LA GRANDE — The Oregon Health Authority is offering to pay pharmacies $35 for each dose of COVID-19 vaccine they give, a move that possibly could help pharmacies hire employees to deal with the growing workload that has resulted in long lines in La Grande and across the state.

The program, which launched this month, also is intended to boost vaccination rates and to ensure that vaccines are available to all residents, said Rudy Owens, a public affairs specialist for the Oregon Health Authority.

To qualify for the payments, pharmacies must meet certain standards for “vaccine equity,” including such things as offering multilingual signing for COVID-19 vaccinations, “expanded vaccine-related counseling aimed at boosting vaccine confidence,” and “a plan for ongoing evaluation and continuous improvement to ensure equitable access,” according to a flyer from OHA.

The agency’s other program more directly addresses the staffing shortages that have plagued pharmacies, as the state will pay temporary pharmacists to bolster workforces.

However, Owens said the temporary staffing program is available only to independent pharmacies. Corporate-owned pharmacies, including the three in La Grande— at the Safeway, Walmart and Rite Aid stores — are not eligible for the program, Owens said. The larger chain pharmacies are eligible for the vaccine payments.

Owens said OHA doesn’t have data yet on how many pharmacies have applied for the supplemental payments.

He said the pharmacy staffing shortages have been exacerbated by the closure of more than 35 Bi-Mart pharmacies, including the one in La Grande, earlier this month.

The bigger culprit in the pharmacy crisis is the limited reimbursements that pharmacies receive from what are known as pharmacy benefit managers, said Brian Mayo, executive director of the Oregon State Pharmacy Association.

If those reimbursements were “fair,” pharmacies would be able to hire more employees and lines would be shorter, Mayo said.

“Many community pharmacies across Oregon are 5 to 14 days behind filling prescriptions because they can’t keep up with the demand,” he said. “When somebody needs a medication they can’t wait two weeks. Patient safety is a huge issue at this point.”

Mayo said the Oregon State Pharmacy Association has been warning for years that low reimbursements to pharmacies by PBMs are a problem.

“The harms we have warned of have now come true,” he said.

The Pharmacy Association is urging elected officials to take immediate action on reforming the PBM system.

The organization also is asking Oregon to exempt prescription drugs from the state’s Corporate Activities Tax, which the Legislature approved in 2019 and which took effect Jan. 1, 2020.

The Pharmacy Association has some high-level backing in its effort to reform the PBM system.

U.S. Sen. Ron Wyden, D-Oregon, recently sent a letter to Chiquita Brooks-LaSure, administrator of the Centers for Medicare and Medicaid Services, a federal agency, citing both PBM reimbursements and the fees charged by PBMs and by Medicare Part D prescription plans as contributing to pharmacy closures.

“I am deeply concerned that the rise of these fees has contributed to the permanent closure of 2,200 pharmacies nationwide between December 2017 and December 2020,” Wyden wrote in his letter to Brooks-LaSure.

Wyden is calling on the Centers for Medicare and Medicaid Services to review pharmacy closures in the U.S. over the past five years, including the nature and effect of PBM payment practices, and to use the agency’s authority to regulate their fees.

Mayo said the current situation, with lines of customers snaking through some stores, is frustrating for pharmacy employees.

“The pharmacists, technicians and interns are working as fast as they can,” Mayo said. “In many cases, they are being forced to continue working without required breaks and voluntarily working longer unrecorded hours so they can provide care to their customers. They want to help the patients. That’s why they chose this profession, but it feels like things are getting out of control.

“We must improve working conditions in pharmacies for the sake of patient safety and pharmacy staff member well-being.”

He said Oregon Gov. Kate Brown’s mandate that health care workers, including pharmacists and pharmacy technicians, be vaccinated or receive a medical or religious exception, has had a “minimal” effect on the current staffing shortages.

He said most pharmacy employees are vaccinated.

According to the OHA, as of Nov. 1, 88% of Oregon pharmacists were vaccinated, and 83% of pharmacy technicians.

The OHA report does not break down the vaccination rate by county, nor does it list how many pharmacy employees have received exceptions.

The vaccination rate for all licensed health care workers in Union County — including doctors, dentists, nurses and others — was 78% as of Nov. 1. That’s the 17th-lowest rate among Oregon’s 36 counties. Statewide, 83% of health care workers are vaccinated.

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