Pharmacy-Based Strep Testing Has Potential

Testing for strep throat in the pharmacy could save money, produce faster results, and improve patient outcomes, a study suggests.

Strep throat? Seeing a pharmacist for diagnosis and treatment may be less expensive, faster, and more effective than current care options, suggests a study published in the April edition of the American Journal of Managed Care.

The study’s authors established 7 possible care models and performed a cost analysis for each. The models incorporated observation, antibiotic treatment based on symptoms, and 2 standard strep tests—a rapid antigen detection test that could be performed by a physician, a nurse practitioner at a walk-in clinic, or a pharmacist, and a throat culture that would have to be performed by a physician.

The models assumed that patients would be adults without strep complications or penicillin allergies and that patients would adhere to the antibiotic therapy and be willing to pay for treatment. The researchers compared the different care models in terms of cost and quality-adjusted life days, but since the models scored similarly in terms of quality-adjusted life days, they focused on cost minimization.

Not counting the costs of the tests themselves, the results showed that diagnosis and treatment by a pharmacist would be the cheapest option. It would cost $53.56 for a pharmacist to administer a single rapid-antigen detection test, $79.12 for a walk-in clinic to administer the same test, $83.77 for a physician to administer a throat culture, and $88.97 for a physician to administer a rapid-antigen detection test.

The authors recommend additional research into integrating strep testing into the pharmacy business model, as well as a cost-benefit analysis of testing children for strep in the pharmacy. States may require that pharmacists receive more training or additional credentials in order to qualify to administer strep tests, the authors noted. Due to the walk-in nature of the tests, pharmacists would also need to incorporate the tests into normal work days.

Although the model cannot predict whether patients would accept strep tests from pharmacists, the authors point out that widespread acceptance of pharmacy-based immunization services could serve as a template for the practice. Prior to 1996, just 9 states allowed pharmacists to give immunizations; by June 2009, pharmacists in all 50 states were empowered to do so.

To read the study, click here.