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April 06, 2020

Coronavirus update

What a wild couple weeks. We hope that you, your practices, and your families are persevering despite these unprecedented circumstances.

While the OPA staff have been busy adapting to different work logistics and rescheduling our upcoming programs and committees, we continue to field your phone calls and emails, as well as address rapid-fire regulatory changes, workplace safety issues, PBM policy shifts, and a flurry of media inquiries.

As we continue to field feedback from our member pharmacists on the ground, we are assessing all suggestions, opportunities, and concerns, and we continue to push them to officials at the governor's office, board of pharmacy, department of health, health plans, and other state leaders. Some of these recommendations have already resulted in changes, and others continue to need advocacy.

Much like you are seeing at your practices, the adjustments to the COVID-19 pandemic are not perfect, but we are working hard to push state officials to get as close to the mark as possible.

As we mentioned in the last Newsline, we have launched a special section of our website dedicated to COVID-19 news and resources. We continue to update it with any and all relevant information. In the interest of serving the profession and the public, we have made this open to all members and non-members alike. 

As mentioned above, we have been pushing state officials for emergency guidance and policy changes to help better equip pharmacists and pharmacy staff with they tools they need to protect themselves and the public. For a complete rundown of these changes, click here.

OPA's quick work to address a multitude of regulatory issues with the Board and governor's office was highlighted this past week by Bloomberg News as, "Leading the Charge" nationally.

OPA is currently evaluating and pursuing a number of other suggestions and requests, including:

  • In light of pharmacy safety concerns, securing reasonable amounts of personal protective equipment (PPE) for pharmacies without the ability to maintain safe distances
  • Temporarily eliminate insurer/PBM requirements for patient signatures, and to protect pharmacies from audit takebacks due to a lack of signatures
    • The Columbus Dispatch highlighted this issue, CMS has pushed to suspend signature requirements, and even the Pharmaceutical Care Management Association showcased how some PBMs were waiving signatures. We have been asking for the state to temporarily suspend these insurer/PBM requirements for weeks, but have yet to receive guidance on the matter.
  • Eliminating insurer/PBM limits and restrictions on mailing and delivering prescriptions, which the American Pharmacists Association has also called for eliminating
  • Empowering pharmacists to test and treat for flu, strep, and other tests, including COVID-19 as appropriate and as it becomes available, and if adequate PPE is made available for testing
  • Ending restrictive insurer/PBM networks and single-source contracts that are restricting patient access to needed medications and supplies
  • Allowing pharmacists to dispense emergency medications without a prescription
  • Requiring insurer/PBM coverage of compounded shortage medications
  • Creating a formal assessment and referral process for pharmacies encountering high-risk patients
  • Removing unnecessary prior authorizations and "refill too soon" limits from insurers/PBMs
  • Allowing therapeutic substitution for drugs of concern and medications that are out of supply or in shortage
  • Implementing Medicaid provider ID numbers for pharmacists
  • Allowing insurance coverage for pharmacist-initiated medications and OTC products 
  • Authorizing and incentivizing pharmacist-rendered services (consult agreement drug therapy management, INRs, etc.) to relieve pressure on health systems and emergency departments
  • Opening up pharmacist consult agreements to mid-level practitioners
  • Addressing ill-timed, yet highly predictable price gouging by PBMs within the Medicaid program.
  • Implementing supplemental dispensing fees in the Medicaid managed care program.

These are just a few of our suggestions, but we are open to hear many more. If you see any opportunities or concerns that you feel need to be addressed, please contact

As we discussed in the last Newsline, we continue to field a lot of phone calls and emails from pharmacists and pharmacy staff raising concerns about a lack of adequate stock of protective equipment, cleaning supplies, and resources for pharmacy team members that could increase the risk of germ spread to pharmacy staff and patients. While many pharmacies have adapted well, and done so quickly, there have been some disheartening stories of poor safety conditions that we have shared with media in an effort to pressure further changes. One of our recent media outreaches occurred in this in-depth Business Insider feature on pharmacy working conditions.

We have also raised these reported safety issues with the board of pharmacy and governor's office, and the board released and has made ongoing updates to their guidance addressing the practice of pharmacy in a safe and effective manner. Please share with your colleagues, managers, and employers. We are very pleased with the Board's work on this issue.

If you feel that your pharmacy is not taking adequate measures to maintain safe distancing between staff and and patients, provide for a clean practice setting, avoiding written correspondence about safety issues, or provide reasonable amounts of protective equipment (recognizing the shortage of PPE), please keep us informed, and let the board of pharmacy know as well.

A reminder to all pharmacists: it is your license, and if you feel that someone is unreasonably getting in the way of the safe practice of pharmacy, it is important to speak out, but it's also important not to wait for a colleague, a manager, a rule change, or board inspector. to keep you and your patients safe. We will be working to make sure your voices are heard. In the meantime, do what you think is right and in the best interest of your patients.

Stay tuned, and stay safe. OPA will continue working for you while you continue working for your patients.

And now, for the news...

