COVID-19 Vaccinations Change the Role of Community Pharmacy

At some independent pharmacies, pharmacists are voluntarily working longer, unrecorded hours to provide patient care.

Amid a huge worker shortage, pharmacies currently are providing the lion’s share of the COVID-19 vaccines (more than 150 million and counting) boosters, and pediatric vaccinations—all on top of providing ordinary patient care.

B. Douglas Hoey, RPh, MBA, CEO of the National Community Pharmacists Association (NCPA) says this is an historic change for community pharmacists. “We are in a new era in the sense that COVID-19 has broken down some of the barriers to pharmacists moving closer to practicing at the top of their training. That’s a good thing and long overdue. Pharmacists have always been critical health care providers, but that’s not always how policymakers saw them,” Hoey told Drug Topics.

With testing, the ability to order immunizations, and now even more COVID-19 therapeutics on the way, Hoey says the opportunity for pharmacists to do more for their patients is enormous. On November 10, 2021, the NCPA released a new survey of independent pharmacists showing that the majority of independent pharmacy owners and/or managers are struggling to fill staff positions and deal with supply chain disruptions. However, market pressures, such as pharmacy benefit manager (PBM) direct and indirect remuneration fees and vertical integration, continue to be the top 2 concerns. 

Findings are based on 318 responses to a survey sent to nearly 5000 pharmacy owners and/or managers between October 26 and November 6, 2021. A strong majority (76%) reported being worried about possible tax increases on small businesses, and 64% reported inflation is a significant concern. Only 31% of respondents described the overall financial health of their business as very good or somewhat good; 28% described it as average, and 41% described it as somewhat poor or very poor. A total of 60% reported they are dealing with supply chain disruptions and nearly 70% of respondents reported struggling to fill staff positions, with the pharmacy technician and clerk/front-end staff slots being the most difficult to hire.

“Generally, the results confirmed what we have been hearing for months. The labor shortage is significant for community pharmacies, though not to the extent of the severity we are reading about with the chain drug stores,” Hoey said. “That’s partially due to the workforce being somewhat more stable at independent pharmacies and because you have the pharmacy owner on the front lines with the rest of the pharmacy team.”

The extra demand for immunization administrations caused by the pandemic has already stretched pharmacy teams. With a small number of applicants, pharmacies are being forced to offer much higher starting salaries. “There is upward pressure on wages, but pharmacies have no recourse to adjust their prices, like most consumer-facing businesses can do, because PBMs determine all pricing decisions,” Hoey added.

At this critical juncture, community pharmacies need to get involved in advocacy. According to Hoey, pharmacists must transform their practices for the future, which means expanding beyond dispensing. “We launched [the Community Pharmacy Enhanced Services Network] CPESN several years ago to get pharmacies involved in clinical services so they can increase their value to payers and patients. CPESN has grown significantly since COVID-19 because it’s part of the federal COVID-19 vaccine partnership. Thousands of pharmacies are getting their COVID-19 vaccine supply through CPESN,” Hoey says.

Everyone instinctively wants to be treated by a familiar face and a person they trust, and that’s the community pharmacist. The big chains can’t compete on the basis of relationships. “COVID-19 reminded everyone how important independent pharmacies are to the health care system, and it’s time to build on that,” Hoey said.

Independent pharmacies are the safety nets protecting their communities, and owners are working overtime, docking their own pay, and doing everything they can to answer the call. Pharmacist Theresa Tolle, BPharm, American Pharmacists Association President-Elect for 2021-2022 and owner of Bay Street Pharmacy in Sebastian, Florida, pointed out that physicians could not manage giving all the vaccines and boosters—and there were just not enough locations to go around. 

“In the testing realm, that elevated the role of our community pharmacies and now they think of us as a healthcare destination. Many are coming back for their boosters,” Tolle told Drug Topics.

Her pharmacy has been operating for 36 years and is just now attracting—for the first time many neighborhood residents. “I think a lot of people who never knew we were here, now know we are here. Many are now transferring their prescriptions to us,” said Tolle.

Brian Mayo, Executive Director, Oregon State Pharmacy Association in West Linn, Oregon, said that many pharmacists and technicians are overwhelmed. In many cases, they are being forced to continue working without required breaks, or voluntarily working longer, unrecorded hours so they can provide care to their customers. “They want to help the patients. That’s why they chose this profession, but it feels like things are getting out of control,” Mayo told Drug Topics.

Pharmacists have played a key role in vaccine administration for decades and especially now during the COVID-19 pandemic. With the ongoing influenza season and the continued COVID-19 vaccine rollout in pharmacies, they are vital to protecting our families, neighbors, and communities, said Mayo, who is hoping all the emergency rules that have been granted during the pandemic become permanent.

Reference

1. Majority of independent pharmacies affected by ongoing labor, supply chain issues, NCPA survey says. NCPA. Published November 10, 2021. Accessed November 22, 2021. https://ncpa.org/newsroom/news-releases/2021/11/10/majority-independent-pharmacies-affected-ongoing-labor-supply