Pharmacy-based CLIA-waived testing in the United States: Trends, impact, and the road ahead

IF 3.7 3区 医学 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Research in Social & Administrative Pharmacy Pub Date : 2024-03-15 DOI:10.1016/j.sapharm.2024.03.003
Ben Zalupski , Zeina Elroumi , Donald G. Klepser , Nicklas S. Klepser , Alex J. Adams , Michael E. Klepser
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Abstract

Background

Federal authorization of the use of Clinical Laboratory Improvement Amendments of 1988 (CLIA) waived point-of-care tests for SARS-CoV-2 by pharmacists during the pandemic resulted in a dramatic rise in the number of community pharmacies that became CLIA-waived test sites. Now as we exit the pandemic, the wide-ranging expansion of the scope of practice facilitated currently by the PREP Act is set to expire in fall 2024. As a result, American pharmacists’ ability to offer CLIA-waived testing services will revert to a patchwork of state laws.

Objective

This study aims to examine both the number of pharmacies in the United States with CLIA Certificates of Waiver before and after the SARS-CoV-2 pandemic and the state-by-state differences in the percentage of pharmacies with CLIA Certificates of Waiver.

Methods

Data were collected from the U.S. Centers for Disease Control and Prevention CLIA Laboratory Search website on May 3rd, 2015, August 4th, 2019, November 26th, 2020, October 6th, 2021, November 23rd, 2022, and December 4th, 2023. The website allows for the exportation of demographic data on all CLIA-waived facilities by state.

Results

The total number of pharmacies with a CLIA-waiver grew from 10,626 (17.9%) locations in 2015 to 12,157 (21.4%) locations in 2019, to 15,671 (27.6%) locations in 2020, and to 29,011 (51.6%) locations in 2023. States demonstrated considerable variability in the percentage of pharmacies possessing a CLIA certificate of waiver in 2023, with a range of 10.7%–87.9%.

Conclusions

Use of CLIA-waived tests in pharmacies has grown by 140% since 2019. The time period from 2019 to 2021 witnessed a 92.5% increase in pharmacies that possessed a certificate of waiver which was largely driven by the pandemic. Interestingly, from 2021 to 2023 the was continued growth in the market of 31.6%. This suggests that pharmacies continue to see opportunity in offering CLIA-waived testing services beyond those that had been extended as a result of the pandemic.

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美国基于药房的 CLIA 豁免测试:趋势、影响和未来之路。
背景:在大流行期间,联邦授权药剂师使用 1988 年《临床实验室改进修正案》(CLIA)豁免的 SARS-CoV-2 护理点检测,导致成为 CLIA 豁免检测点的社区药房数量急剧上升。现在,随着大流行病的结束,《PREP 法案》目前所推动的执业范围的广泛扩展将于 2024 年秋季到期。因此,美国药剂师提供 CLIA 豁免测试服务的能力将恢复到各州法律的拼凑状态:本研究旨在考察 SARS-CoV-2 大流行前后美国拥有 CLIA 豁免证书的药房数量,以及各州拥有 CLIA 豁免证书的药房比例差异:数据分别于 2015 年 5 月 3 日、2019 年 8 月 4 日、2020 年 11 月 26 日、2021 年 10 月 6 日、2022 年 11 月 23 日和 2023 年 12 月 4 日从美国疾病控制和预防中心 CLIA 实验室搜索网站收集。该网站允许按州导出所有 CLIA 豁免机构的人口统计数据:获得 CLIA 豁免的药房总数从 2015 年的 10626 家(17.9%)增加到 2019 年的 12157 家(21.4%),2020 年增加到 15671 家(27.6%),2023 年增加到 29011 家(51.6%)。各州在 2023 年拥有 CLIA 豁免证书的药房比例差异很大,范围在 10.7%-87.9% 之间:自 2019 年以来,药房使用 CLIA 豁免测试的情况增长了 140%。在 2019 年至 2021 年期间,拥有豁免证书的药房增加了 92.5%,这在很大程度上是受大流行病的影响。有趣的是,从 2021 年到 2023 年,市场持续增长了 31.6%。这表明,药店在提供因大流行而延期的 CLIA 豁免检测服务之外,继续看到了提供其他服务的机会。
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来源期刊
Research in Social & Administrative Pharmacy
Research in Social & Administrative Pharmacy PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH-
CiteScore
7.20
自引率
10.30%
发文量
225
审稿时长
47 days
期刊介绍: Research in Social and Administrative Pharmacy (RSAP) is a quarterly publication featuring original scientific reports and comprehensive review articles in the social and administrative pharmaceutical sciences. Topics of interest include outcomes evaluation of products, programs, or services; pharmacoepidemiology; medication adherence; direct-to-consumer advertising of prescription medications; disease state management; health systems reform; drug marketing; medication distribution systems such as e-prescribing; web-based pharmaceutical/medical services; drug commerce and re-importation; and health professions workforce issues.
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