Why shouldn’t pharmacists prescribe medicines?

Should pharmacists be allowed to dispense certain drugs without a prescription from a physician? The US Food and Drug Administration (FDA) is inviting comment on just such a proposal. The idea is to add a new class of "behind the counter" drugs that consumers could buy after consultation with a pharmacist, explain Kathleen Johnson, a professor at the University of Southern California, and Shirley Svorny, a professor at Cal State Northridge.

Consider:

Other countries, including Great Britain, already use this system to dispense drugs that do not require sophisticated diagnosis and prescription.

In 2006, the FDA set the stage for such a system when it allowed pharmacists to sell emergency contraception in the United States to patients over 18 on a behind-the-counter basis.

Other medications proposed for this category include drugs for migraine headache and ones that improve cholesterol levels.

This is the logical next step in a progression to reduce the cost and improve access to healthcare in this country, say Johnson and Svorny.

This proposal would allow pharmacists to take on some tasks previously limited to physicians. Heavy lobbying by physician organisations at the federal and state levels has led to restrictive "scope-of-practice" rules that can't be justified on a clinical basis.

There are many situations in which pharmacists already safely counsel patients on appropriate drug use and the management of chronic diseases. In fact, laws in California and many other states allow pharmacists to initiate or change therapy in co-operation with physicians. These tasks are performed routinely by pharmacists in many organised healthcare settings, such as Kaiser Permanente, the Indian Health Service and the health system of the Department of Veterans Affairs.

Source: Kathleen Johnson and Shirley Svorny, Why shouldn't pharmacists be prescribers? Their specialized training renders them qualified to dispense some drugs without a physician's say-so, thereby lightening doctors' loads, Los Angeles Times, October 22, 2007.

For text: http://www.latimes.com/news/opinion/la-oe-svorny22oct22,0,4504834.story?coll=la-opinion-rightrail

For more on Health Issues: http://www.ncpa.org/sub/dpd/index.php?Article_Category=16

FMF Policy Bulletin/ 30 October 2007