COVID-19 RESOURCE CENTER

 

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Please monitor this page closely for important news that affects pharmacists amid the current COVID-19 pandemic. We will update it daily to keep information & resources current. 

 
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During this challenging time, community pharmacies are on the front line of the health care system's response to the COVID-19 pandemic. As a pharmacist and pharmacy owner, you have four major responsibilities during the COVID-19 outbreak:
  1. Help minimize death & serious side effects among infected patients;
  2. Minimize transmission of the virus;
  3. Protect your pharmacy employees; and
  4. Maintain the orderly functioning of your pharmacy.
  Uploaded via media manager.   How to Safely Reopen Your Doors 

►  Guidelines for Safely Reopening
►  Updated Sample Employee Policies & Procedures
►  CDC Pharmacy Safety Guidance
►  OSHA Pharmacy Safety Guidelines
►  Front Door Sign (CDC)
►  List of Symptoms & Self-Checker Application (CDC)
►  COVID-19 Symptoms Poster 11x17 (CDC)
►  COVID-19 Flowchart for Managing Exposed Employees (CDC)
►  List of Suppliers for Barrier Shields, Signs, Floor Decals & More

Protect the Safety of Your Patients & Staff 

As you reopen your doors to business, you and your employees should take serious steps to mitigate the threat of COVID-19 in your pharmacy. An infection on your staff can jeopardize the health of your employees and the safe operation of your pharmacy.

 ► Download These Guidelines as a PDF

  1. Closely monitor the infection trend in your geographical area. The New York Times maintains a constantly updated, color-coded map showing the infection status of every county in the U.S. If cases are still accelerating in your area, please weigh your situation carefully.
  2. Monitor the health of all employees and check them daily before they enter the pharmacy. This screening should include a temperature and symptoms check. Self-screening is acceptable as long as employees are well-informed and consistent in the effort. Make sure you have an up-to-date list of COVID-19 symptoms - they now include nausea, vomiting, diarrhea and loss of taste/smell.
  3. Post a sign on entrance doors to discourage people from entering if they have any cold- or flu-like symptoms. Encourage them and other patients who are elderly or compro-mised to get their scripts via delivery, drive-through or curbside pickup, or have a healthy friend or relative pick them up.
  4. If you have a high-traffic store, consider limiting the number of people you allow inside. Post signs at your doors and markers inside for maintaining safe distancing (6 feet) in lines and aisles. Use floor decals or colored duct tape to indicate how people should distance or line up.
  5. Regularly disinfect workstations and counters with diluted bleach, alcohol or spray disinfectant. (Supplies of these products have improved greatly.) Disinfect around all cash registers and where patients pick up or drop off prescriptions. Sanitize the handles and surrounding area on all entry doors and any other frequently touched surfaces. Set alarms to conduct these cleanings at regular intervals.
  6. Consider installing acrylic or plexiglass shield barriers (often known as "sneeze guards") at all cash registers and counter locations where you typically interact with patients. If you have a consult room and are resuming patient meetings,  put a tabletop shield barrier in that room.
  7. Make sure all employees know the risks, symptoms and transmission of COVID-19. Employees should use safety precautions at home and elsewhere. Make sure employees tell you immediately if they or any member of their household are not feeling well.
  8. Have a plan in place in case you or one of your employees is exposed to COVID-19. Use the CDC flowchart as a guide.
  9. Make sure your employees know what to do if they identify a patient with COVID-19 symptoms. 
  10. If you are conducting (or planning to conduct) testing for COVID-19 infection or antibodies, consider setting up your test site in the parking lot or some other external location.
 ► Read More
 
RxCompass Boosts Script Volume As Prescribing Drops
    
After an initial surge in prescription volume at U.S. pharmacies in March, many are experiencing continued drops in volume as the pandemic worsens, unemployment rises and social distancing practices keep many patients shuttered. In addition, many of our members are reporting that one or more of their top prescribers have shut their doors or gone out of business.

During this time of rising unemployment, closing prescriber offices and shrinking patient traffic, it is essential that you take decisive action to increase your prescription volume. If you have a solution in place to manage medication adherence, make sure it is effective and easy to manage. If you are  doing automated patient outreach, make sure you pursue all available opportunities with patients and that you monitor your ROI and success rates. 
 
American Pharmacies members enrolled in RxCompass already have a powerful, proven platform to drive this effort. The RxCompass Refills on Time report, no matter how it's used, is proven to increase Rx volume following personal patient outreach. 
 
