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Patients lose if we don't continue to expand pharmacy-based clinical care in the U.S.

By Kevin Ban, Jenni Zilka

Elderly woman talks to pharmacist
As we emerge from the COVID-19 pandemic, it is clear that patients have come to rely on and value the accessibility of pharmacies and the clinical services pharmacists provide. This is evidenced by the 252.1 million doses of COVID-19 vaccines administered by pharmacies this past year, by the Administration’s recent inclusion of pharmacies in the “Test to Treat” initiative for COVID-19 oral antivirals, and by the thousands of patients that seek prevention, wellness and treatment services at their local pharmacy every day.
However, patients are currently at risk of losing essential clinical care access at their pharmacies if the COVID-19 public health emergency is allowed to expire. Access to services like COVID-19 tests, vaccinations and therapeutics, and childhood vaccinations could be in jeopardy if Congress and the Administration do not act. But a poll conducted by Morning Consult and commissioned by the National Association of Chain Drug Stores (NACDS) shows that most Americans support policy to allow pharmacists to continue to provide these services. 
Pharmacists have only been temporarily authorized to deliver this care at scale nationwide based on a variety of Public Readiness and Emergency Preparedness (PREP) Act declaration amendments and advisory opinions. To be clear, pharmacists have had the ability to vaccinate for illnesses like the flu, pneumonia and shingles for many years. In fact, every state in America allows pharmacists to administer vaccines. However, laws vary widely state by state with respect to who pharmacists can vaccinate and which types of immunizations they can provide. Similarly, state laws for pharmacists to administer tests for illness like COVID-19 and flu are also highly variable. 
Even when pharmacists may have authority to perform such activities, pharmacists cannot get paid directly by Medicare for clinical care because pharmacists are not authorized as providers within Medicare Part B. This issue has continued to be a challenge during the pandemic. 

This could change, however, as U.S. Representatives Ron Kind (D-WI), David McKinley (R-WV), Nanette Diaz Barragán (D-CA) and Buddy Carter (R-GA) introduced bipartisan legislation to support pharmacists in providing key access to pandemic-related clinical services for COVID-19 and other illnesses, including flu, strep and RSV. 
H.R. 7213 is an important step forward to improve access to care in the future and an acknowledgement of what pharmacies have accomplished this past year. The COVID-19 vaccination effort was the first time that pharmacists across all states in America had the same autonomous authority to immunize their patients. The results speak for themselves as pharmacies are providing two out of every three COVID-19 vaccine doses administered in America, including to many seniors. Pharmacists’ independent authority and support to vaccinate against COVID-19 also made a difference in supporting rural and under-resourced communities. In fact, 45 percent of pharmacy COVID-19 vaccination sites were reported to be in areas with moderate to severe social vulnerability. 
If this pandemic experience has taught us anything, it is that our healthcare system cannot move backwards. The public needs and deserves greater access to care. The same, aforementioned NACDS survey gave pharmacies the highest ratings for ease of access among healthcare destinations – including emergency departments, primary care physician offices and specialist physician offices. Clinical services authorized for pharmacists during the pandemic must be protected and reimbursement pathways must be established to maintain and strengthen the pharmacists-provided health infrastructure that we’ve built over the last two years to better serve communities nationwide. 

We should continue to evolve the model of pharmacy, allowing it to serve as a meaningful extension of our public health system and as an essential access point for those who need care the most. Otherwise, patients will ultimately lose. We commend Representatives Kind, McKinley, Barragán, and Carter for seeing and addressing this issue. We now hope their fellow Members of Congress and the U.S. Senate will heed the call on H.R. 7213.

About The Authors

Jenni Zilka
Senior Vice President, Community & Specialty Pharmacy & President, Good Neighbor Pharmacy
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