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May 15, 2020

ASHP Launches New Section of Pharmacy Educators and Continues to Advocate for Pharmacists During the COVID-19 Pandemic

Dear Colleagues,

Paul W. Abramowitz, Pharm.D., Sc.D. (Hon.), FASHP

AS YOU KNOW, ASHP staff and members have been working tirelessly during the COVID-19 pandemic to support our members and all healthcare providers to enhance the safe use of medications, deliver quality care, and enhance patient outcomes. This work has served as continued reinforcement of our long-standing commitment to supporting pharmacists across the continuum of care and elevating the vital role that pharmacists play as patient care providers. In our 78-year history, we have continually supported heightened standards and training for pharmacy professionals regardless of practice setting.

In this vein, I am pleased to share that the ASHP Board of Directors has approved the creation of a new membership section that will further strengthen and significantly enhance ASHP’s leadership in the preparation and training of the pharmacy workforce. The new ASHP Section of Pharmacy Educators will provide a unique and distinct membership home and leadership voice within ASHP for pharmacy school faculty, deans, and preceptors who are involved in the training of pharmacists.

The COVID-19 pandemic has shown how quickly healthcare and the pharmacy profession can change, and how critical education and training are to meet evolving patient care demands. Building on our existing world-class educational offerings and professional development expertise, ASHP is well-positioned to support educators in all settings, preparing the next generation of practitioners to provide the highest level of interprofessional patient care in highly dynamic and complex environments. This new section will play a key role in ensuring we can provide our educators with an even greater voice as we work together to face the immense healthcare challenges of today and tomorrow.

ASHP President-elect Tom Johnson will appoint an executive committee in August to lead the section’s work, and the committee will begin meeting virtually this fall. ASHP members interested in serving on the section’s leadership should submit an application by July 24.

Support for Pharmacy Residents

Over the past several weeks, I have shared information on ASHP’s efforts to support residents and our accredited residency programs facing uncertainty during the COVID-19 pandemic. Many members and residency programs tell us about ongoing issues, including the potential impact of licensing exam cancellations prompted by stay-at-home orders and social distancing requirements as well as financial challenges faced by their hospitals and health systems. In response to these concerns, on Monday, ASHP’s Commission on Credentialing and Board of Directors approved an extension of the licensure requirement for residents until January 1, 2021. This action, for the 2020–21 residency year only, temporarily waives the requirement that residents be licensed for two-thirds of the residency year (e.g., a July 1 residency start normally requires licensure by November 1). Our Accreditation Services team, through our partners at the National Association of Boards of Pharmacy, continues to monitor pandemic-related effects on residencies and will take any necessary future actions to alleviate burdens caused by delays in testing or licensure. In the meantime, ASHP will do everything it can to ensure the maximum amount of flexibility to our accredited programs during these extremely challenging times. If programs or others have questions, please reach out to Janet Silvester, vice president of Accreditation Services, or Stephen Ford, director of Residency Accreditation Services, for assistance.

Taking ASHP Meetings Virtual

The impact of COVID-19 has extended beyond our hospitals and health systems and challenged us to think differently when “business as usual” is no longer possible. Public health and safety measures are likely to remain in place in some form for months to come. In response to this changing landscape, ASHP announced on Wednesday that we will be moving three important fall events to virtual forums.

Policy Week, which includes our annual Legislative Day on Capitol Hill, will become a virtual experience in September. ASHP’s National Pharmacy Preceptors Conference and Conference for Pharmacy Leaders will take place in October as virtual events. Watch for forthcoming programming details and registration information about these valuable meetings. We remain committed to leveraging technology solutions to deliver the dynamic, high-quality educational content and professional development experiences our members expect from us.

One of the first ASHP events affected by COVID-19 was our Summer Meetings & Exhibition, initially planned for the first week of June in Seattle. Instead of gathering there, we are offering a free series of educational “Summer Sessions” at the end of June, featuring select content from the ASHP 2020 Summer Meetings as well as sessions on the latest COVID-19 updates. These sessions will be open to all practitioners, regardless of ASHP membership status. Continuing education credits will be available to participants. Stay tuned to ASHP’s NewsLink, social media channels, and other communications for additional information about these Summer Sessions.

Remdesivir Resources and Advocacy

Since my last blog, there has been promising news on the efficacy of remdesivir as a treatment for COVID-19. Last week, the Food and Drug Administration (FDA) issued an emergency use authorization for remdesivir to speed access to the investigational antiviral — the first to show promise against SARS-CoV-2 infection. Subsequently, a remdesivir monograph was published in AHFS Drug Information. As a reminder, ASHP has opened access to AHFS DI to all healthcare professionals for a limited time with the username ahfs@ashp.org and password “covid-19.”

