Health Affairs: Congress Must Act to Codify the Role Pharmacy Plays to Protect Patients from Public Health Threats

Kevin Ban, M.D.,
Chief Medical Officer, Walgreens

Marc Watkins, M.D.,
Chief Medical Officer, Kroger

Kyu Rhee, M.D.
Former Chief Medical Officer, CVS & CEO at NACHC

David Pope, PharmD, CDE
Chief Pharmacy Officer, OmniSYS

November 8, 2023

One of the most salient lessons from the COVID-19 pandemic is that pharmacists have been, and continue to be, a vital resource for accessible, affordable, and high-quality health care for Americans.

As we faced one of the greatest threats to public health in the past century, the US’s pharmacists served at the frontlines going above and beyond to help patients stay healthy and well wherever they are. But pharmacists have relied on a fragile framework of temporary practice authorities enacted under the federally declared COVID-19 public health emergency (PHE). Some of these authorities expired with the end of the PHE this spring, and others are slated to be rolled back next year.

Today, millions of Americans, particularly seniors and those in underserved and rural communities, could face significant barriers to accessing essential health services provided by pharmacists, and only Congress can fix this gap. Federal lawmakers must enact legislation to maintain patient access to testing, vaccination, and treatment for common infectious diseases such as COVID-19 and flu—all provided by pharmacists. Fortunately, a bill that would do exactly that has been introduced in Congress with bipartisan support.

The Crucial Role Of Pharmacists

Over the past three years, millions of Americans visited pharmacies to receive essential care and services for infectious diseases, including COVID-19. Pharmacists provided more than 303.5 million COVID-19 vaccinations and are credited with preventing more than one million deaths, eight million hospitalizations, and saving our country more than $450 billion in health care costs.

Pharmacists and pharmacies were able to successfully protect patients because of their training to provide safe, effective, and efficient care and their flexibility to collaborate with government agencies and other health care providers. Pharmacists are highly educated and trained health care professionals with the knowledge and expertise to provide vaccinations and help patients manage their health. While medical facilities and physicians were overwhelmed during COVID-19, pharmacists worked with health care providers to ensure appropriate medication selection, improve adherence, and monitor patients’ response to therapies. When the government faced the seemingly insurmountable challenge of vaccinating hundreds of millions of Americans, it turned to pharmacists to achieve this public health goal.

Pharmacists are the most accessible health care providers: Nine in 10 Americans live within five miles of a pharmacy, and patients visit their community pharmacist roughly twice as frequently as they visit primary care physicians, with those in rural areas visiting their pharmacist even more often. Rural areas often have a limited health care infrastructure, and pharmacies there serve as accessible points of care. With nearly half of US counties already facing shortages of primary care providers—meaning they have just one doctor or fewer for every 1,500 people—and with the Association of American Medical Colleges predicting a shortage of up to 124,000 physicians by 2034, denying patients, especially seniors, the option to receive basic forms of care from pharmacists is simply irresponsible.

The PHE enacted by the federal government in response to the COVID-19 pandemic enabled pharmacists to provide essential services, including testing, vaccination, and treatment initiation. But the emergency authorization expired with the PHE this May. Regrettably, much of the progress made to increase access to pharmacist-provided care through mandatory coverage during the pandemic was instated on a temporary basis and either has expired or will at the end of the year, putting the most vulnerable populations at risk. In the near future, seniors and patients in rural communities and underserved areas could face access barriers to receiving testing, vaccination, and treatment for common diseases such as COVID-19 and flu.


The Equitable Community Access To Pharmacist Services Act

Congress has an opportunity to ensure patients can continue to access the essential care and services that pharmacists provide. HR 1770, the Equitable Community Access to Pharmacist Services Act, is bipartisan legislation with 82 cosponsors that would create Medicare Part B direct reimbursement mechanisms for pharmacists’ services to protect vulnerable seniors from the threat of infectious diseases, specifically COVID-19 and flu (testing, treatment, and vaccination), strep throat (testing and treatment), and respiratory syncytial virus, or RSV, (testing). HR 1770, supported by more than 190 groups, ensures senior access to these essential pharmacist services and strengthens our nation’s public health response, according to the American Pharmacists Association.

This legislation does not interfere with states’ ability to govern pharmacists’ scope of practice—it simply assures Medicare beneficiaries’ access to services that pharmacists are authorized by states to perform. HR 1770 was referred to the House Energy and Commerce Committee and the Ways and Means Committee in March and is still awaiting action.

Establishing pharmacists as providers is not only a sound policy, it’s smart politics. An opinion poll of seniors conducted last year found 80 percent “want local pharmacy access to vaccines, testing and treatments for flu, strep or future pandemic infections;” and an even greater number (85 percent) said that “they want Congress to ensure older Americans have access to a broader array of pharmacist services,” including testing and vaccination.

It’s time for Congress and stakeholders in the health system to work together to pass HR 1770 and formalize the convenient, high-quality, pharmacist-provided care Americans have come to expect and need.


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