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Managed Care Insights During COVID-19: Art Shinn, PharmD, FASCP

April 07, 2020

By Edan Stanley

artArt Shinn, PharmD, FASCP,  president, Managed Pharmacy Consultants, LLC, and First Report Managed Care editorial advisory board member, shares how his managed pharmacy consulting firm has been affected by COVID-19.

As of April 7, 2020, there are 374,329 COVID-19 cases and 12,064 deaths in the US, according to the CDC

Can you please share your recent experiences with COVID-19 and how it has changed the way you operate?

I run an administrative consulting company. I've worked with aging people a long time. The major thing I've seeing is around the pharmacy benefits. It's really impacting and we're having a lot of issues around prior authorizations, renewing, and drug shortages.

The big thing we have done—and the PBMs have come out with this focus—is extending the prior authorizations 90 days from when they are going to expire.

Big pharma is contacting the physicians' offices. There's no one working in the office. They're not taking calls. They're backlogged. They're just going to voicemail and answering service.

We are putting in an extension for prior authorizations for 90 days. For example, if the prior authorization was going to expire May 15th, it now will be extended till August the 15th, and we're doing that across the board.

Now there are certain prior authorizations that we are limiting and not renewing and extending, mainly Class 2 narcotics.

The other issue we're seeing is there seems to be now a run on hydroxychloroquine and azithromycin, a few of the other drugs. We are putting quantity limits in place, and we're working with a lot of the recommendations that CVS has come out with around that.

We are having quantity limits extended on some of the drugs that we're noticing are becoming more in demand. Between that and the prior authorizations, that's where we are at this point.

With new prior authorizations, for example, someone just gets put on a drug that has prior authorization necessary for it, trying to get that through the system is probably going to be an issue. It's not only the extension of the prior authorization, it's the new prior authorizations.

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