AMA Resolution Says Pharmacists Should Fill All Prescriptions or Provide Referrals
The American Medical Association's House of Delegates on Monday at its annual meeting in Chicago passed a resolution saying pharmacists should be required to fill all valid prescriptions or refer patients to another pharmacy or pharmacist immediately, the Chicago Tribune reports. If pharmacists have moral or religious objections to dispensing certain medications, such as emergency contraception, they should make an "immediate referral to an appropriate alternative dispensing pharmacy without interference," the resolution says.
AMA's action also details the association's support for state and federal legislation that would require pharmacies to fill all prescriptions (Japsen , Chicago Tribune, 6/21). The AMA resolution also includes a provision stating that the group might lobby for federal legislation that would allow physicians to dispense medication if there is no pharmacist available or willing to fill the prescription within a 30-mile radius, the AP/USA Today reports.
The resolution was prompted by the increasing number of pharmacists nationwide who have begun refusing to fill prescriptions for EC, which can prevent pregnancy if taken within 72 hours of sexual intercourse, and other contraceptives (Tanner, AP/USA Today, 6/20).
AMA member Peter Carmel, who is a New Jersey doctor, at a press briefing said the resolution is intended to apply "moral suasion" to the issue (Stern, Reuters, 6/21). More than 12 states are considering legislation about the issue (Japsen , Chicago Tribune, 6/21).
In related news, AMA on Tuesday is expected to authorize a "comprehensive study" on whether direct-to-consumer drug advertising raises costs and leads to unnecessary prescriptions or "other negative side effects," the Tribune reports (Japsen , Chicago Tribune, 6/21).
On Sunday, AMA discussed whether to support proposed federal legislation that would impose a moratorium to delay direct-to-consumer drug advertising after drugs are approved by FDA. Several state and national medical groups within AMA -- which represents about 250,000 physicians -- support a moratorium.
Doctors who testified Sunday said DTC advertising by drug companies increases the number of prescriptions for potentially harmful drugs for people who do not need them. Most doctors testified in favor of a moratorium on DTC advertising that would allow doctors several months after a drug's approval to discuss its safety and efficacy with patients (California Healthline, 6/20). In addition, Illinois Gov. Rod Blagojevich (D) took the "unusual" step on Monday of sending a letter to AMA urging the group to support a ban on DTC drug advertising, the Tribune reports.
However, "lively testimony" and opposition from some delegates on Sunday at the meeting led an AMA committee to defer a vote on the resolution and refer the issue for more study, according to the Tribune. AMA officials said the referral keeps the issue on the AMA's agenda until future meetings but allows delegates to consider additional scientific data and research about legal remedies that could be used to limit DTC drug advertising.
Meanwhile, the Pharmaceutical Research and Manufacturers of America is expected to issue voluntary guidelines for pharmaceutical companies on appropriate advertising next month. "When done right, advertising can be a powerful educational tool," PhRMA Senior Vice President Ken Johnson said (Japsen , Chicago Tribune, 6/21).
AMA also on Monday called for study on "presumed consent," a "controversial proposal to boost organ donation," the Chicago Sun-Times reports. Under the practice, anyone who dies is considered an organ donor automatically, unless the deceased has previously registered an objection.
AMA recommended pilot studies of the proposal "in relatively small populations" to examine whether presumed consent would increase organ donations. Already, some countries in Europe and South America use a presumed consent system, but several U.S. states that have proposed such a system have failed to pass it.
According to attorney Samantha Wilcox, courts are split on whether presumed consent laws are constitutional. Critics say they violate individuals' right to make decisions for themselves, could be perceived as "culturally or religiously insensitive" and could fail to note some people's objections.
AMA also on Monday supported a proposal to perform pilot studies on "mandated choice," under which people who are renewing drivers' licenses or doing other government-mandated activities would be required to express their wishes on organ donation (Ritter, Chicago Sun-Times, 6/21).