AMA Opposes Giving Pharmacists Prescription Authority

The country’s largest association of medical doctors has come out against expanding the role of pharmacists in prescribing medications.

The American Medical Association’s House of Delegates has adopted a policy against allowing pharmacists to prescribe medication without oversight by or an order from a physician. The policy, adopted at the organization’s annual meeting held last month in Chicago, opposes federal or state legislation that would give independent prescribing power to pharmacists or allow them to extend a prescription past its expiration.

The policy was adopted in reaction to a proposal floated by the FDA in March to shift certain prescription drugs for chronic conditions to a new category of OTC drugs that could be dispensed by pharmacists provided that “conditions of safe use” are met. The FDA argues that the move would help improve access to needed medication for many patients, but the AMA has countered that the proposal could jeopardize patient safety.

“While pharmacists are valued members of the patient care team, they do not have the statutory authority to prescribe drugs,” Robert Orford, MD, an assistant professor of medicine at the Mayo Clinic in Arizona, said during an AMA committee meeting, according to MyHealthNewsDaily. “Pharmacists' training is not even close to the comprehensive systematic training of physicians.”

The FDA proposal was based on the concern that many patients with chronic conditions such as hyperlipidemia, hypertension, migraine, and asthma fail to take necessary medication due to the cost and time required to get a prescription from a physician. In order to ensure that patients receiving medication under the new paradigm would be properly diagnosed and monitored, the FDA proposal raised the possibility of employing technology as well as expanding the role of pharmacists. For example, patients could access diagnostic technologies at a pharmacy or via the Internet, and pharmacists could perform routine monitoring using diagnostic tests and determine whether a patient should take a given medication.

According to MyHealthNewsDaily, an FDA representative pointed out that medications approved under the new category would have to go through an FDA approval process to establish that they could be safely administered using the new means of diagnosis and monitoring.

By contrast with the AMA, a number of pharmacy organizations, including the National Community Pharmacists Association, the National Association of Chain Drug Stores, and the American Pharmacists Association, have expressed qualified support for the FDA proposal. All of these organizations registered their appreciation for the expanded clinical role of pharmacists envisioned by the proposal but emphasized the importance of providing reimbursement in exchange for the added responsibilities it would entail.

To read more on this topic, click on the following links:

• FDA Plans Next Round of Rx-to-OTC Switches
• NCPA Offers Support for Nonprescription Class of Drugs at FDA Hearing
• NACDS Expresses Cautious Optimism with FDA's Proposed "New Paradigm" for Third Class of Drugs
• APhA to FDA: Pharmacist Intervention Essential to Potential Revisions to Drug Paradigm