Pharmacists warn supply, pay and staffing hamper COVID treatment access

John Vinson, CEO of the Arkansas Pharmacists Association, told the committee that sotrovimab (IV infusion) is in very short supply and that most doses are concentrated in hospitals. Vinson said one community pharmacy in Sevier County and a handful of others have had limited sotrovimab stock, but the "vast majority" of the tiny supply is in hospital systems.

Vinson described the oral antiviral rollout: initial federal retail partnerships with Walmart because chain systems were ready just before Christmas, followed by rapid onboarding of independent community pharmacies and some federally qualified health centers (FQHCs). He estimated roughly 100 pharmacies and some FQHCs in Arkansas were participating early in January, with inventories and map postings updated frequently.

Panelists warned the committee that dispensing these therapies is labor intensive — ‘‘about 30–45 minutes per patient’’ for medication review, counseling and online reporting — while many payers set very low or no dispensing fees. Vinson said payment varied: Arkansas Blue Cross/BCBS and the state employee plan have taken some steps (examples of $10–$12 dispensing fees), but many commercial plans nationally have provided $0–$1, which undermines a sustainable business model.

Howell Foster of the Arkansas Poison and Drug Information Center added that community pharmacies provided substantial access when earlier monoclonals were effective and urged clearer reimbursement to maintain access as supplies grow. The panel urged clearer public information channels (ADH’s therapeutics map and Walmart’s tracker were cited) so clinicians and patients can find current inventories.

The pharmacists asked the committee to consider payment and staffing supports so community pharmacies can continue to dispense complex antiviral treatments when supply increases.