Pharmacists Prescribing Duties

Pharmacists’ responsibility to properly and thoroughly investigate the prescription medications they are filling is predicated upon both federal and state law. The Commonwealth of Pennsylvania, PA Code addresses the fundamentals of  pharmacists’ responsibilities. Section 49 Pa. Code § 28.18 sets forth all of the recording keeping and due diligence requirements of which a Pharmacists must meet before handing over any prescribed medication to lay person. Included in these precepts is the statement that“A pharmacist may not knowingly fill or refill a prescription for a controlled substance or nonproprietary drug or device if the pharmacist knows or has reason to know it is for use by a person other than the one for whom the prescription was written, or will be otherwise diverted, abused or misused. In addition, a pharmacist may decline to fill or refill a prescription if, in the pharmacist’s professional judgment exercised in the interest of the safety of the patient, the pharmacist believes the prescription should not be filled or refilled. The pharmacist shall explain the decision to the patient. If necessary the pharmacist shall attempt to discuss the decision with the prescriber. “This clause is read together with federal law regarding prescription authority and pharmacists’ duty to conduct due diligence into the person being given the prescription and the doctor writing the prescription. One corporate pharmacy manual I found states: “A pharmacist is required to exercise sound professional judgment with respect to the legitimacy of prescriptions orders dispensed. The law does not require a pharmacist to dispense a prescription order of doubtful origin. To the contrary, the pharmacist who deliberately turns the other way when there is every reason to believe that the purported prescription order had not been issued for a legitimate medical purpose may be prosecuted, along with the issuing physician, for knowingly and intentionally distributing controlled substances.”The federal regulatory basis for this employer manual is found at 21 Code of Federal Regulations § 1306.04, governing the issuance of prescriptions, which provides:A prescription for a controlled substance to be effective must be issued for a legitimate medical purpose by an individual practitioner acting in the usual course of his professional practice. The responsibility for the proper prescribing and dispensing of controlled substances is upon the prescribing practitioner, but a corresponding responsibility rests with the pharmacist who fills the prescription. An order purporting to be a prescription issued not in the usual course of professional treatment or in legitimate and authorized research is not a prescription within the meaning and intent of section 309 of the Act [21 U.S.C. § 829] and the person knowingly filling such a purported prescription, as well as the person issuing it, shall be subject to the penalties provided for violations of the law relating to controlled substances.Significantly, these two statutes are typically read in pharmacy school then in a federal or state indictment charging a pharmacy owner and its individual pharmacists with violating these precepts and selling their pills for cash to individuals who approach with medically fraudulent prescriptions written by bad doctors who are getting paid for the prescriptions.Please call me to discuss your concerns about the legality of prescriptions, or the doctors writing them, of which you are being called on to fill.