AUSTIN (Nexstar) — Proposals in the Texas Legislature would allow Texas physicians to dispense drugs they prescribe to their patients from their practice. Texas is one of four states where that currently isn’t allowed unless there are specific circumstances.
According to the Texas Employers for Affordable Medications, a coalition formed by the Texas Academy of Family Physicians, Texas law only allows physicians to provide prescription medications in three situations:
- if they are samples supplied by pharmaceutical manufacturers for an indigent pharmaceutical program
- if the doctor practices in a rural area
- if a patient is in “immediate need.”
“What we know is a third or so of prescriptions never get filled,” Dr. Michael Garrett with Direct MD said.
House Bill 1622, filed by Rep. Tom Oliverson, R-Houston, physicians would be able to provide or dispense certain non-controlled medications, but not any controlled substances listed in Schedules II through V. It also requires physicians, prior to dispensing the drugs, to let the patient know that the prescription could be filled at a pharmacy. Rep. Matt Shaheen, R-Plano, has filed House Bill 460, which would also allow physicians to dispense the drugs and charge patients for the medication.
That bill is currently pending in committee.
Texas Employers for Affordable Medications says giving physicians the flexibility to provide medications will increase accessibility and convenience for patients, as well as lower drug costs. Dr. Garrett says he often hears from patients about their concerns over high prices or simply not being able to find the time to get their prescription medications.
“It would help patients in terms of convenience to be able to get their medicine and potentially could save them money over the pharmacy cost of the medication,” Garrett said.
This bill would apply to drugs like antibiotics, prescription ibuprofen and other short-term generic medications.
Dr. Chris Larson, with Euphora Health, said he supports this bill because it could help ensure patients actually take the medication they’re supposed to. He often alerts his patients to use a mobile app so they can compare prices of generic drugs. Don Fenton, one of Larson’s patients, learned about the app on Friday. As a small business owner, Fenton says he has to make tough choices when it comes to his healthcare.
“I’m not a rich man,” he said. “It’s like medical insurance or gas? That’s kind of the boat most of us are in.”
“If I were able to dispense the same medication, I can save him money even over what the app might be able to provide for him,” Larson said.
The Texas Pharmacy Association, however, worries about what the bill’s provisions could mean for safety.
“Patient safety is a top priority and pharmacists are the medication experts,” CEO Debbie Garza said in an emailed statement. “Pharmacists know all the medications a patient is taking and how those medications interact. They are trained in the side effects. Physicians do not necessarily have the full patient medication history or depth of knowledge of various medicines.”
Tom Schnorr with Austin Compounding Pharmacy says he doesn’t see a threat to the practice of pharmacy with the legislation.
“I don’t think this is going to cause a sea tide of doctors dispensing medications out of their office because there are requirements in there on proper packaging and proper labeling,” he said.
He also says lawmakers should outline further specifics on packaging and labeling requirements if physicians do end up dispensing drugs.
“My biggest concern is proper labeling, packaging and the infamous making sure there’s followup and counseling.”
Schnorr also said the disagreements between physicians and pharmacists dates back to nearly a decade ago when pharmacists started administering immunization services.
“We threw the first volley back in 1996 with pharmacists getting trained to do injections and doing vaccines,” he said. “That cuts into the bread and butter of the doctors.”
At top of mind for both physicians and pharmacists, though, is the ultimate impact on the patients.
“All this will do is allow them the opportunity to potentially get it at their physician’s office if it’s more convenient,” Garrett said.
Previous versions of these bills were filed in the 85th Legislative Session, but never made it through the entire legislative process. Both bills are currently in committee.