Pharmacists overruling doctors
America's Frontline Doctors (AFLDS) Pharmacy Director Dr. Jen VanDeWater last week let our readers know how large pharmacy chains abuse government mandated Medication Therapy Management (MTM) programs.
Beware your pharmacist - prescriptions your doctor didn’t mention
Known as Medicines Use Reviews (MURs) in the UK, MTMs are meant to avoid dangerous drug interactions and reduce the use of unnecessary medicines or ineffective dosages. Instead, megacorporations like Rite Aid and Walgreens use MTMs to have their staff pharmacists request different or additional, and sometimes unnecessary, medical prescriptions directly from the treating physicians when those prescriptions are “more lucrative”.
Refusing prescriptions
Dr. Jen (she prefers to use her first name) also warns about the practice of many pharmacists to not only attempt to have their customers prescribed with medicines their doctors did not initially consider necessary, but to actually refuse to fill prescriptions for medications their doctors initially prescribed.
While not an entirely new idea, the practice of a pharmacist “overruling” a doctor was not previously done to protect a patient from what the pharmacist perceived to be a medical mistake on the part of the physician. Rather, it was generally a practice employed by pharmacists to avoid going against their religious and/or moral beliefs. For example, tucson.com reports that Arizona Law states that, “pharmacists, hospitals and health professionals are ‘not required to facilitate or participate in the provision of an abortion, abortion medication, emergency contraception or any medication or device intended to inhibit or prevent implantation of a fertilized ovum’ if they object ‘on moral or religious grounds.’”
Alternatives available
This refusal to fill a prescription was not a uniform practice of a pharmacy chain and the pharmacists did not claim that the doctor was mistaken in believing that the prescribed medication would work as intended.
A small minority of pharmacists, for example, refuse to fill prescriptions for the abortion pill. It was actually because the medications were expected to work as intended that the pharmacists objected!
The refusal also did not preclude the patient from obtaining the medication from another pharmacist, even one working in the very same pharmacy.
In fact, Dr. Jen says, “to make sure the patient is able to still receive their medications, the pharmacist must provide an alternative location or pharmacist to fill the prescription. We just cannot tell the patient no and be done. Our obligation is to provide them an alternative pharmacy.”
Government intervention
Whereas state governments like Arizona merely provided individual pharmacists with the ability to refuse to fill certain prescriptions that went against their moral/religious beliefs, and did not call on them to use their judgment to “overrule” the attending physicians, the federal government has taken a completely different approach to some COVID-19 treatments.
In an August 2021, CDC Advisory on the “Rapid Increase in Ivermectin Prescriptions”, the national public health agency of the United States warned, “ivermectin is not currently authorized or approved by FDA for treatment of COVID-19. NIH has also determined that there are currently insufficient data to recommend ivermectin for treatment of COVID-19.”
The very next month, the Massachusetts Board of Registration in Pharmacy referenced the “CDC Advisory Regarding Ivermectin” in advising,
“The Board would like to remind pharmacists that they have a right to refuse to fill or refill any prescription if doing so would be contrary to their professional judgment. Moreover, a pharmacist should not fill or refill a prescription if, in the exercise of the pharmacist’s professional judgement, there is a question as to its safety for the patient.” [Emphases added].
In saying pharmacists “should not fill a prescription” if there’s a safety question in their “professional judgment,” the state government of Massachusetts, acting on the warning of the CDC, called on pharmacists to:
- Overrule doctors on ivermectin as a general rule (since they “should” do so), not as an exception based on their personal moral and/or religious;
- Overrule doctors in all pharmacies, without leaving the patient an alternative way to obtain the medicine prescribed by their doctors; and
- Give more deference to their own professional judgment of the safety or advisability of a medication than to that of the patient’s treating physician.
NGOs too
Non-governmental organizations also followed the CDC warning to pharmacists with warnings of their own. For example, Pharmacy Today, an official publication of the American Pharmacists Association, published an article in November 2021, entitled Pharmacists have the right to refuse to fill ivermectin prescriptions. The publication exhorted pharmacists that, when deciding whether to fill a doctor’s prescription for ivermectin, they need to be, “keeping in mind increased liability and responsibility.”
The article goes on to instruct pharmacists to, “Encourage people to get fully vaccinated against COVID-19, wear face masks, socially distance by staying at least 6 feet away from others in public places …
“Counsel patients against the use of ivermectin as a treatment for COVID-19, emphasizing the potential of nausea, vomiting, and diarrhea.”
The article even features a picture of a medical professional holding an X symbol with a red background while making a “stop” gesture directed at anyone considering following a doctor’s instructions to take ivermectin.
Off label use
Government agencies and NGOs have both made frequent mention of the fact that the treatment of COVID-19 with ivermectin is an “off label use”. The American Pharmacists Association even made a special announcement that, “AMA opposes off-label use of ivermectin for COVID-19.”
Notwithstanding this announcement, it is not only long accepted practice for doctors to prescribe medications for off-label use and for pharmacists to fill those prescriptions, but the FDA itself approves of the practice. “From the FDA perspective, once the FDA approves a drug, healthcare providers generally may prescribe the drug for an unapproved use when they judge that it is medically appropriate for their patient.“
State legislatures to the rescue?
So great has been the pressure on pharmacists to comply with these warnings, and thereby refuse to comply with the treatment instructions of the patients’ doctors, that Arizona State Senator Kelly Townsend has proposed a bill that “would require pharmacies to fill ivermectin prescriptions to treat COVID-19,” according to a report by KJZZ. Townsend was quote saying, “It’s pharmacies themselves making the decision apart from the doctor and the patient to not fill a prescription, and during a health crisis like we’re in right now, that’s inappropriate.”
Conflicts?
Shortly after the government and NGO warnings about filling prescriptions for ivermectin appeared, Precision Vaccinations reported, on November 18, 2021, “New York-based Pfizer Inc. today announced an agreement with the U.S. government to supply 10 million treatment courses of PAXLOVID™, an investigational COVID-19 oral antiviral candidate, for about $529 per course beginning in late 2021.” [Emphasis added].
Ivermectin, which has long been listed as an option in the treatment protocols posted on the website of AFLDS, sells for $6 for a course of treatment (four 3 mg tablets).
Oath of a Pharmacist
In an open letter to her fellow pharmacists, Dr. Jen writes:
“Has our profession sold out? Have we lost sight of our primary responsibility? We took an oath to put our patients’ welfare above all else.
“Has big pharma hypnotized us? For many, sadly the answer is yes.
“To fight back, I joined America's Frontline Doctors (AFLDS) and I encourage you to as well. We need to team up and work with other healthcare professionals to speak truth to our patients, even when it is inconvenient.”
The Oath of a Pharmacist, referenced by Dr. Jen, from the American Association of Colleges of Pharmacy, states, “I will consider the welfare of humanity and relief of suffering my primary concerns.”
The entire oath is reproduced below:
