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On April 8, the U.S. Department of Health and Human services issued new guidance allowing licensed pharmacists to administer COVID-19 tests. This was followed by an executive order last weekend from Gov. Andrew Cuomo of New York, expanding testing authorization to pharmacies in the Empire State.
As the United States continues to struggle to ramp up its testing capacity, finding more qualified people to administer tests and more places to administer them will be critical. One important player in this effort could very well be your local pharmacist.
Retail pharmacy chains such as CVS, Rite Aid, Walgreens and Walmart are already joining forces with federal and state authorities to set up "drive-through" testing sites near their store locations. Kroger claims to have created the first completely pharmacist-led COVID-19 testing site for grocery store associates in Michigan last week. Dozens more sites like it are planned in the near future.
Pharmacies are perfectly situated for the task at hand. 90 percent of Americans live within five miles of a pharmacy, and there are more than 300,000 licensed pharmacists employed in the United States. While progress setting up drive-through testing sites has thus far been slow, the new order from HHS should hopefully help to speed up these efforts.
Pharmacists have plenty of training and experience that can make a difference during a pandemic. There is already a process for pharmacies to become labs capable of conducting certain simple health tests. Under the Clinical Laboratory Improvement Amendments, pharmacies can obtain waivers from the Department of Health and Human Services that allow them to conduct routine tests for conditions like influenza or strep throat.
As rapid-response COVID-19 tests are already being developed and approved for use by the FDA, expect pharmacists to be on the front lines of testing in the coming months.
When the emergency phase passes, however, public health can continue to be advanced by tapping pharmacists’ extensive training and capabilities. In recent weeks, governors around the country have moved to relax many medical regulations that have hampered the government’s response to the pandemic. Laws that impede the ability of pharmacists to test and treat certain routine illnesses should likewise be reconsidered.
Consider, for example, that the number of pharmacies possessing waivers to perform simple lab tests varies immensely across states. One study from 2016 found that states range from having as few as no pharmacies with such waivers to as many as 60 percent of pharmacies possessing them. State-level regulations are a key reason. For example, occupational licensing laws can affect who can oversee a lab, and a pharmacist may not meet the strict criteria set up in some states. Such regulations have already unnecessarily constrained U.S. testing capacity.
In addition, pharmacists should be allowed to prescribe treatment to patients upon the results of tests. Idaho allows pharmacists to prescribe based on results of an authorized test, as well as in a number of other routine situations that are considered low-risk. Canada and some countries in Europe also allow pharmacists to prescribe in simple situations, which saves patients both time and money.
Roadblocks still stand in the way of creating a vast COVID-19 testing network for the United States, not the least of which are shortages of critical testing supplies such as swabs. But there is no reason why there should be a shortage of medical personnel to conduct tests, when pharmacists are primed and waiting on the sidelines to help.
If allowed to test, treat, and eventually vaccinate, pharmacists can take stress off the health care system and potentially save many lives. Just as importantly, it means an army will be standing ready to assist the next time a pandemic arrives at our doorstep.
Economists James Broughel and Yuliya Yatsyshina are the coauthors of the new policy brief “Relax Pharmacy Regulations to help with COVID-19 Testing and Treatment,” published by the Mercatus Center at George Mason University.