Alaska pharmacists will soon be able to practice more of the healthcare that they learned in their education under a new state law taking effect in January. That could include medication management and testing and treating common ailments like strep throat, urinary tract infections and the flu.
The change will be a big shift for Soren White, a pharmacist in Sitka who grew up working in his parents' pharmacies.
Although in his classes he learned how to diagnose, monitor blood pressure and test blood glucose, when he started work he was "really stuck behind the counter, counting pills, answering phones, telling patients 'Don't drink alcohol with this,'" he said.
Sitka has one hospital to serve the rural area and surrounding remote communities and White said the new law means pharmacists can take pressure off of the hospital to offer non-emergency care to people quickly.
State Rep. Justin Ruffridge, R–Soldotna, is a pharmacist who supported the bill. He said pharmacists in rural areas play a vital role.
"We are the most highly accessible healthcare professional," Ruffridge said. "So in many cases people stop in to the pharmacy first before they go on to get other care, kind of as a first test of like, 'Hey, is this serious?'"
Why lawmakers pushed the change
Data show people see pharmacists up to twice as often as primary care providers.
The law builds on other legislation increasing pharmacists' authority in recent years. Ruffridge said pharmacists already do some medication management, but now it will be easier to bill for that work.
The bill passed by wide margins in the House and Senate.
The state health department supported the bill and passing it was tied to funding from the Rural Health Transformation Program, but Gov. Mike Dunleavy vetoed it, saying it would expand the scope of practice too much and too fast. Lawmakers had enough support to override his veto.
Brandy Seignemartin, a pharmacist and executive director for the Alaska Pharmacy Association, helped write the legislation and said it will change healthcare in the state.
"Patients are going to be able to walk into community pharmacies and have access to care for minor ailments, test and treat, those kinds of things," she said.
She said that's really important in a rural state like Alaska. Expanded services may allow more community pharmacies to survive, which is increasingly challenging.
And she said the law will also make it easier for pharmacists to set up collaborative agreements to work with a provider, including getting training to work with specialists.
For example, she said a psychiatrist could diagnose a patient, and then work with a pharmacist to optimize the patient's medication.
"Then the patient maybe doesn't need to see the psychiatrist every single visit," Seignemartin said. "Maybe some of those visits they are coming in, they're checking in with the pharmacist, they're getting administered their long acting injectable antipsychotic medications. Pharmacists can titrate doses."
A “game-changer” for some vulnerable Alaskans
She said the new law also opens the door to pharmacists covering healthcare gaps for Alaska's vulnerable populations. That could include offering HIV prevention medication, like pre-exposure prophylaxis and post-exposure prophylaxis, known as PrEP and PEP, vital because of the recent closure of the state's only dedicated queer healthcare clinic.
She also said this law means pharmacists can start treating Alaskans with medications for opioid use disorder. She said it will provide a pathway for pharmacists to "be able to get a DEA license to be able to be a prescriber for those medications."
She thinks that will be a major game-changer for the ongoing opioid crisis in Alaska.