Our AHFS drug information staff continue to update ASHP’s Assessment of Evidence for COVID-19-Related Treatments. The document outlines evidence about remdesivir, supportive therapies, and other medications used to treat patients with COVID-19. SafeMedication.com, ASHP’s consumer-friendly medication information resource, is an excellent place for patients to learn more about remdesivir.

We also held a live webinar this week describing the early use of remdesivir for COVID-19 patients. The second part of the webinar series, scheduled for May 20, will share clinical experiences in using remdesivir and a discussion of clinical trial results by the Nebraska Medical Center–Nebraska Medicine pharmacy team. Recorded versions of ASHP’s COVID-19 webinars are available for those unable to attend the live sessions.

While remdesivir shows promise in early studies, access to medication is of great concern to pharmacists across the country. Last week, I sent a letter to Vice President Mike Pence urging the administration to make public its process for determining which hospitals will receive allocations of remdesivir, communicate information about the allocations to all hospitals, and provide information on the timeline and details for the commercial availability and distribution of remdesivir. We also asked the administration to coordinate with the FDA and the Department of Health and Human Services (HHS) to allow hospitals the flexibility to reallocate product to meet changing needs.

Our letter was extensively quoted in an Associated Press article picked up by The New York Times — a testament to ASHP’s commitment to being a voice for our profession and leading national efforts to optimize medication use, improve patient safety, and advance clinical pharmacy practice.

At the urging of ASHP and others, last weekend, HHS announced that state health departments will distribute remdesivir to appropriate hospitals in their states. HHS noted that “state and local health departments have the greatest insight into community-level needs in the COVID-19 response, including appropriate distribution of a treatment in limited supply.” We encourage ASHP members who need remdesivir for their patients to contact their state health departments.

ASHP’s Promise to Support the Essential Role of Pharmacists

I wanted to highlight ASHP’s advocacy on behalf of the vital role pharmacists play in the COVID-19 response. Last week, Rep. Carolyn Maloney introduced the Student Loan Forgiveness for Frontline Health Workers Act (H.R. 6720). Unfortunately, pharmacists are not specifically identified as healthcare workers in this important legislation. ASHP, in collaboration with other pharmacy organizations, wrote to Rep. Maloney and urged her to include pharmacists in the loan forgiveness program. We look forward to working closely with Rep. Maloney’s office to support that effort.

Finally, in my last blog, I discussed a letter that I sent to the chief executive officer of Novo Nordisk responding to their advertisements, which omitted pharmacists from a list of individuals, including nurses, doctors, researchers, and other essential workers, who were acknowledged for their caring efforts on the front lines of the COVID-19 response.

I requested that pharmacists be explicitly recognized as healthcare providers and noted for the essential role they are playing, in addition to doctors, nurses, communities, and essential workers. I was pleased to quickly receive a response from Novo Nordisk’s leadership, acknowledging the vital role of pharmacists and agreeing to specifically highlight pharmacists in a new version of the advertisement, which has already been in print.

In closing, I want to reassure our members that ASHP will continue to work across multiple fronts to represent your perspectives and needs as we collectively navigate the ongoing pandemic response so you can provide the best care possible for your patients. Providing you with the latest information and new resources on our COVID-19 Resource Center remains a top priority. Please watch our weekly NewsLink emails to learn about new and updated resources and live webinars, and continue to connect with your peers on our COVID-19 Connect Community. You can also subscribe to @ASHPOfficial to receive content from our daily podcasts.

Thank you for being a member of ASHP and for everything that you do for your patients and our profession.

Sincerely,

Paul

April 30, 2020

ASHP Continues to Support Members and the Healthcare Community Through the COVID-19 Pandemic

Dear Colleagues,

Paul W. Abramowitz, Pharm.D., Sc.D. (Hon.), FASHP

THE COVID-19 PANDEMIC is changing our country’s healthcare landscape every day. Critical health policy changes are occurring at an unprecedented rate. We continue to engage with state and federal policymakers to ensure that pharmacists’ expertise is fully utilized and that healthcare providers are equipped to safely and effectively respond to the pandemic.

Update on States’ Response Efforts

State governors are issuing executive orders that expand pharmacists’ ability to provide high-quality care to patients during this crisis. For example, Michigan now permits pharmacists within licensed health facilities to contribute to routine health maintenance and manage chronic disease states without physician supervision. This expansion alleviates burdens on primary care providers and expands access to care, especially in rural and underserved communities where pharmacists are the most accessible healthcare professionals.

We are also seeing a positive trend in pharmacists’ ability to manage therapeutic interchange. In Iowa and Kentucky, executive orders grant pharmacists the authority to substitute medications in response to drug shortages.

