COVID-19-Community pharmacies are heroes (again)

NCPA March 20, 2020

Dear Colleague,

Doug HoeyWe could see the crescendo of COVID-19 growing but it's still hard to believe that it was just over a week ago when life was still pretty normal. Most businesses and schools were open. Social gatherings were not taboo. And, the NCAA basketball March Madness tournament was still on. Oh, how things have changed. Community pharmacies are on the front line and experiencing big changes to their businesses. NCPA has kept you informed with information and resources relevant to your patients and business while trying not to add to the overwhelming amount of information you have been sent. Here are a few of the things you need to know from this week:

The voice of community pharmacy. NCPA has been working overtime letting government officials know what pharmacies need. Among our many asks, signature log waivers for deliveries were made to CMS and several PBMs have responded. Some require "COVID-19" or something similar where the signature goes. Some though, are only allowing the waiver for Part D prescriptions, so beware of this halfhearted response. The PBM response has been noted and is being reported.

More than two weeks ago (eons ago in this fast-changing world), NCPA raised the hand of independent pharmacy saying we are ready and prepared to help, here's how we can help, and here's what we need in order to help. We followed up with letters to Vice President Pence and members of Congress earlier this week asking for the elimination of pharmacy DIR fees and reform to Medicaid managed care payments. NCPA is advocating strongly for those important needed changes to give pharmacies the relief they need to continue to act as rocks for their communities, but your help is needed.

If there was ever a time to unleash the grassroots power of 21,000 community pharmacies it is now! Tell them how many patients you are serving. Tell them about accommodations you have made to help patients, especially the elderly. If you are offering delivery or compounding hand sanitizer let them know. Community pharmacy owners are unfailingly modest. Now is not that time. Now is the time for action! Your representative and senators offices are probably busy and stressed so be courteous and brief but make this call and send a follow up email letting them know. Urge your representative and senators immediately to include provisions addressing pharmacy DIR fees and ensuring fair reimbursements for community pharmacies that cover both ingredient and dispensing costs in Medicaid Managed Care in their next legislative package to address the COVID-19 pandemic.

Most supplies are holding up. We've had no reports from members of widespread shortages of prescription medications (with an occasional exception we have seen on Twitter) except for hydroxychloroquine because of its reported potential effectiveness (with azithromycin; in a small trial) against COVID-19. On the other hand, surgical masks, thermometers, and isopropyl and ethyl alcohol are all in short supply. Wholesalers and other suppliers have shared that the alcohol shortages should abate soon. There is hope that other types of masks may be approved which would help curb the shortage.

Independent pharmacists are super creative. In the face of so much worry, it's been a joy to see the creativity of pharmacy owners in serving patients. In qAM, NCPA has started including "Members Helping Members" in which members share their ideas to adapt and serve their communities. Here's just one example: Fredi Berkovits at Medical Arts Chemicals and Surgicals in Brooklyn, N.Y. provided this tip about trying to limit spread working in close quarters behind the pharmacy counter: "Try to restrict one person per phone or have wipes next to the phone so if different users switch, they can wipe down." Please continue to send these ideas to qAM!

Last week's Rose Garden press conference. Last Friday President Trump held a press conference in which he declared a national emergency. He also included the CEOs of several chain retailers including Walmart, Walgreens, CVS, and Target. It certainly caught my attention. Upon closer inspection, the president needed parking lot real estate, much like the Red Cross needs after a natural disaster, so public health personnel could conduct drive-up testing. According to a Washington Post story, the program was pulled together quickly and many details are still not clear, such as when would these drive ups start and when the Google questionnaire testing triage tool that the president spoke about be available (one thing that is clear is that the "nasal swab" is not a mere dab of the inside of a nare. One patient said, "Felt like I was getting stabbed in the brain.") Weeks before the press conference, NCPA had made clear that community pharmacists are here and ready to help during this national crisis and we continue to reiterate that message in daily communications to the administration, CDC, FDA, and HHS.

Be a hand sanitizer hero. Hand sanitizer, a product that many people took for granted, is now vital to the national strategy for containing the outbreak, and pharmacists have a chance to fill the supply void. The FDA recently gave its approval for pharmacies to compound hand sanitizer. For some pharmacies, this may feel like a small thing relative to other services they provide, but it's no exaggeration to say that your patients, your communities, and public health professionals are counting on you to meet the need.

PCCA has now made available to all pharmacies a step-by-step guide to compound the World Health Organization's hand sanitizer formulations. Click here to request the formulas and view ingredients. NCPA member Steve Hoffart has made the news by donating hand sanitizer to emergency responders in his hometown of Magnolia, Texas. "It's just really awesome as a compounder to help in a time of crisis," Hoffart said.

NCPA's Coronavirus Resource Center. A few weeks ago, NCPA created the Coronavirus Resource Center. At the time, we didn't know that every waking moment would be occupied by the virus. But we knew that NCPA members needed a place to go for resources, such as posters to print and display in your pharmacy and the communications NCPA has been continuously making to the White House, CDC, FDA, HHS and others.

Sunday night, NCPA will host COVID-19 Alert: National Pharmacy Teleconference for NCPA owners and managers at 8 p.m. ET. Registration is required. The call will be recorded and made available on the NCPA website for anyone not on the call. The purpose of the call is to brief members on the latest from Washington and to share what NCPA is doing to represent community pharmacies during this dynamic time.

It's been an extraordinary week. One in which community pharmacies have proven what we say all the time: that they are crucial to the health of their community—every day, all the time, in crisis or not.



Douglas Hoey, Pharmacist, MBA


P.S. Call and email your members of Congress (see above!)