If you build it, they will come: A safe haven at the pharmacy

In the 1989 film Field of Dreams, an Iowa farmer is inspired to pursue a dream. He builds a baseball field on his farm driven by the promise that, “if you build it, they will come.” His devoted action in pursuit of his dreams brings him amazing results. Baseball fans came in droves to his small farm in Iowa. 

Much like the main character, Ray Kinsella, so too are pharmacists working in dogged pursuit of new vistas, with the goal to continue to provide essential care to our nation’s most vulnerable. During the pandemic, pharmacies and pharmacists built availability and access for patient care services, and patients came in droves for immunizations, testing, and treatments.   

The work of pharmacists has been nothing short of heroic. A new report from the IQVIA Institute for Human Data Science found that pharmacists in the United States administered more recommended routine vaccinations than physicians from 2020 to 2021. The report also finds that the majority of adult COVID-19 and shingles vaccinations took place at pharmacies, and approximately 60% of vaccinations during flu season also took place at pharmacies. The IQVIA data revealed a 30–40% increase in claims for flu vaccines at pharmacies between 2018 and 2019 as well as in 2020. The report also shows that pneumococcal vaccinations increased at pharmacies, and roughly 13–20% of adult HPV vaccines were administered at a pharmacy by the end of 2021, compared with 5–8% in 2018. 

The evidence is clear: Patients rely on pharmacists to access essential health services, including vaccines, testing, and treatments, and to protect themselves from some of the most daunting infectious diseases. Ninety percent of Americans today live within 5 miles of a pharmacy, and pharmacists provide critical access points for patient care services. 

The Public Readiness and Emergency Preparedness (PREP) Act gave pharmacists the temporary ability to vaccinate patients as young as 3 years old, thus helping to fulfill the increasing demand for vaccinations that followed the rise of COVID-19 and close the gaps in access for low-income families and rural communities. The IQVIA report found that there were 15% more pharmacy locations within low-income communities than physician offices, meaning that lower-income families had more access to pharmacists than physicians and could count on them for timely care. 

A study in the Journal of the American Pharmacists Association quantified the contributions of pharmacists and their teams. Pharmacy teams administered 42 million COVID-19 tests, provided over 270 million COVID-19 vaccinations within community pharmacy programs alone, and delivered over 50 million flu and other vaccinations. Findings from the research also indicate that pharmacists prescribed, dispensed, and administered an “enormous” number of antibody products and antiviral medications, including care for 5.4 million inpatients and countless outpatients. In the end, by conservative estimates, interventions by pharmacists and their teams averted over 1 million deaths, over 8 million hospitalizations, and nearly $450 billion in health care costs. 

While we built the field that kept America’s seniors and other vulnerable communities healthy through a pandemic, pharmacists continue to operate under a fragile foundation of temporary authorities that were put in place in response to COVID-19.  Although the PREP Act authorities have been extended, access for these patient care services at pharmacies is temporary for our nation’s seniors because pharmacists are not considered providers under Medicare. 

Congress has recognized this gap with the introduction of federal legislation, H.R.1770, the Equitable Community Access to Pharmacists Services Act. Championed by Reps. Adrian Smith (R-NE), Brad Schneider (D-IL), Larry Bucshon (R-IN), and Doris Matsui (D-CA), the bipartisan legislation would make permanent the temporary authorities to provide essential pharmacist services to protect seniors from the threat of COVID-19, influenza, and other infectious diseases. Congress must act swiftly to pass this legislation to enable pharmacists to continue to provide these services for seniors now and into the future. 

 Last month, Sens. Chuck Grassley (R-Iowa), Sherrod Brown (D-Ohio), Ben Ray Luján (D-N.M.), Bob Casey (D-Pa.) and Cindy Hyde-Smith (R-Miss.) reintroduced, S.1491 the Pharmacy and Medically Underserved Areas Enhancement Act, bipartisan legislation that would authorize Medicare coverage for a broader range of pharmacist services for patients in medically underserved areas in communities that lack easy access to doctors. 

APhA has made it easy for you to contact your legislators to get their support for these bills. Go to https://actioncenter.pharmacist.com/campaigns/ to send letters to your Representative and Senators to support H.R.1770 and S.1491. Click on each bill to send separate letters.  

The numbers speak for themselves. It’s not a field of dreams. Patients want healthcare services from their local pharmacies and pharmacists. Now Congress needs to play ball and build provision of these pharmacist patient care services into the law, and they will come.  

Ilisa Bernstein, PharmD, JD, FAPhA, is the interim executive vice president and CEO of the American Pharmacists Association (APhA).