Policy Studies Competition Policy

How States Can Promote Health Care Access and Affordability While Enhancing Patient Autonomy


Courtney Joslin
Resident Fellow and Senior Manager, Competition Policy
Jeffrey A. Singer
Visiting Fellow, Goldwater Institute

Key Points

The United States is still grappling with how to reduce high prescription drug costs. Some states have addressed the overall costs of accessing health care through either allowing pharmacists to prescribe some medications or doing away with prescription requirements for some low-risk medications.

Emerging evidence shows that allowing pharmacists to prescribe certain low-risk medications—such as hormonal contraception—increases health care access and helps consumers.

More states should allow pharmacists to prescribe appropriate, relatively low-risk medications, which will increase access to care.

Press Release

States Must Expand Pharmacist Scope of Practice Laws

Media Contact

For general and media inquiries and to book our experts, please contact: [email protected]


The state of health care in America suffers no shortage of critics. The perennial issues of access and affordability have forced every president (and presidential candidate) to detail their solutions in front of the watching populace. The issues are bipartisan, but often the proposed solutions are not. However, both sides of the aisle aim to lower prescription drug prices largely through central planning. Yet, these proposals are controversial and may have detrimental, unintended consequences.

The debate over how best to lower prescription drug prices is expected to continue, but it remains focused on only one component of the problem. Many of these proposals miss that the total cost of a prescription is not just monetary: visits to the doctor’s office to get a prescription add a significant time and financial cost to patients. Reducing the need for these costly visits can provide relief to patients and lower the overall cost of access to health care. It can also increase their access to and utilization of therapies, especially by those with fewer economic resources who might otherwise forgo treatment.

Fortunately, there are free market-oriented, scope-of-practice solutions that increase affordability by expanding access. Further, these solutions can occur on the state level with bipartisan support. For example, states are beginning to expand the scopes of practice for highly skilled medical professionals like pharmacists and nurse practitioners as a way to increase access to services and lower the overall costs incurred. However, in many states, there is much more to be done on this front: pharmacists’ scope of practice can be expanded to further improve access and affordability in health care—all without waiting on federal action.

Featured Publications