Best of Pharmacy Focused Efforts 

Drug Shortages and Stockpiling

Best Practice: CPESN Network developing a list of pharmacies with COVID-19 related medications in stock

  • Volunteer to lead this initiative within a local CPESN Network (or group of pharmacies), like Steve Osenbaugh (RelyCare Pharmacy) did with NESP (Nebraska CPESN)

  • Upload the templated Google Spreadsheet to Google Docs, share with pharmacy group and have everyone update inventory totals (NESP pharmacies doing once weekly on Wednesday)

    • Minimally include hydroxychloroquine stock. If azithromycin or other meds are added as COVID-19 related, add new drugs to list of inventory

      • Be sure the document is editable (not view only)

  • If a patient or hospital requests a drug that is on shortage and the drug is prescribed for a legitimate indication, pharmacies can view the Google Doc that was created to see which pharmacy has it in stock

    • Goal: Connect patients / hospitals with pharmacies with the medication in stock

Best Practice: Develop a Protocol for your pharmacy on how to handle shortages

  • Create a protocol for how to best handle hydroxychloroquine shortages for your pharmacy and determining which patients are in most need for these drugs

  • Talk with local prescribers to inform about the drug shortages and discuss alternative options for patients on medications for chronic conditions

  • Discuss your with local hospital(s) and determine their need for the COVID-19 related drugs, in case they are in need for a drug to be supplied by the pharmacy.

    • Utilize the spreadsheet mentioned above to help with connecting hospitals with pharmacies in the area if needed.

  • Stay up to date with ASHP's guidance on Drug Shortages (see info further down page)

Best Practice: Remain Current on Drug Shortages

  • Bookmark AHSF Drug Information® - Open access for 60 days effective 3/16/2020

    • Username: ahfs@ashp.org​

    • Password: covid-19

  • On the tabs, click "Shortages" to view:

    • Medications that are on shortage​ and the reason

    • Manufacturers that are continuing to supply

    • Estimated resupply dates

    • Implications for patient care

Best Practice: Managing the Drug Supply Chain

  • Ensure that you are optimizing/maximizing your medication synchronization program including enrolling patients who are at high risk if COVID-19 is contracted

  • Monitor your primary and secondary wholesalers for supplies of critical medications for your patients, especially those at risk with chronic conditions

    • Ensure you have a sufficient quantity of critical medications in your pharmacy to cover your patients for at least the next 30 days

Best Practice: Be the steward for appropriate use of medications in your community

  • Ensure that medications that have “potential” benefits for COVID-19 treatment (e.g. hydroxycholoroquine, azithroymycin, etc) are first being reserved for your patients using them for proven therapeutic effects (e.g. RA)

    • Patients taking hydroxychloroquine for a chronic condition, consider talking with the prescriber for alternate therapy and/or limit to a 30 day supply​ or less

  • Follow your region/state/board recommendations as to rationing quantities

    • Example from Arkansas in link to the left.

  • Discuss further with prescribers who are ordering quantities for self-use

  • Know and understand the current use of these medications for “off-label use” so you can be a resource for your patients, prescribers, and other stakeholders

    • CDC Therapeutic Options: Click here

      • Although optimal dosing and duration of hydroxychloroquine for treatment of COVID-19 are unknown, some U.S. clinicians have reported anecdotally different hydroxychloroquine dosing such as: 400mg BID on day one, then daily for 5 days; 400 mg BID on day one, then 200mg BID for 4 days; 600 mg BID on day one, then 400mg daily on days 2-5.

About CPESN USA

CPESN® USA is a clinically integrated, nationwide Accountable Pharmacy Organization  structured to advance community-based pharmacy practice. They empower community-based pharmacies that are deeply rooted within their community by fostering their ability to provide high quality, patient-centered enhanced services. CPESN® pharmacies integrate with other healthcare providers on the patient’s care team to coordinate medical treatment. The results are better medication adherence, higher patient satisfaction, and lower healthcare costs. You can find CPESN® networks of pharmacy providers in 45 states across America. To learn more, please visit cpesn.com.

About NCPA

Founded in 1898, the National Community Pharmacists Association is the voice for independent pharmacy, representing 21,000 pharmacies and employing more than 250,000 individuals nationwide. Independent pharmacy is a $75.8 billion marketplace. Community pharmacists are local health care problem-solvers who can customize solutions to local health challenges for groups and employers.   https://ncpa.org/

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