State House and Senate

Legislative measures would allow it after pharmacists train

bills would give Florida pharmacists authority to treat flu sufferers quickly.

Flu sufferers could be swiftly diagnosed and treated by their local pharmacists, if a proposal before the state Legislature is enacted.

Bills in the House and Senate would give pharmacists authority to conduct simple mouth-swab tests for influenza and streptococcus and, depending upon the results, dispense prescription Tamiflu or antibiotics. Tests would have results in about 30 minutes.

Proponents, including the Florida Pharmacy Association, say rapid treatment will accomplish a number of public benefits. For most flu sufferers, the antiviral medicine Tamiflu can ease symptoms if administered in the first day or two after symptoms appear.

Patients diagnosed with strep would more quickly start taking antibiotics and more quickly cease to be contagious.

Pharmacists would require additional training to give the tests and treatments, and specific protocols would be approved by the state Board of Pharmacy. Training standards would be similar to those enabling pharmacists to administer flu vaccines, said Suzanne Wise, president of the Florida Pharmacy Association.

The quick test wouldn’t be for everyone. In Minnesota, which legalized testing and treatment by pharmacists, people with certain conditions are ineligible, and similar exceptions would likely be put in place in Florida, said the bill’s House sponsor, Rep. Rene Plasencia, a Republican representing parts of Brevard and Orange counties. People ineligible in Minnesota are pregnant or nursing, have asthma, heart failure, compromised immune systems, renal disease or chronic obstructive pulmonary disease (COPD), he said.

Other organizations favoring the bill are the Florida Retail Federation, the Florida Society of Health-System Pharmacists and the Florida Independent Pharmacy Network, said Michael Jackson, the Florida Pharmacy Association’s vice president and CEO.

The bill was advanced by a 12-2 vote Jan. 16 by the House Health Quality Subcommittee and referred to the Health and

Human Services Committee, which has not yet scheduled a hearing. A Senate version has not yet been scheduled for a committee hearing.

Opponents include the Florida Medical Association and the Florida Academy of Family Physicians.

Speaking against the proposal on behalf of the Florida College of Emergency Physicians, Dr. Damian Caraballo, a Tampabased emergency physician, said flu-like symptoms can indicate a large number of illnesses that pharmacists would not be able to diagnose with limited training.

“In residency, we do 8,000 to 12,000 hours of training,” he said. “So we know the difference between somebody with the flu, somebody with sepsis, somebody with life-threatening pneumonia, someone with a peritonsillar abscess. There’s a huge difference.”

Voting against the bill, Rep. Ralph Massullo, a Citrus County dermatologist, said pharmacists do not have the experience or expertise to do physical exams or recognize side effects possible with flu and strep drugs.

He said the measure would benefit large-scale pharmacy businesses while putting patients at unnecessary risk.

However, another physician on the committee, Rep. Cary Pigman, who works as an emergency room doctor in Okeechobee, described working a recent 36-hour shift in an emergency room filled with flu patients and said allowing pharmacists to treat flu and strep sufferers would free capacity for people with more serious problems.

“When you come to the emergency department that’s filled with people with flu and snowbirds, I hope you and your loved ones never have an acute heart attack or a stroke,” he said. “If I am bursting at the seams, if I am overcrowded, we are maybe not going to get to you on time.”