Point-of-care testing for COVID-19 is critical to the national pandemic response. Some states already permitted pharmacists, under their scope of practice or through collaborative practice agreements, to order and administer these tests. Pennsylvania, which previously allowed pharmacists to order and administer tests, has taken emergency measures to grant pharmacists explicit authority to order and administer COVID-19 tests. States like Florida, Illinois, Kentucky, and, most recently New York, issued executive orders that permit pharmacists to order and administer COVID-19 tests. State-level COVID-19 response is a rapidly changing situation as local healthcare providers respond to patient surges and the demand for testing. Please check with your state’s board of pharmacy for more information about the status of COVID-19 testing in your area. Helpful information on COVID-19 testing can also be found on the National Community Pharmacists Association’s website.

ASHP applauds state governors’ efforts to expand pharmacists’ scope of practice during this state of emergency. However, we are concerned that authorizing the expansion of pharmacists’ services without authorizing payment for those services will limit the delivery of care in some pharmacy practice settings. COVID-19 is already highlighting shortcomings in state Medicaid payment systems and commercial payer policies that prevent qualified pharmacists from fully serving patients. ASHP is working closely with our state affiliates and other organizations to request reimbursement for the new services they are providing under the state of emergency. This advocacy aligns with ASHP’s Pharmacy Readiness for Coronavirus Disease 2019 (COVID-19) Recommendations for State Policymakers. The recommendations address shortages of drugs and medical supplies and reimbursement of pharmacists for patient care services and also provide readiness and resilience resources for clinicians.

Pharmacists are Essential Healthcare Personnel

ASHP continues to voice our support for all pharmacists who are working tirelessly across the continuum of care in response to the COVID-19 pandemic. Yesterday, I sent a letter to the chief executive officer of Novo Nordisk responding to a full-page NovoCare ad that ran last weekend in the Wall Street Journal and other publications. Pharmacists were omitted from a list of individuals, including nurses, doctors, researchers, and other essential workers who were acknowledged for their caring efforts on the front lines of the COVID-19 response.

In the letter, I reinforced that pharmacists are highly skilled, licensed healthcare professionals who play a key role in selecting and optimizing medication therapy for patients. Pharmacists also oversee the entire medication-use process in hospitals and health systems, including the purchasing, distribution, preparation, and administration of pharmaceuticals. I further explained that, as members of interprofessional healthcare teams, pharmacists are providing a broad range of patient care services during the COVID-19 public health emergency, from directly caring for mechanically ventilated patients in critical care settings, to providing point-of-care testing and medication management to patients in community pharmacy settings and beyond.

It is my hope that Novo Nordisk will appropriately recognize pharmacists and the important role they play in future communications.

ASHP’s Response to Disruptions in Residency Training

In last week’s blog, I discussed the COVID-19 pandemic’s impact on residency training. As a result of disruptions in routine or elective procedures and reductions in inpatient hospital stays, some hospitals and health systems are facing the difficult situation of furloughing their PGY1 and PGY2 pharmacy residents. These actions can disrupt patient care and make residents ineligible for board certification and professional positions that require postgraduate pharmacy residency training. We believe that educating future generations of pharmacists is more critical than ever, and ASHP has issued a statement opposing the furlough of residents.

As always, ASHP is here to support residents and residency programs. If you need assistance with a furlough situation, please reach out to Janet Silvester, vice president of Accreditation Services, or Stephen Ford, director of Residency Accreditation Services.

ASHP is Here for You and the Entire Healthcare Community

Over the past several weeks, I have been sharing information about new and timely resources that ASHP has developed and made available to optimize medication use and patient outcomes during this public health emergency. The response to these offerings, which is captured in a new ASHP infographic, has been tremendous. We are immensely proud of our staff and volunteers who have been working tirelessly to deliver highly relevant information across multiple channels. Our COVID-19 Resource Center is updated regularly with new content and I hope you continue to find the tools and information produced by ASHP valuable as needs related to the pandemic response evolve.

Thank you for being a member of ASHP and for everything that you do for your patients and our profession.

Sincerely,

Paul

 

April 24, 2020

New ASHP COVID-19 Updates

Dear Colleagues,

Paul W. Abramowitz, Pharm.D., Sc.D. (Hon.), FASHP

THE COVID-19 PANDEMIC CONTINUES to cause immense challenges across our nation. Today, I want to acknowledge the difficult situation facing many hospitals and health systems as a result of disruptions in routine or elective procedures and reductions in inpatient hospital stays. Of particular concern is the impact this situation is having on residency training.

Educating future generations of pharmacists is more critical than ever, and ASHP stands ready to support you in this time of need, including seeking ways to maximize the flexibility of our residency accreditation standards. Resident training is a critical component of pharmacy education, and we are hopeful that organizations will not furlough or terminate their current PGY1 and PGY2 pharmacy residents. Doing so could disrupt patient care and make residents ineligible for board certification and professional positions that require postgraduate pharmacy residency training. ASHP encourages accredited programs to adjust learning experiences in ways that give residents sufficient opportunities to complete their program.

