Drugstore disruptors? Walmart, CVS want patients to skip trips to the doctor

Walmart Inc., Walgreens Boots Alliance Inc. and CVS Health Corp. are rolling out new care options normally only available at doctor’s offices.

A new initiative, Testing and Treatment, provides services for strep throat, flu and COVID-19, which are now available from Walmart pharmacists in 12 states, the company said in a statement Tuesday. Walgreens will soon have a similar offering across 13 states. And CVS pharmacists will evaluate symptoms and prescribe flu antiviral medicine and cough suppressants in 10 states, although they won’t offer tests.

The big chains are angling for a larger slice of health-care spending as new state laws allow pharmacists to treat minor ailments. In some cases — like strep tests for children as young as three — that could save people time-consuming and expensive visits to the physician.

“Pharmacists have been clinically trained to do these types of services for many, many years,” Kevin Host, Walmart’s senior vice president of pharmacy, said in an interview. “Now we’re starting to get the states and the regulations in place that allow pharmacists to practice at the top of their training.”

Rite Aid Corp. is also seeking to build its patient services. It offers pharmacist-administered testing and treatment in Michigan, and has plans to expand to other states.

Political momentum

During the pandemic, US officials temporarily allowed pharmacists to administer tests and vaccines. That’s put political momentum behind longstanding arguments they can do more than dispense medication.

In state legislative sessions throughout 2022, there were 178 proposed bills in 38 states relating to pharmacists’ scope of practice and payment, according to the National Alliance of State Pharmacy Associations. By the end of the year, 44 of them became law.

The group has made less progress at the federal level. The Centers for Medicare and Medicaid Services doesn’t currently recognize pharmacists as providers of the treatment options Walmart, Walgreens and CVS are developing. That means Medicare and insurance won’t foot the bill.

So even though the geographic footprint of major retailers and drug chains make them a convenient choice, their services can be costly.

At Walmart, it costs $70 for an assessment and between $59 and $88 per test. Walgreens said the two-in-one flu and COVID-19 test would have an out-of-pocket cost of $19.99, plus $44.99 for the assessment for treatment. CVS declined to discuss pricing.

Related: CVS pays $10.6B for Oak Street Health primary care centers

Bipartisan legislation introduced in the US House of Representatives earlier this year could create a pathway for patients to get reimbursed. If it passes, the bill — the Equitable Community Access to Pharmacist Services Act — would provide Medicare coverage of pharmacist-administered tests and treatments for common respiratory illnesses.

Doctor pushback

The American Medical Association, representing hundreds of thousands of US doctors and health professionals, is resisting the changes. In a letter to House leaders in April, AMA’s chief executive officer, James Madara, said pharmacists don’t have the necessary education or training to assume the role of a physician.

Madara also said that the bill would pile new responsibilities on already overburdened professionals, citing a survey showing that 91% of community pharmacists rated their workload as high or excessively high. In recent years, some of those problems have led to staffing issues, forcing drugstores to cut pharmacy hours.

Walmart has pointed out there’s also an increasing shortage of primary care physicians. And drugstores have said they’re using technology and automation to free up time for pharmacists to offer the services.

Eris strain

Meanwhile, COVID hospitalizations are on the rise. That could be linked to a new variant, dubbed Eris, which has become the dominant strain in the US. The Centers for Disease Control and Prevention is planning to meet mid-September to discuss new vaccines that will be available in the fall.

People looking for the new treatments can walk in or use Walmart’s mobile app to make an appointment. The services are available in 12 states: Arkansas, Colorado, Florida, Idaho, Iowa, Kansas, Kentucky, Michigan, Minnesota, South Dakota, Tennessee and Washington.

Host, the retailer’s vice president, said in addition to patients who’d normally visit a physician, the company is seeking to attract customers who otherwise wouldn’t get care at all.

For a lot of people, “when they wake up in the morning, and they feel that itch in their throat or that fevery feeling, they start coughing or sniffling, they don’t have access to doctors so they just tough it out,” Host said. “They don’t get treated.”

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