Top News

Pharmacists called to do more as Ohio hospitals need more staff to battle coronavirus
WSYX Columbus
There has been a lot of talk about building up hospitals and infrastructure via overflow facilities to take on the COVID-19 pandemic in Ohio. But, what about the manpower needed to care for patients? "We know that we are going to have anywhere from a range of 6,000 to 8,000, on the most dire projections I have seen so far have been 10,000 cases per day," said Dr. Amy Acton of the Ohio Department of Health. With only a portion of that likely needing to be hospitalized, Dr. Acton said different groups across the state are working on innovative solutions. "Take nursing students or nurses who have been doing other kinds of work or patient care assistance and training them for a new job, or training a surgeon how they might become able to do some nursing things," she said. But some pharmacists are putting out the call, wanting to do more, like helping manage chronic patients. OPA member Allen Nichol says that it's time to bring in pharmacists from off the bench.

"In 2018, the Ohio legislature unanimously passed legislation that was signed into law to deploy pharmacists to help complement the vital work of doctors and nurses, but the state has not acted to implement the law yet. In light of the serious health-system capacity issues that have been raised by Dr. Amy Acton amid the COVID-19 pandemic, we have urged Governor DeWine and the Ohio Department of Medicaid to bring pharmacists in from off the bench as a pressure valve release to an overly stressed care delivery system."

Hydroxychloroquine for a dog? Questionable prescriptions poured into Ohio pharmacies
Columbus Dispatch
Jennifer Tackett walked into her Meijer pharmacy in Hilliard on Monday to refill the same prescription of hydroxychloroquine she’s received since 2012 to relieve the crushing arthritis in her hands, only to be told the pharmacy had none. Just days before, an Ohio veterinarian filed a prescription order of the drug for a dog. And an emergency room doctor near Akron requested 1,000 pills for himself. Pharmacists across Ohio last week provided details to The Dispatch of questionable prescriptions for hydroxychloroquine, or chloroquine, that have poured in from doctors in the past week. The prescriptions were filed as soon as an hour after President Donald Trump promoted them as a possible treatment for coronavirus. OPA members Sydney Schnee, Debbie Lange, Dave Burke, and Amber Lilly speak out about the massive influx of odd prescriptions.

IRx Accounting: Details on how the CARES Act impacts your pharmacy
Independent Rx Consulting.vcom/blog
Employee Retention Credit for Employers Subject to Closure or Experiencing Economic Hardship:

This provision would provide a refundable payroll tax credit for 50 percent of wages paid by eligible employers to certain employees during the COVID-19 crisis.

Fix PBM problems so pharmacists can serve patients
Columbus Dispatch
OPA's Stu Beatty writes in the Columbus Dispatch: "Over the past three years, numerous investigations by The Dispatch into pharmacy benefit managers have repeatedly revealed a misuse of government funds and excess profits at the expense of pharmacists, taxpayers and underserved communities. Ohio was one of the first states to fully investigate this growing middleman problem, and the problem has since been exposed in multiple other states and within Medicare plans across the country. Aside from the negative impact that PBM prescription drug overcharges have had on the wallets of plan sponsors such as Medicaid, the impact on patient access to care has been devastating ... Unfortunately, pharmacy closures are just the tip of the iceberg. Many of the pharmacies that remain in business have had to cut hours, services and staff, resulting in increased wait times for patients and less time for pharmacists to perform important functions, increasing the likelihood of medication-related errors, inappropriate drug utilization and patient harm."

FDA requests removal of all ranitidine products from the market

Food and Drug Administration
FDA on Wednesday ordered that manufacturers immediately pull all prescription and OTC ranitidine (Zantac) medications from the market. The decision is the latest step in the agency's ongoing investigation of N-Nitrosodimethylamine (NDMA), a probable human carcinogen, in ranitidine drugs. FDA has determined that NDMA in some ranitidine products increases over time and when stored at higher than room temperatures and could lead consumers to be exposed to unacceptable levels of the impurity. 

Ohio pharmacists say some Medicaid payments shrinking due to CVS Caremark rates
Columbus Dispatch
After years of complaints and promises of government action, Ohio’s small pharmacists say that payments from one player in the state’s Medicaid program are again shrinking, making it difficult to keep doing business as a pandemic strikes. The independent drugstores and small chains, which often are the only pharmacies in Ohio’s small towns, are saying that reimbursements for generic drugs from CVS’ pharmacy middleman have been dropping this year, causing them to lose money.

"We have learned that coronavirus-stricken nations like Italy are heavily reliant on pharmacies, and unfortunately, PBMs have put Ohio in a horrible predicament as the need for local care grows exponentially as the virus spreads."

