Steve Anderson

You may have heard this one-liner popularized in 2020: “In 2015, everyone who answered the standard question ‘where do you see yourself in five years?’ got it wrong.”

Given that few people in 2015 would have foreseen themselves five years later in a mask, in quarantine and confronting COVID-19’s many challenges, that comment describes well the past year’s unpredictability.

While the past year’s events suggest the folly of prediction, it seems safe to project that the developments of 2020 will shape significantly the outlook for 2021 and for the near future.

Heroic teams

First, I want to express the deepest appreciation for everything that National Association of Chain Drug Stores chain and supplier members’ teams are doing to serve their customers, their communities and the nation during the COVID-19 pandemic.

NACDS members include national and regional traditional drug, grocery and mass retailers — with 155,000 pharmacists and 3 million team members across 40,000 stores with pharmacies. NACDS members also include 900 supplier partners and their teams — offering the products that are needed and loved by Americans.

To all of these individuals: Thank you for all you have done and will continue to do, alongside other health care and retail heroes, to meet the extraordinary demands of this pandemic.

First responders

Because of their crucial position and proven effectiveness on the front lines of health care delivery, NACDS members have played a vital role in the pandemic’s response since the beginning. On March 13, 2020, NACDS members had their first of what turned out to be a series of seven calls throughout the year with the Centers for Disease Control and Prevention (CDC).

That first call focused on three key points:

• The CDC urged retailers to do whatever was necessary to stay open and to serve the public.

• Discussion centered on keeping customers and staff safe.

• Communication with local leaders was prioritized to facilitate constant evaluation of the community’s needs.

The CDC’s early emphasis on keeping pharmacies open and fully engaged as leaders in battling the pandemic was a credit to everyone in the industry.

You may recall seeing the NACDS TV ad — titled “Rise” — which we aired nationally starting in April 2020. We pledged that pharmacies would be there for the nation, as in our nation’s prior challenges. That ad set the perceptual framework for pharmacy, and served as the opening statement for the case that we have made together for the federal and state policies that are necessary for pharmacies to maximize their service to the public.

Since that first call with the CDC and since the first airing of that ad, NACDS members have lived up to the pledge to serve Americans with “lights on, doors open.” Action on that pledge will be required into the future, and certainly during what could be an extremely challenging winter.

Overcoming barriers

Advocacy for pro-patient, pro-pharmacy government policies remains a crucial aspect of NACDS’ mission and value. Throughout 2020 and in the face of the pandemic, the industry has had to work through an array of state and federal government policies that in many ways are counterproductive, complicated and archaic — and that ultimately hinder patient care. Continuing to remove needless policy barriers, and preventing a rollback of the preparedness that already has been achieved, will remain a focus in 2021.

Together, NACDS members have fought for policies that help make it possible for pharmacies to:

• Staff wisely and safely.

• Conduct their operations efficiently.

• Help patients stay on their medications.

• Offer expanded options for the delivery of medications and consumer products.

• Put patient care over paperwork.

• Offer enhanced testing and vaccination services.

Prepared to vaccinate

Throughout 2020, pharmacy achieved tremendous progress in public policy that ultimately will help to put the trust, accessibility and professionalism of pharmacies and pharmacists to work for the American people by providing safe and effective COVID-19 vaccinations. The continuation of this work very well could define 2021.

We are succeeding in making the case about the essential role of pharmacies, which are within five miles of 90% of Americans. That role is summarized well by a CDC study that found that our nation can vaccinate 80% of Americans seven weeks sooner when pharmacies are part of the model. Pharmacies and pharmacists will figure significantly in the vital work of reaching the medically underserved and those who have been subject to disparities in health care.

NACDS national and regional members are extremely well prepared as a result of their hard work, of their planning and execution, and of the education and training of pharmacy teams. National, regional and independent pharmacies will be partnering at the federal and state levels in this historic vaccination initiative.

Even so, it will be necessary to continue to anticipate, identify and resolve any nagging barriers that stand in the way of efficient administration of COVID-19 vaccinations and other services that are essential to the American people. We will need to maintain a proactive footing in engaging with federal and state government leaders in that important work.

While the accessibility of pharmacies and pharmacists will contribute mightily to the vaccination initiative, so too will the trust that Americans place in these health care destinations and health care professionals. A survey conducted in August 2020 by Morning Consult, and commissioned by NACDS, found that three in four adults trust pharmacists to provide the COVID-19 vaccination, and one-third of adults are more likely to get the vaccination if it is available at a pharmacy. Pharmacists are among the most trusted health care professionals regarding COVID-19 vaccinations.

Social justice

As we enter 2021, it is not lost on any of us that we continue to face the most severe public health crisis of the past century — at a time when we are extremely divided politically, racially and economically. Yet these divisions are issues on which NACDS has been focused for quite some time and on which we’re redoubling our efforts.

COVID-19 is affecting some races and ethnic groups more than others. Even before COVID-19, we saw the same thing with chronic conditions like diabetes, heart disease and others. And we recognize the contributing factors: access to care, trust of the health care delivery system, and social determinants of health.

Our industry has a strong track record and an ongoing responsibility to help with these issues. NACDS has intentionally focused on these issues as we have recommended government policies related to chronic care and public health. Similarly, we have brought an intentional approach to these issues in our recommendations on COVID-19 issues and in our flu-vaccination communications campaign. This focus must and will remain a top priority.

Reimbursement
and scope

Reimbursement and scope of practice issues have been a major focus across all COVID-19-related issues — from testing, to vaccinations, to helping patients stay on their medication therapies amid the challenges of the pandemic. In addition, reimbursement and scope of practice issues that are outside the realm of the pandemic have demanded continued focus throughout 2020 and into 2021.

We need to make a clear and compelling case that the pandemic has shown the importance of addressing reimbursement and scope of practice issues. Pharmacies are essential for meeting the health and wellness needs of all Americans every day, and certainly during a public health emergency.

The August 2020 survey conducted by Morning Consult and commissioned by NACDS, which I mentioned previously, found that two-thirds of American adults are concerned about the situation whereby “due to current rules on prescription drug pricing, sometimes payments from health plans and government programs made to pharmacies for medications and services they provide are below cost or unpredictable.” That speaks to the need for relief from dire direct and indirect remuneration (DIR) fees and other loopholes that increase patients’ costs and that jeopardize pharmacies and patients’ access to them.

Opioid abuse prevention

As I write this, there is a notable resurgence of media coverage regarding opioid abuse, which is being referred to as another epidemic that continues to face America. The fact is that pharmacies have maintained vigilance on these issues throughout the demands of COVID-19.

NACDS has maintained our focus on public policy strategies designed to help pharmacies and pharmacists remain part of the solution to opioid abuse. The ongoing NACDS public policy agenda includes electronic prescribing, drug disposal, supply limits, prescription drug monitoring plans, health plan design and pain management. This policy agenda complements pharmacies’ actions in the areas of compliance programs, drug disposal, patient and community education, security initiatives, fostering naloxone access, stopping illegal online drug sellers, and philanthropic programs.

So, let’s revisit the comment that began this article: “In 2015, everyone who answered the standard question ‘where do you see yourself in five years?’ got it wrong.”

Perhaps not everyone’s prediction was wrong after all. It is not far-fetched to think that some of us said: “In five years I will be part of an industry that has proven incontrovertibly its essential role in our society.” Those who said that are right.

Count me among those who make a similarly optimistic prediction about our industry in 2021 and beyond, as its heroic teams continue their essential service to the American people.