Death, Taxes, and Tuition Increases

Pharmacy School Tuition From 2019 to 2022

Pharmacy school tuition data for three consecutive fiscal years (2019-2020, 2020-2021, and 2021-2022), published by the American Association of Colleges of Pharmacy (AACP) Office of Institutional Research and Effectiveness, was used to extract pharmacy school characteristics and tuition/fee information.¹⁰ This period was selected to observe cost changes before and during the COVID-19 pandemic, as 2019-2020 budgets were determined prior to any knowledge of the significant economic impact that would ultimately begin in the US in March 2020.

Unadjusted costs were used to represent the actual dollars reported to AACP representing actual amounts charged to students. Costs were defined as the sum of tuition and mandatory fees reported for each year, representing total annual education charges reported by each school. Cost changes were simply the differences between school years included in the sample, reported separately for in-state and out-of-state students. Cost changes were analyzed both as continuous and binary variables. As a continuous variable, individual-level school cost change was assessed from fiscal year 2019-2020 to fiscal year 2020-2021, fiscal year 2020-2021 to fiscal year 2021-2022, and fiscal year 2019-2020 to fiscal year 2021-2022. As a binary variable, the school cost change was considered an increase (cost change > 0) or not (cost change ≤ 0). Cost changes were assessed for the full sample and then evaluated by school type (public vs private). For comparisons between public and private schools, student t test and chi-square test of independence were used (significance: alpha = 0.05).

Of the 138 schools and colleges of pharmacy that reported tuition and fee data to AACP, 68 (49%) public and 70 (51%) private schools were included (Table 1). Most schools were defined as traditional (88%) and used semester-based scheduling (86%). Median in-state charges for all schools were $34,559, $34,695, and $35,185 for 2019-2020, 2020-2021, and 2021-2022, respectively. Median out-of-state charges for all schools were $41,347, $41,534, and $41,640 for 2019-2020, 2020-2021, and 2021-2022, respectively.

Between the 2019-2020 and 2020-2021 school years, median in-state costs increased by $454 (1.3%), with 95 (69%) schools reporting an increase in costs. During that same period, median out-of-state costs increased by $641 (1.5%), with 94 (68%) schools reporting an increase. From 2020-2021 to 2021-2022, median in-state costs increased by $503 (1.4%), with 102 (74%) schools reporting an increase. During that same period, median out-of-state costs increased by $622 (1.5%), with 100 (72%) schools reporting an increase. Over both fiscal years from 2019-2020 to 2021-2022, median in-state costs increased by $1,117, with 117 (85%) schools reporting an increase, while median out-of-state costs increased by $1,367, with 112 (81%) schools reporting an increase (Table 1).

Between 2019-2020 and 2020-2021 academic years, costs increases were similar for public and private schools whether evaluating costs as continuous (p=.76 for in-state, p=.22 for out-of-state) or binary variables (p=.16 for in-state, p=.11 for out-of-state). From 2020-2021 to 2021-2022, private school in-state cost increases were significantly higher (p=.009) with more private schools experiencing cost increases (p=.015). During that same period, private school out-of-state cost increases were not statistically different than public school increases (p=.06), but more private schools increased out-of-state costs (p=.006). Over both fiscal years, private school cost increases were higher for both in-state (p=.024) and out-of-state (p=.024). However, the relationship between school type and “any increase” was not significant over the period (Table 2).

Interpreting Tuition Increases During Covid-19

Pharmacy school cost changes over the COVID-19 pandemic can be viewed positively or negatively, depending on one’s perspective. From the student perspective, actual dollar increases show that a large majority of schools raised their tuition and fees. For school administrators, one could argue that these price increases are much slower than those experienced across all educational institutions in recent years. From a larger societal perspective, Consumer Price Index (CPI) Inflation from 2019-2020 and 2020-2021 was 1.0% and 5%, respectively. This means that pharmacy school enrollment costs to students, while increasing, were comparable to national price increases for common items such as food, electricity, and shelter. However, the Bureau of Labor Statistics (BLS) also disaggregates college tuition and fees for all urban consumers, and the estimated inflation using this index for 2019-2020 and 2020-2021 was 1.0% and -0.05% respectively.¹¹ In other words, while college tuition and fees generally fell during the 2020-2021 school year, pharmacy school increases remained.

Considering the slowdown in pharmacy school applications prior to the pandemic and entry into one of the most significant public health and economically challenging periods in our lifetime, one could argue any unadjusted cost increase passed on to our students may be problematic. What will it take to bend the pharmacy education cost curve and bring real tuition and fees down? Throughout the pandemic, some schools braced for economic hardships through the unknown of a worldwide pandemic and cut operating costs. In some cases, schools may have experienced some cost savings with no or limited in-person instruction. However, the full impact of the pandemic on school operating costs needs further evaluation. Even with educators realizing broader economic challenges resulting from COVID-19, over 80% of schools consciously approved tuition and fee increases, with no real difference between public and private schools.

Pharmacy deans and administrators must consider several factors when developing the annual budget to achieve their respective institutions’ strategic objectives. Schools employ faculty and staff and are charged with delivering instruction at a high level to ensure all graduates are prepared for long careers. Throughout the pandemic, schools were forced to expend resources to adapt to the changing in-person, virtual, or mixed instruction environments. Additionally, market competition changes for talent may have required maintaining or increasing salaries for faculty and staff. For example, public health needs during the pandemic required more clinicians to support testing and vaccination programs, making it more difficult for some schools to retain clinical faculty who recognized higher market demand for their skills.

Public universities typically rely on state and federal funding for a proportion of operations. In cases where state appropriations to schools of pharmacies were cut, the tuition and fee increases may have merely maintained revenues without significant faculty or staff cuts. While other factors are certainly important in a summative judgment around a tuition increase, tuition and fee costs are directly passed to our students and was the focus of this commentary.