Pharmacists get licensing leeway to help fight virus pandemic
Bloomberg Law
State-run pharmacy boards around the country are mirroring federal efforts to relax restrictions for health-care workers by easing local rules on licensing and drug distribution as the nation battles a pandemic. At least thirteen states have offered some kind of reprieve for pharmacy professionals. Some of the biggest changes are green-lighting remote work, giving pharmacists more autonomy to handle certain prescriptions, and allowing out-of-state pharmacists and pharmacy technicians to practice locally if they’re licensed elsewhere. Some states, such as Arizona and California, are also letting out-of-state drug distributors sell products to local pharmacies, which could ease bottlenecks in local supply chains. More states will likely ease burdens on local pharmacists and distributors to promote a broader network of care as cases of Covid-19 increase, regulatory lawyers predict. Georgia, Ohio, Missouri, Virginia, and Texas have already loosened restrictions on out-of-state pharmacists working in their communities.

Restrictions are slowing coronavirus infections, new data suggest
New York Times
Stay-at-home orders and other social distancing measures are contributing to rapid drops in the numbers of fevers recorded in states across the country, according to new data from the medical technology firm Kinsa Health. At least 248 million Americans in at least 29 states have been told to stay at home. Kinsa Health, which produces internet-connected thermometers, first created a national map of fever levels on March 22 and was able to spot the trend within a day. Since then, data from the health departments of New York state and Washington state have buttressed the finding, making it clear that social distancing is saving lives.

Working Heroes: Ohio pharmacist Aimee O'Reilly
Live with Kelly & Ryan via YouTube

Check it out! Last week, OPA member Aimee O'Reilly was featured on Live with Kelly & Ryan, where she discussed how her pharmacy is doing its part in helping the community during the pandemic.

Pharmacists provide care during COVID-19 outbreak
Ohio State University College of Pharmacy
Pharmacists and student pharmacists are on the frontlines responding to the coronavirus-19 (COVID-19) pandemic. As cases grow exponentially in the United States and around the world, citizens continue to converge on their community pharmacies for supplies and medications. As other businesses have been mandated to close their doors, pharmacies remain open—with caring pharmacists, students and staff ready to help.

Could Ohio pharmacists assist with COVID-19 testing?
WEWS Cleveland
Ohio Governor Mike DeWine and state Health Director Amy Acton are both continuing to stress the importance of dramatically increasing Ohio's COVID-19 testing capacity. Acton issued an order requiring all Ohio hospitals, that do not perform their own testing, to send samples to one of four hospitals that can. In response, the Buckeye Institute just released a proposal calling to have many of Ohio's 15,000 pharmacists for on-site flu and strep testing, and later, even testing for coronavirus in the coming months. Greg Lawson, Buckeye Institute researcher, told News 5 if pharmacists were approved to perform on-site flu and strep testing at pharmacies, it would free-up coronavirus capacity for Ohio doctors, urgent care facilities and hospitals statewide. OPA's Antonio Ciaccia discusses the proposal.

Coronavirus: The US governor who saw it coming early
As the coronavirus outbreak barrels throughout the US, states have scrambled to get ahead of its spread, often after weeks of inaction. But one governor imposed sweeping measures days before a single case had been reported in his state.

APhA, OPA, and other pharmacy groups call for expanded pharmacist services amid COVID-19 pandemic
American Pharmacists Association
As the COVID-19 pandemic continues to strain the U.S. health care system and limit the supply of quality health care providers, OPA, through the National Alliance of State Pharmacy Associations, along with the American Pharmacists Association, American Society of Health-System Pharmacists, National Association of Chain Drug Stores, Hematology/Oncology Pharmacy Association, National Community Pharmacists Association, American Society of Consultant Pharmacists, American Association of Colleges of Pharmacy, American College of Clinical Pharmacy, National Association of Specialty Pharmacy, College of Psychiatric and Neurologic Pharmacists, and Accreditation Council for Pharmacy Education, released a joint set of policy recommendations to enhance patient care during the ongoing health crisis.

OPA News

Coronavirus (COVID-19) Resources
Ohio Pharmacists Association
Pharmacists are the most accessible healthcare providers in the U.S. and are on the front lines of the current coronavirus disease 2019-2020 outbreak. The Ohio Pharmacists Association is working with state leaders...

OPA Introduces the OPA COVID-19 Pharmacy Relief Registry
Ohio Pharmacists Association
OPA has been contacted by numerous members about their shortage of pharmacists, interns, and technicians during the COVID-19 outbreak. We are working hard to meet the needs of our members  in any way we can.

OPA Annual Conference rescheduled for August 28-30, 2020
Ohio Pharmacists Association
After direction from Governor DeWine's office, the leadership of the Ohio Pharmacists Association has made the difficult but necessary decision to reschedule OPA's 142nd Annual Conference & Trade Show due to COVID-19. We extend our gratitude to our members, attendees, speakers, sponsors and exhibitors for their understanding and for their commitment to the success of this Conference. The OPA Annual Conference & Trade Show will be held August 28-30, 2020 at the Greater Columbus Convention Center in downtown Columbus.

Extension of Registered Pharmacy Technician Renewal and Technician Trainee Extensions
State of Ohio Board of Pharmacy
To address any possible workforce shortages during the COVID-19 outbreak, the State of Ohio Board of Pharmacy has adopted the following guidance authorizing an extension of the renewal date for registered pharmacy technicians and automatic technician trainee extensions.

