Association Perspective
Ilisa BG Bernstein PharmD, JD, FAPhA
It’s been a busy summer in our nation’s capital, and in state capitals across the country. FDA’s monumental update to the EUA providing patient access to pharmacist services across this country gave pharmacists the ability to prescribe the COVID-19 oral antiviral, Paxlovid (Pfizer), under certain conditions for patients with COVID-19. What does this announcement mean for you, and how can you ensure you are reimbursed fairly for these additional services?
The federal government had already authorized pharmacists to order and dispense oral therapeutics under the PREP Act, but the EUA change on July 6, 2022, permitted Paxlovid to “also be prescribed for an individual patient by a state-licensed pharmacist, under certain conditions.” FDA took this great leap forward following a new analysis by CDC, which confirmed APhA’s findings of inequitable patient access to COVID-19 oral antivirals, particularly in underserved and vulnerable communities.
Since 2020, APhA has worked tirelessly with our partners to successfully advocate for expanded federal authority for pharmacists to immunize, test, and treat patients with COVID-19 under declarations to the PREP Act—including the authority of pharmacists to prescribe, dispense, and administer COVID-19 therapeutics.
We led the way, making the case to the federal government that permitting pharmacists to prescribe oral COVID-19 antivirals would significantly increase equitable access to the Biden Administration’s Test-to-Treat pharmacies by opening the door to communities that need it the most.
According to our analysis that we provided to the Biden Administration, as of June 22, 2022, there were over 28,000 community pharmacies located in federally recognized underserved communities, yet only 838 Test-to-Treat sites in those communities. The data show that tapping the pharmacies in these areas could increase access to treatments by about 3,200%. We now have the authority, but we need the time and sufficient reimbursement to use it.
In your corner on fair payment
I sent a letter to President Biden immediately after prescribing was authorized calling on the Administration “to continue its strong leadership in combatting COVID-19 and promoting health equity by taking immediate, emergency action to ensure coverage of all of the services required for pharmacist prescribing of Paxlovid.”
I emphasized that these “services, which take 15–30 minutes per patient, are reimbursed for every other prescriber, but not for pharmacists. It is inequitable, unfair, and unreasonable to think that this service can be provided for free by pharmacists. A reimbursement pathway must be established. This effort will only be successful and sustainable if CMS and other payers take immediate action to provide adequate, appropriate, and fair payment for pharmacists.”
Driving us forward
As stated in the revised EUA, “FDA recognizes the important role pharmacists have played and continue to play in combatting this pandemic.” It’s clear from the federal government’s continued reliance upon pharmacists as the most accessible health care professionals for COVID-19 testing, treatment, and immunizations that we need to cement pharmacists’ roles as public health partners in delivering this essential care to defeat COVID-19 and respond to future public health emergencies. Recognizing this opportunity to advance pharmacy, APhA joined 10 other likeminded professional organizations and American health care companies to launch the Future of Pharmacy Care Coalition.
Read more (pharmacycare.org) about our efforts to pass federal legislation—the Equitable Community Access to Pharmacist Services Act (ECAPS), H.R. 7213—which would make permanent pharmacists’ ability to provide care and receive reimbursement for pandemic-related services, including the prescribing of COVID-19 therapeutics.
You are the engine that drives us forward and I look forward to continuing to update you directly on APhA’s efforts to represent the voice for all of pharmacy. ■