temporary alternate address to which medications may be delivered. For patients with specialty medications lost or damaged due to the storm, Express Scripts instructed retail pharmacists to use an override code for the “Refill Too Soon” rejection claim in 15 states determined to be disaster areas.

Drugmaker trade group Pharmaceutical Research and Manufacturers of America and other groups involved in the medicine supply chain activated an emergency website October 31, 2012, called Rx Response. This website, created initially in response to Hurricane Katrina, helps direct patients to open pharmacies following the aftermath of Hurricane Sandy. Through their Pharmacy Status Reporting Tool, Rx Response, in partnership with the National Council for Prescription Drug Programs (NCPDP), identified which pharmacies in the disaster area were open based on which ones were submitting prescription claims.

Rx Response has also been working with FEMA, the Department of Health and Human Services, and the Department of Homeland Security to help secure fuel for hospitals and pharmacies operating on generator power. “We look forward to continuing our close coordination with Rx Response and government agencies to help ensure that our member companies can continue critical deliveries of medicine to hospitals and pharmacies,” said Perry Fri, senior vice president of industry relations, membership, and education for the Healthcare Distribution Management Association, in an NACDS release.

During a national emergency, pharmacists can also use ICERx.org (In Case of Emergency Prescriptions), a secure information network solely for health care providers. As a member of ICERx, your pharmacy can fill prescriptions and access information for hurricane-affected patients even if the patient normally uses another pharmacy.

Considering the delicate nature of specialty pharmaceuticals, specialty pharmacies must take measures to ensure they have a crisis communication plan in place in the event of a natural disaster or an emergency. In addition, they should draft and follow a medication preparedness action plan if their location stores multiple specialty medications or biologics to avoid losing these expensive medications

For more information about the hazards of Sandy, read Hurricane Sandy Leads to Lingering Health Concerns.