NCPA - National Center for Policy Analysis


June 1, 2004

Scribbling out prescriptions was once a task reserved for doctors with years of specialized training. But a growing number of states are allowing health-care providers with less medical education -- including pharmacists, certified midwives, and naturopaths -- to prescribe drugs to patients.

The shift is occurring as state lawmakers look for ways to cut health-care costs and make it easier for people to get routine medications such as vaccines or birth control. The new laws are often supported by insurance companies, which stand to save money since they can reimburse nondoctors at lower rates. In some cases, major drug makers are also lobbying for new rules, although the industry is divided on the issue.

While some nondoctors with substantial medical training -- including nurse practitioners and physician assistants -- have long been able to prescribe in most states, the list of professions seeking their own prescription pads is growing:

  • Last fall, California became the latest state to allow naturopaths, who specialize in herbal remedies, to prescribe some regular pharmaceuticals.
  • Naturopaths in Arizona and Hawaii can already write some prescriptions and lawmakers in Alaska recently established a task force to evaluate a similar proposal.
  • In February, Washington state launched a pilot program that lets pharmacists prescribe birth-control pills and patches to women.

This year, eight state legislatures dealt with bills that would let women get prescription emergency contraception, known as the morning-after pill, directly from a pharmacist -- without seeing a doctor. The future of many of the proposals hasn't been determined, but this year Maine became the sixth state to let pharmacists give the prescription drug to patients who haven't seen a doctor.

In a handful of other states, lawmakers are considering bills that would expand prescriptive rights for groups including nurse anesthetists, and optometrists.

Source: Jane Spencer, "Getting Drugs Without the Doctor: States Extend Prescription-Writing Powers To a Growing Range of Nonphysicians," Wall Street Journal, June 1, 2004.

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