We are here to assist you, and I encourage residency programs to reach out to Janet Silvester, vice president of Accreditation Services, or Stephen Ford, director of Residency Accreditation Services, for help. Please also read our guidance on the pandemic’s impact on residency training. We know how difficult things are right now, and ASHP wants to help you and your residents in any way we can.

Real-Time COVID-19 Information and Resources

ASHP continues to develop and disseminate important clinical guidance, real-time information, and lessons learned among pharmacists to help those working in current hot spots and to prepare others for potential patient surges.

Last week, we launched a weekly webinar series to provide information and guidance from your peers on the front lines, including live webinars offered by ASHP Consulting. Today’s live webinar from ASHP Consulting describes how health systems in Detroit and Southeastern Michigan — Beaumont Health, Ascension Michigan, and Henry Ford Health System — are managing supply chain and pharmacy operations during the pandemic. Please look for new webinars each week for an inside look at how pharmacists across the country are responding to the challenging circumstances surrounding this health crisis. Recorded versions of all webinars in ASHP’s COVID-19 webinar series are also available for those who can’t attend the live session.

Our popular daily @ASHPOfficial podcast continues to provide credible information on topics related to COVID-19. We have produced 25 episodes to date, with nearly 13,000 downloads of @ASHPOfficial in the past 30 days. We attribute this remarkable number to members and nonmembers taking a strong interest hearing about first-hand experiences from the front lines. We have listeners in every state in the country, indicating that ASHP members featured in the podcasts are reaching a broad healthcare community. I encourage you to subscribe to @ASHPOfficial to receive this free, timely content packed with valuable information, personal experiences, and lessons learned from your colleagues with direct knowledge of COVID-19.

Our newly enhanced COVID-19 Resource Center is updated often with new and revised tools to assist all healthcare professionals in responding to patient needs across the continuum of care. ASHP’s Assessment of Evidence for COVID-19 Treatments, which has been downloaded more than 16,000 times, is updated at least twice weekly and provides clinical guidance to help frontline practitioners better understand current therapeutic approaches and recommended care for patients with COVID19. I encourage you to visit the Resource Center regularly to ensure you are using ASHP’s most up-to-date tools.

As medication experts, pharmacists are frontline patient care providers and trusted sources of information for patients. One of our most important roles is educating patients about their disease states and how to optimize their medications. This week, we added a special section to SafeMedication.com, ASHP’s consumer-focused website, with information about COVID-19 for patients and their families. The special section features consumer content in key areas, including how to treat mild cases of COVID-19 at home, an explanation of potential treatments for COVID-19, information about cloth face covers, and more. We will continue to enrich the site with pharmacist-written content to provide patients with a timely, accurate, and trustworthy source of information.

ASHP Survey and Advocacy

ASHP continues to survey our members about the latest developments related to essential pharmacy resources, such as personal protective equipment (PPE). Our latest survey also addresses the inventory status of intensive care unit (ICU) drugs needed to treat mechanically ventilated COVID-19 patients. We found that the ICU drugs with the most critical shortages include cisatracurium, fentanyl, ketamine, vecuronium, and midazolam. The full details of the survey results are available on the COVID-19 Resource Center.

ASHP continues to respond to member feedback by advocating for the increased production and availability of PPE and for solutions to drug shortages resulting from this public health emergency. We were encouraged by this week’s announcement from the Food and Drug Administration about new flexibilities for 503A pharmacies — including those in hospitals and health systems — and recent guidance for 503B outsourcing facilities to support increasing the supply of critical medications. ASHP will work closely with the agency to seek additional flexibilities as needed.

New Products to Meet Your Needs

In closing, while we continue to do everything we can to support you during the COVID-19 response, we remain committed to supporting you throughout all facets of your career. In that spirit, this week, ASHP launched a new Pharmacy Revenue Cycle Management Certificate, our newest self-guided, online certificate program designed to increase knowledge and skills in calculating reimbursement, documentation and billing, Medicare rules and regulations, and more. We know that tools like these are critical as many hospitals and health systems also face severe financial difficulties during this public health emergency. We will continue to develop products and services that will help our members gain important knowledge and meet continuing education needs.

As always, I extend my sincere thanks to you for being a member of ASHP and for everything that you are doing for your patients and our profession.

Sincerely,

Paul

 

April 16, 2020

New ASHP Resources and Efforts to Help You Combat COVID-19

Dear Colleagues,

Paul W. Abramowitz, Pharm.D., Sc.D. (Hon.), FASHP

ASHP CONTINUES TO WORK ACROSS MULTIPLE FRONTS to help our members and all healthcare professionals to address the COVID-19 pandemic. We have intensified our advocacy efforts and continue to create new and timely resources to ensure that you are prepared to meet the demands of this sustained public health crisis.

