By: Gina Lohr, Senior Consultant, and Elle Choi, Analyst
Covid-19 will drastically shape the future of health care as we know it. During recent virtual discussion groups hosted by the Pharmacy Executive Forum, pharmacy leaders across the country shared their experiences with the “total disruption and chaos” faced during the crisis and insight on how to prepare. Those insights are summarized here.
Leaders also discussed what health system pharmacy might look like in a post-Covid world and potential impacts related to supply chain and telehealth. Read our insight below for two potential impacts of Covid-19 on pharmacy and the key takeaways for each.
1. Covid-19 upending the drug supply chain
Pharmacy leaders discussed their frustrations with, and the current limitations of, the drug supply chain. Covid-19 may be the “straw that breaks the camel’s back,” to inflect change on this issue.
Health systems are looking to middle-men, such as group purchasing organizations and wholesalers, to demonstrate value. If the health system feels their partners are not providing value, they may use their collective pressure to drive change. Pharmacy leaders note that there is more opportunity than ever to identify alternative supply chain solutions.
Health systems are considering options for aggregate purchasing to prevent future supply chain disruptions from impacting care delivery. Bulk purchasing also allows health systems to take advantage of pricing opportunities. Health systems are looking to work with their supply chain partners on these opportunities, but they need to see greater willingness to truly collaborate and greater willingness to invest in transparency tools in return.
Health systems are frustrated by drug allocation models that primarily rely on historic utilization. These models often proved unhelpful in responding to the Covid-19 surge. For example, demand for fentanyl was 400% higher during peak surge at some health systems, while health systems without a substantial surge had lower-than-expected demand. Health systems are looking to suppliers and distributors to adopt more flexible allocation models.
2. Pharmacy's role in expanded telehealth and home health services
Organizations are finding creative ways to care for patients outside of hospital and clinic settings, with providers ranging from physical therapists to dentists now offering telehealth services. Given that many pharmacy services are well suited to virtual care, pharmacy leaders are looking to think strategically about how to serve patients in their homes.
Pharmacists in some ambulatory clinics are using telehealth appointments to reduce the need for patients to come in to the clinic. Telephone or video visits may replace in-person chronic disease management visits or enable remote follow-up conversations after a clinic appointment or hospital discharge. This can fill gaps in care for vulnerable patients who are social distancing or have difficulty coming to the clinic. In addition, given CMS’s new flexibilities to fight Covid-19, pharmacists can often now bill for these services.
Although many clinical pharmacy services lend themselves to a telephone or video consult, pharmacists’ ability to provide telehealth services at top-of-license varies by state. In states where pharmacists enjoy provider status, they are exploring providing Medicare annual wellness visits via telehealth. However, pharmacists in other states are limited by state regulations.
Home health options, including infusion services, help protect patients from exposure to the coronavirus, while maintaining continuity of care. Establishing or expanding home infusion services is one way that health systems may be able to maintain revenue streams despite the impact of Covid-19 related closures.
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Four priorities for pharmacy leaders in the Covid-19 pandemic
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