WASHINGTON (Nov. 23, 2020)—As the United States grapples with how to improve health care access and affordability during the COVID-19 pandemic, a new policy paper from the R Street Institute and the Goldwater Institute argues that lawmakers should consider state-level reforms—such as expanding pharmacists’ scope of practice—rather than waiting on federal action.

R Street resident fellow of Commercial Freedom Courtney Joslin notes that: “Addressing prescription drug costs does not begin and end with the price tag on the drug. Lawmakers need to consider a wide range of reforms that help Americans achieve quality care with fewer roadblocks in the way.”

Goldwater Institute visiting fellow Jeffrey A. Singer adds: “States took swift action during the COVID-19 crisis to remove some of the red tape that kept health care professionals from utilizing all of their skills and training. Expanding pharmacists’ scope of practice in the current crisis is the right approach, but these temporary reforms should be extended and made permanent to promote health care access and affordability. States must look ahead to the critical role pharmacists will likely play in a future COVID-19 vaccine effort and remove the hurdles that block them from providing more services for which they have already been certified.”

The paper describes emerging evidence that suggests allowing pharmacists to prescribe certain low-risk medications—such as hormonal contraceptives, travel medications, immunizations and opioid antagonists—increases health care access and helps consumers by lowering barriers to healthier choices. For example, Arizona Gov. Doug Ducey issued proactive executive orders increasing Arizonians’ access to health care through various measures, including permitting pharmacists to refill prescriptions up to 180 days. Many states neighboring Arizona—like Oregon and Utah—already allow this practice and others should follow suit.

Further, the authors explain how the increasingly popular, state-level “pharmacy access” or “pharmacist-prescribing” model provides a solution to help disintermediate certain drugs based on their safety and wide use. When it comes to oral contraceptives, for example, 16 states and Washington, D.C. have to date used this model, which effectively reaches more patients and improves access. Some states with this model have also allowed pharmacists to prescribe or supply a variety of travel medications, smoking cessation products, opioid antagonists and immunizations.

In the end, states have the authority to determine the scope of practice of the health care practitioners they license. But to date, few states are using this power to increase health care access, improve patient quality of care and lower prescription drug costs.

You can read the full paper, “How States Can Promote Health Care Access and Affordability While Enhancing Patient Autonomy,” here.

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