Based on concerns expressed by ASHP members who are on the front lines of the COVID-19 pandemic, I’ve had calls with a wide array of industry stakeholders, including wholesalers, about ways to help ensure that providers have the medications they need to treat their patients. Please continue to let us know of challenges you may be facing related to COVID-19, and we will work to do everything we can to help address them at the national level.

To that end, today, we launched a new COVID-19 microsite to better organize our resources and optimize access for those who need them. The microsite features content for pharmacists and other healthcare providers in key areas, including patient care, infection prevention, policy and advocacy, and more. We will continue to enhance the site with new and updated content, which remains open to all professionals who are engaged in the COVID-19 response.

A critical focus of our continued support remains facilitating real-time information sharing among pharmacists, including those in the current epicenters, to help ongoing response efforts and prepare areas where the peak of the pandemic is yet to come.

In response to the COVID-19 pandemic, we have accelerated production on our popular @ASHPOfficial podcast, moving to a daily release schedule. We have produced 20 episodes to date dedicated to COVID-19 on topics that include managing drug shortages, evaluating the scientific literature, and ethical considerations. Last week, a member let us know that information from an @ASHPOfficial podcast helped her to change treatment protocols for patients at her long-term care facility, potentially saving many lives. I encourage you to subscribe to @ASHPOfficial to receive this free, timely content that includes credible information, best practices, and important experiences from your peers who are working on the front lines of the pandemic.

We have also recently launched a free webinar series dedicated to COVID-19 response. Tomorrow’s live webinar describes how New York’s Mount Sinai Health System and Montefiore Health System responded to their COVID-19 patient surge, and the coordinated efforts of New York City’s pharmacy leadership to support hospitals and health systems. Please be on the lookout for new webinars each week that will provide valuable perspective and intelligence on how pharmacists in varied settings are responding to the pandemic.

Our COVID-19 Connect Community has become a robust venue for discussion and information sharing among pharmacists. There are more than 52,000 community members actively engaged in 800 different discussion threads covering a range of topics. ASHP is also using this platform to help inform our efforts to develop and deliver crucial resources to assist those on the front lines.

I would also like to make you aware of another new initiative launched this week by ASHP. The Pharmacy Executive Leadership AllianceTM – or PELATM – was created for chief pharmacy officers and multi-hospital system pharmacy executive leaders who face distinct challenges working within highly complex, vertically and horizontally integrated networks and multi-hospital health systems.

PELA will leverage ASHP’s resources for information exchange on issues unique to this executive-level group. PELA participants will gain valuable insights on market trends and innovations for advancing medication use that is always optimal, safe, and effective for all people across our nation’s complex health networks. Key areas of focus will include health-system-wide integration of digital and telehealth, effective enterprise revenue cycle management, strategies for addressing industry disrupters, optimization of horizontal and vertical integration, and new technologies and science. Emerging issues related to COVID-19 business recovery will also be addressed.

Although ASHP has been planning the launch of PELA for some time, the unprecedented demands of the COVID-19 pandemic underscore the importance of providing opportunities to connect and share critical information for pharmacy executives. I look forward to sharing more information about this exciting initiative, as well as relevant outputs from the group, with our members in the future.

Finally, I wanted to share some news from the advocacy front. This week, the Drug Enforcement Administration (DEA) announced flexibilities for satellite hospitals or clinics as a result of COVID-19. During the national emergency, DEA will allow a DEA-registered hospital or clinic to handle controlled substances at a satellite hospital or clinic location under the organization’s current registrations. DEA is relaxing limits on the distribution of controlled substances between practitioners. Under the new flexibility, registered practitioners can distribute or dispense more than 5% of their total doses to another registered practitioner without registering as a distributor. Practically speaking, this will better enable health systems and hospitals to get controlled substances where they are most needed. DEA is also allowing distributors to ship controlled substances directly to these satellite hospitals or clinics. This is a significant change for many of our members who use additional satellite hospital and clinic locations to accommodate the large influx of COVID-19 patients presenting for treatment. Having these flexibilities will allow our members to more effectively treat their patients.

I am also pleased to note that, at the urging of ASHP and its members, USP has issued “Operational Considerations for Sterile Compounding During COVID-19 Pandemic,” a new document that supports risk-based enforcement discretion of compounding standards. The document addresses the assignment of beyond-use dates and considerations for certification and recertification of engineering controls, and reinforces CDC recommendations for cleaning and disinfecting a facility when someone is ill.

