Long-Term-Care Pharmacies Seek COVID-19 Vaccine Role, Govt. Relief

DATE: December 18, 2020

Inside Health Policy
By John Wilkerson

The Senior Care Pharmacy Coalition is urging the Centers for Disease Control and Prevention (CDC) to consider matching nursing homes to pharmacies they have a relationship with for coronavirus vaccinations, instead of matching nearly everyone with Walgreens and CVS.  Long-term-care pharmacies also are requesting the government give them money from the Provider Relief Fund to defray major financial losses and increased costs due to the pandemic.

Doctors and nurses began receiving coronavirus vaccines Monday (Dec. 14) and nursing home residents are next in line.

The Trump administration in October designated CVS and Walgreens as the suppliers of free vaccines to nursing homes. Nursing homes were allowed to choose vaccine suppliers, but Senior Care Pharmacy Coalition President and CEO Alan Rosenbloom said there was no guarantee that nursing homes would receive the vaccines as quickly if they chose the long-term-care pharmacies they normally do business with, so nearly all nursing homes and assisted living facilities chose one of the two chain pharmacies.

However, CDC can override those choices, and Rosenbloom said CDC should match nursing homes with the long-term pharmacies they have a relationship with, to the extent possible.

The plan to use the two chain pharmacies was designed in part to deal with Pfizer’s vaccine, which requires expensive equipment to hold the vaccine at ultra-cold temperatures. Now it looks like Moderna’s vaccine will be available soon, too, and Moderna’s vaccine is much easier to transport and store.

“Particularly now that we may not have to be exclusively focused on a vaccine that requires a lot of special handling, maybe it’s time to rethink the degree to which you can rely more on the existing infrastructure,” Rosenbloom said.

Operation Warp Speed officials said they formed the public-private partnership with Walgreens and CVS because it’s the quickest and easiest way for the government to get vaccines to those in greatest need. CDC said it cannot contract with all of the independent long-term-care pharmacies, but the agency later agreed to contract with group purchasing organizations and a pharmacy services administration organizations that represent long-term-care pharmacies. At least two of those entities now have government contracts that are similar to the contracts with CVS and Walgreens, Rosenbloom said, and that opened the door for greater long-term-care pharmacy participation.

The pandemic has hurt long-term-care pharmacies financially. Revenues are down 20% on average and costs are up 10%. The Senior Care Pharmacy Coalition is trying to get funding from the Provider Relief Fund, but HHS blocked their eligibility by determining that pharmacies do not provide patient care.

But long-term-care pharmacies do provide patient care, including direct services for patients and their families, medication therapy management and drug regimen reviews, Rosenbloom said. CMS even requires that long-term-care pharmacies provide patient care and has stated that long-term-care pharmacy services are integral to patient care in nursing homes and assisted living facilities.

Giving long-term-care pharmacies relief comparable to that provided to hospitals and physicians would cost about $350 million, Rosenbloom said, and there is $20 billion to $30 billion left in the fund.

“Failure to provide prompt relief to this vital sector risks catastrophe for vulnerable seniors and the LTC pharmacies that serve them,” Rosenbloom said.

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