Senate Bill 871 is a bill affecting prescription drugs that has probably been little noticed except by the lobbyists on both sides. But it might be worth a closer look. Current law strictly prohibits a physician from having an ownership interest in a pharmacy. This is to avoid placing physicians in a position where they may be tempted to prescribe a drug they sell rather than one that is best for the patient, or a drug that is unneeded but profitable. The legislature has made an exception allowing physicians to “dispense” drugs if no pharmacy is “conveniently available” to patients.
This exception has now grown so large as to swallow the rule. Currently, the Maryland Department of Health’s regulations permit a pharmacy to be determined to be “not conveniently available” even if there is a pharmacy right next door. Many physician “dispensaries” are large enterprises filling tens of thousands of prescriptions a year, often right within sight of an open pharmacy. Physicians, in effect, actually do own and operate pharmacies; they are just called “dispensaries.” But these dispensaries are not regulated like pharmacies.
Inspection of dispensaries has been handed over to a division whose primary mission is the control of narcotics and whose expertise is only in that area. This office is not competent to, nor does it have the resources to, conduct detailed pharmaceutical inspections of these dispensaries. Some physician enterprises are thus running huge, essentially unregulated pharmacies while the physicians they employ have an incentive to prescribe the drugs that are on hand. The legislature clearly should require that “dispensaries” over a certain size (for example, one that fills over 5,000 prescriptions a year) have a pharmacist on board, and be subject to all regular pharmacy rules and regulations.
Senate Bill 871 proposed by Sen. J.B. Jennings would make matters worse by allowing dispensaries to fill prescriptions by mail order, even for drugs that require a difficult or unusual process of delivery to the patient or that need special patient preparation or management. It’s bad enough having a non-pharmacist answering the patient’s questions about their drugs, but to allow this consultation to take place by mail is ridiculous, if not dangerous.
Thomas W. Keech, Catonsville
Add your voice: Respond to this piece or other Sun content by submitting your own letter.