THE NEED FOR MAINTENANCE MEDICATION AVAILABILITY IN DISASTER PRONE REGIONS: ACTIONS AT THE STATE LEVEL ARE NEEDED TO AUGMENT THE EPAP PROGRAM

Abstract

The availability of maintenance medications for chronic disease sufferers immediately following a disaster is of great importance in order to limit the worsening medical severity, reduce comorbid cross exacerbation, and increased mortality rates. The two existing U.S. federal initiatives focus on only two concepts to this end: The 2010 Emergency Prescription Assistance Program (EPAP) and the 2022 Emergency Use Authorization Act (EUA). Neither of these plans addresses how to get medications to the roughly 13% of the population that never evacuates and faces several days to a couple of weeks in disaster areas with no access to maintenance medications due to loss or destruction of them. In analysis of this topic, this study utilized quantitative descriptive and comparative methodologies in the analysis of 34 peer-reviewed articles covering the following topics: role of the EPAP; successes and limitations of the EPAP; federal alternatives to EPAP; independent state initiatives; international strategies; negative effects of going without maintenance medications; and the potential for unmanned aerial vehicle (UAV) use to aid in medication dispensation in disaster areas. Gaps in knowledge were discovered in EPAP performance, EUA performance, state initiatives, and the lack of official Federal Aviation Administration (FAA) policy for the use of UAVs in the delivery of medications and medical supplies. The federal government needs to develop an incentivized framework for states to follow that provides for the rapid adoption of UAV technology, seek to empower pharmacist with special authorities during these scenarios, increase the number of pharmacies in disaster prone areas, develop pharmaceutical stockpiles of maintenance medications with international best practice stock rotation strategies, and develop multiple tactics for getting medications and care to disaster victims that don’t evacuate