Employer-Based Pharmacy Technician Training Programs offered
Ohio Pharmacists Association
Are you an employer who needs to train technicians and wonders how to meet the board of pharmacy requirements for an employer-based training? OPA now offers two Employer-Based Pharmacy Technician Training Programs for purchase by a pharmacist.

OPA releases sample protocol for pharmacists to dispense epinephtine autoinectors without a prescription
Ohio Pharmacists Association
In 2019, Ohio delivered a big win to patients who suffer from life-threatening allergies when Governor John Kasich signed HB 101, the Epinephrine Accessibility Act, into law.

Want to be engaged with Provider Status? Take the Ohio Pharmacy Services Survey.
Ohio Pharmacists Association
Have you ever wondered what different clinical services hospital pharmacists provide versus community pharmacists? Do you want to be involved with implementing Provider Status in Ohio? Find the answers to these questions and start engaging with Provider Status by participating in the Ohio Pharmacy Services Survey.

May 13: APhA’s The Pharmacist & Patient-Centered Diabetes Care Certificate Training Program
Ohio Pharmacists Association
This program is an educational experience designed to equip pharmacists with the knowledge, skills, and confidence needed to provide effective, evidence-based diabetes care.

June 24: Pharmacist Training Program for Immunizations
Ohio Pharmacists Association
The Ohio Pharmacists Association was instrumental in the passage of HB 394 which allows Ohio pharmacists and pharmacy interns to administer all immunizations recommended by the Advisory Committee on Immunization Practices (ACIP) of the Centers for Disease Control and Prevention (CDC) to individuals 7 years of age and older.

Ohio Pharmacy News

New Board of Pharmacy rules proposed
State of Ohio Board of Pharmacy
The State of Ohio Board of Pharmacy values the input of all stakeholders in the regulatory process and encourages your participation in the rule revision/development process. Below you will find information on rules currently being proposed by the Board.

In this section you will find rules, including public hearing notices, currently under the review of the Joint Committee on Agency Rule Review:

If you have any comments or concerns on the above rule proposals, please email Antonio Ciaccia at

Naloxone access skyrockets after law permits Ohio pharmacists to dispense
Pain Medicine News
Over the past few years, the number of naloxone prescriptions filled in Ohio increased by more than 2,000%, according to a new study. That increase is attributable to a law passed by the state government in 2015, allowing pharmacists to dispense naloxone without a prescription in accordance with a physician-approved protocol.

Health insurers ease filling emergency supplies of prescriptions
Cleveland Plain Dealer
OPA's Antonio Ciaccia and OPA member Jason Briscoe discuss some of the ways that patients can work with their doctor and pharmacist to be as prepared as possible for the current state of emergency.

In memoriam: Ralph Foster
We are saddened to report that we lost one of the good ones last month. Long-time OPA member, volunteer, and supporter Ralph Foster passed away at the age of 87. Ralph and his wife Ruth donated the funds for the flagpole outside the OPA offices, and spent a lot of time giving back to his profession. We will miss his sporadic visits, pharmacy stories, and infectious good nature.

Inhaler medication shortage during COVID-19 pandemic
WJW Cleveland
As coronavirus cases continue to rise some pharmacists are expressing concern about a shortage of albuterol inhaler medication often used by people who have asthma. "We're definitely seeing that the albuterol shortage is impacted by the COVID pandemic," explained OPA member Jaclyn Boyle, Assistant Professor of Pharmacy Practice a Northeast Ohio Medical University. Boyle says the concern is patients with COVID-19 in the hospital using a nebulizer to help with breathing could spread the virus in the air. Although she stresses the science behind that worry so far is unproven. OPA Executive Director Ernie Boyd also discusses the supply issues.

Ohio should enlist pharmacists to fight the pandemic
Buckeye Institute
In a new policy memo, Policy Solutions for the Pandemic: Enlisting Pharmacists to Fight COVID-19, released recently, The Buckeye Institute outlines how Ohio can relieve some of the burdens on other health care workers by allowing pharmacists to test for COVID-19 and treat common illnesses.

A look at the COVID-19 crisis from a pharmacist's perspective
OPA member Twila Boyd, a pharmacist in South Charleston, Ohio, explains what it's like to treat patients in the midst of the coronavirus outbreak. Excellent interview!

Ohio pharmacy board restricts prescriptions for experimental coronavirus treatment drugs
Columbus Dispatch
Ohio doctors are obtaining so many prescriptions of a possible coronavirus treatment for themselves, their families, their colleagues and their friends that it’s wiping out the supply for everybody else — including people with lupus who will become more susceptible to the virus without their usual medication. As a result, Ohio’s pharmacy board, in an emergency meeting Sunday morning, barred pharmacists from dispensing chloroquine or hydroxychloroquine for COVID-19 unless a person has tested positive for the virus or is otherwise approved by the pharmacy board’s executive director. In order to get either of those drugs, the patient must have their positive test disclosed by the doctor on the prescription request. The prescription must be limited to a 14-day supply, and no refills are permitted without a new written prescription.

