Pharmacists prescribing OTCs

[Somatic]

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With the new health care law that requires OTC items to be obtained by prescription in order to be paid for by flex spending cards, pharmacists should be able to write prescriptions for OTC items. What do people think?

 

[Pharmavixen]

Puts us in a potential conflict of interest.

 

[deleted205891]

I agree, it's a conflict of interest, unless you have a dispensing and a nondispensing pharmacist working together. The nondispensing pharmacist would prescribe OTCs, do MTM, diabetes education, etc... I don't think chains would ever go for this model.

 

[Rockinacoustic]

I agree, it's a conflict of interest, unless you have a dispensing and a nondispensing pharmacist working together. The nondispensing pharmacist would prescribe OTCs, do MTM, diabetes education, etc... I don't think chains would ever go for this model.

I've heard CVS and WAGs are sending recruiters to Psychiatric centers looking for Pharmacists with DID to fill this very void

 

[wes011]

I personally think that pharmacists should have prescribing rights for OTC medicines, especially to satisfy the requirements for flex spending accounts. I do not understand why anybody should have to go to their MD in order to obtain a medicine that is found to not require MD supervision or MD monitoring in order to utilize it appropriately.

More of a burden will be placed on the pharmacist, however, I think if people want to get real on saving health care dollars then this is a practical way to eliminate unnecessary costs.

I believe the key for pharmacists not to have a conflict of interest is to recommend a specific drug instead of a specific brand.

Kentucky was looking at OTC prescribing rights for pharmacists for a couple counties out in the boonies, however, it died in the state senate.

 

[wes011]

I agree, it's a conflict of interest, unless you have a dispensing and a nondispensing pharmacist working together. The nondispensing pharmacist would prescribe OTCs, do MTM, diabetes education, etc... I don't think chains would ever go for this model.

Chains won't go for this model now because the value of the pharmacist is tied directly to the medication. When pharmacists can get paid for cognitive services rendered the health care delivery and finance model will change. Until then, status quo.

 

[R2pharmD2]

I personally think that pharmacists should have prescribing rights for OTC medicines, especially to satisfy the requirements for flex spending accounts. I do not understand why anybody should have to go to their MD in order to obtain a medicine that is found to not require MD supervision or MD monitoring in order to utilize it appropriately.

More of a burden will be placed on the pharmacist, however, I think if people want to get real on saving health care dollars then this is a practical way to eliminate unnecessary costs.

I believe the key for pharmacists not to have a conflict of interest is to recommend a specific drug instead of a specific brand.

Kentucky was looking at OTC prescribing rights for pharmacists for a couple counties out in the boonies, however, it died in the state senate.

Prevent pharmacists from writing DAW RXs. Problem solved. Well, partially solved. You might still have an issue when you consider the difference in price between OTC meds used for the same purpose, like Claritin vs. Allegra.

 

[deleted205891]

Prevent pharmacists from writing DAW RXs. Problem solved. Well, partially solved. You might still have an issue when you consider the difference in price between OTC meds used for the same purpose, like Claritin vs. Allegra.

Well, problem not solved, because pharmacists could be writing erroneous Rxs and not catching their own prescribing errors. Also, if pharmacists get prescriptive authority, you know chains will say that pharmacists have to write an Rx and dispense it in 15 mins or less or the pt. will get a gift card.
2 pharmacists would work fine. The other pharmacist could be trained in a community or am care residency.

 

[R2pharmD2]

Well, problem not solved, because pharmacists could be writing erroneous Rxs and not catching their own prescribing errors. Also, if pharmacists get prescriptive authority, you know chains will say that pharmacists have to write an Rx and dispense it in 15 mins or less or the pt. will get a gift card.
2 pharmacists would work fine. The other pharmacist could be trained in a community or am care residency.

You must have missed the fact that I was responding to the conflict of interest issue. And the word partially.

