Pharmacies Rise to the Challenges Imposed by COVID-19

As many Americans are out of work and losing their health insurance due to the coronavirus disease 2019 (COVID-19) pandemic, pharmacies are finding ways to adapt and step up to the challenge in order to ensure that patients receive their treatments, panelists said Wednesday during the Pharmacy Quality Alliance (PQA) 2020 Annual Meeting.

Currently, there are over 20 million Americans out of work due to the pandemic, many of whom were covered by employer-provided health care plans and will now be eligible for Medicaid under the Affordable Care Act.

Many patients are suddenly unsure of how to continue their care, and Bruce Japsen, a senior health care writer for Forbes, suggested checking the government health care websites to find out what benefits they are eligible for.

“We don’t want a co-pay to get in the way. We don’t want a deductible to get in the way. And we certainly don’t want them to…not go to the doctor [or get] care because they don’t think [primary care providers are] open or they’re afraid to leave their house,” said Japsen.

Changes to the Pharmacy Structure

Japsen mentioned that pharmacies are expected to do well during the pandemic because they are classified as essential businesses and may remain open.

Some pharmacies “saw a huge uptick in people getting their prescriptions because some insurance companies allowed people to get prescriptions for several months rather than 1 or 2. So then, guess what happened in April? They had fewer people coming to the store, which was kind of hurting their business,” he said.

Pharmacies have had to change how they run their business entirely, from exclusively using drive-throughs to investing in telemedicine and medication deliveries.

Pharmacies have also become testing centers for COVID-19 and may be points of access for vaccines. Benjamin McNabb, PharmD, the owner of Love Oak Pharmacy in Eastland, Texas, wants pharmacies to keep those designations and hopes pharmacies will provide greater access to vaccines and tests.

“I would like to see pharmacies be given that opportunity to maintain that designation and possibly enter into other point-of-care testing like for [glycated hemoglobin] and cholesterol testing. There’s a lot of things that pharmacists can do,” he said.

McNabb expects that that some storefronts for pharmacies, including his own, will reopen in the next few weeks, meaning that procedural changes will be needed.

“We have to think about requiring patients to wear masks as they enter. We will most likely have to have an employee stationed at the front door instructing people. Can we help clean their hands with a spray bottle of alcohol, since some of the sanitizers are hard to find?” he said.

Pharmacies across the nation will also have to contend with establishing capacity levels for reopening, as restaurants and stores are doing.

How Pharmacies Have Risen to the Challenge

McNabb pointed out that certain pharmacies have received government approval to produce their own hand sanitizers for the public in light of shortages during the pandemic.

“Nearly half of all independent pharmacies are still compounding pharmacies, and they’re making quite a bit of hand sanitizer. Many of them are donating it to their communities, their patients, local businesses, and health care first responders,” he said.

Additionally, pharmacies, especially in rural areas, have made continued efforts to maintain local relationships, which is more critical than people realize, according to McNabb.

“In certain rural areas where phone and internet access might be limited, it’s sometimes patients, especially the highest-need patients, who are the costliest….Achieving the best outcome possible is very difficult to do, sometimes, through telephonic means,” said McNabb.

Some, including McNabb’s pharmacy, have expanded their delivery services and telemedicine to include pharmacy personnel in order to ensure continued treatment management for at-home patients. Drivers can give information on health care and can provide blood pressure screenings for individuals at home.

“I think there’s a void that we can fill to partner with telemedicine, to partner with local physicians, especially in chronic disease management,” said McNabb.

Pharmacies have also taken initiative to ensure treatment for patients with underlying conditions who are considered to be at higher risk of developing COVID-19—related complications by encouraging use of value-based patient models.

“I think an interesting thing to be thinking about is how are we managing underlying health conditions that might be exacerbated by COVID-19? So, partnering with pharmacists for these guide-based delivery models, I think, is invaluable,” said McNabb.