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Tucked away in the heart of Raleigh, NC, one independent pharmacy is serving its community and setting an example for others to follow. Since the start of the pandemic, Health Park Pharmacy has been the first line of defense for its patients 一 offering COVID-19 tests, vaccines, and supportive care to the Raleigh population. A year and a half in, though, Health Park Pharmacy is changing the way that COVID-19 patients are treated, as well as the way that independent pharmacies are perceived. It’s all thanks to a new innovation: monoclonal antibody treatment.
In the world of science and medicine, monoclonal antibodies are all the rage right now 一 and independent pharmacies are in on them. Monoclonal antibody treatment is a new type of treatment designed for COVID-19 patients who are at a high risk of developing severe symptoms from the virus. By mimicking the body’s immune response to COVID-19, monoclonal antibodies can reduce COVID-19 symptoms and decrease the risk of hospitalization by as much as 70%. Of all the available COVID-19 treatments, monoclonal antibodies are among the most promising.
Earlier this year, the FDA issued an emergency use authorization (EUA) for 3 monoclonal antibodies: casirivimab plus imdevimab, bamlanivimab plus etesevimab, and sotrovimab. At first, hospitals were the primary beneficiaries of the EUA. With so much demand for monoclonal antibodies, though, other healthcare hubs 一 like independent pharmacies 一 are now being called on to administer treatment and meet demand.
Two months ago, when Health Park Pharmacy had the opportunity to get in on monoclonal antibody treatment, owner Steve Adkins jumped.
Since 2007, Steve and his team have worked around the clock to meet the needs of the Raleigh community. This only became more apparent when COVID-19 hit last year. At the beginning of the pandemic, the team received access to COVID-19 tests and successfully tested thousands of patients. Then, in January, they became the third pharmacy in North Carolina to get access to vaccines 一 and transformed their entire practice.
They traded out their 2,400-sq.ft. pharmacy for a 5,500-sq.ft. physician’s office, which they then converted into a mass immunization clinic. They recruited the help of local nurses and over 250 volunteers to handle vaccines, and they even set up shop at other off-site clinics. To date, they have administered over 25,000 vaccines, which has cemented their reputation in the eyes of patients and providers alike.
Thus, when monoclonal antibody treatment became available and hospitals became overrun a few months ago, it was no surprise that Health Park Pharmacy was the first call for help.
Steve explains, “All of the hospitals in our area were maxed out at capacity. They were getting so many phone calls from patients that they couldn’t return them for up to 48 hours.” And those 48 hours, Steve says, make all the difference. COVID-19 symptoms develop fast, especially for high-risk patients 一 so it’s crucial that they are able to get tested and get treated as quickly as possible.
When he saw the need in his community, Steve decided to open up the pharmacy for monoclonal antibody treatment. The decision was simple, but the process was a bit more complicated.
To start with, there was the issue of space. Even with the pharmacy and clinic in full force, Steve explains, “There was no easy way for us to get a COVID-positive patient in without risking them encountering another person.” This meant that Steve and his team would have to find a separate, safer location for patients to get treated. Then, there was the issue of logistics. Because monoclonal antibody treatment is usually administered through an IV, most pharmacies that currently offer it are infusion pharmacies. Health Park Pharmacy, however, is not. This presented another challenge that would have to be worked around.
In the true spirit of independent pharmacy, though, Steve and his team wouldn’t be stopped. With a bit of strategic thinking, planning, and adaptability, they were able to develop a new system to safely and effectively treat patients. Instead of treating patients on-site, Steve arranged for his team to conduct at-home visits. He says, “Home visits are the best way to get patients in without putting other people at risk… They also help because [sick patients] already feel terrible, and in some cases, they may not be able to drive to get treated.”
As an added layer of protection, Steve and his team administer treatments in isolated areas of the home, like a carport or garage. He says, “If you are at a COVID-positive person’s home, their HVAC will be circulating the virus throughout the home, which will increase the risk to others.” By keeping patients in a central area with minimal ventilation, as well as having his team wear PPE, Steve minimizes this risk. Then, treatment can begin.
As a way around infusions, Steve was able to get approval to administer monoclonal antibodies via subcutaneous injections. Injections aren’t the most common method of treatment, but in this case, they are the best method. Injections are much more accessible than infusions, and they are easier to administer during home visits. For each patient, Steve and his team administer REGEN-COV (casirivimab plus imdevimab) in 4 different injection sites, usually in each arm and on either side of the abdomen. Then, they monitor the patient to make sure that there are no adverse reactions. From start to finish, the process takes around an hour and a half.
Since starting monoclonal antibody treatments, Steve and his team have been able to effectively treat close to 50 patients and see better outcomes across the board. The treatment helps minimize current COVID symptoms and prevents more severe symptoms later down the line 一 ensuring that patients are up on their feet in no time.
Not only has monoclonal antibody treatment helped Health Park Pharmacy treat patients, but it has also helped them to expand their network, collaborate with other providers, and gain more respect as trusted healthcare professionals.
Ever since they opened their vaccine clinic earlier this year, Steve and his team have been partnering with registered nurses. This partnership has only expanded since they opened up monoclonal antibody treatment. For every home visit that he schedules, Steve sends a registered nurse to the site.
He says, “Our nurses have a lot of experience working with COVID patients, and they can help with clinical operations. They know what to look for and what to do in the case of adverse reactions or emergency situations.”
By working with nurses, Steve and his team have been able to expand their own clinical knowledge and learn how to react in situations they hadn’t previously encountered. Just as nurses (and other providers) have helped Health Park Pharmacy, though, Health Park Pharmacy has also helped them. By taking in more patients, they have been able to lighten the burden off of other providers and build a strong healthcare team.
In this case, the decision to partner with other providers has helped Steve and his team to form connections that will last far past the pandemic.
Monoclonal antibody treatment is one of the most important breakthroughs in the age of COVID-19. It has the potential to save millions of lives, but it can’t be done without the right people or the right tools behind it. The most innovative independent pharmacists are looking to break ground on monoclonal antibody treatment 一 and they are relying on the most innovative software system, PioneerRx, to help them do it.
Health Park Pharmacy sets the standard, but your pharmacy can follow its lead and be a part of the movement to protect patients and bring the pandemic to a close.
If you are interested in learning more about monoclonal antibody treatment, head over to Health Park Pharmacy’s website and look for the mAb information sheet, which offers monoclonal antibody guidelines, potential talking points, and screening questions for patients.