Patients Rising Now joined several other advocacy groups in sending a letter of support for H.4066 and S.1425 in the Massachusetts State Legislature to the Joint Committee on Financial Services and Joint Committee on Public Health. The COVID-19 pandemic put into focus two key details of our healthcare system: the strong importance of local pharmacies & the services they provide and the disastrous results of interruptions in the administration of treatment, scans, testing, etc. H.4066/S.1425 would allow the State Board of Pharmacy for Massachusetts to establish a written statewide protocol for pharmacists to test/screen for diseases and then initiate a treatment or therapy regimen for patients, which immediately increases access to care for those who most need it. You can read the letter in its entirety below.
The Joint Committee on Financial Services
24 Beacon Street
Room 112
Boston, MA 02133
The Joint Committee on Public Health
24 Beacon Street
Room 111 and 130
Boston, MA 02133
Re: H4066/S1425 “An Act Relative to Pharmacists as Healthcare Providers”
Dear Chairs Feeney, Murphy, Cyr and Decker,
We, the undersigned organizations, represent a broad range of healthcare advocates who care deeply about improving the lives of Massachusetts patients while doing our part to enhance the healthcare profession and make it more efficient.
Before we start we would like to applaud the legislature’s actions in helping us enact
“An Act promoting a resilient health care system that puts patients first.” This has given the pharmacy profession an ability to build a solid foundation to start addressing the gaps in patient care.
Unfortunately, COVID-19 exposed an outdated regulatory system in Massachusetts regarding the aforementioned Act’s designation of pharmacists as healthcare providers. Since the law did not specify what else a pharmacist could do, pharmacists, the Board of Registration in Pharmacy and the Department of Public Health were all confused as to what pharmacists could legally do while dealing with a devastating pandemic. To avoid this situation again and to help Massachusetts patients be prepared for the next emergency, we turn our attention to H.4066/S.1425.
We write to you today regarding the need for H.4066/S.1425 so that patients can get help whenever faced with issues such as COVID-19, strep, flu, HIV PrEP/PEP and any other healthcare emergency approved by the Board of Registration in Pharmacy and the Department of Public Health.
State governments have been relying more heavily on pharmacists to provide patients with access to essential healthcare services, from COVID-19 testing to patient counseling and administration of certain drugs. This has been in addition to more patients who have been increasingly reliant on pharmacists utilization as their major healthcare provider, especially in the rural neighborhoods where the pharmacist is typically the only healthcare provider. Knowing this, this bill would allow the Board of Pharmacy to establish a written statewide protocol for pharmacists to test or screen for and initiate treatment or therapy for qualified health conditions leading to increased access to care.
Pharmacists are trained to provide a variety of services that promote patient health, prevent disease, and reduce the total cost of healthcare. Similar collaborative community pharmacy-based models for disease management have proven safe and effective for other acute infectious conditions such as group A Streptococcus, influenza, and HIV pre-exposure prophylaxis.1-3
These models are used in several countries including the United States, Canada, England, and New Zealand. Data show that upward of 54% of individuals using these services report not having a primary care physician and 38% presented outside traditional clinic hours for evaluation.1 Algorithms incorporating risk factors and clinical presentations direct pharmacists to refer patients for higher-level care (eg, emergency department, urgent care, or primary care physician) when necessary, versus determining which patients require anti-infectives or over-the-counter symptomatic relief.2 In fact, these models were initially created to develop infrastructure and skills to allow pharmacies to offer a higher level of care should a pandemic arise.
Pharmacists play a vital role in healthcare and public health. With 91% of Americans living within 5 miles of a community pharmacy4 and with longer business hours than traditional medical offices, pharmacies are commonly used as care access points. Medicare beneficiaries visit community pharmacies an average of 6–7 additional times annually compared to primary care physicians (PCPs), with the largest discrepancies in rural areas5. Not only are pharmacists highly accessible healthcare providers, they are also consistently viewed as one of the most trustworthy professions6.
The implementation of these services by pharmacists will expand access to care for patients, which will ultimately take us towards the goal of achieving health equity. This includes those who may not yet have a primary care provider, those who cannot get a timely appointment with their provider, or by extending times patients can be seen, beyond the traditional clinic hours. Additionally, by providing these functions, pharmacies will provide an alternative option for patients who are currently utilizing the emergency department for non-urgent visits contributing to hospital and health system capacity challenges.
We thank you for your ongoing commitment to addressing the lasting impacts of the COVID-19 pandemic and ask for your support of this much needed legislation.
Sincerely,
Ron Lanton III, Esq.
Lanton Strategies, LLC
Massachusetts Society of Health-System Pharmacists
Northeast Pharmacy Service Corporation
Massachusetts Independent Pharmacists Association
Western Massachusetts Pharmacists Association
The Massachusetts Chain Pharmacy Council
Massachusetts Pharmacists Association
National Community Pharmacists Association
HIV & Hepatitis Policy Institute
Patients Rising
Headache & Migraine Policy Forum
Immune Deficiency Foundation
Michael J. Fox Foundation for Parkinson’s Research
Resolve New England
Disability Policy Consortium
Lupus and Allied Diseases Association, Inc.
Cancercare
Families Fighting Flu, Inc.
References:
- Klepser DG, Klepser ME, Smith JK, et al. Utilization of influenza and streptococcal pharyngitis point-of-care testing in the community pharmacy practice setting. Res Social Adm Pharm 2018;14:356–359.
- Klepser DG, Klepser ME, Murray JS, Borden H, Olsen KM. Evaluation of a community pharmacy-based influenza and group A streptococcal pharyngitis disease management program using polymerase chain reaction point-of-care testing. J Am Pharm Assoc 2019;59:872–879.
- Zhao A, Dangerfield II DT, Nunn A, et al. Pharmacy-based interventions to increase use of HIV pre-exposure prophylaxis in the United States: a scoping review. AIDS Behav 2022;26:1377–1392.
- Qato, DM, SZenk, S, Wilder, J, Harrington, R, Gaskin, D, Alexander, GC. The availability of pharmacies in the United States: 2007–2015. PLoS ONE 2017;12:e0183172
- Berenbrok, LA, Gabriel, N, Coley, KC, Hernandez, I. Evaluation of frequency of encounters with primary care physicians vs visits to community pharmacies among Medicare beneficiaries. JAMA Network Open 2020;3:e209132.
- Gallup poll website. https://news.gallup.com/file/poll/388700/220112HonestyEthics.pdf Accessed January 24, 2023