Ohio doctors under investigation for self prescribing Hydroxychloroquine
WEWS Cleveland
Some Ohio doctors are under the microscope for self prescribing the drug Hydroxychloroquine, which is now being used to treat some COVID-19 patients. Authorities said immediately after President Trump mentioned the drug showing promise in fighting COVID-19, Ohio pharmacies saw an uptick in prescriptions. "We were seeing about double or triple the demand that is typical, " said Antonio Ciaccia, Ohio Pharmacists Association. Pharmacists were so concerned, Ciaccia said, the OPA went to the State of Ohio Board of Pharmacy about doctors inappropriately prescribing the drug.

Local distiller begins churning out hand sanitizer during crisis
Athens News
With the dwindling supply of hand sanitizer and other cleaning supplies in the U.S. due to the coronavirus (COVID-19) pandemic, local distillers including Kelly Sauber, owner of the West End Distillery and Ciderworks in Athens, are moving to produce their own hand sanitizer, using equipment they already have. Sauber last week began selling his locally made liquid hand sanitizer at Shriver's Pharmacies, available in bulk or in pre-prepared 4-ounce spray bottles.

Northeast Ohio coronavirus drug hoarding hurting lupus, arthritis patients
WEWS Cleveland
The desperate search for drugs, which may help fight the coronavirus, is now causing a growing shortage of a drug that is crucial for patients suffering from lupus and arthritis. The Ohio Pharmacists Association reported a huge run on the drug hydroxychloroquine, shortly after President Donald Trump announced the drug showed some promise in the treatment of COVID-19 last month. Antonio Ciaccia with the Ohio Pharmacists Association said the Ohio Pharmacy Board was then forced to issue stricter standards in the prescribing of hydroxychloroquine after some Ohio doctors were accused of fraudulently starting to prescribe and hoard the drug.

Pharmacists get creative to make sure Ohioans get their prescriptions amid coronavirus
Columbus Dispatch
Pharmacists on the front lines of the COVID-19 pandemic are doing what they can to fill prescriptions for patients while keeping employees safe and slowing the spread of the disease. At O’Reilly’s Family Pharmacy in Worthington, many prescriptions are now being delivered or picked up outside. Pharmacists and technicians are washing their hands between serving patients who do come in; they also are wearing gloves, masks and other protective gear when handling medications, and bleaching everything. “We’ve increased home deliveries and started doing curbside pickup so patients can pull up in their car and give us a call, and we’ll bring their medications out to them,” said OPA member Aimee O’Reilly.

Report shows opioid prescriptions in Ohio nearly cut in half
WFMJ Youngstown
A new report by Ohio's State Pharmacy Board shows a continued decline in opioids dispensed to patients for the seventh consecutive year in 2019. According to a newly released report from the State of Ohio Board of Pharmacy's Ohio Automated Rx Reporting System (OARRS), total doses of opioids decreased from a high of 793 million in 2012 to 415 million in 2019, a 48 percent decrease. During the same period, the total number of opioid prescriptions issued to Ohioans decreased by 5 million. The report also finds Ohio healthcare providers are utilizing OARRS at record levels.

Coronavirus: Ohio AG Dave Yost, Ohio medical board want self-prescribing doctors to come forward
Columbus Dispatch
The State Medical Board of Ohio confirmed Monday it is working with Ohio Attorney General Dave Yost to investigate claims some doctors improperly wrote prescriptions for themselves and others to try to ward off the coronavirus. Yost also urged Monday that doctors who wrote such prescriptions report their actions to the medical board. Pharmacists across Ohio reported a surge in questionable prescriptions two weeks ago for hydroxychloroquine or chloroquine. The prescriptions were filed as soon as an hour after President Donald Trump promoted the drugs as a possible treatment for the coronavirus.

In Ohio’s Amish Country, coronavirus is taken seriously, health officials say
Akron Beacon Journal
In the heart of Ohio’s Amish Country, the Plain community has traditionally held itself a step or two away from the frenzy of the modern world. But after a 2014 measles epidemic rampaged through Holmes and Knox counties, many more Amish started getting vaccines and forged tighter bonds with public health officials. Those bonds appear to be paying dividends in the current coronavirus epidemic.

Editorial: Hogging medicines worse than hoarding toilet paper
Columbus Dispatch
The upending of normal life by the coronavirus crisis has given rise to tale after heartwarming tale of people doing thoughtful things to help each other through a tough time. These make the other tales — the ones of callous selfishness — a little easier to take, but no less outrageous. One especially unseemly gambit is a surge in inappropriate prescribing of two medications needed by people with certain autoimmunological diseases. It seems doctors have been writing just-in-case prescriptions for chloroquine and hydroxychloroquine for themselves, their friends and their families on the unproven idea that it might be helpful against COVID-19.

