State considers prescription transfer limit like Ohio's

A move by Ohio officials to limit the number of times consumers can transfer prescriptions between pharmacies -- often as they chase discounts or deals -- could spur changes in Pennsylvania, too.

Since Jan. 1, the Ohio Board of Pharmacy has mandated that, with few exceptions, no single prescription can be transferred to a different pharmacy more than once a year.

The move follows a rash of discounts offered in recent years as retailers with pharmacies -- places such as Target, Walgreens, Giant Eagle and others -- competed to fill prescriptions in the hopes that customers would make other purchases while in the store and maybe even become loyal shoppers.

"We've had so many prescriptions being transferred, and every time a transfer occurs, there is an increased chance of error because they're all done verbally," said Ernest E. Boyd, executive director of the Ohio Pharmacists Association. Errors can occur in phone calls between pharmacists, with possible points of confusion including many drugs having sound-alike names or dosages being misunderstood.

One pharmacist he spoke to grew suspicious of a prescription that had gone through nearly a half-dozen transfers. After investigating, the pharmacist confirmed the drug named on the prescription was right, but "several other parts of the prescription were totally incorrect by the time it bounced around the number of pharmacies."

The Ohio board acted after hearing similar reports from around the state, said Tim Benedict, the board's assistant director.

"It wasn't one or two pharmacists complaining. We were hearing it constantly, from everybody."

The concern does not stop at Ohio's borders.

Pennsylvania State Board of Pharmacy chairman Richard Smiga mentioned Ohio's action at his board's Jan. 18 meeting. "He encouraged the board to consider a regulation in Pennsylvania that would similarly restrict the number of times that a prescription could be transferred," said spokesman Kevin Murphy.

"At this point, the matter is under preliminary consideration and will likely be discussed at future board meetings," he added. "As a fundamental legal matter, the pharmacy board's counsel was asked to research whether the board had the authority to propose this type of regulation."

Pharmacies at places such as Giant Eagle, CVS and Kmart offer coupons or have done so in the past to encourage customers to transfer prescriptions. The idea is to draw customers into the store with the coupon, then keep them coming back.

The stakes are big. U.S. Department of Commerce figures show that drugstore sales grow every year, up to $218.2 billion business in 2009, compared with $130.9 billion in 2000.

Transferring a prescription can be done easily, too, in some cases online. Typically it's just a matter of bringing information about a current prescription and pharmacy information to the new pharmacy, then letting them arrange the transfer.

But some customers take advantage of each new coupon to change pharmacies several times a year.

Transfer limits already exist for Schedule II drugs, such as opiates, so someone with a drug problem can't access more pills by transferring a prescription around. But Ohio is setting limits for non-addictive medications as well.

"With so many marketing campaigns out there, people are jumping their prescriptions all around," said Pat Epple, executive director of the Pennsylvania Pharmacists Association.

Beyond the possible mix-up in the prescriptions, she said it's also possible that both prescriptions could remain "live," with patients filling them at both places.

"It's not good if people end up taking twice as much as they should."

The Ohio regulation does allow multiple transfers if it is done within a single pharmacy chain's online pharmacy system.

CVS spokesman Mike DeAngelis said the drugstore chain is not currently offering transfer coupons and he does not think CVS customers will see a big impact because of the online pharmacy exemption.

As for those who switch from pharmacy to pharmacy because of coupons, he said, "Our position is that people should get all their prescriptions from the same pharmacist, who knows all the medications they're taking, to avoid potentially harmful drug interactions."

Dick Roberts, spokesman for Giant Eagle, said the O'Hara-based grocer is watching to see how the changes play out for its Ohio locations. "It is still early in the process and Giant Eagle is determining the best ways to comply with the new changes in Ohio. At this time, we are unable to speculate on whether the Ohio change will impact our other marketing areas."

A spokeswoman for discount retailer Target, when asked about Ohio's new regulation, said, "We have nothing to share, but Target does abide by all state and local laws."

Mr. Benedict of the Ohio pharmacy board said serial prescription transfers can turn into a game of post office, where some important detail -- say, dosage or how often you take a pill -- can get distorted or left out at each transfer, with possibly disastrous consequences. "Even though we haven't had a major incident, we just don't want to wait until that happens."

If Pennsylvania follows Ohio's lead, Mr. Murphy said it will take time to ensure any proposal meets regulatory requirements. In the meantime, the board here can watch and learn from the Ohio program.

Mr. Benedict acknowledged the board there has already had complaints from Ohio "snowbirds," state residents who winter in Florida or other warm climes. They typically transfer their prescriptions when they go, and then transfer them back upon returning. The new regulation would appear to block that second transfer.

"Under a strict reading of the rule, that would be true," he said, adding he believes the board may modify the regulation in coming months to account for such situations.

Independent pharmacists, who seemingly would benefit by not having to run in the coupon race with big chains, nevertheless have concerns, too, because of the online pharmacy exemption.

"While a prescription could be transferred multiple times within a chain, it can't be transferred from independents to another without counting against the limit," said John Norton, spokesman for the Virginia-based National Community Pharmacists Association.

"We will be interested to see how this concern is addressed and will offer whatever assistance would be needed from member pharmacies and pharmacy groups in Ohio."

Many others will be watching, too.

"There probably is some better way to do it," said Ms. Epple of the Pennsylvania pharmacists group, "but this looks like a good idea to contain some of this hopping around."

First published on January 30, 2011 at 12:00 am