15. Administering medication requires medical follow-up
Administering medication requires acquaintance with the patient’s medical history, his behavior as a patient and as a medication consumer, as well as ongoing monitoring of the patient’s medical condition and any change in the development of the illness – all these, are part of the role and training of the doctor, not the pharmacist, regardless of the latter’s knowledge concerning the composition of the medications and their effect, if any.
16. Complexity of the procedure
Issuing a prescription for medication is not a simple procedure and is not risk-free. Numerous hospitalizations are the result of negative reactions to medications. Can pharmacists take responsibility for such situations and furthermore, do they know how to remedy them?
17. The danger entailed in “shortening procedure processes” and in “freedom of prescription”
How can we prevent a situation in which patients will be tempted to turn immediately to a pharmacist to receive a prescription medication, instead of contacting a doctor that is able to diagnose diseases and pathological situations and/or identify changes that took place?
Will the State or the pharmacists take responsibility that the patient will continue to consume medications without receiving an up-to-date status of his medical condition? Needless to say that without strictly limiting the type of prescriptions, this danger expands to the point of causing significant damage to patients. We would like to remind that the chairperson of the Labor, Welfare and Health Committee decided in February 2005 to return the draft law that authorizes pharmacists to issue medication prescriptions since the Ministry of Health itself did not formulate a consolidated position concerning the type of medications that pharmacists will be authorized to be prescribe.
18. Quality control and professional responsibility
A large share of doctors in Israel are employed in the public health system and is monitored by the system through a quality control mechanism. The majority of pharmacists on the other hand are employed in the private sector and it will be difficult to impose quality control on prescriptions they issue.
Obviously doctors will not be able to take responsibility for the negative ramifications and effects of prescription medications issued by pharmacists.
19. Financial cost
Transferring the authority for issuing prescription medications to the private sector can, in the long run, increase medication prices. This will fall on the shoulders of the patients, and raise the already inordinately high private expenditures for health.
20. Enhanced efficiency in treating chronic patients
It should be noted that the existing arrangements with the health funds are directed to ease the predicament of patients and all health funds have arrangements that enhance the efficiency of contact with chronic patients, including the administrative aspect, such that the change is not expected to improve their situation, yet may, on the other hand, have a negative effect on several aspects as detailed above.
21. Is it necessary to change the existing situation?
What is the background for the proposed change concerning the authority to issue medication prescriptions? Are there complaints about the existing situation? A draft law or a draft amendment to a law is expected to be passed in the aim of improving an unfavorable existing situation. We have not seen any data indicating that there is a flaw in the current process of issuing prescription medications by doctors or information demonstrating how the transfer of authority to pharmacists will enhance efficiency and improve the current situation and if so, according to what criteria.
With respect to medications that it was agreed that they do not require a doctor’s prescription - this was the raison d’etre underlying the OTC medication process that was already established and implemented in the field. Furthermore, it is indeed recommended to periodically review the medications that meet the criteria and to change their status to OTC medications if necessary.
In any case, pharmacists should not be permitted to issue medications that do not meet the criteria only because an amendment was passed permitting the sale of OTC medications not only in pharmacies. This is an unprofessional, dangerous and extraneous consideration.