Honestly though, I don't see a whole lot of opportunity for errors. Not that they couldn't happen (people always find new and creative ways to screw things up), but if pharmacists had these types of limited prescribing rights, the sig would only need to say take as directed per package instructions. I assume the patients would basically be telling the pharmacist what they want and then they'd write a script for it, so there really wouldn't be much opportunity for errors in judgement either.

 

[Ackj]

I personally think that pharmacists should have prescribing rights for OTC medicines, especially to satisfy the requirements for flex spending accounts. I do not understand why anybody should have to go to their MD in order to obtain a medicine that is found to not require MD supervision or MD monitoring in order to utilize it appropriately.

I think this is just circumventing the whole process. If you want to use healthcare dollars on medication, get your doc to diagnose something. If you just feel like picking up a bottle of ibuprofen, but don't want to spend cash on it, then say "hey rph, write a script so I can buy this" ... it doesn't really seem to serve a purpose. I mean, sure, we recommend OTCs all the time, but prescribing it seems a bit different.

 

[R2pharmD2]

I think this is just circumventing the whole process. If you want to use healthcare dollars on medication, get your doc to diagnose something. If you just feel like picking up a bottle of ibuprofen, but don't want to spend cash on it, then say "hey rph, write a script so I can buy this" ... it doesn't really seem to serve a purpose. I mean, sure, we recommend OTCs all the time, but prescribing it seems a bit different.

Good point. Requiring a prescription to use a flex spending card for OTC meds is silly anyway. A better solution would be to remove that requirement entirely. I'm not sure why they did this in the first place. Was it intended to save money by preventing people from using their flex cards for meds they don't really need? If so, I'm not sure how anyone is saving money by making extra trips to the doctor to get their OTC meds. I don't see how paying pharmacists to fill OTC meds saves the system money either. Is there another reason for the change to flex spending accounts that I'm not aware of?

 

[Somatic]

I am surprised more people are not all for pharmacists being able to help people bypass going to the doctor to get simple OTC stuff on their flex card. It seems like most people have a flex card these days. Recommending OTC items is basically like prescribing them... You can recommend allegra because you think it's superior to loratadine. We need all the job security we can get and I think this is a perfect opportunity to give us more job security.

I am dissapointed with how many people don't see the value of this idea. No wonder our profession hasn't advanced as much as it could and pharmacy has missed so many opportunities...

 

[R2pharmD2]

I am surprised more people are not all for pharmacists being able to help people bypass going to the doctor to get simple OTC stuff on their flex card. It seems like most people have a flex card these days. Recommending OTC items is basically like prescribing them... You can recommend allegra because you think it's superior to loratadine. We need all the job security we can get and I think this is a perfect opportunity to give us more job security.

I am dissapointed with how many people don't see the value of this idea. No wonder our profession hasn't advanced as much as it could and pharmacy has missed so many opportunities...

As pharmacists, we probably should be all over this if for nothing else than our own self-interest. It would increase script counts -> increase sales -> increase the number of retail jobs available (theoretically). But like I already said, the whole thing is silly. It's a waste of time and money for patients.

 

[Somatic]

As pharmacists, we probably should be all over this if for nothing else than our own self-interest. It would increase script counts -> increase sales -> increase the number of retail jobs available (theoretically). But like I already said, the whole thing is silly. It's a waste of time and money for patients.

Well isn't it more of a waste of time and money for patients to go to the doctor to get a script for something OTC???? That would be so great for people to have to go through the pharmacist to get OTCs... People often could make better choices about which OTCs they select...Pharmacists can help patients make the best choice. Plus doctors don't know **** about OTCs anyways! This should be our responsibility!

 

[R2pharmD2]

Well isn't it more of a waste of time and money for patients to go to the doctor to get a script for something OTC???? That would be so great for people to have to go through the pharmacist to get OTCs... People often could make better choices about which OTCs they select...Pharmacists can help patients make the best choice. Plus doctors don't know **** about OTCs anyways! This should be our responsibility!

I'm sure most doctors would take exception to the idea that they "don't know ****" about OTCs.