On Tuesday, ASHP, the American Pharmacists Association, and the National Community Pharmacists Association authored a letter to New York Sen. Chuck Schumer thanking him for recognizing pharmacists as providers of essential patient care services and asking him to support pharmacists’ critical role as frontline healthcare providers during the COVID-19 pandemic. ASHP will continue to work with Sen. Schumer and others to recognize the vital patient care role of pharmacists and to support the proposed Heroes Fund legislation that provides premium pay for essential front line workers – including pharmacists – during this current public health crisis, and we will continue our broader efforts to advocate for expanded patient access to pharmacist services.

In closing, please know that we remain committed to supporting you by providing robust, timely, and relevant resources to assist you in your practice, to advocate on your behalf, and to help you focus on your own health and well-being during this ongoing public health emergency.

Thank you for being a member of ASHP and for everything that you do for your patients and our profession.

Sincerely,

Paul

 

April 9, 2020

Important Wins on the Advocacy Front in the Fight Against COVID-19

Dear Colleagues,

Paul W. Abramowitz, Pharm.D., Sc.D. (Hon.), FASHP

AS THE IMPACT OF THE COVID-19 PANDEMIC CONTINUES TO ESCALATE ACROSS THE COUNTRY, there is increased urgency to ensure that frontline pharmacists, pharmacy technicians, and our healthcare partners have the medications and equipment they need to successfully treat their patients. ASHP continues to spearhead multiple advocacy efforts that support your ability to provide the best care possible for those in need.

Mitigating shortages of critical medications like propofol, fentanyl, midazolam, paralytics, and others remains a high priority. We continue to engage with relevant federal agencies to improve access to medications. I am pleased to report that the Drug Enforcement Administration (DEA) and the Food and Drug Administration (FDA) have taken critical actions in direct response to ASHP’s advocacy efforts.

ASHP, in coordination with the American Medical Association, the American Hospital Association, the Association for Clinical Oncology, and the American Society of Anesthesiologists, sent a letter last week to the DEA requesting an immediate increase in the annual production quota allocations for Schedule II controlled substances. This would enable manufacturers and 503B outsourcing facilities to increase the supply of opioids critical to the care of COVID-19 patients on ventilators. As a direct result of this collaborative advocacy effort, the DEA announced yesterday that it is taking immediate actions to address this critical issue. These actions include increasing the annual production quota for controlled substances, including fentanyl, morphine, and hydromorphone, that are used for the treatment of mechanically ventilated COVID-19 patients, and increasing the amount of ketamine, diazepam, and other controlled substances that can be imported into the United States.

We also sent a letter to the FDA advocating for regulatory flexibility in compounding drugs in shortage and compounding in hospitals. ASHP’s advocacy efforts, including significant staff engagement on the issue, directly triggered the FDA to clarify existing compounding guidance, including the removal of the one-mile radius requirement for hospitals compounding medications. FDA’s quick action to reduce regulatory hurdles for health systems is an important step to help clarify compounding guidance during this crisis.

ASHP will continue to advocate for additional compounding flexibility, including the expansion of FDA’s drug shortage list to include products ASHP has identified as in shortage. We will also continue to seek 503B outsourcing facility flexibility, particularly for hospital-owned or affiliated 503B operations, to help ensure they can meet hospitals’ medication needs.

Yesterday, we were pleased to see that the Department of Health and Human Services (HHS) authorized pharmacists to order and administer COVID-19 tests pursuant to the Public Readiness and Emergency Preparedness (PREP) Act. The authorization is responsive to the joint COVID-19 recommendations we created with other national organizations. While this authorization does not address pharmacist reimbursement, we are encouraged to see HHS providing pharmacists with a greater role in supporting the COVID-19 response, and we continue to work on that issue.

We also continue to actively advocate for Congress to recognize pharmacists as providers in the Medicare program to further support the COVID-19 response and beyond. Yesterday, ASHP and 11 other national organizations sent a letter requesting that Congress immediately support legislation that would establish pharmacists as providers in Medicare Part B on an emergency basis to provide COVID-19 and flu testing. This authority is an important step in being able to rapidly expand access to testing across our country to support the national response to this crisis. We also see this as a step toward expanded recognition of pharmacists by payers, including Medicare.

Finally, ASHP is also working with our members and other stakeholders to gain access to medications from the Strategic National Stockpile (SNS). Most recently, we joined with several organizations to request that FEMA immediately release all available quantities of a number of critical drugs from the SNS to the New York and New Jersey Departments of Health to address urgent patient care needs. We are also working to support other state affiliates and members across the country with these important requests.

ASHP and its government relations team will continue to work tirelessly with our collaborating partners to ensure that U.S. regulatory authorities are responding to the current needs of pharmacists and healthcare providers.

