They are establishing disease management programs in areas such as asthma, diabetes, hypertension and HIV, participating in drug compliance programs and documenting the counseling services they provide in an attempt to receive payment from insurers. Oncology pharmacy is under development, with the first examination scheduled for October. Seventeen states now authorize pharmacists to prescribe drugs, and more than a dozen others are considering similar action. Except in Florida, this power is limited by collaborative practice agreements and drug therapy protocols. The states establish panels of physicians and pharmacists to define situations in which pharmacists are allowed to write prescriptions, then set up strict protocols for them to follow.
Most prescribing pharmacists are in hospitals or managed care organizations.
But some are in community settings. Drug Emporium, a pharmacy chain with 18 franchises in Washington, last year sought protocols from the state for immunizations and guidelines for smoking cessation. Twenty-two states allow pharmacists to provide immunizations. The West Virginia University School of Pharmacy and the Centers for Disease Control have joined forces to expand the role of rural community pharmacists as advocates and providers of childhood immunizations. The Health Care Financing Administration has issued major revisions to the Medicare billing guidelines.