Drug Topics - October 8, 2007 - (Page 16)

16 DRUG TOPICS OCTOBER 8, 2007 www.drugtopics.com JP AT LARGE Jim Plagakis, R.Ph. The more we go forward, the behinder we get drugs. These drugs would be initially ordered by a legal prescription written by a licensed prescriber. After that, all bets are off because medications in this new fourth class of drugs will be renewable at the pharmacist’s discretion. What a remarkably forward-looking idea. Pharmacists are perfectly capable to assist in the streamlining of the system, helping patients in need get the appropriate medications. However, you know and I know that the American Medical Association will hesitate to give up In 2007, it is very clear that kind of power. That organization of physicians even put that patients benefit up a fuss about Plan B being with the entire medical sold at the discretion of pharmacists. With AMA, it is all team in the loop. about power. The old guard of doctors is having conniption fits all over the place because the young physicians out there are allowing the medical pyramid to be flattened. Docs are still at the apex, but the drop down to the foundation is not that far anymore. I recently called a young doctor and had this conversation: “How about giving your patient a break,” I said. “Let me dispense fluoxetine instead of what you wrote for, Cymbalta, duloxetine. She has no insurance.” “Is there a price difference?” “You betcha,” I said. I gave him the figures. “That much?” “Can I change it?” “Of course you can. Why are you even calling me? There can’t be any therapeutic difference. It’s OK with me if you change something like that.” “Ah, we’re not there yet, doctor.” He will learn. He is young. They’ll beat some elitism into him whether he likes it or not. “You can just call my nurse. Have her change the chart.” Ah, what an idea that is. I did not read about this idea of a fourth class of drugs in a recent Drug Topics magazine. I read about it in a Drug Topics magazine dated April 6, 1964. Someone was making groundbreaking suggestions more than 40 years ago. That was a time when pharmacists G idea, the proposal that there be a new class of adzooks! This has got to be a remarkably modern could be reprimanded for putting the name of the drug on the label without the prescriber’s permission. You could get in trouble if you dared to counsel! In the late 1960s, I had a doctor in California work me over because I suggested that his patient avoid dairy products while taking tetracycline. He had written take with food on the prescription. I had to mail a package insert, suitably highlighted, to him before he got off my back. In 2007, it is very clear that patients benefit with the entire medical team in the loop. Double gadzooks! A class of Rx-only drugs that can be refilled at the pharmacist’s discretion? The modern thinker in 1964 was the executive director of the American Pharmaceutical Association, William S. Apple. What do I have to say about Apple? Where is he when we really need him? The medical establishment is about ready to break or fall apart, if we continue to put the load of final decision-making on the shoulders of physicians who cannot even be trusted to call back in a timely manner when there is need of their definitive word on a prescription. People go without because prescribers are just too loaded down with work. It is distressing to me that a fourth class of drugs giving pharmacists more power was suggested in 1964 when we can’t even get an extended third class. Septra DS (sulfamethoxazole/trimethoprim, Monarch Pharmaceuticals) for urinary tract infections would fit well. There is some good news, though. The FDA commissioner, Andrew von Eschenbach, has come out in favor of a third class of drugs. Our leaders should be on this with both feet. We are in the 21st century. How could we be getting behind? is a community pharmacist who lives in Galveston, Texas. You can e-mail him at jpgakis@hotmail.com and cc us at drugtopics@ advanstar.com. You can also check out his Web site at jimplagakis.com or see details on Jim’s new book at www.shopadvanstar.com/plagakis. THE AUTHOR Got a question? Do you have a question you’d like one of our columnists to address? If you have a legal question, John E. Dinardo, R.Ph., Esq., will answer it in his Legal Q&A. If you have an ethical question, Sue Bliss, R.Ph., will tackle it in Eye on Ethics. If your question is about Medicare Part D, Earlene Lipowski, Ph.D., will handle it in Unraveling Medicare. Finally, if your question is clinical in nature, Jack Rosenberg, Ph.D., will respond to it in his Clinical Q&A. http://www.drugtopics.com http://jimplagakis.com http://www.shopadvanstar.com/plagakis

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Drug Topics - October 8, 2007 Latebreakers Latebreakers in Depth Letters Rx Care Community Practice JP at Large 150 Years of American Pharmacy Hospital Practice Are You Getting Pharmacy's Message Across? Self-Care Government and Law Legal Q&A The Pharmacist as First Responder in Disaster Relief Technology Update New Products Advertisers Index Statement of Ownership Classified Viewpoint

Drug Topics - October 8, 2007

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