By Karen L. Kier, Pharmacist
On behalf of the ONU Healthwise Team 

Halloween and trick-or-treat are on their way.  It is estimated that the average American will spend $36.40 on candy for a national total of $4.1 billion. Americans will spend another $4.3 billion on decorations and $4.4 billion on costumes. This totals $13.5 billion for the nation, with the average American spending $115.14 on Halloween. 

Compared to Halloween spending, the average insured American spends between $30 to $75 for an urgent care visit for a sore throat, the flu or COVID-19. An uninsured or cash-paying patient can spend between $184 and $365 for a visit to urgent care.

When a sore throat strikes, getting medical care can become a project of its own. Finding a doctor’s appointment, driving to an urgent care center and waiting to be seen may take hours. Is there another alternative to urgent care or emergency department visits for these conditions?

Is it strep throat, a virus or something else?

A growing approach to health care called “test-to-treat” could make that process easier. Instead of visiting one location for a test and another for treatment, patients could potentially visit their neighborhood pharmacy, where a specially trained pharmacist could test for certain illnesses and prescribe medication when appropriate.

Ohio is considering legislation that could make this option more widely available, following the lead of states that have already expanded pharmacists’ roles in treating common infections.

Under a test-to-treat model, pharmacists can screen patients, perform FDA-approved rapid diagnostic tests, evaluate the results and dispense treatment for specific conditions within their authorized scope of practice.

For example, someone with a sore throat might receive a rapid strep test at the pharmacy. If the result is positive and the patient meets the treatment criteria established by physician-approved protocols, the pharmacist could prescribe an appropriate antibiotic. Someone with flu symptoms might be tested and, if eligible, receive an antiviral medication.

The important distinction is that treatment would depend on the test results, the patient’s symptoms, medical history and established clinical protocols—not simply on a request for medication. Pharmacists would need to recognize when symptoms suggest a more serious illness and refer patients to a physician or emergency department.

The potential advantage would be convenient access, quicker answers and fewer unnecessary trips between healthcare providers. Pharmacists are often more accessible in the community with longer working hours, including weekends. 

Ohio Senate Bill 230, sponsored by Senator Mark Romanchuk, was passed by the Ohio Senate in June 2026 and sent to the House for consideration. As of October 22, the bill remains in the legislative process and has not become law.

The measure would authorize qualified pharmacists to screen, test and treat patients ages five and older for specified respiratory illnesses, including influenza, COVID-19 and strep throat. Pharmacists would follow protocols established by the State Board of Pharmacy, with provisions for appropriate referrals and insurance reimbursement.

Ohio would not be the first state to implement the concept of pharmacist test-to-treat. New Mexico, Virginia, Illinois, Iowa and Tennessee are among the states that have adopted laws or protocols expanding pharmacists’ authority to test and treat certain conditions.

Research offers encouraging evidence that patients value these services and treatment can be delivered efficiently. A 2023 review in the Journal of the American College of Clinical Pharmacy examined pharmacist-provided test-and-treat programs for acute infections. The researchers identified potential benefits, including improved access to care, less unnecessary use of other health services and better-informed antibiotic prescribing.

A 2025 study published in Innovations in Pharmacy, titled “Project IMPACT: Test and Treat,” evaluated pharmacy-based testing for COVID-19, influenza and strep infections. Pharmacists enrolled 253 patients. Among 71 positive test results, 26 patients received prescriptions, and 23 of those patients obtained their medication within one day. Overall, 98% of survey respondents reported satisfaction with the service.

Test-to-treat does not mean pharmacists replace primary care physicians, nurse practitioners, or physician assistants. Nor does a negative rapid test always rule out infection. Some patients may need additional testing, a broader evaluation or follow-up care.

Essential components of test-to-treat require clear eligibility rules, pharmacist training, and communication with patients’ healthcare providers. Antibiotics must be prescribed when appropriate because unnecessary use contributes to antimicrobial resistance.

Test-to-treat aims to put timely care within easier reach. If Ohio lawmakers approve the proposed legislation, a neighborhood pharmacy could become a more useful first stop when certain common infections appear.

Lawmakers could provide a nice treat to help Ohio residents receive a test-to-treat option for their health care.