Can a pharmacist legally deny a patient a prescription?
That’s the question local doctor and addiction medicine specialist Dr. Ken Starr is struggling to understand after an unusual experience at a Central Coast pharmacy.
He treats dozens of patients who are dependent on opioids and he often prescribes Suboxone to reduce symptoms of addiction and withdrawal.
"This is a very commonly prescribed medication and it is considered a first-line treatment for anyone who has an opioid use disorder," Dr. Starr said.
It’s a strip that dissolves under the tongue or against the inside of the cheek. Dr. Starr has been prescribing this medicine for seven years without a problem, until recently.
The issue involved the Sav-On pharmacy inside the Albertsons on Niblick Road in Paso Robles.
"When I called the pharmacy, to just check in on why it wasn’t available there, at first it was sort of the story, ‘oh, it’s back-ordered,’ and then I kind of informed them that it wasn’t and when I really drilled down to about why, it came down to that pharmacist’s personal belief was that this wasn’t a medicine that they were comfortable giving out because they didn’t think it was helpful," Dr. Starr explained.
We talked with one local man who takes Suboxone. He was in a car crash in 2011 and was prescribed pain medication to deal with his injuries. He became addicted.
He wished to remain anonymous in our interview.
"It’s not something I ever thought would happen," he said. "I’m a normal functioning member of society. I’ve had a job now for a long time. I have a family. It’s something that I’d never considered and I feel it could happen to anybody."
His friend who was addicted to pain pills and did not get help, he says, died from an overdose.
Learning that one patient was denied the medicine that’s kept him on the right path is shocking to him.
"All it does is it allows you to function. It curbs the withdrawal symptoms. You just feel normal."
"I was really in disbelief to find out that a pharmacy didn’t think it was a useful medicine and didn’t want to dispense it to their patients," Dr. Starr said. "I mean, this is a standard of care in medicine and this medicine every day prevents people from overdosing and dying."
A spokeswoman for Sav-On, Albertsons and Vons told us the companies do not have a policy against stocking and dispensing Suboxone, but the pharmacists have the final say.
"While our pharmacists do have the right to conscientiously object to dispensing a prescribed medication because of their personal beliefs, they have a shared responsibility with the prescriber to provide medications that are safe and effective," said spokesperson Melissa Hill in an emailed statement to KSBY.
In California, pharmacists can refuse to fill a prescription if their company allows it and if the patient can get the medication somewhere else in a timely manner.
The man we spoke with says the drug has been invaluable. It’s saved his life.
"If it wasn’t for this medicine, I probably wouldn’t – my marriage would probably have ended a long time ago. I’m sure I wouldn’t have a job. I probably would be in prison or dead, to be honest with you, and that’s not a hyperbole. I’m not exaggerating."
Less than half of all states have something on the books about pharmacist refusals.
We reached out to the pharmacist directly involved in this case but she declined to comment.