The American Pharmacists Association (APhA) 2020 Annual Meeting & Expo was scheduled to take place March 20-23 in National Harbor, Maryland. Due to the current COVID-19 pandemic, the live event was canceled, but the House of Delegates meeting was still held virtually – a first in the organization’s 165-year history. Delegates include all national pharmacy associations, those appointed by APhA academies, and elected members and leadership. There were three urgent new business items (NBI) discussed at this virtual event, all related in some way to COVID-19, all of which are critical to the pharmacists who are on the front lines during this unprecedented public health situation.
Urgent new business order #1: Protecting pharmacy personnel during public health crisis
“As the coronavirus continues to spread and impact Americans throughout the country, lawmakers are cutting red tape and clearing the way for frontline providers, such as pharmacists, to be a greater resource to patients during these troubling times,” according to the NBI #1 document.
“Patients of America’s pharmacists should have the full benefit of pharmacists’ expertise in medication therapy and management of patient care services during a health crisis. Pharmacists with appropriate safeguards and protections are ready and able to serve the needs of their communities. However, many healthcare providers are concerned regarding the lack of protective gear (PPE: surgical masks, N-95, etc.), cleansing products or modification of pharmacy procedures that limit direct exposure to patients (i.e.,. delivery service, and drive-through and curb side pickup, etc.). Protecting pharmacists, and their entire pharmacy team, including student pharmacists and pharmacy technicians, protects patients and their continued access to their pharmacists and the services they offer within the pharmacy practice. As screening and testing, treatment and prevention procedures, and systems are developed, pharmacists and pharmacy staff must be afforded appropriate protections in order to ensure the safety of the pharmacist and the entire pharmacy team, the public and the family members of health care workers.”
Motion: APhA urges federal and state government officials, manufacturers, distributors, and health system administrators to recognize pharmacists and pharmacy personnel as “front-line providers” that should receive appropriate personal protective equipment and other resources to protect their personal safety and support their ability to continue to provide patient care.
Urgent new business order #2: Pharmaceutical safety and access during emergencies
“There have been reports from pharmacists that wholesale prices for certain pharmaceuticals and medical supplies have escalated beyond inflationary expectations as the result of national emergency declarations in place. In addition, vendors and even other healthcare providers are soliciting products via phone, fax or social media at extraordinary prices,” according to the NBI #2 document.
“This is creating further supply chain disruption and placing tremendous burdens on cash flow for pharmacies, which can lead to lack of access to critical medicines and supplies to patients. Additionally, restriction in product access, or fear of that, could drive hoarding and further shortage exacerbation. Further, PBMs/payers are unable to adjust their reimbursement databases as quickly as the price fluctuations are occurring, negatively impacting practitioners trying to serve the needs of their patient base.”
Motion: APhA urges government authorities to hold pharmaceutical manufacturers, wholesalers and other pharmaceutical supply distributors, and providers accountable to state and federal price gouging laws in selling those items to pharmacies, hospitals and other healthcare providers during times of local, state, or national emergency.
The motion was carried and amended to also include pharmacies that may participate as contract pharmacies for 340B, in addition to applying to patients who could be impacted.
Urgent new business order #3: Inappropriate and unethical prescribing/ordering of medications and medical supplies for own use
“As soon as the media and government reported shortages of medical supplies and the testing of medication treatments for coronavirus, such as hydroxychloroquine, physicians and other healthcare professionals began prescribing or ordering large quantities of these items for personal use or use by colleagues and family members, further exacerbating the supply of these items,” according to the NBI #3 document.
“Many of these requests were to stockpile these products in anticipation of a need, not to address a current issue. This activity could hamper access of these medications and supplies to patients who need them for continuity of care. This proposed policy is not directed at healthcare practitioners obtaining reasonable amounts to ensure availability if they develop a need, but what we are seeing is activity that one could equate to as “insider trading.” Reports from pharmacists has dramatically increased regarding tensions between pharmacists and prescribers in these situations.”
Motion: In the face of a declared emergency situation, APhA condemns the inappropriate or unethical anticipatory ordering and prescribing of medications and medical supplies by healthcare professionals for personal use or use by colleagues, family members and patients, and encourages regulatory bodies to adopt and enforce regulations and guidance against this activity and the exacerbation of product shortages.
The motion was carried and amended by excluding only in the face of a declared emergency.
At Sentry, we recognize and appreciate pharmacists’ leadership during this challenging time and applaud how pharmacy organizations are working together to incorporate pharmacists’ needs in upcoming legislation and policy discussions.