Barriers are in place at the cash register and the prescription drop-off area at Riverside Pharmacy on Green Street in Gainesville.
Owner Scottie Barton’s staff are encouraged to wear facemasks while persistently spraying and wiping down countertops and door handles.
The delivery drivers are instructed to avoid contact by leaving the items at the door, as home deliveries have boomed.
Riverside normally has 20-25 deliveries a day; the new normal under the coronavirus puts that number closer to 35-40.
“A lot of our customers at this time are just wanting to get the 90-day fills and try to prepare for longterm events, I guess,” Barton said.
The main drug concern has been hydroxychloroquine, which is needed for those with immunodeficiency conditions prior to the coronavirus outbreak.
“With the run on that drug, the patients that we have on that we’ve been trying to fill those for 90-day supplies because the supply on it has been down for the past few weeks. We’ve just wanted to make sure that they’ve been able to stay on those medications,” McElveen’s Pharmacy owner David Stanley said.
Pharmacies are competing against each other to get the drug, which has driven the price up considerably, Stanley said.
“We haven’t seen a whole lot of prescriptions come in for the off-label use, whether it be prophylactically or to treat COVID-19. I may have gotten two or three of them, but the price that some of the manufacturers are asking for is like 10 to 20 times what I paid for it just three months ago,” he said.
Federal contracting records show the U.S. Department of Veterans Affairs and the U.S. Bureau of Prisons have placed emergency orders for more than $250,000 worth of hydroxychloroquine sulfate tablets from private suppliers over the last two weeks, with both agencies apparently planning to use the drug to treat COVID-19.
The Food and Drug Administration recently authorized the drug’s experimental use for COVID-19 in response to anecdotal reports of its effectiveness — while warning in one notice that “we do not know if it works for COVID-19.” FDA Commissioner Dr. Stephen M. Hahn warned last month that “it might do more harm than good.”
“We’re hoping within the next two to three weeks that that will be back on the market, which will help us out tremendously for our patients who are taking that drug for rheumatoid arthritis or lupus,” Barton said.
Gov. Brian Kemp has signed a handful of executive orders that have loosened regulations for pharmacies and their employees in response to the COVID-19 outbreak.
“All licensed Georgia pharmacists are hereby permitted to dispense a 90-day supply of a prescription drug in the event that the patient has no remaining refills and the pharmacist is unable to contact the issuing practitioner to obtain refill authorization,” reads one executive order signed March 20. The emergency authorization can only be used once per prescription
The same executive order allowed pharmacists to dispense early refill prescriptions for prescription drugs, but both rules do not apply to Schedule II controlled substances.
Schedule II drugs are defined by the Drug Enforcement Administration as substances “with a high potential for abuse, with use potentially leading to severe psychological or physical dependence.” Examples include oxycodone, Adderall and Dilaudid.
Regarding Schedule II drugs, Northeast Georgia Physicians Group Dr. P. Tennent Slack said electronic prescribing has allowed for a three-months supply to be sent in, but the patient would still have to go to the pharmacy every 30 days. That saves the patient a trip to the doctor’s office.
“It’s been fortunate that the electronic component has pretty much got up and running before all this stuff happened, because it does mean one less place for the patient to have to go. And no patients want to go near a hospital or a doctor’s office if they can avoid it,” said Slack, who specializes in pain management.
Slack has been doing exclusively telehealth through NGPG for the past couple of weeks and will be doing so at least through the end of April.
“People appreciate that you’re trying to talk to them, but they also understand there’s very little I can do because I don’t have access to procedures, and that’s probably the most effective way to get an acute pain flare-up under control. All I can do is prescribe medication,” Slack said.
While deliveries have gone up some, Stanley said the biggest change has been people receiving their over-the-counter items and medications curbside. There are also new faces and increased foot traffic from people desperate to find rubbing alcohol, gloves, masks and hand sanitizer.
An executive order signed March 31 suspended some regulations to “allow pharmacy technicians and pharmacists to complete computer-based processing of prescriptions at alternative locations, including from the residence of the pharmacy technician or pharmacist.”
Stanley said they have not taken advantage of this executive order, as it would take some effort to set up the software and secure the connection.
“It would be an added expense, and we haven’t been so bogged down that we haven’t been able to do it there at the pharmacy,” Stanley said.
The Associated Press contributed to this report.