NACDS urges administration to ensure pharmacists’, pharmacies’ role in access to vaccines

In response to President Biden’s press conference calling on pharmacies to administer more boosters, the National Association of Chain Drug Stores' president and CEO Steve Anderson sent a letter to the President, Secretary Becerra, the White House COVID-19 Task Force and members of Congress, laying out how the administration must act now to ensure patient access to critical vaccines.

NACDS said the issue is that while both Trump and Biden Administrations leaned on the nation’s pharmacies to get the vaccines out to communities across the country, there is currently no stable pathway to ensuring pharmacies can get shots in arms for flu, COVID and other important vaccinations, as well as provide testing and and offer treatments like Paxlovid.

With the impending “tripledemic” of respiratory illness, flu and COVID-19, NACDS said that there could be mass confusion among Americans, and NACDS is imploring the administration to "plan now, extend the PREP Act and enact long-term solutions - not short-term bandaids - to ensure access to these services."

[Read more: NACDS report highlights role local pharmacies, pharmacists play in patient-centered services]

 "Our pharmacies and pharmacy teams are honored to have provided 276 million vaccinations for COVID-19 and stand ready as the primary point of access for Americans who seek vaccinations for both COVID-19 and influenza," Anderson wrote. "However, to continue to meet the volume of care services and equitable reach in communities across the country, the National Association of Chain Drug Stores:

• Seeks your partnership in making sure that a disruption of vaccination access and uptake does not adversely – and unnecessarily – affect the economy and workforce;

• Asks for immediate issuance of a new Public Readiness and Emergency Preparedness Act amendment that sustains the policies essential for pharmacies to plan staff structures and to meet public demand;

• Calls on the administration to release a transparent plan for commercialization of COVID-19 countermeasures to help sustain access to care – especially for the uninsured and underinsured; and

• Urges Congress to pass bipartisan legislation to create a reliable pharmacy reimbursement pathway through Medicare for equitable access to COVID-19 treatments, including Paxlovid (H.R. 7213, the Equitable Community Access to Pharmacist Services Act)."

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

Anderson also noted that pharmacies and pharmacy teams have helped America get on top of the COVID-19 pandemic. "The fact that 90% of Americans live within five miles of a pharmacy has proven decisive and irreplaceable. Pharmacies have provided more than 276 million COVID-19 shots. At times in the pandemic they’ve given more than 50% of the COVID-19 shots in this country, and now they are giving two of every three shots. More than 40% of individuals vaccinated at pharmacies are from racial and ethnic minority groups and half of pharmacy COVID-19 vaccination sites are in areas of high social vulnerability. Pandemic interventions by pharmacy personnel have averted more than 1 million deaths, more than 8 million hospitalizations, and $450 billion in healthcare costs. The impact defined by sheer volume of care services and equitable reach provided by pharmacies seemed unimaginable to many prior to the pandemic. The data tell the real story."

Anderson also wrote that currently, two trends are re-emerging: lingering pandemic challenges are apparent, and the government is again turning to pharmacies and pharmacy teams for help.

"Unpredictable COVID-19 variants now loom amid an increasingly active flu season. Unfortunately, pandemic fatigue may cause some Americans to delay vaccinations. We anticipate potentially the worst “twindemic” to date – and even a “tripledemic” with the rise of “RSV” cases affecting respiratory systems. We commend your leadership in urging Americans to get their flu shots and COVID-19 boosters. Further, we anticipate that – as seen before – Americans ultimately will surge to pharmacies for vaccinations given growing health threats, a desire to travel for the holidays and urgency to stay at work and to keep children in schools. They also will look to pharmacies for testing and for treatments like Paxlovid. The nation cannot afford to have an economic slowdown caused by COVID-19 and flu hospitalizations," Anderson said.

Anderson continued, "For preparedness, we must reiterate the call for action that we have urged throughout 2022 – a crucial remedy for an important missed step. It is imperative that the U.S. Department of Health and Human Services and the Biden Administration issue a new Public Readiness and Emergency Preparedness Act amendment to extend the expiration date of pandemic pharmacy flexibilities until Oct, 1, 2024. Together, the PREP Act flexibilities are a catalyst for preparedness. They make it possible for pharmacy team members – for example, pharmacists and pharmacy technicians – to perform vital roles in vaccination, testing and treatment for COVID-19, for flu and for other illnesses. The purpose of the PREP Act during the pandemic is to harmonize policies across the country, rather than relying on a patchwork of state policies."

[Read more: NACDS touts pharmacists’ role in administering COVID-19 vaccines]

Anderson went on to say that states are modernizing their laws to ensure pharmacy teams can perform needed services, though that has not yet occurred to a degree that is sufficient to maintain preparedness amid ongoing public health risks. "We must ask: why keep pharmacies guessing about whether team members will remain empowered to perform vital pandemic services? Why keep Americans guessing about whether they will have access to vaccinations from their trusted pharmacy?"

Anderson pointed out that to simplify a complex situation, two events would curb the PREP Act authorities by which pharmacies have been able to meet Americans’ needs during the pandemic. These two events are the expiration of the public health emergency and the move from federally purchased to commercially available (i.e., an end to the government programs) COVID-19 vaccines and treatments including Paxlovid. "PHE extensions by law can only be made three months at a time. While these extensions have been somewhat predictable throughout the pandemic, signals from the federal government suggest there is nothing certain about further 90-day extensions. Regarding commercialization, HHS continues to shift timelines – recently indicating February 2023 as a start date and now moving to a murky early-to-mid 2023 timeframe," Anderson wrote.

He added, "Because of the lack of clarity, pharmacies are hanging on every word from the government to anticipate whether an end to the PHE or the move to commercialization will halt the ability of pharmacy team members to perform critical services. In one example, PREP Act expiration would reduce vaccination capacity by almost 40%. The ability of pharmacy technicians to vaccinate for COVID-19 and flu is largely tied to the PREP Act. Pharmacy technicians have provided up to 38% of vaccination doses provided by pharmacies. The current cloud of uncertainty is starkly inconsistent with calls for Americans to protect themselves with vaccinations, and with calls for pharmacies to do even more."

Anderson identified additional key actions that need to be taken and said that by taking the key actions outlined in this letter, "pharmacies and pharmacy teams in communities across the country can continue to meet the needs of every American, and particularly the most vulnerable."

Read the entire letter here.