Missouri Pharmacists Can Provide Effective Patient Therapies

Missouri House Emerging Issues Committee

Chair Patterson, Vice Chair Davidson, Ranking Member Aune, and members of the House Emerging Issues Committee:

My name is James Broughel, and I am a senior research fellow at the Mercatus Center at George Mason University. I am also an adjunct professor of law at Antonin Scalia Law School at George Mason University. My research focuses on regulatory process and reform topics, including the improvement of regulations affecting the scope of practice of pharmacists. The Mercatus Center is dedicated to advancing knowledge about the effects of regulation on society. As part of its mission, scholars conduct careful and independent analysis that employs contemporary economic scholarship to assess regulations and their effects on economic opportunities and societal well-being. Thank you for the opportunity to submit this written testimony today on pharmacy regulation in Missouri.

Since the COVID-19 pandemic began, licensed pharmacists as well as their support staff at pharmacies around the country have proven to be one of the American medical system’s most valuable resources. In Idaho, for example, pharmacists have been able to diagnose minor ailments and prescribe simple medications for several years. During the pandemic, this ability has facilitated a better public health response than would have occurred otherwise and may have helped prevent other parts of the healthcare system from becoming overloaded. Other states, such as Utah, have taken steps to expand pharmacists’ prescribing authority in the years since the pandemic began. In addition, pharmacies are now one of the most important outlets for administering COVID-19 vaccinations in the United States, slowing the spread of the coronavirus and undoubtedly saving untold numbers of lives. This explains why states such as Arkansas are expanding the ability of pharmacists and pharmacy technicians to vaccinate.

In many states, in order for pharmacists to provide necessary care during the pandemic, lawmakers have had to make emergency changes to the regulatory system, thereby enabling pharmacists to practice closer to the full extent of their training. Such changes have included granting permission to vaccinate, test, and treat in some cases. Now that the pandemic is receding, it is logical to consider what temporary changes made during the emergency period should be made permanent. Legislation being considered before this committee today, House Bill 2452, is very much in this spirit.

Attached to this testimony are two publications written by me and my colleague Elise Amez-Droz from the Mercatus Center. The first is a report that provides an overview of the regulatory landscape across the states with respect to pharmacists’ prescribing authority. The second is a newspaper column explaining the outsized role pharmacies have played in the COVID-19 pandemic response and why state legislatures should consider reforms to pharmacy regulation and pharmacists’ prescriptive authority. These documents provide strong evidence that the reforms being considered today in Missouri are well within the mainstream of what other states permit.

I appreciate the opportunity to submit these materials for the official record. Please feel free to contact me with any questions.


James Broughel and Elise Amez-Droz, “Expanding Pharmacists’ Prescriptive Authority: Options for Reform” (Mercatus Policy Brief, Mercatus Center at George Mason University, Arlington, VA, December 2021).

James Broughel and Elise Amez-Droz, “We Should Allow Pharmacists to Prescribe Some Medications,” The Hill, January 14, 2022.