Expanding Pharmacists’ Role Through Test-and-Treat Services
Pharmacists are increasingly positioned to enhance community health by offering point-of-care test-and-treat (POCT-and-treat) services for common infectious conditions such as COVID-19, influenza, streptococcal pharyngitis, and respiratory syncytial virus (RSV). These services build on the profession’s evolving role in medication therapy management (MTM), advancing beyond traditional dispensing and counseling to include diagnostic and therapeutic interventions when state regulations allow.
Growth in Testing and Prescriptive Authority
The ability for pharmacists to perform POCT and initiate treatment varies widely based on the state's scope of practice. As of mid-2025, pharmacists in 42 states and Washington, DC, have legal authority to administer CLIA-waived tests, and in 30 of those jurisdictions, they can prescribe certain medications informed by test results. Common treatments under these authorities include antivirals such as nirmatrelvir/ritonavir (Paxlovid), oseltamivir (Tamiflu), baloxavir marboxil (Xofluza), and zanamivir (Relenza).
West Virginia’s 2025 legislation reflects this trend, permitting pharmacists to test and treat for multiple respiratory infections. However, regulatory differences remain significant across states, affecting the extent to which pharmacists can independently diagnose, treat, or refer.
Training and Competency Development
Responding to the growing interest in these services, pharmacy education and continuing professional development programs have emerged. For example, the American Pharmacists Association, in collaboration with the University of Florida College of Pharmacy, offers an accredited 8-hour certificate program. The curriculum covers POCT regulations, patient assessment skills (including vital signs and physical exam techniques), specimen collection, interpreting test results, and clinical decision-making — including when to refer patients to other health care providers.
Such training is designed to support pharmacists in delivering evidence-based care while reinforcing appropriate documentation practices and, when applicable, collaboration under established physician protocols.
Impact on Patient Care and Access
Research cited suggests that pharmacy-based test-and-treat programs can improve access to timely care, particularly for populations with limited access to primary care services. One community pharmacy study showed high patient satisfaction with POCT and treatment services and comparable utilization rates among insured and uninsured patients. These findings point to the potential of pharmacist-led services to help reduce disparities in care delivery.
At the same time, programs often operate within collaborative practice agreements or protocols with supervising clinicians, reinforcing the importance of interdisciplinary communication and agreed treatment algorithms.
Considerations for Practice
Although the expanding role of pharmacists in test-and-treat services describes a positive patient reception, it implicitly acknowledges ongoing variability in practice authority and implementation challenges. Not all states permit independent prescribing based on POCT, and service integration requires careful attention to legal frameworks, training, and workflow adjustments.
For pharmacy students, residents, and practicing pharmacists, understanding local regulations, obtaining appropriate training, and structuring effective collaborative relationships with other health care providers will be key to successful implementation of test-and-treat models in community and ambulatory settings.
