Byzantine State Regulations Delay Vaccine Access at Pharmacies, Study Reveals

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Susan Jara

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UPPER NYACK, NY — A groundbreaking study titled “Removing Barriers to Pharmacy Vaccination: A Path to Better Health and Lower Health Care Costs” has uncovered a tangled web of regulations preventing pharmacists from efficiently providing vaccines to adult patients.

Led by Robert Popovian, PharmD, MS, Founder, Conquest Advisors and Chief Science Policy Officer, Global Healthy Living Foundation, Esteban Rivera, MS, Associate Director of Data Science, GHLF, and Dr. Wayne Winegarden, PhD, Senior Fellow in Business and Economics at the Pacific Research Institute and Director of PRI’s Center for Medical Economics and Innovation, the study underscores the pivotal role pharmacists play in vaccination efforts and the urgent need for regulatory reform.

The research shines a light on the significant obstacles faced by pharmacists, who are often the most accessible health care providers for vaccinations. These hurdles, including bureaucratic paperwork and redundant requirements, not only contribute to increased health care expenses but also pose a risk to patients’ well-being by delaying essential immunizations.

“Post-pandemic data unequivocally reveals adult patients’ preference for vaccinations at pharmacies, with nearly 90 percent of immunizations provided by pharmacists or pharmacy technicians. In 2023, this preference was underscored as over 80 percent of respiratory syncytial virus (RSV) vaccines were administered at pharmacies across the United States,” noted Dr. Popovian. “The convoluted web of state laws regulating pharmacist vaccination authority leads to negative economic impacts and, most critically, denies patients access to care at their preferred location — the local pharmacy.”

The researchers found that these state regulations are causing unnecessary delays in vaccine availability at pharmacies — sometimes up to 18 months — which impacts patients’ health, increases costs, and can lead to them forgoing vaccination altogether. This situation is particularly troubling for patients in low-income communities who have better access to pharmacies than health care provider practices.

The study authors assert that although it may not be a straightforward remedy, the solution is clear-cut: Pharmacists should possess equivalent authority to physicians in administering vaccines upon FDA approval or CDC recommendation. Such a move would promote equity in health care access and elevate vaccination rates to recommended levels.

“One of the most important things the study does is get our arms around the trunk of the tree of this Byzantine system we have in terms of the states imposing regulations,” remarked Dr. Winegarden. “Remember, these vaccines are already FDA approved, so all of these delays and costs really aren’t adding anything in terms of patient safety or vaccine efficacy.”

The researchers identified nine different pathways, which could require as many as five steps for pharmacists to navigate. What’s more, not all states are equal with regards to regulatory barriers.

“Each additional step adds more time, and as a result, adds costs,” said Rivera. “If I were a policymaker looking at this and saw my state in one of the more convoluted pathways, I’d think, wow, what can we do to improve this and make it easier not only on patients but ourselves too.”

This research serves as a clarion call for policymakers to recognize the indispensable role of pharmacists in vaccine delivery and to enact reforms that empower pharmacists to fulfill their potential as key immunization providers.

To learn more about the study and to download a full report, visit https://ghlf.org/removing_barriers_to_pharmacy_vaccination/.

GHLF’s Patient-Focused Economic and Policy Research Division

At the Global Healthy Living Foundation, the Patient-Centered Economic and Policy Research Division conducts original research focused on health policy economics and outcomes research to better understand how current and proposed health policies, regulations, and legislation affect patients’ financial, healthcare, quality-of-life, and other outcomes. We aim to increase transparency and understanding of the public health policies, regulations, and legislation impacting chronic disease patient communities by sharing our research via publication, our website, social media platforms, and conventional media. Our researchers also address these important topics through opinion editorials, speaking engagements, and our world-class podcast series – Healthcare Matters. Our experts have published extensively on the impact of biopharmaceutical and health policies on costs and clinical outcomes in the most prominent medical sources and media publications. They are sought-after speakers, providing briefings and expert reviews for the U.S. Congress, dozens of state legislatures, and at conferences and medical symposiums around the world. Learn more at https://ghlf.org/our-work/economic-policy-research/.