In the News

As HIV Infection Rates Rise in Colorado, Pharmacies Can Now Prescribe Preventative Pills

Posted: November 18, 2020

Colorado this month became one of the first states in the nation to let pharmacists prescribe HIV prevention drugs, part of a public health effort to curb rising infection rates nearly a decade after breakthroughs in medicine that can stop HIV’s spread. 

 

Starting this week, pharmacies can begin offering the daily preventative pill or an emergency version that works only if taken within 72 hours of an exposure to the virus. 

The goal is to provide greater access to the medication by allowing people who are at risk of HIV to simply walk into a pharmacy and get the medication after a short consultation with a trained pharmacist. 

While wide swaths of rural Colorado might have just two or three primary care doctors, they typically have about a dozen pharmacies. And 90% of people live within five miles of a pharmacy, according to the Colorado Pharmacists Society. 

 

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Colorado Patients Can Now Get Preventative HIV Medications From Pharmacists

Posted: November 12, 2020

On Saturday, a new statewide protocol will be officially enacted making Colorado one of the first states to allow pharmacists to prescribe PrEP and PEP, preventative HIV medications. 

PReP, or pre-exposure prophylaxis, is more than 90 percent effective in preventing an HIV infection, and PEP, post-exposure prophylaxis, can reduce the risk of getting HIV after exposure by more than 80 percent — and yet the drugs are underused

“It's pretty well known that these drugs just aren't being used as much as they should,” said Emily Zadvorny, executive director at Colorado Pharmacists Society. “We don't know all the reasons why, but opening up another avenue of access to clinical care and these medications within communities, within trusted relationships, within a more flexible setting, that's really important in these situations, which can be a very timely situation that you need to get the medications.”

 

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Pharmacies Grapple With Red Tape as States Try to Allow Pharmacists to Prescribe PrEP

Posted: September 30, 2020

Featured is CPS Executive Director, Emily Zadvorny, and CPS Past-President, Gina Moore, with their comments regarding the pharmacist's role in PrEP

"...As for big pharmacy chains, it’s not clear when or whether they will opt in, said Gina Moore, Pharm.D., M.B.A., assistant dean for clinical and professional affairs at the University of Colorado Anschutz Medical Campus. Moore, who served as president of the Colorado Pharmacists Society as the bill was being crafted, said that state laws allowing pharmacists to prescribe contraception and smoking cessation meds could provide some clues. “[For smoking cessation and contraception], we’ve seen three big chains that have opted in: King Soopers/Kroger, Albertsons/Safeway, and Costco, plus independent pharmacies,” she said. “As for Walgreens and CVS pharmacies offering PrEP, we aren’t sure what they will do yet, but if they opt in, very likely they will come up with their own training. HMOs will do their own thing.”

The current executive director of the Colorado Pharmacists Society, Emily Zadvorny, Pharm.D., BCPS, affirmed that there was no carrot or stick to encourage pharmacist buy-in. “Our board will promote the availability of protocols, and, fortunately we have seen a lot of interest from independent pharmacies, especially in central Denver.” Moore and Zadvorny said that getting pharmacist input early in the bill-crafting process was helpful in raising awareness." 

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Colorado Agencies Monitoring Drug Shortage Concerns as DEA Takes Steps to Increase Production

Posted: April 7, 2020

DENVER (KDVR) – The Colorado Hospital Association and the Colorado Pharmacists Society are monitoring concerns from hospitals about the availability of drugs used to place patients on ventilators in Colorado.

“As the numbers (of COVID-19 cases) keep increasing, the concern gets higher and higher,” Emily Zadvorny, the executive director of the Colorado Pharmacists Society, said.

Sedatives and pain killers like fentanyl, hydromorphone and morphine are on the FDA shortage list, said Zadvorny. Other drugs used to help sedate and reduce pain for ventilated patients include ketamine, propofol, precedex, lorazepam and midazolam, she said.

In Colorado, “nobody has run out, per se,” said Zadvorny. “The medical and pharmacy staff (are) working together for alternatives to the standard of care. So, (we’re) looking at - can we use a different medication? Can we compound any medications? Can we use something different? But just grave concern that's there’s very limited supplies."

National organizations like the American Society of Health System Pharmacists have raised concerns about drug availability and access to federal agencies like the Drug Enforcement Administration, warning of “supplies dwindling quickly.”