While our collective attention is on the needs of frontline practitioners, I wanted to take an opportunity to highlight some positive news about the newest members of our profession. ASHP’s 2020 Residency Match concluded this week, and I want to congratulate the 5,269 future pharmacists who matched with 2,551 PGY1 and PGY2 pharmacy residency programs across the country. This number represents a 46% increase in the number of available positions over the past five years – a remarkable rate of growth. I am pleased that our accredited residency programs have demonstrated an outstanding commitment to training during the pandemic. While managing multiple critical priorities, these programs continued to interview applicants virtually. This undoubtedly will be a unique time during which to begin a residency program regardless of its focus. ASHP is committed to ensuring that these young practitioners and their programs have the needed resources to successfully conduct critically important resident training this year and beyond.

In the same vein, please know that ASHP stands ready to offer you and your healthcare colleagues that same level of steadfast support. In addition to advocating to give you access to critical medications, ASHP continues to update and create new resources and tools that can be found on our COVID-19 Resource Center. We have also opened access to many evidence-based online resources and tools on ashp.org, making them widely available to all pharmacists and the broader healthcare community.

Over the last few weeks, I have heard countless stories from members and others about the challenges they are facing, but I’ve also heard many stories of hope and heroism. I, and David Chen, ASHP assistant vice president for Pharmacy Leadership and Planning, have listened in on calls from pharmacy leaders at major health systems in New York City, the pandemic’s current epicenter. We are incredibly impressed by how these leaders have shared their information and experiences and how they support each other and their frontline staff. This is a tremendous example of how peer-to-peer connection and communication can aid in the pandemic response. Their experiences and willingness to share their stories will undoubtedly help others in responding to COVID-19 in facilities across the country. We applaud them for these efforts.

Please also know that ASHP is here to support your well-being, which should remain a priority for all healthcare personnel during this challenging time. Please make sure that you are taking care of yourself and your family.

“ASHP has our backs.” These are the words of a member who recently reached out to us. This really resonated with me, and I can assure you that we will continue to work across all fronts, leveraging our talented staff, our valued partners, and our amazing members to provide you with the information, connections, and resources you need today and in the future.

Thank you for everything you do for your patients and the profession.

Sincerely,

Paul

April 3, 2020

ASHP Update on COVID-19

Dear Colleagues,

Paul W. Abramowitz, Pharm.D., Sc.D. (Hon.), FASHP

WEDNESDAY EVENING I had the opportunity to participate on a director of pharmacy roundtable call with members of the New York State Council of Health-System Pharmacists. On the call, the current situation on the ground and lessons learned regarding the COVID-19 pandemic were shared by New York City pharmacy leaders. These individuals and their teams are true healthcare heroes. They are dealing with patient care situations that are beyond compare. Patient care needs have required an increase of propofol, fentanyl, and midazolam utilization by 400-600% in the past 14 days as they manage the demands of the intensive care unit and ventilated patients. One healthcare system shared that three weeks ago, it had 18 COVID-19 positive patients. As of Wednesday, they had 1,100.

We have all watched and listened to reports from New York, New Jersey, and other COVID-19 epicenters responding to this national pandemic. Listening firsthand to the heroic efforts of pharmacists on the front lines underscores the urgent need to proactively provide data to our health system, local, state, and national leaders on the pharmacy staff resources and drug supply needed to meet the needs of our COVID-19 patients. These extraordinary times will require remarkable coordination and responsiveness among our industry partners and government agencies.

ASHP has put the full weight of our advocacy efforts toward resolving these issues. This week, ASHP and the American Hospital Association, the American Medical Association, the Association of Clinical Oncology, and the American Society of Anesthesiologists, sent a letter to the Drug Enforcement Administration (DEA) requesting an immediate increase in controlled substances (CII) annual production quota allocations to manufacturers and 503B outsourcing facilities to increase the supply of opioids critical to COVID-19 patients on ventilators. ASHP’s letter notes the tightening CII supply and the need to increase production of fentanyl, hydromorphone, and other supportive CIIs as quickly as possible to avoid exacerbating existing shortages. ASHP will continue to work with the DEA, the Food and Drug Administration, manufacturers, and distributors to provide hospitals with the CIIs and other medications that are in short supply and critically needed to treat patients during the COVID-19 response.

Yesterday we sent a letter to Vice President Mike Pence, imploring him to encourage agencies to coordinate their efforts to increase manufacturing capacity for critical medications, including opioids, sedatives, and paralytics, to the greatest extent possible.

A colleague in New York expressed that a “tsunami” of drug shortages is coming as more hospitals and health systems struggle to manage the exponential rise in patient load. It is ASHP’s number-one priority to keep this issue at the forefront of public attention, and we will activate all of our partners and resources to help ensure you have the medications your patients need.

Launch of New Free Service: ASHP CareerPharm Rapid Connect

ASHP has been working on many fronts to assist you, our members, and all healthcare professionals to combat the COVID-19 pandemic. We continue to create new resources to support your valuable work on the front lines of patient care.