 
 
Apply For a CLIA Waiver NOW to Perform COVID-19 & Post-Pandemic Testing
 
The April 8 guidance issued by the U.S. Department of Health & Human Services (DHHS) authorizes all licensed U.S. pharmacists to perform any on-site test for COVID-19 that has been authorized by the Food and Drug Administration. We have all read for weeks about the shortage of COVID-19 tests across the country, but the FDA recently has granted multiple Emergency Use Authorizations (EUAs) to test developers and production has ramped up considerably to improve the supply and variety of available tests. The ability to do COVID-19 testing at your pharmacy has arrived.
We understand that many of you are enduring great stresses as you operate in closed-door mode, often with reduced staffing, product & PPE shortages, and cash-flow challenges. But it is vital to keep one eye on the future for the opportunities it affords independent pharmacies -- opportunities that have materialized much quicker in our new reality.
Pharmacy-based testing for COVID-19 represents a great opportunity to expand both your revenue channels and your status as a health-care practitioner. The April 8 DHHS order essentially creates opportunities to participate in two types of COVID-19 testing that are available now:
  • The COVID-19 RT-PCR test is a polymerase chain reaction test that detects nucleic acid from the SARS-CoV-2 virus in upper and lower respiratory patient specimens. These tests detect active infection in the first 7-14 days of exposure. Because these tests must be processed at a laboratory and pharmacy involvement is limited to collection of the patient specimen (usually via OP/NP swab or bronchial/nasal aspirate), a CLIA waiver is NOT required for specimen collection. This means you may be able to purchase, collect samples for and charge patients for some tests with no CLIA waiver (check with the test developer to confirm). New tests are coming out that test saliva/sputum or blood for the presence of the virus. (These tests usually cost around $100, but prices are beginning to fall as more come on the market.)
  • The COVID-19 serology antibody test detects traces of SARS-CoV-2 / COVID-19 N-Protein IgM / IgG antibodies in human serum, whole blood or finger prick samples. These tests do not detect active infection, but rather the presence of antibodies that are generated starting at 7-10 days after exposure to the virus. These are less-complex tests and generate results in just a few minutes, but because the specimen collection and processing are completed on-site, they require a CLIA waiver for your pharmacy to give them. (These tests cost as little as $30.)

► Read More

ACT QUICKLY TO GET EMERGENCY FEDERAL LOANS
 
Economic Injury Disaster Loans
The Coronavirus Aid, Relief, and Economic Security Act (CARES Act) signed into law on March 27, provides a broad array of economic relief to individuals and businesses. The Small Business Administration's (SBA) existing Economic Injury Disaster Loan (EIDL) program was expanded by the CARES Act to provide longer-term loans with favorable borrowing terms to eligible companies in all 50 states to address economic injury caused by the COVID-19 pandemic. EIDL loans are available in amounts up to $2 million, carry an interest rate of 3.75% and have a repayment term of up to 30 years.
 
We encourage you to apply quickly if you are interested in an EIDL. We understand that the amount Congress allotted to the EIDL program is limited and will be provided on a first-come-first-served basis. Furthermore, you can request a grant of $10,000 within three business days of application just for applying, which can be used for authorized business expenses without any obligation of repayment.
 
An application for a CARES Act EIDL loan can be made directly through the Small Business Administration's online application. The application takes 25-30 minutes to complete. ► Read More 

IF YOU HAVEN'T DONE IT, CLOSE YOUR DOORS NOW

►  Guide to Closed-Door Operations  (Updated 3-28-20) 

We have previously urged our member pharmacies to close their doors to the public to protect staff and patients from the accelerating risk of infection and to enable the ongoing operation of your pharmacy. If you have not yet done so, YOU MUST IMMEDIATELY SWITCH TO CLOSED-DOOR MODE and provide only drive-through, curbside pickup and delivery options for patients. Infection hotspots are springing up in too many areas and the risk to your staff, patients and operations is far too serious to allow anyone other than carefully screened staff to enter the pharmacy. IF JUST ONE WORKING MEMBER OF YOUR STAFF GETS SICK, YOU WILL HAVE TO CLOSE DOWN.  ► Read More

Labor Dept. Allows Pharmacies to Exempt Staff
From COVID-19 Emergency Leave Expansion

On Saturday (March 28), U.S. Secretary of Labor Eugene Scalia issued new guidelines designating all pharmacy employees as "health care providers" under the recently enacted Families First Coronavirus Relief Act that takes effect April 1. As a result of this new guidance, pharmacy owners are no longer required to (but may still choose to) grant extended leave to eligible employees for reasons related to COVID-19.

Among other things, the FFCRA expands paid leave available to employees who are dealing with certain issues related to COVID-19. The FFCRA permits employers of "health care providers" to exempt their employees from the leave requirements, however pharmacy employees were not covered by the FFCRA's original definition of those providers prior to Scalia's Saturday action, leaving independent pharmacies at risk of staffing shortages if several employees took leave at the same time. Such mass departures could threaten the ability of many pharmacies to continue in operation. ► Read More

AmerisourceBergen Market Shortage Report
Uploaded via media manager.Our drug wholesaler has compiled an extensive report showing generic, brand and OTC products that are in short supply and what allocations are in place. The report, which will be updated each Monday, also shows the expected resolution timeline ("Get Well Date") for each item on the list.
 
