Bulletin Today
APhA Staff
On March 24, Congressman Ron Kind (D-WI), Congressman David B. McKinley (R-WV), Congresswoman Nanette Diaz Barragán (D-CA), and Congressman Buddy Carter (R-GA) introduced the Equitable Community Access to Pharmacist Services Act, a groundbreaking piece of legislation that would allow Medicare patients to continue to receive treatment from pharmacists for pandemic-related health services and would permit pharmacists to respond to ongoing and future public health crises.
“Pharmacists have been essential providers in rural and underserved communities during this pandemic, providing essential care and services where they are the only accessible health care provider,” said Theresa Tolle, BSPharm, FAPhA, APhA president, in a press statement. “This legislation will ensure that millions of patients in communities across the country will continue to receive health care services from pharmacists, alleviating gaps in patient care and advancing health equity.”
The new legislation would
- Add pharmacists as eligible providers for Medicare Part B beneficiaries of pharmacy- and pharmacist-provided services related to the COVID-19 pandemic and specific infectious diseases, such as testing (for COVID-19, flu, respiratory syncytial virus, and strep throat), treatment (for COVID-19, flu, and strep throat), and vaccinations (for COVID-19 and flu)
- Prepare for future emergencies by creating a mechanism to establish Medicare coverage and payment for pharmacy- and pharmacist-provided services when there is a public health need, such as during a public health emergency or similar event
- Authorize the HHS secretary to identify services as needed, including those needed to close gaps in health equity
- Be limited to state scope of practice or incident to physician’s services, or more broadly if provided under a PREP Act declaration
- Enable pharmacists across the country to provide services to Medicare beneficiaries in order to address COVID-19 and other pressing health needs in all areas of the country
The legislation, H.R.7213, was spearheaded by APhA in partnership with the Future of Pharmacy Care Coalition. ■
DEA commits to expand access to MAT
DEA administrator Anne Milgram has announced the agency’s continued support for expanding access to medication-assisted treatment (MAT) to help individuals with substance use disorder.
Effective March 2022, practitioners working in hospitals, clinics, and emergency departments will be able to request an exception that permits them to dispense a 3-day supply of MAT to treat patients experiencing acute opioid withdrawal symptoms.
Also, DEA—in partnership with HHS—said it is engaging in regular outreach with pharmacists and other practitioners to express support for the use of MAT for people with substance use disorder.
“Medication-assisted treatment helps those who are fighting to overcome substance use disorder by sustaining recovery and preventing overdoses,” Milgram said in a press release. “At DEA, our goal is simple: we want medication-assisted treatment to be readily and safely available to anyone in the country who needs it.”
DEA—working with federal, state, and local partners—has been supporting several initiatives to widen access to MAT for people with opioid-related substance use disorder.
In response to the COVID-19 public health emergency, DEA adopted temporary regulations permitting MAT to be prescribed via telemedicine, and it is now working to make those changes permanent. ■
Young children with uncomplicated pneumonia could be OK without antibiotics
A study in Open Forum Infectious Diseases revealed that among children aged 3 years or younger who were hospitalized for uncomplicated community-acquired pneumonia (CAP), a sizable proportion of them fared well without undergoing a full course of antibiotics.
In the retrospective, observational study, researchers from the University of Alabama at Birmingham examined data on previously healthy children aged 3 to 36 months who were treated at Children’s of Alabama for uncomplicated CAP from September 2011 through December 2019.
They compared outcomes in children treated with antibiotics—defined as treated for more than two days with an antibiotic or discharged home with an antibiotic prescription—with those of children who received two days of antibiotics or fewer or were discharged home with no antibiotics.
Tracked outcomes included illness severity, length of hospital stay, and readmission after discharge.
A total of 322 children were included in the study, and 266 (83%) received more than two days of antibiotics or were discharged with antibiotics.
Furthermore, 56 children received two days or fewer of antibiotics and were discharged without antibiotics and 32 children received no antibiotics.
The proportion of patients treated with antibiotics decreased from 88% in the early part of the study period (2011–2013) to 66% from 2017 to 2019.
