Rx crackdown pitting pharmacists against doctors

As the Drug Enforcement Administration (DEA) increases scrutiny of pharmacies dispensing controlled substances that are sometimes illegally diverted, new policies designed to curb Rx abuse are pitting pharmacists against physicians.

As evidenced by the $80 million fine recently levied against Walgreens for record-keeping and dispensing violations, DEA has set it sights squarely on pharmacies and pharmacists that have, willingly or not, contributed to the huge problem of Rx abuse and fraud. In some cases, the feds have also targeted doctors who write bogus prescriptions.

In response, Walgreens and others have taken steps to stem the fraud and abuse, including requiring pharmacists to verify some controlled-substances scripts by contacting prescribers. This has delayed some dispensing, upsetting some customers and physicians.

The American Medical Association (AMA) recently weighed in on the issue by passing a strongly worded resolution criticizing telephone calls from pharmacists requesting additional information about pain medication Rxs.

The resolution stated that AMA “deem[s] inappropriate inquiries from pharmacies to verify the medical rationale behind prescriptions, diagnoses, and treatment plans to be an interference with the practice of medicine and unwarranted.”

It further threatens that AMA might “advocate for legislative and regulatory solutions to prohibit pharmacies and pharmacists from denying medically necessary and legitimate therapeutic treatments to patients.”

Several pharmacy groups responded to the AMA rebuke. The National Community Pharmacists Association called the resolution “short-sighted” and “simplistic.”

“We support a collective approach to controlling abuse and diversion that involves everyone: Patient, pharmacist, pharmacy benefit manager, wholesaler, manufacturer, and prescriber,” NCPA’s response read.

NCPA further noted that the Department of Health and Human Services’ Office of the Inspector General recently identified more than 700 physicians who exhibited questionable prescribing patterns and called for better education for prescribers.

Kasey Thompson, PharmD, the American Society of Health-System Pharmacists’ vice president of policy, planning and communications, said AMA and pharmacy groups must collaborate to stem the problem. “The bottom line is that there is a major prescription drug abuse epidemic in this country and we need to find more ways to work together as a health care community to solve it,” Thompson said in a published report.