You can see the report in the ABC Order program; just follow these instructions to access it. You can also view the list in the password-protected Generic Edge section of the American Pharmacies website: https://www.aprx.org/aprx-generic-edge. We will post an updated copy of the report there each Monday going forward.

Emergency Dispensing Is Authorized in These States:

TX 30 days KS Up to 7 days
 NM 30 days
AL 30 days KY
 30 days NJ Up to 9 days
AZ Yes, qty. not specified LA
 30 days NY ? can't be determined
CA 30 days MA Up to 90 days OH 30-90 days
CO Yes; qty. varies MI Yes; qty. not specified PA 3 days
CT Up to 90 days MN 30 days SC 30 days
FL 30-90 days MO 30 days TN 30 days
GA 30 days MS  Yes; qty. not specified VA Yes; qty. not specified
IN  30 days; Medicaid 90
 NC 30-90 days WV 30 days

Please verify with your state pharmacy board, as these standards may change and specifics may vary on days' supply allowed by type of drug, whether the dispensing is for Medicaid vs. other plans, and special procedures for dispensing controlled drugs. Some states have not authorized emergency dispensing at all or have not increased their days' supply allowed from their standard policy.

SPECIAL NOTICE TO TEXAS & OHIO MEMBERS: these states have taken action to limit the dispensing of chloroquine and hydroxychloroquine.

Texas: Effective March 20, 2020, any new prescriptions issued for chloroquine, hydroxychloroquine, mefloquine or azithromycin must contain a diagnosis.  The diagnosis must be consistent with the manufacturer’s recommended use or any other FDA-approved treatment.  New prescriptions may be limited to a 14-day supply.  However, patients previously established on any of the four medications prior to March 20, may continue to receive the full quantity prescribed. Refills are not permitted on new prescriptions issued after March 20. See the Texas Order

Ohio:  Prescriptions for chloroquine or hydroxychloroquine must have avalid dgnosis code and may not exceed a 14-day suply. Any diagnosis for COVID-19 must be accompanied by a valid positive test result. See the Ohio Order

NEWEST RESOURCES

 Recommended Guidelines for Operation of Closed-Door Pharmacy
 

Reporting Potential Cases
If you are concerned that a patient may have COVID-19, contact your local or state health department immediately for consultation and guidance. If you do not have a city or county health authority, report it to your state health department. Following are links to directories of both local and state health authorities for all 50 states and U.S. territories.

More Resources & Important Information
It is important that you monitor the government health authorities who are coordinating the state and local response to the virus outbreak in your area, most especially your state health department. These authorities will have vital information about the availability and location of screening/test kits/facilities, declarations of emergency conditions, emergency health-care or dispensing guidelines, and closings of businesses and governmental/educational institutions.

DOWNLOAD THESE RESOURCES IN PDF FORM 

Impact on AmerisourceBergen (ABDC) Inventory & Deliveries
ABDC’s product sourcing teams are monitoring ordering activity and inventory levels and are placing allocations on products as needed. Due to high ordering volumes across its entire network, AmerisourceBergen is experiencing delays with pick, pack and ship processes. Additionally, because of increased volumes, couriers are also experiencing delays in their re-packing processes, and increased security measures at some customer sites are also delaying end-mile drivers. ABDC customers can help the wholesaler manage this situation by taking the followng steps:

  1. Submit orders as early as possible: Submitting your orders early in the day will allow ABDC to start preparing orders earlier and help minimize staffing disruptions.
  2. Submit orders in a single purchase order: Submitting orders in one purchase order can lessen the impact on distribution center operations, ensuring more timely deliveries.
  3. Consider critical purchases when submitting orders: We understand that you need to be prepared, but please order strategically -- not just more items.
  4. Please return totes with your driver: If you have any ABDC totes, lids or cold chain coolers in your facility, please return them to us. We need an adequate number of totes to ensure the most efficient process when filling your orders.

AmerisourceBergen is proactively addressing increased order volumes and delivery delays by working with its manufacturers and by inceasing staffing at its distribution centers. To facilitate continued deliveries in the event that certain geographic areas are sealed off in "lockdown" status, ABDC is providing drivers and distribution center associates with a verified letter that designates them as an Authorized Responder. If stopped by authorities, they can provide this letter based on AmerisourceBergen’s role in healthcare delivery. We also work with national healthcare agencies and the government to ensure access as a critical part of the healthcare infrastructure.

 

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