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Supermarket shelves quickly cleared of toilet paper and disinfectant in an uncontrolled run on goods as public awareness and fear of coronavirus took hold weeks ago.

As store managers and stockers scrambled to bring in new shipments of household products due to a rush that dominated headlines and swirled in social media, long lines of shoppers also more quietly overwhelmed the drug counters at in-store and standalone pharmacies.

Pharmacists and technicians have worked long non-stop hours to keep up with patients’ demands to stock up on pills and formulas for the unknown duration of the virtual national shutdown.

Surveyed late last week, the stress on druggists was apparent as several at Indiana area pharmacies begged off answering questions — one even hung up on a reporter — because they were too busy to step away from filling orders.

Pharmacist Sara Dilascio at Rite-Aid, 375 Philadelphia St., estimated that the store had been filling about 20 percent more than the normal number of prescriptions and that the staff’s workdays had extended to 12 hours to meet demand.

That spike could have been higher, she said, had insurance regulators earlier eased up on the limits on how early patients could refill their prescriptions.

“It would be more (than 20 percent) if insurance was paying for any amount of time,” Dilascio said. “They want everything so they can last for a while at home I suppose.”

A more recent easing of the refill limits by Pharmacy Benefit Managers served to pump up the demand for prescriptions at 132 drugstores in the four-state Martin’s Food Store and Giant supermarket chain, according to corporate spokeswoman Ashley Flower.

“Currently, the pharmaceutical supply chain is experiencing unprecedented demand,” Flower wrote in an email message to the Gazette.

“One factor is the relaxation of early refill restrictions by PBMs, which allows for customer pandemic planning activity. As a result, our pharmacies have seen an increase in patients and prescriptions over the past few weeks. Our team has been working feverishly to meet the needs of their patients and working with providers and insurers, the team has done a great job delivering care.”

She didn’t mention the workload for the Martin’s pharmacy at Regency Mall in White Township or mention which medications are in peak demand.

At Gatti Pharmacy, 1024 Philadelphia St., the drug counter has kept up with a rush of customers but has maintained stock by helping patients stay “within reason” on their medication supplies.

“We’re trying to be careful. We’re under limitations from our wholesalers, and they’re trying to limit us to historical numbers for what we can order just so there’s a way to help prevent shortages,” said Stephanie Smith Cooney, president and pharmacist. “So we’re trying to take the same approach with our patients. We’re trying to keep it within reason so that we’re not helloing to create a problem.

“While we’ve had a few requests for early refills, it’s not been excessive and my team has done a great job of making sure of that.”

Dilascio said there’s been a rise in new prescriptions for antibiotics and antiviral drugs at Rite-Aid, but especially for the anti-malaria drug and lupus treatment, hydroxychlorquine.

“We had a massive increase on a medication called Plaquenil. It’s an anti-malaria drug shown to possibly be effective in stopping the (coronavirus) from replicating at the speed it really does,” said Dilascio, a pharmacist for Rite-Aid stores for more than five years. “Doctors are getting their colleagues to phone in prescriptions for them since they know they may be exposed to coronavirus in their patients.

“We do get a decent amount (of scripts for Plaquenil) as it is but there has been a noticeable increase.”

Demand at Gatti has been rising for hydroxychloroquin and azithromycin, especially over the past weekend, Smith Cooney said.

“Those are the two things President Trump mentioned that garnered interest, that there isn’t data for, but it of course created interest and shortages as a result.”

“Patients have been eager to stock up but it’s about managing the panic that people may be feeling, and helping them to feel confident,” Smith Cooney said. “We have patients enrolled in a synchronization program, where we automatically fill for them once a month. So that takes off some of the panic, making sure we have product in stock … managing it the same way we always do, delivering it the same way we always do.”

Part of Gatti’s strategy has been to lock doors and limit the number of people inside.

“People feel comfortable coming if they know they aren’t going to be exposed to a bunch of people,” Smith Cooney said. “They can just sit in their car. I don’t know if that’s why we’re seeing less panic, but I think that’s probably helped. The way we manage our flow brings people peace of mind. While we’re busier than normal, it’s not excessively crazy with people using their minds. We’re not seeing that.”

Over-the-counter medications, just as Clorox and Charmin did, sold out unchecked.

“They cleared out our shelves. We don’t even have a thermometer left in the place,” Dilascio said.

Most of those remedies went without pharmacists’ advice. Had they been asked, Dilascio said, they staff would recommend against ibuprofen. Acetaminophen, found in Tylenol or generic versions, has been suggested for quelling symptoms of coronavirus infection.

At the Giant Company, parent of Martin’s Food Store, Flower said the in-store pharmacies began a schedule of opening at 6 a.m. on Wednesdays with the first hour of business reserved for customers age 60 and older and those who are immunocompromised.

Those customers can phone in their orders and park in the spaces reserved for the Martin’s Direct service near the front door, Flower said.

“Once the customer arrives at the store, they call the pharmacy regarding their prescription pickup,” Flower explained. “A pharmacy team member will then deliver the prescriptions to the customer’s vehicle, verifying the customer’s information while having them sign in order to receive.

“For our senior customers who do not wish to come into the store, The Giant Company is now offering UPS mailing of prescriptions. The prescriptions will need to be paid for (by credit card) in advance by calling your local GIANT or MARTIN’S pharmacy. The prescription will arrive in two business days and there will be no shipping charge at this time.”

Smith Cooney said pharmacists across the state have shared with her the same experience.

“We are under extreme pressure in our industry with low reimbursement. And what’s interesting right now is  that independent and community pharmacies, are putting our workers at risk, They are front line in many ways and being exposed frequently to who knows what,” Smith Cooney said. “We’re still accepting the same low reimbursement that we cannot control; we’re providing delivery service and going above and beyond to solve people’s problems.

“Community pharmacies are helping people in a pandemic situation and there’s been no stipulation to make sure when we deliver to get any additional fees. We’re solving problems that are popping up every day for people and we are losing our shirts. That’s a call out to legislators and policymakers that the payment system is very broken. This is an example of where we’re helping but we’re not making money doing this. We’re just doing what’s right for our community at a time when our community requires it.”