CMS Guidance Sets Up Oral Antivirals for Failure, Limiting Patients’ Access to COVID-19 Treatments

WASHINGTON, D.C. (Nov. 30, 2021) – A group of six pharmacy organizations today criticized the decision of the U.S. Centers for Medicare & Medicaid Services (CMS) to only “encourage” but not require payment to pharmacists for testing, patient assessment, ordering/prescribing and dispensing for oral COVID-19 antiviral drugs, potentially limiting the ability of Medicare patients to access these lifesaving medications– particularly those in rural and underserved communities.

The issue is extremely time sensitive, because a committee of the Food and Drug Administration is meeting today to determine whether to issue an Emergency Use Authorization for molnupiravir, an oral antiviral medication developed by Merck.

The group stated, “After more than a year of continuously expanding the ability of patients to access COVID-19 tests, immunizations, and therapeutics from pharmacists and other pharmacy personnel, the failure of CMS to require pharmacists to be compensated for testing, patient assessment, and ordering/prescribing, in addition to dispensing oral antivirals makes little sense and sets up the distribution program for failure.

“CMS needs to clearly delineate a payment pathway necessary to allow pharmacists’ patients to access these lifesaving medications. Ninety percent of Americans live within five miles of a pharmacy, making them the most viable access point for patients to receive these medications. In addition, the neighborhood pharmacy in rural and underserved communities may be the only health care provider for miles.

“The federal government has made it clear we need all-hands-on-deck to defeat COVID-19 and advance health equity by authorizing pharmacists and other pharmacy personnel to order and administer oral antivirals. Without hesitation, throughout the pandemic, our nation’s frontline pharmacists have stepped up to meet the public health needs of our patients.”

Supporting organizations:
American Pharmacists Association
American Society of Consultant Pharmacists
American Society of Health-System Pharmacists
College of Psychiatric and Neurologic Pharmacists
National Alliance of State Pharmacy Associations
National Community Pharmacists Association

Media contacts:
APhA: Frank Fortin, ffortin@aphanet.org; (202) 223-7189
ASCP: Jim Lewis, jlewis@ascp.com; (724) 288-3995
ASHP: Aretha Hankinson, press@ashp.org; (301) 452-0569
CPNP:  Brenda Schimenti, bschimenti@cpnp.org; (402) 476-1677
NASPA: Rebecca Snead, rsnead@naspa.us; (804) 285-4431
NCPA: Andie Pivarunas; andrea.pivarunas@ncpa.org; (703) 600-1174

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