There is an urgent need for collaboration between diagnostic laboratories and pharmacies to enhance patient care in the evolving healthcare ecosystem. By joining forces, labs and pharmacies can unlock three key benefits that can not only improve patient care and outcomes, but also contribute to revenue stream growth.

Partnerships between pharmacies and labs help rural and underserved communities

Although 20% of the U.S. population lives in rural communities, only 11% of physicians practice in such areas. That means that the patient-to–primary care physician ratio in rural areas is only 39.8 physicians per 100,000 people, compared with 53.3 physicians per 100,000 in urban areas. However, right now, almost 90% of Americans live within 5 miles of a pharmacy and 73% live within 2 miles (J Am Pharm Assoc [2003] 2022 Jul 15. doi:10.1016/j.japh.2022.07.003).

Besides being accessible, pharmacist-provided care is also what people want. An opinion poll of seniors conducted last year for the Future of Pharmacy Care Coalition found that 80% of respondents “want local pharmacy access to vaccines, testing and treatments for flu, strep or future pandemic infections." Moreover, 85% wanted Congress to ensure older Americans have access to a broad array of pharmacy services, including testing and vaccination for infectious diseases such as flu, strep, and respiratory syncytial virus. The J.D. Power 2021 U.S. Pharmacy Study found that 51% of Americans visited the pharmacy to get a health and wellness service such as vaccinations, routine screening or COVID-19 testing. Is it any wonder that pharmacies are seeing their patients 10 times more than physicians or other healthcare providers?

In 2024, we are now at the crossroads of pharmacy and diagnostics, as pharmacists are in the process of innovating and looking to expand through “test and treat” and “screen and treat.” Across the country, pharmacists are testing for pharmacogenomics (California), cholesterol (Ohio), colon cancer (Kentucky), and even infectious diseases such as HIV. Genetic testing is in great demand for targeted treatments pertaining to all major cancers and new areas such as thalassemia and obesity, as are next-generation sequencing techniques and pharmacogenomics. Beyond providing insights on the compatibility of medicines based on a patient’s DNA and associated metabolism by drug type, genetic tests can also ensure the right dosage for greater clinical effectiveness based on the patient’s genomic profile.

Prior authorization policies from payors can require routine rapid tests, such as international normalized ratio, liver function, and complete blood count, as well as low-acuity type tests, which cannot be provided without the help of labs.

Financial opportunities for growth for both pharmacy and lab

Today, pharmacists across the country, operating at the intersection of diagnostics and treatment, will book office hours. Put another way, pharmacists are a “new” provider in town. Additionally, pharmacists can order and prescribe medications in certain states. Currently, 37 states allow pharmacists direct access to testing. Nearly 40 states recognize pharmacists as providers, thanks to the Public Readiness and Emergency Preparedness (PREP) Act, which was established in 2005 and reaffirmed in 2020, to allow pharmacists to prescribe oral medication to COVID-19 patients.

Retail, specialty and outpatient pharmacies can all benefit from a stronger relationship with labs and in doing so, help each other financially. Helping to drive revenue are specialty oncology and immunotherapy medications, which accounted for 55% of all pharmacy sales in 2022, nearly doubling from 28% in 2011, according to an IQVIA report. Autoimmune medications grew by 459% and oncology was up 346% in that same period. However, autoimmune therapies require special considerations because they cost hundreds of thousands of dollars.

Specialty pharmacies need help to gather lab test results before and after dispensing. Among the specialty drugs requiring lab tests are:

• hepatitis C treatments, which require checking viral loads;
• HIV pre- and post-exposure prophylaxis, which can be prescribed after testing; and
• Clozepine, which cannot be dispensed until verification of current white blood cell count.

For the relationship to work best, laboratory, specialized diagnostics, and pharmacy leaders must understand the following:

• the real-world impact of diagnostics on patient treatment decisions are critical for advancing personalized medicine initiatives;
• the opportunity for greater patient convenience and affordability as some services shift away from the physician’s office to the pharmacy; and
• changing regulatory trends enable pharmacists to perform more clinical services to help ensure better treatment utilization, coverage, and patient/provider experience.

As payors demand more testing data for services, the great digital ecosystem will funnel more patients into pharmacies, creating a greater need for lab services.

Align to support patient access to care

Pharmacies and labs must align on advocacy, particularly key legislation introduced across the country, including in the U.S. House and Senate in Washington, D.C., such as the Equitable Community Access to Pharmacist Services Act.

David Pope, PharmD, is the chief pharmacy officer at the healthcare information technology company XiFin, and has served as an advisor for the CDC as well as multiple Fortune 500 healthcare-related organizations.