The researchers concluded “it appears that a substantial proportion of previously healthy children less than 3 years of age hospitalized with uncomplicated CAP will do well without antibiotic treatment… Better tools for identifying those that require antibiotics will make it possible to achieve a significant advance in antibiotic stewardship.” ■
Could some arthritis drugs reduce Alzheimer and related dementias risk in those with heart disease?
Some rheumatoid arthritis drugs may help reduce the incidence of Alzheimer disease and related dementias in individuals with cardiovascular disease, according to new findings from the ongoing Drug Repurposing for Effective Alzheimer’s Medicines (DREAM) study.
The findings do not advocate the widespread use of these drugs for treating dementias, but the results may indicate a possible use of precision medicine in certain groups of at-risk people.
The study assessed data in Medicare claims from more than 22,000 people to see if those with rheumatoid arthritis who took one of three different classes of arthritis drugs were protected from dementia.
There were no statistically significant associations with lowered dementia risk except among those with cardiovascular disease who were treated with one class of arthritis drugs called tumor necrosis factor (TNF) inhibitors. TNF is a substance that can cause inflammation in the body and lead to immune-system diseases such as rheumatoid arthritis. The National Institute on Aging (NIA) DREAM study previously identified several FDA-approved drugs that are being tested as candidate treatments for Alzheimer disease and related dementias.
The research was published in JAMA Network Open and led by researchers at NIH’s NIA in collaboration with teams at Johns Hopkins University School of Medicine, Rutgers University, and Harvard Medical School. ■
APhA House of Delegates passes policy addressing access to pharmacist-provided services
During APhA’s annual meeting held in San Antonio, TX, March 17 to 21, 2022, APhA’s House of Delegates introduced and passed an urgent new business item that addressed the American Medical Association (AMA)’s policies related to pharmacists’ scope of practice.
“APhA’s policy calls on the American Medical Association (AMA) to join dozens of other health care organizations who recognize and support pharmacists providing essential patient care such as testing and immunization, which has been and will be so important throughout this pandemic and beyond,” said an APhA press release about the recently passed policy.
The policy is a response to recent public statements by AMA on the Biden Administration’s “Test to Treat” COVID-19 plan. That plan would allow individuals with COVID-19 symptoms to go to select pharmacies for a COVID-19 test, and if positive, receive a prescription for and be dispensed an antiviral COVID-19 drug.
After the administration’s announcement, AMA came out with a statement that disapproved of the plan, saying “…establishing pharmacy-based clinics as one stop shopping for COVID-19 testing and treatments is extremely risky.”
However, physicians and other health professionals know that pharmacists are the medication experts. There are no other health care professionals with more extensive training in medication use and safety than pharmacists. Pharmacists provide patient care services related to medications by testing, treating, immunizing, and educating patients; managing medication therapies; and providing consultative advice and information to other health care professionals. For a primer on pharmacy standards of care, see the April 2022 issue of Pharmacy Today.
“Pharmacists have exceedingly demonstrated their value to patients during the pandemic,” said Ilisa Bernstein, PharmD, JD, FAPhA, APhA’s senior vice president of pharmacy practice and government affairs. “It’s time to work together, break down barriers, and focus on the patient as a health care team.”
“AMA’s policies directly conflict with contemporary standards of practice and pharmacists’ extensive training and expertise. These policies impede the ability of health care professionals to work together to address health equity and provide accessible care to vulnerable populations,” stated APhA in the press release. “The pandemic has highlighted the tremendous health disparities in our nation, and pharmacists are able to directly address these disparities among socially disadvantaged and underserved communities.”
The policy statements passed during APhA’s annual meeting include:
1. APhA opposes policies and practices by the American Medical Association (AMA) and other professional organizations that inhibit interprofessional care, patient access to pharmacist-provided care, and health equity.
2. APhA calls on the American Medical Association (AMA) to rescind its policies opposing expanded scopes of practice for pharmacists.
3. APhA adamantly supports the continuation and expansion of collaborative patient care models among pharmacists, physicians, and other health care professionals to improve patient access to care, health equity, and health outcomes. ■