Members of the Pharmacy, Medical, Consumer and Regulatory Communities:
This week the American Medical Association House of Delegates adopted a resolution (Resolution 218) calling “inappropriate inquiries from pharmacies to verify the medical rationale behind prescriptions, diagnoses and treatment plans to be an interference with the practice of medicine and unwarranted.” Such actions help call important attention to an issue, but don’t address the real problem or offer solutions for patients and regulators.
The real problem is that the US faces a major public health epidemic with prescription drug abuse, particularly opioid abuse. The problem is not that pharmacists are asking too many questions of their physician colleagues. That’s just a symptom. The DEA and other government entities have placed an increased, often unilateral burden and expectation on pharmacists to validate prescription orders received and medications dispensed in pharmacies. This pressure is largely due to concerns with substance abuse and growing public pressure to address the associated public health issues. Unfortunately, pharmacists do not typically have access to pertinent clinical information, so this management and verification process often requires reaching out to prescribers.
It is not pharmacy's intent to delay patients from receiving these needed medications or to unnecessarily interrupt prescribers. The current situation highlights the need for pharmacy, medicine and regulators to collaborate on solutions that address the root cause of our health care system inefficiencies and abuse problems in this country.
While pharmacists are disappointed in the passage of a resolution that discourages a team-based approach to health care, the policy provides an opening to find solutions for controlled substance verification. These solutions need to incorporate changes to policy and Health Information Technology.
The solution is truly more physician/pharmacist collaboration, not less. Pharmacists and physicians share the responsibility to ensure that controlled substance prescriptions are valid and appropriate and that patients understand the risks and benefits from the use of these medications. There are patients who legitimately need these controlled substance medications and all healthcare professionals should be united in advocating for those patients. Meanwhile, we also need improved government enforcement of the supply chain and support from practitioners in that effort.
Pharmacists are essential healthcare team members. We encourage physicians to continue working and talking with their patients’ pharmacists. Open access and communication with the physician is vital to our patients’ optimal health outcomes. We look forward to our continued discussions with the AMA on the pharmacist’s responsibility to verify a prescription.
Thomas E. Menighan
BSPharm, MBA, ScD (Hon), FAPhA
Executive Vice President and Chief Executive Officer
American Pharmacists Association