Charitable pharmacy continues serving Stark, Carroll residents
Canton Repository
Jim McInnes has taken a prescription antibiotic since a work injury in 2009 led to surgery and a re-occurring infection. Methicillin-resistant Staphylococcus aureus (MRSA) returned whenever he stopped taking the drug. McInnes said his prescription originally cost $10 a month but increased to an unattainable $70 a month while he was recovering. “So, I quit taking it,” McInnes said. His physician connected him to the Beacon Charitable Pharmacy in Canton — one of three nonprofit pharmacies in Ohio. McInnes said he has no prescription coverage through Medicare and couldn’t afford his medication without the agency. He now pays $2 a month, the recommended donation for one medication.

From whiskey bottles to hand sanitizer: How Cleveland Whiskey teamed up with Cleveland Clinic to fill a demand
WEWS Cleveland
Always testing the traditional production of whiskey, Cleveland Whiskey has crossed over into producing a different type of product: hand sanitizer. The local company teamed up with Cleveland Clinic pharmacists to formulate, blend and bottle hand sanitizer for the hospital system.

Local Pharmacy makes over 200 hand sanitizer bottles for first responders
NBC4i Columbus
A local pharmacy delivered over 200 bottles of hand sanitizer to the county’s first responders. OPA member Dave Burke and Dave’s Pharmacy report that they made over 200 hand sanitizer bottles in their pharmacy and donated them to Union County first responders over the past couple of weeks. This is an effort to support and keep their communities’ first responders safe according to officials.

Seeking candidates for an open pharmacy position? 
OPA members can submit job postings to the OPA Career Center for free here.

Welcome new OPA members!

We'd like to welcome the following new OPA members who joined up in March:

Gary J. Balster, R.Ph.
Brittany A. Bennett, R.Ph., PharmD
Brian C. Bisher, R.Ph., PharmD
Marko Blagojevic, R.Ph., PharmD
Janna L. Briner, R.Ph.
Jacob M. Cameron, R.Ph., PharmD
Dustin T. Carneal, R.Ph.
Ali Cheaib, R.Ph., PharmD
Kelsey L. Commager, R.Ph., PharmD
John R. DeJames
Ronni T. Ehlers, R.Ph., PharmD
Anthony E. Ferstler, R.Ph., PharmD
Zachary D. Fettman, R.Ph., PharmD
Brian F. George, R.Ph., PharmD
Paige Giessler, R.Ph., PharmD
Michelle L. Grush, R.Ph., PharmD
Allison M. Harrison, R.Ph., PharmD
Susan E. Hohenstein, R.Ph.
Matthew J. Hoover, R.Ph., PharmD
Cameron D. Howard, R.Ph., PharmD
Richelle M. Huffman, R.Ph., PharmD
Kyle R. Huston, R.Ph., PharmD
Ralf Jadoopat, R.Ph., PharmD
Allison Landis
Patrick Lavella
Nathan L. Lawwill, R.Ph., PharmD
John H. Maness, R.Ph.
Ian M. Martin, R.Ph., PharmD
Ariel C. McDuffie, R.Ph., PharmD
Benjamin P. Meek, R.Ph., PharmD
Matthew T. Mitchell, R.Ph., PharmD
Naruhisa Oda, R.Ph., PharmD
Benedicta U. Oduah, R.Ph., PharmD
Jenny M. Ohler, R.Ph., PharmD
Mathew A. Pagano, R.Ph., PharmD
Jane C. Peterson, R.Ph., PharmD
Hanna Russ, R.Ph., PharmD
Celynn A. Vaughn, R.Ph., PharmD
Alphonse P. Verret, IV, R.Ph., PharmD
Stephen S. Wisneski, R.Ph., PharmD, MBA
Filiz Yucebay, R.Ph., PharmD
Candace Lin P. Zheng, R.Ph., PharmD

National news

Pharmacists at CVS and Walgreens describe nerve-racking interactions with potentially infected customers as locations are overrun during the coronavirus pandemic
Business Insider
Pharmacies have been inundated as the coronavirus pandemic spreads. CVS Health is hiring an additional 50,000 employees and paying out bonuses, similar to what other big retailers are doing with workers who are providing essential grocery and pharmacy services. Retail reporter Irene Jiang has been speaking to pharmacists about what they're seeing and the frustrations they're facing as they try to stay healthy amid the pandemic. One told her an instance of when the pharmacist had to frantically wipe down everything in the store a patient showing symptoms of COVID-19 came in. OPA's Antonio Ciaccia discusses what we've been hearing from pharmacists on the ground.

DEA says schedule II prescriptions by phone are OK in emergencies
American Pharmacists Association
According to guidance released Monday, March 30, DEA will allow oral prescriptions of schedule II controlled substances when they are needed for the proper treatment of a patient, there are no appropriate treatment options, and when submitting an electronic or paper prescription to the pharmacy prior to dispensing the substance is not possible. Prescribers can make the determination based on whether individual patients’ circumstances meet these criteria—not all controlled II prescriptions will be prescribed by phone.

