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COVID-19 for Pharmacy Patients

If you are one of the approximately 119 million Americans that uses at least one prescription medication, chances are you already have a routine down for how to obtain your medications. Unfortunately, the impact of COVID-19 is likely to impact a lot of routines.

And as we find new evidence for therapies that may work against SARS-Cov-2 (the virus which causes COVID-19), many of you who don't normally have to visit pharmacies may be faced with needing medication from a local pharmacy, either for yourself or a loved one.

But don't worry (at least about this one thing)! Pharmacies are one of the only places that STAY open, even in a global pandemic. We will be there to care for you, but operations may look a little different for awhile.

Here is a pharmacist's guide on navigating pharmacies during the pandemic.

1) Do not stockpile.

While some public health agencies recommend having a short-term supply of medication on hand in case of emergencies, you not only do not need a year's supply of medication right now, BUT attempting to stockpile such large quantities will cause supply chain issues and leave other patients without necessary medication if stockpiling becomes widespread.

Plus, filling medications every 90 days or so ensures that older medicines nearer their expiration dates get used up first, rather than sitting on your shelf at home for the next year, possibly outside the ideal storage conditions that pharmacies are required to maintain.

2) Stay away if you can.

In order to preserve our ability to stay open as long as possible, we need as few people as possible contributing to traffic flow and spread of viruses within the pharmacy - COVID-19 or otherwise. This is a two-fold mechanism - it both helps you stay home and away from others, and it could help our pharmacy staff stay healthy longer so that we are able to continue caring for our communities without coming down with illnesses ourselves (because then who will fill your prescriptions?).

3) Skipping the pharmacy doesn't mean skipping medicines.

Skipping medications could put you at risk for needing other types of medical care otherwise unrelated to COVID-19. If you have to visit a medical facility for those problems - then you're a) taking up preventable medical resources and b) potentially exposing yourself to the viruses and other pathogens circulating in those medical facilities.

So, how are you supposed to stay away if you need medications? Here are a few ideas:

4) Refill now.

If you take regular medicine and are close to being due for a refill, check to see if you can get a 90-day supply filled. Many insurances are allowing overrides so that patients can fill medication earlier or in larger quantities than usual.

***IMPORTANT*** Refilling now will not be possible for everyone or every Rx. There will be numerous exceptions. Listen to what your pharmacy says about whether your medications qualify and whether YOU will need to contact your insurance company for overrides.

5) Ask about delivery.

Mail-order pharmacy isn't the only way to get your medication without physically visiting a pharmacy. Many independent pharmacies have always offered free delivery services, and CVS recently waived home-delivery fees and Walgreens also recently announced they would be waiving delivery fees for "eligible prescriptions". Check with your local pharmacies to see what their policies are.

6) Make use of technology.

If you do need to go to the pharmacy, make use of their available technology offerings. Many pharmacies offer apps that will show you when your Rxs are in Ready status - this means you can go and get them without guessing whether they are actually available for pick-up...or stuck in a queue of hundreds of other prescriptions (and you certainly don't want to be in line any longer than necessary). Making use of pharmacy apps, text messaging notifications, and phone messaging systems is a great way to reduce the burden on your pharmacy staff and allow us to help our communities more efficiently (because when we are answering less phone calls, we can fill more medicines faster and get you through the line faster).

7) Read carefully

Apps and texts are great tools, BUT, and this is a big BUT, you must take care to carefully read or listen to the message. A message that says, "Your prescription is ready for refill" does not mean the medicine is ready to be picked up. It means we are waiting for you to confirm that you need the refill - because many, many refills are never filled and never needed. If you mis-read this message, you're going to get to the pharmacy and be very disappointed when there is nothing there for you to pick up and/or you have to wait even longer.

8) Use the drive-thru.

Normally those of us working in the pharmacy prefer that you save drive-thru use for the patients who have greater need for it - the injured or elderly, people with living with disabilities, and parents of sick infants and children. But when seeking to slow a pandemic infection, the chance that you are either exposed to virus, or pass virus-laden respiratory droplets to others may be minimized by using pharmacy drive-thrus, rather than coming inside. This can also help your local pharmacy teams stay healthier and keep their locations open and operating longer.

And here are some general, human tips to help us all work together cohesively during a tumultuous time:

9) Be patient.

Many of you already wonder what takes so long at the pharmacy, and I can understand that. But on top of the factors that normally take so long, realize that we are being overwhelmed with huge numbers of people asking the same exact questions you are, and many of our other patients have concerns just as serious as your own. We want to help you all, but you may have to wait longer, especially if pharmacies convert to drive-thru only modes and everyone is trying to come through the same line. Give us some grace as we work through this together (and remember to use your apps and automated systems if possible!).

10) Take responsibility.

Earlier publications encouraged patients to have their pharmacist call their insurance companies for early refill authorizations and overrides on some supposed "direct line" we have to your insurance company. This is a misrepresentation of the situation. While we do have a separate service line to call than the line for patients, which is usually called the "Member Services" line, this line is for us to call on clinically complicated or technical issues that require the attention of a pharmacist. We don't get helped any faster than you do - in fact, probably even less so, since you are their paying customers.

So, if your pharmacy tells you that you need authorization to refill early, call the Member Services line yourself. Expecting pharmacists, who already operate on skeleton crews, to call on everyone's early refills would completely disrupt our ability to actually fill prescriptions - and then no one is getting their meds in a timely fashion. We simply will NOT have the staff available to accomplish this even if it was our favorite thing to do (tbh, some days it is. people yell at us a lot for things outside our control. Insurance representatives are at least surface-level polite).

11) Realize there are exceptions to every rule.

You may have to come inside the pharmacy.

You may not be able to refill for longer or earlier than normal, especially if your prescription is for a controlled substance.

You may get lucky and live in an area where COVID-19 does not hit as hard, and none of these problems may impact you.

If so, that's great! But that will probably only happen because others followed these and other recommended precautions.

12) Think of others.

Whether you are scared out of your wits or brushing this off as nothing, please stop to think about your communities. If you are afraid and want to stockpile, realize that doing so harms both your community, and by extension, yourself. If you take all the hygiene products and leave everyone else with none, the people around you will not be able to follow precautions, putting you at increased risk. If you are brushing this off as "NBD", remember that others in your community may have different reasons to be worried, such as serious health conditions and other risk factors. Please save masks for the ill and for healthcare providers performing procedures that truly require these masks.

In Italy right now, the only businesses allowed to stay open are groceries and pharmacies. This is because pharmacists take our responsibility to care for and provide health services to our communities very seriously and access to medications is vital to both individual and public health. But there is a major difference between these two types of businesses. Grocery stores have a much larger pool of people who can be hired to safely run their operations, whereas the safe operation of a pharmacy requires highly trained personnel. If pharmacists fall ill, there is not the failsafe of being able to hire most anyone who is willing to work.

So, in light of number 12, please consider one another and use these precautions help us all stay healthy in the pharmacy, so that we can continue serving you, our community, in times of emergency.

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