As the U.S. prepares for community spread of the Coronavirus Disease 2019 (COVID-19), plan sponsors may be questioning if there is anything that they need to do with respect to their pharmacy benefit. Below are a few things to consider.
Test kits for COVID-19 are only available for use by laboratories designated by the CDC as qualified and certified under the Clinical Laboratory Improvement Amendments (CLIA) to perform high complexity tests. At this time, the test is not available in U.S. hospitals, other primary care settings, or through retail pharmacies.
Since testing is not performed in the ambulatory setting, there are no current changes recommended for the pharmacy benefit. Plan sponsors may want to consider how test kits and processing fees would be managed under the medical benefit by inquiring with the medical insurance provider.
There is no specific antiviral treatment recommended for COVID-19. People with COVID-19 should receive supportive care to help relieve symptoms. As an outpatient, supportive treatment will likely mean rest, fluids like good-ole’ chicken noodle soup, and OTC fever-reducing medications such as acetaminophen. In some cases, inhalers may be prescribed. For more severe cases, patients infected by COVID-19 may require hospitalization and will be quarantined.
Some Pharmacy Benefit Managers (PBMs) are adjusting their policies to allow for early refills of maintenance medications for members in states with the highest prevalence of COVID-19 diagnosis. The PBMs are also arranging alternate delivery methods for specialty drug products in these areas. Truveris supports the temporary ease of access to maintenance and specialty medications that are not controlled substances during this time.
The best way to prevent illness is to avoid being exposed to the COVID-19 virus. The CDC has published recommendations to help prevent the spread of the respiratory disease. The best thing you can do: wash your hands – often.
Stay up to date with updates on COVID-19.
A clinical professional with a diverse background in the pharmacy industry, Alysha brings experience ranging from retail pharmacy to working with Fortune 500 companies to identify and achieve the goals of their pharmacy benefit plans. Alysha leads the company’s thought leadership initiatives and is responsible for strategic account management. Before joining Truveris, she worked in Aon Hewitt's National Pharmacy Practice and practiced as both a hospital clinical pharmacist and a retail pharmacist.