New Tools for a New Normal in Pharmacy

More than ever before, the coronavirus disease 2019 (COVID-19) pandemic has placed pharmacists on the front line of health care. The primary point of care in sourcing and dispensing needed medications, pharmacists have been addressing medication shortages, providing and administering testing, counseling patients, and so much more.

Many pharmacists are now operating at the top of their license or at least are well on their way. In fact, according to a recent COVID-19 survey from the National Community Pharmacists Association, 56% of pharmacists anticipate the pandemic will lead to increased scope of practice, which means they’ll be performing more health care services in addition to dispensing medicine. It’s about time.

So now that we are operating in a new normal, pharmacists need new tools to reduce administrative burden and provide the best care to patients, as they too are coping with new challenges.

Managing Patient Cost

The rising cost of many medications, plus an increase in the number of uninsured, means that pharmacists are increasingly challenged by their patients to find cost-effective medication options on their behalf.

Additionally, during the pandemic, many patients looked to increase the supply of their medication, for example from 30 to 60 or 90 days, all while pharmacists were also navigating drug shortages.

How much is this medication going to cost?

“It’s probably the most-asked question we get,” said Mehul Khakhkhar, owner and operator of Upgrade Pharmacy in Addison, Illinois. “The reality is pharmacists don’t have access to costs without taking additional steps. Wanting that information up front is reasonable, but we haven’t had access to it.”

Historically, finding the cost of prescriptions or therapeutic alternatives required price checks across various medications and dose-form combinations, submission and reversal of “test” claims, and multiple callbacks to prescribers just to get a list of viable options.

However, technology is now available that enables pharmacists to access information on out-of-pocket prescription costs and therapeutic alternatives at the point of dispensing. The tools also empower pharmacists to seamlessly collaborate with patients and prescribers on choosing an alternative medication that is both clinically appropriate and affordable.

With pricing, coverage and prior authorization information shared directly from the patient’s benefit plan, pharmacies now have insight into different days' supply and options on formulary that may be less expensive.

According to Khakhkhar, a benefits-based tool is exceptionally useful for community pharmacists.

“Often times we are the messenger between the insurance company, the prescriber’s office and the patient. So, before a prescriber sends us an electronic prescription, they may call to ask if we think it’s covered through a specific plan,” Khakhkhar said. “This tool gives us insight into whether or not the prescription sent to us will be covered by that particular patient’s PBM [pharmacy benefit manager]. And if it isn’t covered, it offers alternative formulary options appropriate to the patient.”

Navigating Drug Shortages

RxChange transactions, which are part of the NCPDP SCRIPT Standard, are designed to streamline communication between the pharmacy and prescriber during the electronic prescribing process. When the pharmacist identifies a need to make a change to or clarify the original new prescription, they can send a request to the prescriber electronically, and the prescriber can then reply electronically, without leaving either of their workflows to pick up the phone or send a fax.

The importance of technological solutions are amplified by the coronavirus pandemic, as the FDA has taken action to manage potential drug shortages. Pharmacies can send electronic requests to prescribers to let them know a medication is out of stock, and prescribers can respond and initiate any changes for the pharmacy—again, without having to pick up the phone or send a fax.

In addition to the current pandemic scenarios, there are various use cases that involve a change or request for more information. RxChange transactions can be used to suggest a therapeutic alternative or generic substitution, notify a prescriber that prior authorization is needed, or help clarify, confirm if a drug is out of stock, and request prescriber authorizations—all within the pharmacy management workflow.

While many prescribers aren’t working in their normal office locations during the pandemic, technologic solutions allow them to access their electronic health record system remotely. This helps eliminate tiresome calls and faxes, and reduces the overall administrative burden associated with requesting prescription changes and restocking abandoned medications.

Concerns about prescription costs, adverse effects or availability can lead to treatment delays or abandonment. That’s because manual processes for requesting changes and securing approvals are time-consuming and frustrating for everyone involved.

Chaos Breeds Opportunity

The past several months have been hard on everyone, especially pharmacists and their staffs. You have had to adapt and adopt a new way of doing business essentially overnight. And now, the pharmacy business model may be forever changed—and that may be a good thing.

As you prepare for what comes next, there are many new health information technology tools you can use to modernize e-prescribing to improve patient safety, reduce cost for patients, eliminate many faxes and phone calls, and support better experiences for pharmacists and patients alike.

About the Author

Ken Whittemore, Jr, is Surescripts vice president of Professional and Regulatory Affairs.