Coronavirus in NY: Pharmacists blast Walgreens, CVS for lack of protections
New York Post
Pharmacists working at chain drug stores in the city are blasting Walgreens and CVS, saying the corporations have done little to protect their employees during the raging coronavirus pandemic. A New York pharmacist told The Post the company has provided little guidance for coping with COVID-19. She said a couple weeks ago her store had yet to be deep-cleaned and there is no hand sanitizer for employees.

Essential drug supplies for virus patients are running low
New York Times
As U.S. hospitals confront a surge in coronavirus cases, they are also beginning to report shortages of critical medications—especially those needed to ease the disease's assault on patients’ respiratory systems. Drugs used to keep patients’ airways open, antibiotics, antivirals, and sedatives are among the most commonly reported areas of shortage. Demand for these drugs significantly increased in March as the pandemic took hold in the United States. Orders for antibiotics like azithromycin and antiviral medicines like ribavirin nearly tripled. Medicines used for sedation and pain management, including fentanyl, midazolam, and propofol, increased by 100%, 70%, and 60% respectively. Demand for the asthma inhaler medication albuterol has also risen significantly due to its importance in easing the breathing of patients with severe infection. At the same time, the rate at which these prescriptions are filled and shipped to hospitals has declined by one-half to more than three-fourths in the last month, according to data collected by Premier Inc. In a recent survey of 377 hospitals and 100 long-term care, home infusion, and community pharmacies, Premier found that drug shortages were pervasive in acute care settings, where 70% of respondents reported at least one shortage for coronavirus drugs. Among long-term care facilities, home care settings, and community pharmacies, 48% reported shortages.

Inappropriate prescribing poses dilemma for pharmacists
American Pharmacists Association
There is scant evidence that chloroquine/hydroxychloroquine, alone or in combination with azithromycin, are effective treatments for COVID-19—but in the face of uncertainty and encouragement from President Trump, many health professionals have seized on their use. As pharmacies across the country have been flooded with fill requests for the drugs, troubling pharmacists and potentially contributing to shortages, pharmacy, medical groups, and state boards have taken a stand against the phenomenon.

Justice Dept. warns hoarders of masks and drugs that Trump has touted as coronavirus treatment
Washington Post
The Justice Department is warning people hoarding masks, gowns and medication touted by President Trump as a possible coronavirus treatment that they are in the crosshairs of federal prosecutors cracking down on covid-19 profiteering. Attorney General William P. Barr this week made his first appearance at a White House coronavirus briefing, standing alongside Trump as he warned potential hoarders of medical masks, “you will be hearing a knock on your door.” OPA Executive Director Ernie Boyd discusses the actions Ohio has taken to curb illegitimate stockpiling of hydroxychloroquine.

Rite Aid to rebrand PBM and consider acquisitions
The drugstore chain Rite Aid is rebranding its pharmacy benefit management company as “elixir” with plans to grow it by attracting new clients in the middle market and potential future acquisitions of other PBMs. Rite Aid’s PBM, which has been known as EnvisionRxOptions, is taking steps to remain competitive as an independent business at a time when larger PBMs are now owned by health insurance companies.

Insulin prices and pharmacy benefit manager rebates: pin the tail on the patient
Over the past 15 years, insulin prices have more than doubled. Pharmaceutical companies have been on the receiving end of most of the blame, and the chorus of angry voices has grown louder given Speaker Nancy Pelosi’s H.R. 3 bill, which shows that Americans pay three times more for the same medicines than Europeans do.

The coronavirus pandemic is creating a drug supply crisis just when we most need medicine
As the world scrambles for a magic pharmaceutical bullet to stop the coronavirus, drugs perceived as cures – despite reed-thin evidence — have vanished from pharmacy shelves. Just last Friday, after President Trump touted the still unproven remedy of a malaria drug, hydroxychloroquine, the Food and Drug Administration lifted a restriction it had imposed on a Indian drug manufacturer with a record of manipulating its quality data, to allow it to make the active ingredient now suddenly in hot demand. With the United States long dependent on foreign drug manufacturers for low-cost medicine and key drug ingredients, it is little wonder that we have arrived at this frightening moment, with the FDA allowing companies that it didn’t even trust enough last month to make any drug for the American public, to now churn out unproven drug ingredients for a largely untested off-label use.

Medication adherence suffers because of high drug costs
American Pharmacists Association
In a recent study published in Circulation, researchers found that one in eight patients with atherosclerotic cardiovascular disease (ASCVD) in the United States did not adhere to their medications because of cost.

Potential coronavirus treatment touted by Trump already in shortage, pharmacists say
An old malaria treatment that has been tried with some success against the new coronavirus and was touted by U.S. President Donald Trump at a news briefing last month is in short supply as demand surges amid the fast-spreading outbreak. OPA Past President Jeff Bartone discusses the shortage issues.

