NACDS, Johns Hopkins report: Pharmacies play a vital role in achieving health equity

A new report, by the National Association of Chain Drug Stores and the Johns Hopkins Center for Health Security, entitled “Striving Toward Health Equity in the National COVID-19 Response – The Role of Pharmacies,” highlights the ways in which local pharmacies can be further leveraged to enhance equity for even more patients.

Specifically, the report demonstrates pharmacies’ ongoing commitment to healthcare access and equity, and lays out recommendations for legislative solutions that will help maintain patients’ equitable access to critical clinical care long after COVID-19 has been defeated.

Pharmacies’ role in and commitment to helping the nation advance health equity started well before the emergence of COVID-19.

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According to NACDS and Johns Hopkins Center for Health Security, local pharmacies, which exist within 5 miles of 90% of nearly every American and provide integrated healthcare destinations within the communities they serve, “have increasingly provided enhanced access to routine vaccinations, screening and testing for conditions including HIV and hepatitis C, chronic care management for diabetes and cardiovascular disease, [and] support for behavioral health conditions including mental health and substance use challenges.”

Additionally, the report notes that pharmacies have been planning and preparing for response to a pandemic — collaboratively with government at the state and federal levels — for over a decade: During the 2009 influenza pandemic, “pharmacies administered 23% of H1N1 vaccinations within a three-month span via CDC’s 2009 H1N1 Vaccine Pharmacy Initiative.”

Now, during the COVID-19 pandemic, pharmacies share the Biden administration’s priority focus on an equitable mass vaccination campaign, and comprehensive focus on health equity and breaking down access barriers.

Thanks to pharmacy flexibilities granted under the Public Readiness and Emergency Preparedness Act and other key federal actions, pharmacies have been able play a significant role in testing and vaccination during the COVID-19 pandemic:

• Pharmacies, through federal partnerships, have provided more than 133 million COVID-19 vaccination doses, as of Sept. 22, 2021. (Pharmacies’ actual vaccination totals are even higher given that, in addition to shots provided through the Federal Retail Pharmacy Program, pharmacies also are providing shots through state programs).
• During the past two weeks as reported on Sept. 22, 2021, more than 49% of the doses administered through the program have gone to a person from a racial or ethnic minority group (among people with known race or ethnicity).

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• As reported by the Centers for Disease Control and Prevention at the Advisory Committee on Immunization Practices meeting on Sept. 23, 2021, over 70% of current COVID-19 vaccine administrations are occurring in pharmacies. More than 40% of pharmacy sites in the FRPP are in zip codes with high social vulnerability; and
• Pharmacies ramped up testing capacity across all 50 states, establishing more than 6,000 testing sites that processed nearly 10 million samples under a public-private partnership with the Department of Health and Human Services. (Nearly three-quarters of these sites serve areas with moderate to high social vulnerability. Pharmacies have also deployed COVID-19 testing outside the HHS program, further enhancing access).

Importantly, federal actions also “have temporarily cleared the way for meaningful changes that foster and prioritize equity and access in the pandemic response” and across communities.

According to the report, pharmacies have deployed a wide variety of strategies to enhance equity throughout the COVID-19 response and vaccination campaign:

During the nation’s Month of Action, pharmacies committed to expand access to vaccinations by increasing the number of mobile and pop-up clinics, extending vaccination hours and partnering closely with community leaders, faith-based organizations and organizations representing racial and ethnic minority groups, and making walk-in opportunities for vaccination widely available.

Pharmacies have collaborated with rideshare companies, deploying mobile vaccination units, meeting people where they are — even going door-to-door — transcending community outreach strategies that work well for flu shots, offering appointment times well into the evening hours and on weekends, and working to overcome disparities in technology access.

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“Beyond providing COVID-19 vaccinations and testing, pharmacies also continued to provide needed preventive care; dispense critical medications; administer routine and catch-up vaccinations to adults and children; and provide patients with education and referrals,” according to NACDS and Johns Hopkins Center for Health Security.

Of critical importance, NACDS and Johns Hopkins Center for Health Security concluded the report noting that although progress has been made to eliminate the health inequities and disparities that have proven detrimental during the COVID-19 response, the work is not complete:

“The valuable experiences and lessons learned during the COVID-19 response should serve as a clear blueprint to turn successful, proven flexibilities into permanent changes … . Securing such changes permanently will help ensure the nation builds on progress to achieve better health for all, rather than walking back on it, allowing Americans to access care at pharmacies they know and trust into the future for evolving health needs.”

As a critical next step, the authors recommend steps to serve communities on the front lines to better prepare the nation for future health crises and to empower the healthcare system to better provide the routine care that supports the health and well-being of the nation’s most vulnerable communities every day:

• Policymakers should support the immediate development and implementation of a sustainable patient care access model that includes a permanent payment pathway for pharmacies to deliver clinical care;

• Policymakers should make permanent expanded patient access to pharmacy care through scope of practice changes based on demonstrated benefits for patients and communities during the COVID-19 pandemic; and
• Pharmacies, with public health agencies, community-based organizations and other groups similarly aligned in mission, should build upon the tremendous COVID-19 efforts to combat health equity toward collectively addressing this issue beyond the pandemic.