Pharmacists to Prescribe?

Someone asked me if I thought pharmacists would be allowed to prescribe medication to patients. I’m not familiar with any legislation on this topic (although there well might be some).

My opinion is that the better model is that physicians are responsible for diagnosing and basically writing a prescription for the type of drug (e.g., statin). I think the pharmacist is in the best position to talk with the patient about which drug within that category they should use looking at drug-drug interactions, form of the medication, formulary status, costs, side-effects, and other things that usually result in a follow-up call to the physician. Given that 40% of scripts written today hit some type of edit as an exception, I can’t imagine pushing that responsibility to the physician.

One of the most creative scripts I saw at Express Scripts around this was a physician that had just written all the PPIs (e.g., Prilosec, Nexium, Protonix) on the script and said pick one. I don’t know if it was legal, but I thought it made the point that they didn’t want the call back.

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