The Oregon Health Authority is offering to pay pharmacies $35 for every dose of COVID-19 vaccine they give, a move that could potentially help pharmacies hire employees to deal with the growing workload that has led to long rows in the state.
The program, which kicked off this month, also aims to increase vaccination coverage and ensure vaccines are available to all residents, said Rudy Owens, a public affairs specialist for the Oregon Health Authority.
To qualify for the payments, pharmacies must meet certain “vaccine equality” standards, including things like offering multilingual signs for COVID-19 vaccinations, “comprehensive vaccine-related counseling aimed at increasing vaccine confidence” and “a plan for continuous evaluation’ and continuous improvement to ensure fair access,” according to a flyer from OHA.
The agency’s other program more directly addresses the staff shortages that have plagued pharmacies as the state will pay temporary pharmacists to bolster the workforce.
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However, Owens said the temporary staff program is only available to independent pharmacies. Company pharmacies are not eligible for the program, Owens said.
The larger chain pharmacies are eligible for the vaccine reimbursement.
Owens said OHA does not yet have data on how many pharmacies have applied for the additional payments.
He said staff shortages in the pharmacy have been exacerbated by the closure of more than 35 Bi-Mart pharmacies earlier this month. (The Bi-Mart stores themselves will remain open.)
The bigger culprit in the pharmacy crisis is the limited reimbursements pharmacies receive from so-called pharmacy benefit managers (PBMs), said Brian Mayo, executive director of the Oregon State Pharmacy Association.
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If those fees were “reasonable,” pharmacies would be able to hire more employees and lines would be shorter, Mayo said.
Customers have recently had to wait two or three hours, in some cases, to pick up their prescriptions.
Those delays are not acceptable, Mayo said.
“Many Oregon community pharmacies are 5 to 14 days behind on filling prescriptions because they can’t keep up with demand,” he said. “If someone needs medication, they can’t wait two weeks. Patient safety is a major issue right now.”
Mayo said the Oregon State Pharmacy Association has been warning for years that low reimbursements to pharmacies by PBMs are a problem.
“The damage we warned about has now materialized,” he said.
The Pharmacy Association is urging elected officials to take immediate action to reform the PPE system.
The organization is also asking Oregon to exempt prescription drugs from the state’s business tax, which the legislature passed in 2019 and took effect January 1, 2020.
The Pharmacy Association has some high-level support in its effort to reform the PPE system.
U.S. Senator Ron Wyden, D-Ore., recently sent a letter to Chiquita Brooks-LaSure, administrator of the Centers for Medicare and Medicaid Services, a federal agency, detailing both PPE reimbursements and the reimbursements provided by PBMs and by Medicare Part D cites prescription plans as contributing to pharmacy closures.
“I am deeply concerned that the rise in these rates contributed to the permanent closure of 2,200 pharmacies nationwide between December 2017 and December 2020,” Wyden wrote in his letter to Brooks-LaSure.
Wyden is calling on the Centers for Medicare and Medicaid Services to review U.S. pharmacy closures over the past five years, including the nature and effect of PPE payment practices, and to use the agency’s power to adjust their rates regulate.
Mayo said the current situation, with lines of customers meandering through some stores, is frustrating for pharmacy workers.
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“The pharmacists, technicians and interns are working as fast as they can,” Mayo said. “In many cases, they are forced to work without mandatory breaks and voluntarily work longer unrecorded hours so that they can provide care to their clients. They want to help the patients. That’s why they chose this profession, but it feels like things are getting out of hand.
“We need to improve working conditions in pharmacies for the sake of patient safety and the well-being of pharmacy workers,” Mayo said.
In a written statement to the Baker City Herald, Jill McGinnis, director of communications and public affairs for the company that owns both Safeway and Albertsons stores, wrote: “The country is currently facing a shortage of technicians and no doubt all pharmacies have been affected. Fortunately, during staff shortages and illness, we were able to stay open, taking patients from dispensaries that could no longer stay open so we could continue to serve the Baker community and keep the prescriptions local.
“We hope our customers will remain patient with us as we strive to fill open positions in a challenging work environment, complete their needed prescriptions, and continue to ensure our community is vaccinated.”
He said the Oregon Gov. Kate Brown that health workers, including pharmacists and pharmacy technicians, need to be vaccinated or receive a medical or religious exemption has had “minimal” impact on current staff shortages.
He said most pharmacy workers have been vaccinated.
According to the OHA, as of Nov. 1, 88% of Oregon pharmacists had been vaccinated and 83% of pharmacy technicians.
The OHA report does not break down vaccination coverage by province, nor does it state how many pharmacy employees have been granted exemptions.