Covid-19 demonstrated how quickly the United States can mobilize to produce and distribute new tests, vaccines, and treatments for a previously unknown virus. The pandemic also highlighted significant inequalities and gaps in its health care system, with many rural and underserved urban areas lacking sufficient access to care.
Amid those two realities, pharmacists played a central role in providing access to testing, vaccination, and treatment, especially for older and socioeconomically vulnerable Americans who may have otherwise been left behind in the nation’s response.
Before the Covid-19 pandemic, pharmacists could prescribe and administer flu vaccines in many states. In response to the pandemic, the federal government used its emergency authority under the Public Readiness and Emergency Preparedness Act, to allow pharmacists to order and administer vaccinations for flu, Covid-19 and other infectious diseases nationwide. It used the same authority to allow pharmacists to prescribe Covid-19 tests and antivirals in every state. The federal government also established a program to pay pharmacists for prescribing Covid-19 testing and certain treatment services, and administering vaccines, to the uninsured. Many commercial insurers cover these pharmacist services for their beneficiaries.
Medicare, however, does not cover pharmacists’ services related to testing and treatment of Covid-19, flu, strep and other infectious diseases. Congress should pass legislation requiring Medicare to cover these pharmacist services for America’s seniors now and during future public health emergencies.
Pharmacists have helped Americans through the worst health emergency in a generation. As we write this, pharmacists in all settings — community pharmacies, hospitals, clinics, and health centers — have established more than 41,000 vaccination sites across the country and delivered more than 263 million Covid-19 vaccines. That means two out of every three Covid-19 vaccines in the United States have been delivered by pharmacists. In addition, pharmacists within hospitals, clinics, and community health centers have worked alongside physicians, nurses, and other health care professionals to treat patients with Covid-19 throughout the pandemic.
People in underserved communities and older Americans, who were at higher risk of contracting Covid-19 and needing to be hospitalized or dying from it, have been particularly reliant on pharmacists during the pandemic. Seventy percent of pharmacy testing sites were in areas with moderate to severe social vulnerabilities, and 40% of people vaccinated at pharmacies were people of color. Beyond the response to Covid-19, pharmacists are actively involved in designing and implementing patient care plans and improving health outcomes for people of color. For instance, people of color had better outcomes after undergoing regular appointments to manage diabetes at their pharmacy.
Even before the pandemic, many communities lacked sufficient access to primary care. The U.S. currently faces a shortfall of more than 14,000 primary care providers and that number will grow to between 17,800 and 48,000 by 2034. More than 30 million Americans need to travel more than an hour to receive medical care. Before and during the Covid-19 pandemic, pharmacists have been essential in bridging those existing gaps in access, as new evidence in the Journal of American Pharmacist Association confirms that 90% of Americans live within five miles of a pharmacy and nearly 97% live within 10 miles of one.
Because of the essential role pharmacists play to keep communities healthy, Medicare coverage of pharmacist services for beneficiaries is critical. Members of Congress have introduced bipartisan legislation, the Equitable Community Access to Pharmacist Services Act (H.R. 7213), that would ensure Medicare beneficiaries can benefit from essential services provided by pharmacists — those related to Covid-19 as well flu and strep throat, including testing, immunization, and initiating treatment — now and in any future public health emergency, as determined by the Department of Health and Human Services. The legislation is co-sponsored by Representatives Ron Kind (D-Wis.), David McKinley (R-W.Va.), Nanette Barragán (D-Calif.), and Buddy Carter (R-Ga.).
According to a new national survey conducted by the Future of Pharmacy Care Coalition, of which our organizations are members, four in every five older Americans want the government to reimburse pharmacists so that they can access testing, vaccinations, and treatments for Covid-19, flu, strep throat, and other infectious diseases at their pharmacies instead of always having to do that at a doctor’s office.
Pharmacists have been part of the first line of defense against Covid-19 and other infectious diseases and are an accessible source of care and support for older Americans. H.R. 7213 would create the infrastructure and pathway that empowers pharmacists to meet the needs of senior communities now and during any future public health emergency. Congress should act to ensure that pharmacists continue to have this capacity.
The experiences and lessons learned from this pandemic will better prepare the U.S. to respond to future public health emergencies — but only if we act now.
Ilisa BG Bernstein is a pharmacist and interim CEO and executive vice president of the American Pharmacists Association. Paul W. Abramowitz is a pharmacist and chief executive officer of the American Society of Health-System Pharmacists.
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