Discussion and action on health disparities are essential.

Editor’s Note: NACDS president and chief executive officer Steve Anderson offers the following update on NACDS’ COVID-19 response:

I appreciate the chance to update Chain Drug Review readers on the status of NACDS’ COVID-19 response. This has been an ongoing dialogue since the earliest days of the pandemic, which reflects the focus of retailers, suppliers and NACDS in meeting the needs of our nation, of our communities and of the public.

Steve Anderson

Health Disparities in Focus

An unmistakable fact about the current state of pandemic response is that it is occurring alongside a revived and much-needed conversation about social justice. The latter, of course, is the result of the horrific killing of George Floyd and others. At the intersection of these two story lines is the realization that Black Americans are affected disproportionately by COVID-19.

Discussion and action on health disparities are essential — a point that NACDS has made prior to recent tragedies and a point to which NACDS has recommitted itself. The report that we issued on May 15, titled “Pharmacies: A Vital Partner in Reopening America,” details recommendations for meeting the needs of the medically underserved in the areas of COVID-19 testing and ensuring access to COVID-19 treatments and vaccines when available. Because COVID-19 has illuminated broader needs in the care of chronic conditions faced by underserved and disadvantaged communities, NACDS is emphasizing the ways in which pharmacies and pharmacists help to fill the void in care deserts.

In fact, NACDS has been highly engaged in these efforts in recent years, in recognition of NACDS members’ commitments. We have engaged in the World Health Care Congress to help elevate the discussion of social determinants of health. We also have partnered with federal agencies, with the American Public Health Association, and with others on initiatives specific to diabetes and hypertension, immunizations and more. This is consistent with NACDS member companies’ forward-thinking ­initiatives.

NACDS’ consistent and ongoing commitment to addressing health disparities will only ­increase.

Advancing Scalable, Sustainable COVID Testing

NACDS has been highly engaged at the federal and state levels to ensure pharmacies and pharmacists can help meet their communities’ needs for COVID-19 testing. This work is essential for building on the tremendous work of NACDS member companies participating in public-private partnerships that have helped to ramp up COVID-19 testing since the early days of the pandemic.

In May, the Department of Health and Human Services (HHS) acted on a request by NACDS, member companies and individual pharmacists. The department stated powerfully that federal law, along with executive branch actions, “preempts any state or local requirement that prohibits or effectively prohibits a pharmacist from ordering and administering a COVID-19 diagnostic test that the Food and Drug Administration has authorized.” This action reinforced prior guidance from the federal government. In addition, more than 40 individual states — at the urging of NACDS, member companies and state partners — have taken significant action to help remove barriers to pharmacist-provided testing.

It is imperative as well to secure fair reimbursement for pharmacies providing COVID-19 testing. Recognition of pharmacists as providers under Medicare is among the means to that end. Put simply, the degree to which government leaders succeed in addressing this issue will figure significantly in their success in building a sustainable and scalable approach to testing.

Further, the time is now to ask the question: Thinking beyond the COVID-19 crisis, why would a state want to roll back the level of pandemic preparedness that has been achieved? It is important to make permanent a proactive approach to protecting individuals and communities.

After all, pharmacist-provided testing for various conditions is not a new concept, and is entirely consistent with the public health opportunities presented by the accessibility and education of pharmacists. Pharmacists currently provide a variety of CLIA-waived tests to patients for flu, HIV, hepatitis C, tuberculosis, strep throat and other illnesses in more than 40 states. In addition, pharmacists provide tests to monitor chronic conditions, such as diabetes, to assist patients in achieving better control of these conditions. In 17 of those 40 states, pharmacists can initiate treatment for flu and strep among other minor ailments.

Just as states enhanced their preparedness after the 2009 H1N1 pandemic by making permanent enhanced vaccination authority for pharmacists, states now should preserve and build on additional coronavirus testing preparedness by looking to pharmacists and pharmacies.

Now is the Time to Prepare for COVID Vaccines, Treatments

COVID-19 testing has demonstrated vividly the complexities of health policy and the length of time that is needed to change it. The lesson for government leaders at the federal and state levels is that now is the time to ensure pharmacists are able to provide treatments and vaccines for COVID-19 as they become available.

NACDS and the public health community are well equipped with lessons from pharmacy’s effectiveness during the 2009 H1N1 pandemic, including studies that show the importance of pharmacies and pharmacists in the deployment of vaccines and treatments. Centers for Disease Control and Prevention (CDC) researchers found that 80% of the nation can be vaccinated seven weeks sooner when neighborhood pharmacies are included in the vaccination deployment model.

It will be extremely important for pharmacists to have the ability to initiate treatment with an antiviral therapy, when available, based on a positive COVID-19 test. It also will be critical for pharmacists to be empowered to be in a “ready, set, go” status to prevent delays in adequately protecting Americans with vaccines.

In addition to ensuring pharmacists’ vaccination authority, the government must prioritize pharmacies to be recipients of the vaccine early on. The most accessible health care providers should not be placed at the back of the line. Further, as is the case with COVID-19 testing, fair reimbursement must be secured, and recognition of pharmacists as providers under Medicare is among the means to that end.

Ensuring Flu Vaccine Readiness

The demand for flu vaccines — including those provided in neighborhood pharmacies — is expected to soar this season and is expected to occur in a compressed time frame of mid-August to October. In addition, pharmacies must remain well positioned to meet patients’ diverse health and wellness needs for a variety of conditions, particularly given the challenges that could be faced by the entire health care delivery system when COVID-19 collides with the flu and allergy seasons.

As a result, states should maintain, and in many cases make permanent, the flexibilities that they have initiated to help keep pharmacies open, to help protect patients and pharmacy staff, and to help patients stay on their medication therapies. These policies involve remote supervision, emergency dispensing, mobile vaccination programs, remote claims processing, relaxed audit protocols, and enhanced engagement of pharmacy technicians.

NACDS already is working with HHS to coordinate on critical issues related to preparedness for the flu season. That collaboration must continue.

In addition, NACDS members have a tremendous role to play in educating all Americans about recommended vaccines, and getting back onto the regular vaccination schedule. Due to the physical distancing recommendations at the height of the pandemic, the CDC called a time-out, urging a break from regularly scheduled vaccines. In the interest of public health, it is important to resume the recommended schedule of vaccines.

As always, I want to salute the NACDS membership for remarkable service to the American people at this extremely challenging time. NACDS members’ teams are among the true heroes of our nation, and this shines through every day — and certainly amid our greatest challenges. We appreciate the chance to report in the pages of CDR about our vital work ­together.

Steve Anderson is president and chief executive officer of the National Association of Chain Drug Stores.