Marc Joffe and Jeffrey A. Singer
How often do people have to leave work early for a medical appointment and wait for an hour for the doctor to perform a simple test and prescribe a routine medication that they knew in advance would happen? Like a routine urinary tract infection? Or a strep throat? Imagine if they could stop off at their local pharmacy on the way home from work, ask the pharmacist to perform the simple test, and prescribe the medication for the routine condition. There are several jurisdictions—including three states—where this convenience and accessibility is a reality.
Our new policy briefing paper, Let Pharmacists Prescribe, explores a reform that would improve the quality of US healthcare while partially addressing the shortage of primary care physicians. We propose that states allow pharmacists to leverage their education and experience to safely prescribe a wider range of medications to their customers.
The traditional arrangement under which physicians prescribe and pharmacists dispense has already been breached throughout the United States. During the COVID-19 pandemic, the federal government authorized pharmacists to dispense Paxlovid without a prescription on the grounds that patients needed to start taking the anti‐viral medication soon after being diagnosed, so there was no time to wait for a doctor’s visit. States have also reached a similar conclusion about Naloxone (marketed as Narcan), which reverses the effects of opioid overdose if administered quickly. Several states authorize pharmacists to prescribe birth control pills and HIV prevention.
But shouldn’t a policy that works for COVID-19, drug overdoses, birth control, and HIV prophylaxis be applicable to other conditions?
In our paper, we consider the cases of Alberta, Ontario, and Queensland (Australia), all of which have extended pharmacist prescribing to more than a dozen common conditions. In the first six months of 2023 alone, Ontario pharmacists wrote over 250,000 prescriptions.
Among US states, Idaho has taken the lead in broadening pharmacist prescribing, specifying four general categories under which they may prescribe. Subsequently, Montana and Colorado enacted similar legislation.
When considering prescribing a medication, physicians often consult with pharmacists about interactions with drugs the patient is already taking. Pharmacists are well qualified to address such inquiries because they interact with a large number of patients and most receive as much classroom training as physicians.
States should eliminate unnecessary requirements for people to see doctors to make simple diagnoses and prescribe medicines. Patients should be allowed to go directly to the pharmacy, freeing up physicians for higher priorities and removing a hurdle for patients seeking relief.