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Pharmacy Board Moves Forward On Expanded Practice

The Florida Channel
Leon County Judge John Cooper on June 30, 2022, in a screen grab from The Florida Channel.

Members of the state pharmacy board agreed Wednesday to remove heart failure from a list of chronic conditions that pharmacists would be authorized to treat in collaboration with physicians.

The decision came as the Florida Board of Pharmacy moved to carry out a new law that will expand the authority of pharmacists to treat patients. Pharmacists and physicians have wrangled about which conditions pharmacists should be able to treat.

Board of Pharmacy member David Wright, a Fort Pierce pharmacist, voted against removing heart failure from proposed regulations, saying that it would be irresponsible. He was joined by board member Mark Mikhael, an Orlando pharmacist.

The law passed during this year’s legislative session to expand pharmacists’ scope of practice was championed by House Speaker Jose Oliva, a Miami Lakes Republcan who maintained that doing so would expand access to affordable health care.

The Board of Pharmacy’s proposed rule, along with fleshing out details of the collaborative agreements between pharmacists and physicians, lays the groundwork for another part of the law that allows pharmacists to begin testing and treating patients for influenza, streptococcus, lice, skin conditions and minor, uncomplicated infections. Pharmacists would need to have written protocol agreements with physicians to  begin testing  and treating for those conditions.

The DeSantis administration has said it wants the proposed rule to be fast-tracked so pharmacists can begin providing direct patient care in the fall, in time for flu season.

The law specified that pharmacists may enter into collaborative arrangements with physicians to treat patients for chronic medical conditions that include arthritis; asthma; chronic obstructive pulmonary diseases; Type 2 diabetes; human immunodeficiency virus or acquired immune deficiency syndrome; and obesity. 

It also allowed the Board of Pharmacy to expand the list of chronic medical conditions to include “any other chronic condition adopted in consultation with the Board of Medicine and Board of Osteopathic Medicine.”  

Members of the Board of Medicine and the Board of Osteopathic Medicine, the state’s physician boards, met twice over the summer with the Board of Pharmacy Rules Committee about the proposed rule. 

At a July 29 meeting, members of the Rules Committee gave tentative approval to a proposed rule that added opioid abuse disorder; hypertension; hyperlipidemia; smoking cessation; and anticoagulation management to the conditions that were identified in the law. 

But the Rules Committee scheduled an additional meeting this week and considered adding  “heart/cardiovascular disease”and  mental health to the list of chronic conditions that could be treated. 

After lengthy deliberations Monday, the Rules Committee agreed to include “heart failure” and to discuss the potential of adding mental health to the list at a meeting in October. 

During the Board of Pharmacy’s teleconference meeting Wednesday, Tampa physician Hector Vila asked the board to reconsider the Rules Committee’s decision.

Vila, vice chairman of the Board of Medicine and one of the physicians who worked with the Rules Committee on the proposed regulations, told the panel  that physicians had concerns with the inclusion of heart failure and that “it was very disappointing” the professions couldn’t reach an accord on the issue. 

“Please put it off. Delay it. Because, if not, the whole thing is going to get delayed by this,” Vila said, encouraging the Board of Pharmacy to stick with the proposed rule that was agreed to at the July 29 meeting.