Patient choice is a fundamental value of the American health system; unfortunately it is increasingly being ignored.
Approximately 1 out of every 4 health plans in California include mandatory mail-order policies for prescription drugs, meaning patients are required to get their medications through the mail rather than visiting their local pharmacy.
That may change soon. The Assembly has overwhelmingly passed a bill that protects a patient's right to choose where they get their prescription drugs. Now it is the Senate's turn to act.
Patient advocacy groups and pharmacists urge state senators to support AB2418, sponsored by Assemblywoman Susan Bonilla, D-Concord, when it comes to the Senate for a vote.
Numerous health advocates -- and a majority of California voters -- believe patients should have the freedom to choose the pharmacy that best meets their needs.
Many times, that is a local community-based pharmacy like the one I own, ScriptWorks Compounding Pharmacy in Walnut Creek. Rather than simply dispensing medications prepared by a drug manufacturer, compounding pharmacies are able to tailor medications to address each patient's unique health-care situation.
Our integrative, one-on-one approach to patient care can actually improve health outcomes.
Typically, medication adherence -- the extent to which patients take their medications as directed -- is sorely lacking among patients with chronic illnesses. Half of patients with chronic conditions do not take their medications as prescribed, putting them at greater risk for hospitalization and for their conditions to continue to deteriorate.
Pharmacists can intervene with a number of strategies to improve adherence, including counseling, education and reminders such as calls or texts when it is time for a refill.
Studies have found that chronically ill patients with HIV/AIDS, chronic obstructive pulmonary disease, high blood pressure and diabetes experience improved clinical outcomes when they work with their pharmacists to manage their health conditions.
But these strategies work best when there is a close pharmacist-patient relationship.
Mail-order pharmacies simply cannot provide the same type of one-on-one service patients get from their local community pharmacies.
Consumers seem to know this instinctively. By a 4-to-1 ratio, patients prefer to get their medications from a community pharmacy rather than through the mail.
Assemblywoman Bonilla's bill responds to these compelling patient and health concerns. The legislation allows patients to opt out of a health plan's mandatory mail-order program, if they would rather visit a community pharmacy for their prescriptions.
In an ideal world, patients would not be subject to health insurance policies that limit their choice of where to receive care. But increasingly, they are.
So it is up to the state Senate to follow the lead of the Assembly, and pass AB2418 to allow patients to opt out of mandatory mail order prescription programs.
Bob Brensel is a pharmacist and the owner of ScriptWorks Compounding Pharmacy in Walnut Creek.
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