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MAIL-ORDER PHARMACY LAW QUESTIONED

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A year-old law requiring mail-order pharmacies to counsel patients about the drugs they receive has some companies questioning its true purpose.

The state board that licenses pharmacists says the law is needed to protect consumers and ensure their safety. But a spokesman for the mail-order prescription-drug industry believes such requirements are aimed at preventing competition.Since the 1980s, mail-order pharmacies have gained a growing share of the prescription-drug retail trade. In 1981, sales totaled $100 million, according to the American Managed Care Pharmacy Association in Arlington, Va., which represents the mail-order-pharmacy industry.

By 1993, the total had ballooned to $5 billion.

That year, the federal government began requiring patient counseling by pharmacists dispensing drugs to Medicaid and Medicare recipients. Many states, including Utah, adopted rules extending the counseling to all patients.

Association Vice President Del Konor contends the rules were intended to protect turf.

"Pharmacy as a profession . . . has attempted to get more involved in pharmaceutical care through the whole area of patient counseling," Konor said. "It was initiated as a barrier to our industry."

Utah's Pharmacy Board adopted a counseling rule in 1993, requiring pharmacists to personally offer to discuss matters regarding drug therapy. The discussion should be in person, when practical, or by telephone.

Fifty-three out-of-state mail-order pharmacies have been licensed in Utah based on their promise to obey the rule. The pharmacy board and Division of Occupational and Professional Licensing rejected applications of companies that did not make such a promises.

For example, Medco Containment Services of Montvale, N.J., attempted to license six of its mail-service pharmacies. Company officials said they would provide counseling by sending each patient written information. The pharmacies also would provide a 24-hour a toll-free number for patients.

The state board decided verbal counseling did not include written instructions. But Constance White, Commerce Department director, sided with Medco.

"I do find that (Medco's) procedures appear to give Utah patients a reasonable amount of protection and, in fact, may actually provide a more realistic offer to counsel than is true under the current practices of at least some in-state pharmacies," White wrote in her order reversing the board's decision.

White's order will force the pharmacy board to review the counseling rule.

"What's asked certainly has to be doable and reasonable," said pharmacy board Chairman Russell K. Hulse. "Those aren't easy issues. Everyone has their own ideas."