As states evaluate plans to reopen, despite cases of coronavirus continuing to rise, Congress has been at work on another COVID-19 emergency supplemental bill. House Democrats released a whopping 1,800-word initial draft of the Health and Economic Recovery Omnibus Emergency Solutions (HEROES) Act this past week. Included in this bill are additional provisions for workers, Medicare & Medicaid beneficiaries, and assistance for agricultural producers. A hefty section of the bill is devoted to healthcare workers and community support provisions.
You might be asking, why does this matter to me? Well, let me direct your attention to two primary points where this bill will impact the practice of pharmacy, 1) essential worker designation, and 2) the drug distribution system.
Essential worker designation
Within the language of this draft, “[p]harmacy work, physically performed in pharmacies, drug stores, or other retail facilities” is recognized as essential work. This may not be jaw-dropping, and to be honest it shouldn’t be, but the importance of this comes into what the government hopes to be able to do to support essential workers. As essential workers that are performing “pharmacy work”, following the stipulations within this legislation, workers would be entitled to premium pay if their employer is receiving certain COVID-19 grants from the government. This is a good thing, as our essential workers deserve appropriate compensation based on the dedication they are making to care for patients during the state of emergency.
The drug distribution system
A second area of interest that could impact pharmacists across care settings is the recommended changes to the drug distribution system as a result of this draft legislation. According to the ASHP Drug Shortage Statistics, the U.S. experienced 186 new drug shortages in 2018 and 166 in 2019. Primary literature and systematic reviews, such as that published by Phuong et al in 2019, have found that drug shortages “have adverse economic, clinical and humanistic outcomes to patients.” Currently, a majority of pharmaceutical manufacturing has been outsourced to other countries. While there are some economic benefits to this strategy, some are worried that the outsourcing of pharmaceutical manufacturing could result in subsequent shortages of medications in the case of emergencies or pandemics.
Recognizing the negative outcomes that can be associated with drug shortages, this draft of the HEROES Act requests the development of strategies to “end United States dependence on foreign manufacturing” for “critical drugs and devices”. Doing so, may end up having positive implications on patient outcomes. By controlling the supply chain, we can better manage drug shortages at all times, which could have positive implications for patients across the country. However, doing so would fundamentally change the entire drug distribution system. What would be the consequences as the U.S. transitions to an independent manufacturing system? What could happen to the countless foreign workers that may be impacted by this change? How might it impact economies and the health of people around the globe?
These are all questions too big for one blog post to answer, but as pharmacists that took an oath to “consider the welfare of humanity and relief of suffering my primary concerns”, we can’t ignore both the positives and negatives that may come from such a disruption. As more information is released, there will be plenty of opportunities to bring the pharmacist perspective to these potential changes.
Your voice matters
This bill will certainly be amended in the coming days and it won’t be the last bill introduced to provide relief from the pandemic. As healthcare professionals, it is important for us to be actively engaged in this process by contacting our members of congress and informing them of our perspectives as essential healthcare providers.
Until next time, stay curious and passionate.