As the impact of the pandemic escalates, we are hearing from healthcare organizations nationwide that pharmacy departments are struggling to keep pace with the demands of the growing COVID-19 patient population. In response, I am pleased to share that ASHP has quickly developed and launched a new free service, ASHP CareerPharm Rapid Connect, to help healthcare organizations connect with pharmacists who can provide critical services including surge support with temporary onsite staffing, remote medication order review, remote clinical pharmacy specialist services, and other staffing needs. ASHP’s CareerPharm Rapid Connect also will help organizations connect with pharmacy technicians. We hope this free service will provide opportunities for hospitals, health systems, and others to fill a growing demand for pharmacy personnel during this urgent time of need.

PPE Shortages

In addition to the troubling issue of drug shortages related to COVID-19 patient care, ASHP members and other healthcare providers continue to face shortages of personal protective equipment (PPE). As I noted in last week’s blog, we are continuously surveying our members to understand the real-time impact of this issue. According to our most recent survey results, 58% of respondents whose organizations perform sterile compounding reported the need to reuse masks, and 42% reported a major or moderate disruption in the availability of medical masks. This is a substantial increase from the first survey, where 15% of respondents indicated disruptions in their supplies. We will continue to survey this situation and provide you with updates in the weeks ahead.

Given the data, ASHP is advocating for increased production and supply of PPE to ensure pharmacy personnel and other healthcare providers have adequate protection from exposure. We also continue to advance ASHP’s policymaker recommendations that address shortages of PPE for pharmacists and drug shortages to Congress, HHS, and the Vice President’s COVID-19 Task Force. Over 5,000 ASHP members have contacted their members of Congress to share those recommendations. If you haven’t yet, please consider reaching out to your members of Congress to ensure your concerns are heard.

We also created a dedicated section on ASHP’s COVID-19 Resource Center with the latest sterile compounding and PPE guidance and health policy statements. Resources include additional tools that ASHP created to support your needs as well as guidance from others, including the United States Pharmacopeia Compounding Expert Committee’s recommendations in response to shortages of garb and PPE for sterile compounding.

In addition, we continue to work on creating tools and resources to protect and assist you, our members, and all healthcare professionals as you work on the front lines of patient care. Today, we released our newest recommendations for pharmacists and pharmacy technicians on ways to prevent exposure to COVID-19 while in the workplace as well as recommendations on how to protect your family and friends to reduce exposure at home. Given the rapidly evolving guidance and recommendations supporting this effort, we will be updating these materials regularly.

Extending the Reach and Impact of the ASHP Community

ASHP supports our members by serving as a professional home and facilitating a sense of community. During this challenging time, we’ve expanded that community to include and support the interprofessional teams that are working together to treat patients in the face of unprecedented challenges.

In this spirit, you may recall that a few weeks ago, we opened access to our evidence-based online resources and tools on ashp.org, making them widely available to all pharmacists and the broader healthcare community. It gives us great satisfaction to know that members and non-members alike are using and sharing many of our important COVID-19 resources. More than 32,000 professionals have taken advantage of our free offering of ASHP’s Critical Care Pharmacy Specialty Review Course, Practice Exam, and Core Therapeutic Modules package, including more than 24,000 who are not currently ASHP members.

ASHP will continuously offer credible, trusted resources and share best practices, advice, and experiences from those on the front lines across the country. We recently launched a daily COVID-19 podcast on our @ASHPOfficial podcast channel with episodes featuring ASHP members and pharmacy practice leaders who discuss the evolving clinical, operational, and leadership challenges surrounding the COVID-19 pandemic. In the latest podcast episode, nationally recognized drug shortage expert Erin R. Fox and ASHP experts share the most recent information on drug shortages related to COVID-19 and the impact the recent relief bill passed by federal legislators will have on managing the supply chain. I encourage you to subscribe to @ASHPOfficial to receive this free, timely content.

As a reminder, we also recently established a COVID-19 Connect Community that ASHP members — and all healthcare providers — can use to ask questions, receive answers, share experiences, post resources, receive updates, and learn best practices related to COVID-19. Since it was launched less than two weeks ago, this active community has grown to more than 51,000 members and has generated nearly 500 discussions. It’s a wealth of real-time, real-life information. Please join and participate if you haven’t already.

Summer Meetings

Finally, I’d like to address our decision announced earlier this week to cancel the Summer Meetings in June. Our top priority is the safety of our meeting participants and staff, and supporting your patients’ needs. We are working on a plan to deliver many of the important activities from the Summer Meetings virtually, including educational programming and the House of Delegates. We’ll share the details as they become available.

In the meantime, please take care of yourself and your families. Be assured that we will continue to work tirelessly on your behalf. Thank you for everything you do for your patients and the profession.

Sincerely,

Paul

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