Facing of one of the deadliest flu epidemics in the history of Centers for Disease Control and Prevention data, a Senate committee temporarily postponed a measure which would give Floridians greater access to antiviral medication, critical in the treatment of the flu and strep.
SB 524, sponsored by St. Petersburg Republican Jeff Brandes, would allow a pharmacist to test for and treat influenza — in collaboration with a physician, through a rigorously written protocol approved by the doctor.
While these services are well within the education and expertise of pharmacists, the bill required additional training approved by the state Board of Medicine. In addition to the strict medical protocols, SB 524 also mandates pharmacists to carry $200,000 in professional liability insurance, to test and treat for influenza virus and streptococcal infections.
“It’s all about access,” Brandes told members of the Senate Health Policy Committee.
However, physicians oppose the bill, arguing pharmacists were not adequately trained to treat or diagnose the illness.
Among those speaking to the committee included a doctor of internal medicine, adding a level of confusion to what should have been a very straightforward proposal. This physician claimed SD 524 would allow pharmacists to diagnose and prescribe.
Unfortunately, this is untrue. There would be no diagnosis by a pharmacist under the proposal.
Used in the process are simple (and accurate) devices which detect whether the disease is present, employing a procedure that takes as little as three minutes. There would be no prescribing by a pharmacist. Strict guidelines are laid out by a physician — in meticulous detail — describing what a pharmacist is allowed to do in the case of a positive or negative test.
The doctor also told senators that flu tests are only “60 percent sensitive,” an interesting statistic, considering Food and Drug Administration requires flu tests be at least 90 percent sensitive for influenza A to even be used in the United States.
There are currently 10 FDA approved rapid diagnostic tests to screen for influenza and that the tests can give results within about 15 minutes. These devices are the same ones now used in doctor’s offices.
If such devices are not good enough for pharmacists, why would they be used in doctor’s offices and hospitals?
What’s more, the doctor acknowledged he does not even see flu patients face-to-face — admitting he only talks to them on the phone and writing a prescription based on the conversation.
In another contradiction, this doctor said the best treatment for flu is hand-washing and rest — yet still prescribes antivirals over the phone. Antivirals only decrease the longevity of the disease by about 24 hours, he said, but antivirals also decrease the severity of symptoms, which can lead to life-threatening complications like pneumonia.
In the end, the real reason all of the doctors and associations were standing in opposition to the bill: they are trying to protect their profession.
Allowing pharmacists to perform these services is eroding primary care, he said, and that pharmacists are trying to “replace” primary care physicians.
Over 30 percent of people in Florida currently do not have primary care physicians. Without such access, patients will go either without care or end up in the hospital.
Early antiviral treatment shortens the duration of fever and flu symptoms, reducing the risk of complications. Reports show, in some cases, early treatment can even prevent death.
The best clinical benefit for the flu is through early administration of antiviral treatment, especially within 48 hours of onset of symptoms. Quick access to care is imperative to saving lives and controlling the spread of disease.
Hospitals are more crowded than in the 2014-2015 flu season — the previous record of 710,000 Americans needing medical care to beat the flu, according to the Centers for Disease Control and Prevention.
Hospitals, urgent care centers, and doctor’s offices are all full — a situation further aggravated by the state’s doctor shortage.
In Florida, access to care is getting increasingly worse. But with 86 percent of the population living within 5 miles of a pharmacy and many 24-hour options, pharmacists are the most accessible health care professionals for a majority of Floridians.
Allowing pharmacists to test and treat influenza will save lives and decrease the spread of the disease — keeping people out of crowded hospitals and reducing the duration of the disease.
Why is the Senate refusing to act, especially when it saves lives?