Impact of COVID-19 Leaves Lasting Impression on Pharmacies

The coronavirus disease 2019 (COVID-19) pandemic is likely to leave a lasting impression on pharmacy and the services provided by pharmacists, according to some industry experts with the Pharmacy Quality Alliance (PQA).

In a virtual session of the 2020 PQA Annual Meeting on Thursday, panelists Susan Cantrell, RPh, CAE, CEO of the Academy of Managed Care Pharmacy (AMCP), and Ceci Connolly, president and CEO of the Alliance of Community Health Plans, discussed with moderator Laura Cranston, RPh, CEO of PQA, supply chain issues that have occurred as a result of the pandemic, as well as the quick evolution of pharmacy practice that has occurred out of necessity for socially distant patient care.

According to Cantrell, supply chain issues are among the pandemic-related concerns that AMCP members have faced. She cited unusual drug usage patterns as a cause, as medications indicated for other conditions started being used to treat COVID-19.

“This was leading to some anticipated shortages and also some inappropriate prescribing,” Cantrell said.

Cantrell noted that albuterol and hydroxychloroquine are among the medications that have been in short supply.

Although protective measures were put into place, such as quantity limits, Cantrell said they had to be balanced with ensuring that patients could receive the medications they needed.

“Allowing 90-day supplies and relaxing refills too soon, and some things like that, have the potential to contribute to the supply chain challenges. But at the same time, [these measures] were absolutely essential for patients on chronic medications,” Cantrell said.

According to Cantrell, AMCP members have monitored the supply chain and have been working 1-on-1 with patient members, which has been successful in mitigating some of those drug shortages. However, she said the pandemic has shown that the supply chain needs strengthening.

The pandemic also brought about the implementation of telehealth services much faster than some in the industry had anticipated, the panelists said, but many more have quickly adapted to this system of delivering care.

According to Connolly, the turnaround has been “remarkable” for the implementation of telehealth services. She noted that although some providers had invested in capital improvements prior to the pandemic with telehealth in mind, those that did not have technology already in place have resorted, in many cases, to using popular digital services, such as Zoom and Facetime, to remotely reach patients.

Cranston said she believes there’s no turning back from telehealth. “I only see telehealth growing,” she added.

However, Connolly said telehealth isn’t without challenges and that the development of audio-only services is needed to reach many more patients. She noted that many individuals do not have access to broadband or high-tech devices with capabilities required for video telehealth visits. Still, others simply aren’t knowledgeable enough about the technology to make it work.

“Getting past just the technology hurdles, this [COVID-19] crisis has really underscored the inequities of this country,” Connolly said.

According to Connolly, hurdles include a need for technological infrastructure in many rural communities, as well as payers permitting audio-only telehealth visits. In some cases, she said, providers need to get creative in order to reach patients, such as simply driving around to create in-person visits.

Cantrell agreed with getting creative. “This is a period of innovation,” she said.

During the discussion, the panelists also touched upon the expansion of pharmacists’ roles. States, such as California and Connecticut, are looking more to pharmacists to provide patient care services, including ordering and administering testing for COVID-19. In addition, federal lifting of some regulations has made telehealth services possible for many pharmacies, Cantrell noted.

“We can feel good about some of the wins we’ve seen in this crisis,” Cantrell said. “We really need to think about how we can build upon that.”

Cantrell also noted that more policy work is needed. She said giving pharmacists access to information about treatments prior to their approval by the FDA would be beneficial to patients and providers. She cited recent FDA actions with Emergency Use Authorization for certain drugs during the COVID-19 pandemic as a reason that information is needed.

“We have a textbook example now about why that’s important,” she said.

Overall, the pandemic has placed a spotlight on pharmacists, their roles in health care, and their ability to provide more to patients and to professional teams.

“We’re seeing many success stories about the important role pharmacists have played in this crisis. We really need to leverage what we’ve learned about pharmacists and other nonphysician health care providers,” Cantrell said.

According to Cranston and the panelists, the impact of COVID-19 on pharmacy has been significant in the short-term, and recent developments have shown that there is opportunity for that impact to translate into long-term changes for the industry.

REFERENCE

Cranston L, Cantrell S, Connolly C. The Impact of COVID-19 on Quality. Presented online: 2020 PQA Annual Meeting; May 14, 2020.