Short and long term impact of COVID-19 on community pharmacy
Whether it’s delivery options, remote pharmacy, growing roles for pharmacists and technicians, or fluctuating patient volumes, the impact of COVID-19 can be felt in community pharmacies. across the United States.
With the current coronavirus disease 2019 (COVID-19) pandemic, it is no surprise that the impact seen in the pharmaceutical industry is long-lasting. The first waves of change that were felt at the start of 2020 will certainly come with a ripple effect as things start to normalize.
This is strictly speaking for the United States of course, as other parts of the world that were previously unaffected are now seeing a substantial increase in cases. Whether it’s delivery options, remote pharmacy, the increased role of pharmacists and technicians, or the increase (and then sudden decrease) in patient volume, the impact of this virus is being felt in community pharmacies across the United States.
One of the first things seen across the United States in areas where cases were rising was undoubtedly panic. This panic that the virus was now in its hometown caused many pharmacies to run out of items such as hand sanitizer, surgical masks and gloves.
The panic has also caused a potential shortage of over-the-counter items that could be used to treat symptoms of the virus, such as coughs and fevers.1 Early waves of COVID-19 resulted in many pharmacies being cleared of items such as thermometers, sanitizers and toilet paper. Shortages of these types of items in a community can have significant public health implications.
Increased patient volume
The days following initial outbreaks can be accompanied by patients trying to get longer refills on their medications (like 90-day refills) as people want to reduce exposure to the virus as much as possible. This is causing many community pharmacies to experience a higher than normal workload due to insurance calls, waivers and more prescriptions being filled than usual. Thus, the importance of pharmacy technicians has been amplified due to the residual effect of the pandemic.
Decrease in patient volume
The wave of increased patient volume is sometimes followed by a decrease, as many patients on chronic medications seek waivers for longer fills and take as many medications as possible in case they are needed, leaving more long periods of time between them having to return to the pharmacy.
This decrease in patient volume may cause community pharmacies to reduce working hours as fewer prescriptions are filled.
In an effort to limit patient-to-patient contact, many community pharmacies have followed CDC recommendations on implementing curbside pickup, home delivery, and drive-thru pickup.2 Community pharmacies offer free delivery services to some, if not all, patients. Pharmacies with drive-thru options experience higher volumes when it comes to their drive-thru windows.
Some states incorporate laws to temporarily allow early refills for controlled drugs or to perform a one-time 90-day emergency refill on controlled substances.3 Other changes in the laws include granting temporary pharmacy licenses to out-of-state pharmacists for practice. Florida is one of those states that allows this.3 In Maryland, pharmacists can compound and sell over-the-counter hand sanitizer.3
In Nebraska, there have been quantity limits and diagnostic codes required for dispensing hydroxychloroquine and chloroquine.3 These are just a few examples of short-term legislative changes brought about by COVID-19.
With the COVID-19 pandemic still evolving in the United States, it’s hard to say for sure exactly what long-term impacts we’re going to see from the remnants of this virus.
Several pharmaceutical companies are racing to develop a vaccine to fight COVID-19 with clinical trials already underway. Since these clinical trials take time to complete, it has been predicted that there will not be a fully developed vaccine until late 2020 or early 2021.
This vaccine, if available in community pharmacies, will likely have a similar impact to the Shingrix vaccine, with shortages and waiting lists, as there will be high demand for it. Initial shipments of a potential COVID vaccine will likely run out quickly and there will be long queues of patients at pharmacies waiting to receive it, such as seen in community pharmacies during the COVID-19 season. flu.
As we do not know for sure when this pandemic will end, it can be assumed that a significant number of patients will ask for the largest amount of medication they can receive in case things turn for the worse. With the pandemic still evolving in different parts of the world, it is possible that countries that manufacture drugs will be hit hard by the virus, causing disruption in the drug supply chain.4
This could lead to a health care crisis entirely separate from COVID-19 if patients cannot receive their medications.
Pharmacists are the most accessible healthcare providers and as such it is important to give correct and up-to-date information to patients when asked about the virus. With so much information about the virus in the media, new studies published, and older information withdrawn, it is important that pharmacists stay abreast of COVID-19 research developments in order to properly educate the public.
When the COVID-19 pandemic finally dies down, we can be sure that there will be many lessons to be learned from all of this. However, as the aftermath of this pandemic unfolds, it is certain that pharmacists and technicians will need to undergo more training to be better equipped to deal with such a situation if it happens again.
Education may very well be the most lasting impact of the COVID-19 pandemic.
about the authors
Shivangi Patel is a PharmD candidate at Shenandoah University Bernard J. Dunn School of Pharmacy, expected to graduate in spring 2021.
Jonathan Ogurchak, PharmD, CSP, is the Founder and CEO of STACK, a pharmacy compliance management software, and serves as a preceptor for a Virtual Experiential Advanced Pharmacy Practice Rotation for Specialty Pharmacy, during which this article was written.
- Gong Z, Hu T, Liu S, et al. Providing pharmacy services during the coronavirus pandemic. Int J Clin Pharm. 2020;42:299-304.
- N/A. Guidance for pharmacists and pharmacy technicians in community pharmacies during the COVID-19 response. https://www.cdc.gov/coronavirus/2019-ncov/hcp/pharmacies.html?fbclid=IwAR3iN830jGJl9nL4ZC_3-6oYqtfBb_uJGkaQK1bzupq-sMnFluKJnIkTACI. Written: March 28, 2020. Accessed: June 12, 2020.
- N/A. COVID-19: State Information. https://naspa.us/resource/covid-19-information-from-the-states/. Written: June 09, 2020. Accessed: June 15, 2020.
- Hedima EW, Adeyemi MS, Ikunaiye NY. Community pharmacists: on the front line of health services against COVID-19 in LMICs. AMPS. 2020; doi:10.1016/j.sapharm.2020.04.013.