Viewpoint: Montana can lead by empowering pharmacists
Luka Ladan
Soon, residents of Montana may have the ability to skip weeks of waiting for doctor’s appointments or expensive emergency room visits and instead meet with their friendly, neighborhood pharmacist.
SB 112, a bill currently under consideration in the House, would permit pharmacists to prescribe medication for minor conditions such as lice and urinary tract infections, or other non-emergency medications where there is an established patient-prescriber relationship and the diagnosis is minor or generally self-limiting.
As the population ages and there is a significant physician shortage, patients are struggling to get timely appointments with their family doctors or specialists. All but five counties in Montana are considered Primary Care Health Professional Shortage Areas, where getting an appointment with a primary care provider is difficult and can take weeks of waiting and involve driving to major cities.
Yet, there is not a single town or community in Montana without access to a pharmacy within 10 miles. Giving pharmacists an expanded ability to help their patients is a great way to expand the supply of providers for individuals living with lifelong, manageable conditions.
There are at least two types of patients that would benefit greatly from this legislative change: Patients with asthma and patients with diabetes. These patients often see the same pharmacists for decades about routine medications—such as rescue inhalers or pre-filled insulin pen needles—that help prevent worse outcomes like surgeries by maintaining their long-term conditions. For these patients, avoiding the urgent care of emergency room to get prescription medication when their specialist is booked may save thousands of dollars in medical bills and free up resources for time-sensitive patients with life-threatening conditions or injuries.
Given all these benefits, why do we not let these pharmacists medication decisions? Is there a risk to patient safety?
Montana patients don’t need to worry that pharmacists are not adequately trained. Pharmacists have a Doctor of Pharmacy degree that requires four years of undergraduate coursework followed by four-years of graduate-level classes on biology, chemistry, and pharmacology.
Pharmacists must know all the potential chemical interactions and side effects of all their medications, and as new medications come out, they take a minimum of 30 hours of continuing education credits every two years to keep up to date with patient safety.
Montana can also look to its neighbor to the west for some guidance and would not be going out on a limb by making this change. Idaho passed similar legislation in 2017 that gives pharmacists the right to prescribe medicines for a limited set of minor conditions.
In a new working paper, I analyze the effect that this change has had for patients in Idaho. Since then, access to maintenance medications like rescue inhalers and insulin pen needles has increased, with nearly 2,000 additional inhalers being prescribed in one year to Medicare beneficiaries alone. Having access to medication for minor or self-contained conditions helps keep people healthy, and avoids disastrous, expensive trips to the emergency room.
Montana patients may soon have an easier time getting access to care that is sorely needed—and it will not cost Montana taxpayers a dime. Empowering pharmacists to deliver care seems like a common-sense reform.
Alicia Plemmons is Assistant Professor and Coordinator of Scope of Practice Research at the Knee Center for the Study of Occupational Regulation at West Virginia University.