The state Board of Pharmacy has heard all the opposition to changing a rule that bans pharmacists from refusing to give out a drug.
The opposition comes from women’s-rights groups worried about access to Plan B, the emergency contraceptive; from an overwhelming majority of the thousands participating in a public comment period; and from Gov. Chris Gregoire, who appointed all the members of the board.
But the board agreed Thursday on a 3-2 vote to move forward with the changes.
At issue is a rule the board set in 2007 with Gregoire’s support. It requires pharmacies to dispense all legal drugs.
That prompted a lawsuit from the owners of Ralph’s Thriftway in Olympia, which out of moral opposition doesn’t stock Plan B, the morning- after contraceptive. That lawsuit has dragged on and put pressure on the board to relent.
“We can’t afford more lawsuits,” said board member Dan Connolly, who made the motion to move forward. “If we don’t change the current rule, this board is going to always be in litigation.”
A trial set to begin in July in the case was put on hold after the board’s lawyers in Attorney General Rob McKenna’s office negotiated a legal stipulation with the suing pharmacists. The stipulation says the board intends to adopt a rule allowing druggists to refer patients to a different pharmacy, “including for conscientious reasons.”
Board members Thursday asked staff for information to help them craft a rule allowing pharmacists to refer patients to someone else for “time-sensitive” medication. That includes Plan B and hundreds of other drugs, members said.
The board agreed unanimously in June to start the rule-making process, but that united front has cracked after a public comment period that brought in 5,359 comments – including 4,448 in opposition to a change. Groups like Planned Parenthood Votes Washington and NARAL Pro-Choice Washington prepared form letters online that opponents could send.
While board members Christopher Barry and Al Linggi joined Connolly in supporting a change, Rebecca Hille and Vandana Slatter voted “no.” Chairman Gary Harris also spoke against a change, but he does not vote except in case of ties. Kim Ekker did not attend the meeting.
Slatter said the board is “reacting solely to litigation by one pharmacy, when all the other pharmacists seem to be functioning with the current rule in place.”
The existing rule allows an individual pharmacist to pass a patient to a co-worker, as long as the pharmacy fills the prescription.
“There’s no compelling reason to have a green light to reopen these rules,” said Slatter, a Bellevue pharmacist who also has served on the board of NARAL Pro-Choice Washington.
The board’s majority says opponents are too focused on Plan B. Linggi, a Fircrest pharmacist, said the rules need changing to make sure small pharmacists aren’t run out of business by the high cost of having to stock every conceivable medication, even those seen as specialty drugs.
Supporters say the answer is “facilitated referral,” allowing pharmacists to help patients find the drug they need at someone else’s shop. Referral is a common practice now, but supporters say encoding it in a rule will help patients obtain drugs that might be hard to find now.
“We’re trying to improve access to medication, not trying to decrease it,” said Barry, a Cheney pharmacist.
Harris said separate rules for stocking drugs have never required pharmacies to buy every drug, only those that are representative of its customers’ needs. Board members asked McKenna’s office to offer an interpretation of those rules.
On one thing, supporters and opponents agree. The debate is not just about Plan B.
Opponents say too-loose rules for druggists would allow them to deny patients, for example, lifesaving HIV drugs.
What if a pharmacist believes “marriage is one man, one woman, and I have some gay men that come in,” asked Harris, a Redmond druggist. “(What if) I were to say ‘Gee, it’s against my religious background. You’ve brought this on yourself.’ ”
Staff will report back to the board at its Dec. 16 meeting, when board members could provide more direction on what new rules would look like. Once they’re written, the public would have another chance to weigh in.