A spokesperson for ASHP said the DEA has been responsive.

“Agency officials have set up a regular meeting to share information and data,” Aretha Hankinson said, explaining that the DEA has been approving Aggregate Production Quota (APQ).

Aggregate Production Quotas, according to the DEA, “represent the total amount necessary to meet the country’s medical, scientific, research, and industrial needs, lawful export requirements, and the establishment and maintenance of reserve stocks.”

The DEA announced Tuesday it would increase the 2020 APQ by 15 percent for various drugs needed to treat COVID-19. It also said it would approve increases in imports of medications necessary for patients on ventilators.

“DEA is committed to ensuring an adequate and uninterrupted supply of critical medications during this public health emergency,” Acting Administrator Uttam Dhillon said. “This will ensure that manufacturers can increase production of these important drugs, should the need arise.”

“The real call is please, please increase the production of these medications as quickly as you can and get those allocated to the most critical hospitals and the most critical areas,” Zadvorny said.

“We’re carefully watching our supply," Julie Lonborg, a representative for CHA, said.

While there are no current shortages in Colorado, Lonborg said facilities in northern Colorado, the Denver metro area, Vail and Eagle have expressed the most concern.

“And that’s consistent where the (COVID-19) hot spots are,” she said.

Lonborg said CHA has been in touch with drug manufacturers and federal legislators, requesting that the production of drugs be increased even though some of the necessary drugs are opioids.

“I think all of your viewers would recognize the effort that that we as a country have placed on reducing our dependence on opioids and all of the work that had gone into that. And that included a reduction in the production of those drugs as well,” she said. “Because of the need for those drugs during this specific event and this pandemic, we’ve actually asked the manufacturers to ramp back up the production of those things.”

Lonborg said Colorado hospitals previously established a memorandum of understanding among themselves as part of a pandemic preparedness plan. The MOU allows hospitals to share supplies, including medications.

“We also have a number of health systems in our state who are part of national health organizations, and they’re able to draw on their national organizations to try to fill any supplies,” she said.

 

FOX 31 Article: Lupus patients nervous over run on Trump-dubbed ‘game-changer’ COVID-19 drugs

Posted: March 27, 2020

Check out the article below, featuring CPS Executive Director, Emily Zadvorny, which covers the prescribing of hydroxychloroquine and prescribing in Colorado. 

 

DENVER (KDVR) -- Patients who use the medication hydroxychloroquine to combat debilitating symptoms associated with lupus or rheumatoid arthritis say they’re worried about a potential shortage of the medication after President Donald Trump suggested it could be possibly a “game-changer” in the fight against COVID-19.

“It’s scary and it’s stressful, and I worry about myself. I worry about my patients. It makes me very nervous,” said Alaina Schilling, a pregnant medical assistant who uses the drug to prevent bad rashes, joint pain and fevers that sometimes prevent her from getting out of bed.

“I can’t stop this medication right now. It’s the only medication for lupus that is approved for pregnancy and breastfeeding, so if we run out of the drug, I can’t take anything else for my lupus right now, so it would go haywire,” she said.

Schilling, who works at the Arthritis and Rheumatology Clinic of Northern Colorado, said she fielded at least 40 calls in the last 24 hours from other concerned patients who have had trouble filling their prescriptions. The facility handles patients around Colorado, Wyoming, South Dakota and Arizona.

“There is starting to be a shortage of the drug in the smaller towns,” she said. “Cheyenne, Wyoming is having a hard time getting the drug in,” she said. Schilling said mail-order pharmacies are also having difficulty keeping the medication in stock. “That is really scary because that’s some of the only drugs that are working for these people," she said.

On Thursday, the Colorado Pharmacists Society sent a letter to the governor, asking for limitations on how the prescriptions are dispensed.

“A lot of states are doing this,” said Emily Zadvorny, the group’s executive director. “What we are asking for is that if there are prescriptions for these medications that they indicate on the prescription that they have a legitimate medical purpose and what that diagnosis is."

“We’re also asking to not start new prescriptions for those medications, but if they are being continued before March 8, 2020, then they can continue those," she added.

Zadvorny said any prescriptions written for COVID-19 patients should only be dispensed to patients who have recently been hospitalized.

“There is a little bit of evidence, again, in the truly sick people, that his might be part of a treatment algorithm. So those are the things we’re asking for in our letter to the governor’s office,” she said.

 

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