Pharmacy Daily | Evidence favours pharmacist Rx

SUGGESTIONS that financial interests will supersede patient safety if pharmacists are empowered to prescribe, do not match the reality in jurisdictions where prescribing is part of pharmacists' scope of practice, a Queensland-based research says.

Writing in The Conversation, University of Queensland Primary Care Clinical Unit Postdoctoral Research Fellow, Greg Merlo, said arguments proffered by former Federal MP and general practitioner, Dr Kerryn Phelps, that allowing pharmacists to prescribe would lead to negative patient outcomes were unfounded.

"What Phelps is suggesting is that a pharmacist may manipulate a consumer into purchasing an unnecessary drug," Merlo said.

"When there is no information asymmetry, supplier-induced demand disappears.

"Paracetamol, for instance, is unlikely to be subject to supplier-induced demand despite direct sale from pharmacists because consumers have experience of using the product regularly and understand its effects.

"[However] there is no reported evidence of inappropriate prescribing by pharmacists in any countries that have introduced regulated, controlled models of pharmacist prescribing."

Merlo, noted that while there was little to support claims that pharmacists were likely to prescribe inappropriately, studies in countries where doctors are able to dispense, showed evidence of financial profits influencing prescribing decisions.

"A Swiss study, for instance, found physician dispensing leads to a 34% increase in drug costs per patient, as doctors overprescribe and prescribe more expensive medications," he said.

"An evaluation of pharmacist prescribing in the UK found it was safe, clinically appropriate, and was generally viewed positively by patients.

"Extending the scope of practice for pharmacists has the potential to lower costs to the health system because of fewer GP visits, be more convenient for consumers, and free up busy general practitioners to spend time on high-value care."

However, he noted pharmacist prescribing could see patients skip GP visits, cutting out opportunities for clinical interventions.