Pharmacist rules face physician objections
Thursday, June 25, 2020
Posted by: DCMA
The News Service of Florida
By Christine Sexton
TALLAHASSEE --- The chairman of a state physician-licensing board on Thursday warned that proposed rules to expand the role pharmacists play in health care could face legal challenges if changes aren’t made.
The high-profile rules could be challenged unless the Board of Pharmacy agrees to delete language that would allow pharmacists to treat “any disease state that is expected to last greater than one year or more,” said Florida Board of Osteopathic Medicine Chairman Joel Rose, a Tampa physician.
Rose said inclusion of the “catch all” phrase in the proposed rules runs afoul of a requirement that the pharmacy board consult with the Board of Osteopathic Medicine and the Board of Medicine before increasing the number of medical conditions pharmacists can treat under a recently enacted law.
During a telephone hearing that included the Board of Pharmacy Rules Committee and representatives of the two physicians’ boards, Rose alluded to a desire by the pharmacy board to move forward with the rules as soon as possible.
“But if you go against some of the things legislatively, you could find yourself in some rule challenge that would then slow the whole process down,” he said. “So I recommend you keep that in mind as you consider what you want on your list.”
Rose wasn’t alone in his concerns, as representatives of several physician groups said the proposal exceeds legislative authority or the intent of the law.
The Board of Pharmacy Rules Committee did not vote on the proposed rules during the meeting. Chairman Jeffrey Mesaros. an Orlando pharmacist and an attorney, said another meeting of the Rules Committee will be scheduled before the full Board of Pharmacy meets Aug. 25 and Aug. 26.
The discussion about the proposed rules comes after the Legislature this year passed a bill --- over objections of physicians --- to give pharmacists broader authority to provide health-care services. The law was a priority of House Speaker Jose Oliva, a Miami Lakes Republican who has made a priority of revamping the health-care system.
The proposed rules lay down the requirements that need to be followed for pharmacists and physicians who agree to enter into collaborative arrangements. The law specifically authorized pharmacists to treat designated patients for arthritis; asthma; chronic obstructive pulmonary diseases; type 2 diabetes; human immunodeficiency virus or acquired immune deficiency syndrome; and obesity.
But the law also authorized pharmacists to treat “any other chronic condition adopted in rule” by the pharmacy board after consulting with the Board of Medicine and Board of Osteopathic Medicine.
It’s more than the “any disease state” language, though, that worries Rose and other physicians.
The Board of Pharmacy proposal also would authorize pharmacists to treat patients for hyperlipidemia; hypertension; anticoagulation management; smoking cessation; osteoporosis and osteoarthritis; and opioid use disorder.
While Rose said he was on board with some of the additions, such as opioid use disorder and smoking cessation, he said the others “need to be vetted out a little bit.”
The Florida Society of Rheumatology is submitting written objections to the proposed rule, said Toni Large, a lobbyist who represents the specialty physicians.
“Remember, most patients who go to a rheumatologist have already gone to five doctors to finally get to the specialist who can manage their conditions,” she said. “So these are very fragile and frail patients. And we don’t want them on that initial first list.”
But Board of Pharmacy Rules Committee member Jeenu Philip said the additions will help improve patient care. Philip, a St. Johns County pharmacist, said he has “yet to find a single study that demonstrates where a pharmacist’s participation in the disease state decreases or worsens patient care.”