Your pharmacy: The one-stop-health-shop

By Ruth Reader , Ben Leonard and Grace Scullion

Rina Shah | Walgreens

Covid-19 has meant big business for pharmacies, which have played a crucial role in fighting the disease.

The Department of Health and Human Services used its emergency authority during the pandemic to expand what pharmacists could do to test, treat and vaccinate, in some cases preempting state restrictions.

Pharmacies say their performance has shown they can safely do more to serve Americans’ health care needs going forward, and they’re looking for Congress to agree.

Rina Shah, Walgreens’ vice president of pharmacy of the future, spoke with Future Pulse about the chain drugstore’s plans. The interview has been edited for length and clarity.

Do laws need to change for Walgreens to do more as a health care provider?

The silver lining around Covid was that the federal government removed some of those administrative restrictions and really allowed us to be able to administer millions of life-saving vaccinations and testing services.

However, when that all peels back, the scope does vary by state. And so we have been working on federal reform, so that we can have consistency across the health care system to ensure that our pharmacists are recognized as health care providers. In parallel, we're also working at the state level, state by state, to be able to ensure consistency.

What should that reform do?

It is focused on Covid, flu, respiratory illnesses and being able to provide vaccinations for pediatrics — similar to what we did during the pandemic. And it’s around test-to-treat and counseling services along with that.

How would it work?

Let’s say a diabetic patient should be getting their A1C [blood sugar] levels tested on a quarterly basis. And so with test-to-treat, the intent is that we’d be able to provide testing and then, based on the results, help that patient navigate where they need to go next.

Do pharmacists have the training to do more?

Pharmacy is about the comprehensive care that you can provide to a patient. At pharmacy school, you’re on rotations with physicians, with nurses, with the entire care team to care for a patient. A patient visits a pharmacy three to four times more than they do their physician or other care providers.

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Today in our Pulse Check podcast, Megan Messerly talks with Lauren Gardner about an Arizona ballot initiative that would limit how much interest creditors can charge people with overdue medical bills. Plus, David Agus, the Ellison Institute’s CEO, on using the technology behind Covid passports to remind people they are due for all sorts of inoculations.

Remdesivir was the first drug approved by the FDA to treat Covid-19. | AP

Black patients were less likely than white patients to receive evidence-based treatment for Covid-19, which added to worse outcomes, researchers from the University of Pittsburgh and Yale found in a study of more than 43,000 hospitalized veterans.

The study, published in JAMA Network Open on Tuesday, found that Black patients were less likely to receive the antiviral remdesivir, steroids and immunomodulators that work to calm the immune system. The disparities are attributable to differences both in treatment within and between hospitals, the authors said.

“There’s the hard truth probably of providers’ bias, unconscious or implicit, that also factored into the decision-making and maybe contributed to some of these differences,” Florian Mayr, a study author and assistant professor of critical care at the University of Pittsburgh, told Future Pulse . “It’s another reminder that disparities exist, and we have to do more work to try to reduce these disparities.”

The authors looked at the care provided at 130 VA facilities between March 2020 and March 2022. Of those who received supplemental oxygen:

• 57 percent of white patients were prescribed remdesivir compared to 46 percent of Black patients.

• 70 percent of white patients received steroids as opposed to 60 percent of Black patients.

• 10 percent of white patients were given immunomodulators versus 7 percent of Black patients.

Confounding results: The researchers wrote that despite those differences in treatment, they “did not observe consistent differences in clinical outcomes between Black and White patients.”

In the U.S. population as a whole, death rates were much higher for Black patients early in the pandemic but are now on par with white patients, according to CDC data crunched by The New York Times.

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If the Covid-19 pandemic didn’t create a partisan trust gap in science, it certainly revealed one.

Democrats have been more willing than Republicans to follow the guidance of government scientists on social distancing and masking. And they’ve gotten their Covid vaccines in greater numbers.

But a new survey from the Pew Research Center finds that while there’s a big difference in how partisans view scientists, there’s also a significant divide among racial groups within the Democratic tent.

Black and Hispanic Democrats were only half as likely as their white counterparts to have a great deal of trust in scientists to act in the public’s best interest. That put them closer, in percentage terms, to white Republicans.

Pew wasn’t able to reach a reliable sample of Black and Hispanic Republicans for comparison’s sake.

Still, only 23 percent of Black Democrats and 14 percent of Hispanic ones had little or no confidence in scientists — the rest said they had “a fair amount” — compared to 37 percent of white Republicans with little or no trust.

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