Opinion: Why Michigan needs more pharmacy reform

James Broughel

During the month of May, Gov. Gretchen Whitmer signed two executive orders unleashing the talents of Michigan pharmacists in the fight against COVID-19. The first one, which was signed on May 19 and extended several past orders, expanded pharmacists’ operational capacity and authority to dispense certain types of medications during the crisis. Then on May 26, a second order affirmed that many Michigan pharmacists and other medical professionals can administer COVID-19 tests.

Given the continuing imposition and extension of temporary emergency measures like these — which downplay old health care regulations and empower providers — one has to wonder whether the restrictions were ever needed at all. 

Gov. Gretchen Whitmer has taken important steps to expand health care access during this emergency, Broughel writes.

All across the country, governors have been relaxing regulations to aid in the fight against COVID-19. Now, as the nation starts to reopen and business gradually returns to normal, policy makers in Michigan and elsewhere should scrutinize regulations that appear to have failed us when we needed our health care system to be at its best.

Pharmacy rules should be at the top of any list.

Whitmer’s temporary executive orders do a few things: First, pharmacists, based on their professional judgment, can dispense emergency prescription refills covering up to a 60-day supply. If there is a shortage of a prescribed medication, pharmacists can substitute a therapeutically equivalent medication without the expressed authorization of the prescriber. They can supervise pharmacy technicians remotely using audio-visual camera systems, or operate a pharmacy in an area not specifically designated on their license. Finally, pharmacists can administer COVID-19 tests, so long as they are in compliance with the relevant federal laws and regulations governing clinical labs and diagnostic testing.

These reforms are all just common sense, and there’s little reason why they shouldn’t be made the law of the land. In fact, many other states already have similar provisions in place, and there seems to have been little-to-no downside from making them permanent.

One example is the state of Idaho, where even during ordinary times pharmacists are allowed to substitute a drug with another one in the same therapeutic class, so long as the original prescriber authorizes it. This is true regardless of whether a drug is in shortage or an emergency has been declared, as is the case in Michigan now. Pharmacists in Idaho are also allowed to oversee multiple remote pharmacies using audio-video technology, which has allowed pharmacies to open in isolated parts of the state that in some cases haven’t had a pharmacy in decades.

Making Whitmer’s executive order permanent is just the kind of bipartisan solution Michigan residents are looking for from their leaders. The governor has made pharmacy reform a part of her policy agenda in the past. Just last January, she signed legislation allowing for remote pharmacies. However, these reforms could be expanded, for example by eliminating geographic restrictions which mandate that the location of the remote pharmacy cannot be within 10 miles of another pharmacy.

As of last count, there have been about 6,000 deaths from COVID-19 in Michigan. As the state starts to reopen, a lot more testing will need to be done to avoid a resurgence of the virus. And should a second wave come, stress will need to be alleviated from parts of the health care system that could become overloaded. 

This is where pharmacists have an important role to play. Whitmer has taken important steps to expand health care access during this emergency. Now she should think about how to keep that access open permanently.

James Broughel is a senior research fellow with the Mercatus Center at George Mason University and author of the recent study, “Relax Pharmacy Regulations to help with COVID-19 Testing and Treatment.”