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Oncology Pharmacy Making Adjustments

Web Exclusives - COVID-19
Michael Reff, RPh, MBA
President, National Community Oncology Dispensing Association (NCODA)
Ray Bailey, BPharm, RPh
Pharmacy Director, Florida Cancer Specialists

Mr Reff and Mr Bailey addressed the modifications that oncology pharmacies are making to keep staff and patients safe during the coronavirus pandemic.

Since its virtual Spring Forum, NCODA has been hosting weekly calls that include some of the approximately 700 oncology practice settings it represents, to discuss how best to adjust to the new reality of COVID-19, said Mr Reff.

“The oncology practice settings focus on the importance of the continuation of care, specifically on the provision of oral chemotherapy,” he said. “This oral oncology ecosystem represents several unique business models, which are dependent on the size and scope of the practice they serve.”

For Mr Bailey and his colleagues at Florida Cancer Specialists, who are used to hurricane disasters, the pandemic posed new challenges as they launched their crisis response.

“We had never encountered anything like this,” he said. They started with protecting the dispensing staff by sequestering them in an ISO 9 cleanroom with its own entrance. Staff are now wearing masks and gloves, and are subject to temperature checks and questionnaires at the beginning and end of shifts, Mr Bailey noted. In addition, staff were cross-trained to provide backup for the dispensing staff, who are critical to getting medications to patients.

Pharmacy support staff were transitioned to work from home. Because most staff and nurses are accustomed to working in a pharmacy setting, this posed technologic and infrastructural challenges. “It was a heavy lift for us,” Mr Bailey added. It helped that all their systems are cloud-based.

Also, Microsoft Teams has proved invaluable for tackling challenges and IT issues, as well as reaching patients, he said.

Pharmacy benefit managers (PBMs) have also adapted to the new paradigm, with some allowing 90-day prescription fills and shipping for some retail contracts. They have suspended audits, and reauthorizations have largely been delayed or suspended. “We appreciate that partnership with the PBMs who are supporting us and our patients,” Mr Bailey added.

With pharmacy pickups suspended, delivery practices have changed as well. The signature requirement on delivery slips was changed; now, FedEx delivery drivers wait for the package to be taken inside and then sign “COVID-19” on the signature pad instead of having the patient sign.

Some pharmaceutical companies have made changes to Risk Evaluation and Mitigation Strategy programs for certain drugs that allow flexibility in dispensing pregnancy tests and longer duration of prescription fills, Mr Bailey said.

Patient education about adherence to oral medication, which has always been done via a phone call, has not changed much for Florida Cancer Specialists.

“Maybe one silver lining to this is that all our patients are home, so when we call, we’re not having to leave messages,” noted Mr Bailey.

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