ROANOKE TIMES
Copyright (c) 1997, Roanoke Times
DATE: Friday, February 14, 1997 TAG: 9702140065
SECTION: VIRGINIA PAGE: B-1 EDITION: METRO
SOURCE: Associated Press
RICHMOND
A bill to stop pharmacists from pressuring doctors to switch prescriptions was killed Thursday after lawmakers decided the issue needed further study.
The bill, proposed by a coalition of small pharmacies, would have outlawed pharmacists' recommendations to doctors if they were motivated by money. The Senate had approved the bill 32-7 on Feb. 4.
But the House Committee on Health, Welfare and Institutions voted 13-7 to kill the bill. The legislature is assembling a task force to study the issue.
``There are much better ways to deal with the medical issues,'' Del. John Rust, R-Fairfax County, told the committee.
The bill's backers said the problem arises because many health maintenance organizations will reimburse their members only if the medicines they obtain come from a list of drugs the HMO has approved. Drug companies often pay large premiums to be included on those lists.
The HMOs then pay pharmacists a bonus if they can persuade a physician to switch a prescription to a brand on their lists, said Mark Green, a consumer's advocate for the city of New York, who has studied the HMOs' preferred drugs policies.
The drug prescribed by the physician and the alternative suggested by the pharmacist may treat the same disease, but they may not be chemically identical. Green said such variations could have unforeseen side-effects and hurt patients.
Green said a study his office conducted found that 10 percent to 15 percent of the pharmacists they monitored switched drugs doctors had prescribed because the drugs were not on lists HMOs had approved.
Physicians say the practice sometimes forces them to rethink their decisions about what medicine to give a patient weeks after seeing the patient.
``I feel it is unfair that I've always got to be on my toes,'' said Dr. James Cane, a Richmond gynecologist. ``I've written what I've determined to be the best prescription for my patient.''
The bill's opponents, including HMOs, drug companies and some large employers, said it would have ended competition among drug companies and increased medical costs.
Frederic Curtiss, whose Texas company creates the drug lists for HMOs, said bonuses are simply a compensation for the work pharmacists do. ``There is no bounty here,'' he said.
``This bill is a sledgehammer'' to deal with an issue that has not been studied by experts, said May Fox, executive director of the Virginia Association of HMOs.
The bill would have made Virginia the first state to ban pharmacists from asking doctors to reconsider the prescriptions they write, Green said.
Supporters of the bill promised to revive the issue next year.
LENGTH: Medium: 59 lines KEYWORDS: GENERAL ASSEMBLY 1997by CNB