The COVID-19 pandemic disrupted every sector of American life, and pharmacies were no exception. During the pandemic, my family and I operated our community pharmacy in one of the country’s largest cities. I witnessed firsthand the changes in patient care and how it impacted pharmacies. Many of these changes proved positive and should endure into the future. Yet, the pandemic also exacerbated long standing challenges that remain to this day.
How Pharmacies Changed Due to COVID-19
When the pandemic hit, the initial concern for community pharmacies was continuing to get patients their medication. We needed to make sure patients received their prescriptions safely. As a result, the pharmacy community and agencies that control it quickly created logistical changes to make medication access safe and reliable. Delivery service and curbside pickup became common. Pharmacy management systems added virtual queues and mobile availability, while government Emergency Use Authorizations were put in place to ease regulations. As it turned out, these logistical changes were only the beginning.
As the pandemic unfolded, the health care industry was forced to lean on community pharmacies in other ways. Previously, pharmacies had been underutilized, considered by many as little more than dispensaries for medication where customers can also buy candy, make-up, and everyday household items.
Responding to the pandemic, however, required the health care system to tap the full scope of pharmacy practice and utilize our expertise. Patients feared going inside a medical building to see a provider or undergoing an elective procedure, but they continued to go to their pharmacy.
Patients picked up their medicine utilizing contactless services while realizing there was a trained clinician easily available to them. Providers started appreciating that pharmacists had reliable access to patients month over month and used that to their advantage, leaning on pharmacists to be the liaison between them and their patients.
All of a sudden the message that pharmacists and community pharmacies have been saying for years was heard: We provide health care and we can support physicians to provide the best care possible for patients.
Community pharmacies were called upon to step up in new ways that combined our access, skills, and expertise. At the start of the pandemic, pharmacies were some of the first point-of-care testing sites for COVID-19. Pharmacy owners set up drive-throughs in their parking lots, while some opened new locations or refurbished existing locations to be testing centers. Many of those centers continue to operate as clinical facilities today, utilizing pharmacy teams to test for viruses, check cholesterol levels, administer vaccinations, and even provide wellness services like diabetes education.
When COVID-19 vaccination became available, pharmacies became a central hub for administering vaccines. There was no other segment in health care that could support the vaccine rollout like community pharmacies. Pharmacies started vaccinating hundreds of patients per day, while ramping up staffing, creating workflows, and reporting data overnight.
According to the CDC, pharmacies administered more than 258.1 million doses of COVID-19 vaccine as of July 7, 2022 through the Federal Retail Pharmacy Program and that is not counting the pharmacies that were administering under a state program. This was achieved while operating testing sites, supporting providers in new ways, and continually getting patients their medication. Community pharmacies finally proved their worth in health care.
Since then, the appreciation of pharmacies has expanded, and pharmacists have the opportunity to practice under a more clinical scope. Providers and patients are taking advantage of testing and disease state management programs. Care teams are being led by pharmacists collaborating with physicians, and patients are connecting with their pharmacists to ask questions about medications.
The Remaining Challenges
A big problem for pharmacies prior to and during the pandemic continues to be proper recognition and inadequate reimbursement. Consider the case of Paxlovid, the COVID-19 antiviral. Pharmacists were given the authority to prescribe and dispense this medication. To ensure it is appropriate for a given patient, pharmacists need to conduct a lengthy screening process. In the average community pharmacy, this step takes about 15 minutes, with another 10 minutes needed to access health records, usually via phone since most pharmacies cannot access electronic medical records. An additional 10 minutes is needed for data entry and to physically fill the medication. Then the pharmacist needs to counsel the patient. The entire process takes at least 40 minutes.
How much is the pharmacy actually reimbursed for the pharmacists’ time? According to the Wall Street Journal, pharmacists receive a single penny to about $10 for filling each prescription. I could digress into the history of poor reimbursement and provider-status legislation in pharmacy, but as we look beyond the pandemic, community pharmacies need to keep up the momentum that we so rightfully earned throughout the COVID-19 pandemic.
During the pandemic, community pharmacies came to be seen as the health care hubs while pharmacists were proven to be clinical experts capable of supporting patients and providers. Now that our critical role in health care has been demonstrated, it’s time to secure a sustainable future for our practice.
Clearly pharmacies should be properly paid for the services provided. We should be reimbursed in a transparent way that values our time and expertise while fairly covering our costs. Pharmacists should be utilized to the best of their ability to support patient goals and continue taking steps toward collaboration with care teams. Both physicians and pharmacists are experts in their respective roles, and they can work together to increase the quality of patient care.
Lindsay Dymowski is president of Centennial Pharmacy Services. She is a medical-at-home pharmacy leader, devoted community pharmacy advocate, passionate entrepreneur, and public speaker.
The opinions expressed in MPR guest submissions are the author’s and are not necessarily those of MPR or its editors.