one word changes everything – Le Kansan
By Gregory Burger
“I will consider the welfare of mankind and the relief of suffering as my primary concerns.”
This line is part of the solemn oath I took as a pharmacist over 30 years ago. I chose pharmacy while still in high school, after a long hospital stay where I witnessed how healthcare professionals truly change lives.
Over the years, I have come to understand how our complex healthcare system needs checks and balances to reduce the risk of harm, even unintended, to the patient. This care is especially vital in pharmacy, where even a seemingly benign drug can have negative consequences if it is not administered to the right patient, in the right dose, at the right time.
I have a doctorate in pharmacy. I hold a tri-state license, have additional degrees, participate in continuing education, and serve on national boards and organizations to advance our field. This is standard for most pharmacists. Years of medical training and residency are just the beginning.
Health care is more than a job for us. It’s a passion.
This is why current legislation at the Kansas Statehouse, including former Senate Bill 381, has been cut so deeply. This bill would have required a pharmacist to dispense any FDA-approved drug, including but not limited to ivermectin and hydroxychloroquine, for off-label use to prevent or treat COVID-19 in any patient.
My concerns have nothing to do with ivermectin, hydroxychloroquine, or any other off-label COVID drugs. I moonlight weekends with a company in Kansas that provides remote pharmacy services to several dozen rural hospitals. I assess orders to ensure prescribed medications are safe for patients based on their medical history and condition. I checked countless orders for ivermectin and hydroxychloroquine.
My concerns are based on this single word in the original bill: “a pharmacist must dispense”.
The feeling of this word changes everything. By dictating that a pharmacist must dispense a drug, regardless of a myriad of medical factors, you are essentially robbing us of our ability to serve patients.
All medications, including over-the-counter medications, carry a risk of side effects. There are currently 19,000 FDA-approved drugs on the market. Our job is to understand how each interacts with a patient’s underlying health condition and other medications, from baby aspirin to opioids. If we find a problem, our duty is to notify the doctor and “stop the line”. This team-based system ensures the safest and most effective care.
Medicines prescribed for the prevention and treatment of COVID, such as ivermectin, could be very harmful in patients taking certain blood thinners (anticoagulants), by increasing the risk of bleeding. In such a case, a pharmacist could keep his oath by “cutting the line” and consulting the doctor.
It has nothing to do with our political beliefs and everything to do with our professional obligation.
Back to SB381: The original bill was then inserted into House Bill 2280 and the language changed. It now read: “Nothing shall prevent a pharmacist from refusing to fill or refill a prescription…unless that prescription is being used to treat or prevent COVID-19 infection.”
Again, the sentiment of one word – “unless” – is chilling. In a more indirect way, this bill indicates to each pharmacist that despite years of training, experience and commitment, he cannot exercise his professional duty to screen a drug to ensure its safety if this drug is any way to COVID.
I am not a politically savvy person. I don’t know what will happen next with the legislation, but I am seriously concerned about these conversations. The current language of HB2280 now requires a pharmacist to dispense anything COVID-related regardless of patient safety.