It's a waste of time and money compared to the "old" way of doing things where they could go to the shelf, pick their product and pay for it, not compared to going to the doc.

 

[Somatic]

I'm sure most doctors would take exception to the idea that they "don't know ****" about OTCs.

It's a waste of time and money compared to the "old" way of doing things where they could go to the shelf, pick their product and pay for it, not compared to going to the doc.

It's true though. Doctors DON'T know OTCs. How hard is it to diagnose allergic rhinitis or any of the simple conditions OTCs are used to treat?

Do you want pharmacists to be more recognized as providers? Do you want to benefit from providing cognitive services instead of just giving free advice all the time? Here's a great opportunity. This new way could improve health outcomes by having pharmacists help people diagnose simple conditions and prescribe meds avail as OTC.

 

[R2pharmD2]

It's true though. Doctors DON'T know OTCs. How hard is it to diagnose allergic rhinitis or any of the simple conditions OTCs are used to treat?

You're entitled to your opinion, but I think it's silly to suggest doctors aren't familiar with OTC meds. Maybe not as familiar as pharmacists, but they competently recommend OTC meds to patients all the time. You're going to get an earful if any of the med students/residents stop by

Do you want pharmacists to be more recognized as providers? Do you want to benefit from providing cognitive services instead of just giving free advice all the time? Here's a great opportunity. This new way could improve health outcomes by having pharmacists help people diagnose simple conditions and prescribe meds avail as OTC.

I don't need extremely limited prescriptive authority to help stroke my ego and become a "more recognized" provider. If I wanted to be a doctor, I would have gone to medical school. Pharmacists are already able to improve health outcomes by recommending OTC meds. The only difference here is we'd be writing prescriptions to get flex cards to pay for the meds. I don't have a problem with giving out "free" advice either, as pharmacists are pretty well compensated as far as I'm concerned.

 

[Ackj]

Good point. Requiring a prescription to use a flex spending card for OTC meds is silly anyway. A better solution would be to remove that requirement entirely. I'm not sure why they did this in the first place. Was it intended to save money by preventing people from using their flex cards for meds they don't really need? If so, I'm not sure how anyone is saving money by making extra trips to the doctor to get their OTC meds. I don't see how paying pharmacists to fill OTC meds saves the system money either. Is there another reason for the change to flex spending accounts that I'm not aware of?

I completely agree that it doesn't save money if you're getting a doctor's visit for the otc rx. However, last year (before the law went into effect) toward the end of the year people were buying 500 count bottles of ibuprofen, apap, asa, and any other thing they could find on the shelf, just so the money "didn't go to waste." Certainly they didn't need the stockpiles, but I'm really not sure if the law helped with that. The only rationale I can think of is for drug interactions with rx meds, so we know what otc they're currently taking. However, that sort of makes it not-otc anymore. Weird ruling, imo.

 

[All4MyDaughter]

I guess the idea is that if you make it a hassle to get OTC product with your FSA dollars, people will contribute less to FSAs and that will lead to increased tax revenue. Or maybe people will have money left over at the end of the year that is forfeited?

 

[pharm B]

It seems like letting us prescribe OTC stuff wouldn't be a change to anything except the addition of a paper trail to your normal counseling. "I'd recommend meclizine. (rip) Here ya go."

 

[meister]

What level of intervention would be required to prescribe an OTC? Focused H&P? Do y'all get training in that at all? Seems like it'd be a pain in the ass that would result in more work for pharmacists and more metrics for your DMs to email you about 10 times a day.

 

[pharm B]

What level of intervention would be required to prescribe an OTC? Focused H&P? Do y'all get training in that at all? Seems like it'd be a pain in the ass that would result in more work for pharmacists and more metrics for your DMs to email you about 10 times a day.

One of the biggest roles a retail pharmacist plays is in recommending OTC products. We take a focused "self care" class at my school during the first year that focuses on what products treat what ailment, and how to know when self care is not appropriate.