Kentucky and Florida expand pharmacists’ role, giving patients more health care options
American Pharmacists Association
In response to the COVID-19 pandemic, Kentucky Gov. Andy Beshear announced an executive order on March 10 allowing pharmacists to fill prescriptions for non-controlled medications for 30 days, including an emergency refill, so patients can stock up and avoid going out to stores. In Florida, Gov. Ron DeSantis signed into law HB 389, Practice of Pharmacy, which will allow pharmacists to test and treat patients with illnesses such as influenza and strep throat as well as patients with chronic illnesses.

Expand pharmacists’ authority to promote access to forthcoming COVID-19 vaccine
Private pharmaceutical companies and the National Institutes of Health have outdone themselves. Thanks to the funding provided by the NIH, a Phase 1 clinical trial for a COVID-19 vaccine  is underway. In separate efforts, Inovio, Sanofi, Vaxart, GlaxoSmithKline, and Johnson & Johnson are all developing potential vaccines. In total, “about 35 companies and academic institutions are racing to create a vaccine, at least four of which already have candidates they have been testing in animals. The first of these – produced by Boston-based biotech firm Moderna – will enter human trials imminently.”

Pharmacists added to federal tax holiday legislation
American Pharmacists Association
Pharmacists will be included in legislation creating a tax holiday for health professionals and first responders who continue to serve during the COVID-19 pandemic. The legislation, the Helping Emergency Responders Overcome Emergency Situations (HEROES) Act of 2020, initially did not include pharmacists as beneficiaries, but after a request from the APhA Government Affairs team, bill sponsor Rep. Bill Huizenga (R-MI) added pharmacists to the list. 

Rural pharmacies respond to COVID-19 pandemic with change in outreach services
Pharmacy Times
In the midst of the coronavirus disease 2019 (COVID-19) pandemic, patients in rural areas continue to face existing challenges to care, such as poverty, inconsistent information about the virus, and lack of transportation. Pharmacies that serve these populations are focused on bringing the best care possible to their communities and are working hard to provide their patients with high-quality services. OPA member Michael Rush, of Ohio Northern University (ONU), said that serving the community is now more important than ever, specifically through the ONU HealthWise community pharmacy and mobile clinic options.

India bans all exports of virus drug often touted by Trump
India banned all exports of hydroxychloroquine, a malaria drug that President Donald Trump has repeatedly touted as a “game changer” in the fight against Covid-19. Exports of the drug and its formulations are prohibited “without any exceptions” and with immediate effect, India’s Directorate General of Foreign Trade said in an April 4 order on its website. The trade regulator had last month restricted overseas shipments of the drug, allowing only limited exceptions such as on humanitarian grounds and for meeting prior commitments.

Pharmacists frustrated by trying to secure masks from Strategic National Stockpile
Fierce Healthcare
Amid concerns about dwindling stockpiles of protective equipment, pharmacists are expressing frustration with their hospitals’ ability to obtain masks from the national stockpile. A new survey from the American Society of Health-System Pharmacists (ASHP) polled 382 hospital-employed pharmacists and found that 28% had requested masks from the Strategic National Stockpile. 

PBMs practice prescription drug price gouging during pandemic
Penn Live
We want the public to know that Pennsylvania’s independent pharmacists are doing all we can to make sure families in our local communities have the medicine they need while remaining at home and practicing social distancing. We are following the practice of: Step Up — Pitch In — Limit Contact — Make Free Deliveries. As you well know, Medicaid patients not only have numerous physical health care deficiencies, but also deal with a myriad of behavioral and social problems — psycho-social issues, literacy and poverty to name a few. Where would these individuals turn for help when their local independent pharmacy is no longer there? That’s a real possibility due to the behavior of pharmacy benefit managers (PBMs) during this pandemic.

Amazon shifts employees to PillPack and PBM RxAdvance
Amazon is making a bigger move into pharmacy by moving thousands of employees and their prescription benefits to a new cloud-based pharmacy benefit manager, RxAdvance, and Amazon’s own PillPack online pharmacy. The move is being viewed by some as the latest effort by Amazon to tap into the healthcare business by first testing a new way to control prescription costs and improve medication adherence for its U.S. employees.

Fraudulent COVID-19 tests flood the market
Food and Drug Administration
Pharmacies are being inundated with companies promoting potentially fraudulent materials related to COVID-19 testing, including marketing FDA certification. The FDA is still in the process of reviewing many of these authorizations and have shared with us a few key points to help discern whether a company is legitimate. The FDA list of all current authorized tests, updated daily, is on this page.

These FDA pages addresses available diagnostic and therapeutic medical devices to diagnosis and respond to COVID-19:

Here is a list of Laboratories and Manufacturers that are Offering Tests for COVID-19:

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Upcoming Events

Mark your calendar for upcoming OPA events (subject to change with coronavirus cancellations):
May 12 - Required OSHA Training for Immunizing Pharmacists webinar, RxCEonDemand
Sept. 17 - Required OSHA Training for Immunizing Pharmacists Webinar
Oct. 3 - OPA Midwest Independent Pharmacy Expo
Oct. 4 - OPA/IACP: Compound Conference

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