Posted on 02/12/2020 2:21:51 AM PST by The Houston Courant
The Institute for Justice has taken up the cause of doctors in Texas who want to offer their patients affordable medications at the point of care—a practice known as physician dispensing of prescription drugs. As the doctors point out, the Texas ban on physician dispensing is irrational. “As 45 other states have recognized, doctor dispensing is a safe and effective way to increase patients’ access and adherence to their prescribed medications—which is good for patients, doctors, and the broader healthcare system,” IJ attorneys said in a press conference outside the Travis County Civil District Court where the lawsuit was filed.
Our research is clear—physician dispensing makes sense. Yet efforts to convince the 86th Texas Legislature to allow it went nowhere. That’s why doctors—and the attorneys from the Institute for Justice—feel it’s now appropriate to bring this state constitutional challenge to the courts in an effort to vindicate the rights of licensed Texas doctors.
In fact, physicians have attempted for nearly a decade to bring Texas in line with the majority of the nation, with no success at the legislative level. Efforts to expand physicians’ ability to dispense drugs are contested by pharmacy cooperatives throughout the state. Their primary stated reasons for opposition are patient safety, the need for regulatory oversight, and potential conflicts of interest. Even though all of these points have been debunked (again, see our research), Texas is still one of five states in the nation that does not allow for a competitive option that is safe and affordable. This is especially grievous at a time when patients are struggling to afford their medications.
The new lawsuit has two points on which doctors say the state constitution has been violated. The first is based on the fact that the state forbids the Legislature from imposing irrational, oppressive, and protectionist restrictions on the right to pursue a chosen business. Clearly, this has been violated by the instituted ban—and by the exemptions and exclusions given to physicians that are inconsistent with their stated oppositions.
For example, physicians can give out free samples to their patients, and there is another state law that allows physicians to dispense from their office so long as there is not a pharmacy within 15 miles of their location. Clearly, the practice is safe—otherwise these two provisions in current law would be targeted by not only the pharmacy industry, but by physicians themselves, whose top concern is the safety of their patients.
The second claim of constitutional violation is based on the fact that the Texas Constitution forbids the Legislature from drawing irrational, oppressive, and protectionist distinctions between similarly situated groups. The distinction doesn’t exist in 45 other states—or in Texas when a doctor’s office is more than 15 miles from a pharmacy—so this is clearly irrational, oppressive, and protectionist in nature.
At a time when the high costs of prescription drugs are discussed at every level of government—and around the water cooler—it is more important to offer more venues where patients can get the medications they need. According to the Kaiser Family Foundation, “about three in ten (29%) of all adults report not taking their medicines as prescribed at some point in the past year because of the cost. This includes about one in five who say they didn’t fill a prescription (19%) or took an over-the counter drug instead (18%), and about one in 10 (12%) who say they cut pills in half or skipped a dose.”
Physician dispense can improve mediation adherence by making prescription-filling more convenient and providing patients the opportunity to take their first dose in the physician’s office with assistance from their doctor or nurse. Physician dispensing (at the point of care) will expand physicians’ ability to provide care, improve patients’ experience, and reduce the underuse of medications.
I worked with a nuerosurgeon once who got Percocet by the thousand in the mail. Guess what he had problems with? My dad’s cousin was a doctor in the 40s-60s, addicted to Morphine, shot himself with a shotgun.
Personally, I think it’s a good idea to keep the pharmacy and the prescription pad in two different buildings.
But maybe that’s just me. Take away the guard rails for everybody, otherwise. You can’t think being strict on doctors and pharmacies while decriniminalizing heroin, coke, and meth for the homeless is actually a serious consideration, can you?
OTOH, It does “get doctors out of the recreational pharmaceutical industry” which is something I have long wished for.
The real reason Pharma wants this is if they can get your doctor to prescribe their drug at $200 per month which can conveniently be taken once a day saving you 5 minutes a month instead of the drug that has been around for 30 years and has a proven record but only costs $10 a month they win! Especially if all it costs is a hoagie and a bag of chips. (And you should see the girls they hire to deliver the chips!)
I fear narcotics. I don’t want them nearby, but they are a necessary sometimes. I agree with you, it’s best to keep large quantities of Controlled Substances out of Physicians offices, and make sure that small quantities are carefully regulated. Separation of the Pad and Pharmacy is a good idea.
Limit the items not to be dispensed at the doctor’s office to those items on the controlled substance list.
“Limit the items not to be dispensed at the doctor’s office to those items on the controlled substance list.”
This makes the most sense.
You can often get the newest, most effective & expensive drugs as samples from your Dr. Not every medication though.
Sometimes on a long term basis if you’re financially strapped.
If you believe in liberty and that free people should be in control of every aspect of their lives, then all government restrictions on access to medical care should be removed. Let people live with the consequences of their personal decisions, both good and bad.
And abortion is not health care.
Considering the way they prescribing Statins like candy these days, with virtually ZERO evidence that they help anyone (and far more evidence that they hurt people), perhaps the best option to prohibit both doctors and pharmacies from dispensing drugs.
“Let people live with the consequences of their personal decisions, both good and bad”
This ^. I have a bottle of hydro, and a box of fentanyl patches I was given for pain I no longer have ... and haven’t touched either of them since.
I guess if I ever break an appendage off or something I’ll be in good shape...
I think the doctor should diagnose and the pharmacist should prescribe. Pharmacists have so much more knowledge of pharmaceuticals than physicians. In this age of digital data, the physician could transmit the diagnosis and the patient chart to the pharmacy and the pharmacist would then prescribe the medication and fill it and call the patient when it’s ready. Or have a drone deliver it - lol.
I find it fascinating that the powers that be decide that doctors not be allowed to dispense the drugs, but meanwhile are the people that determine their use and write scripts for them so pharmacies can fill them for profit.
I had a pharmacy tell me they wouldn’t fill a prescription for me when the doctor said I should have it. I told them they should have told me that in advance as I sure wasted my time going to the doc when they had the final say on the drug. It was not a narcotic, it was too expensive in their inventory so they wouldn’t carry it to dispense it and there’s nothing less expensive to use instead. So I could, at least, save gas if I get it at the doctor’s office. No difference.
rwood
We moved from Texas to Florida, our doctor has a pharmacy in his office owned by the doctor. Convenient.
It's also a way to get a lot of doctors hooked on various substances. Just dip into the medicine closet.
A much better way to save patient’s money is to create a “perpetual prescription”, so that patients taking non-schedule drugs, who are otherwise stable, are no longer required to have an doctor visit to renew those prescriptions.
Even an annual physical is an expensive proposition, especially when the patient has no other complaints.
Conversely, many such drugs should only require a one time prescription. If the doctor thinks their approval is necessary after a brief check, it could be performed by a Nurse.
Follow the money and you’ll find the motivation. This has nothing to do with the patient and saving him money or making things better for him. It is about adding a profit center to the doctor’s office.
Not a pharmacist but I worked in a pharmacy. I saw the pharmacist gently handle enough doctor mistakes to convince me that I want that additional step of quality control in issuing a prescription that the pharmacist brings.
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