Alexandria, VA—New federal guidance on their obligations when it comes to dispensing reproductive health medications drugs puts pharmacists in a more precarious position instead of clarifying the issue—which was the stated intent of the Biden Administration—according to key pharmacy groups.

The National Community Pharmacists Association (NCPA) asserted that pharmacists who are trying to abide by state laws on abortion could be caught in the middle by the guidance issued by the federal Department of Health and Human Services (HHS) Office of Civil Rights (OCR).

"States have provided very little clarity on how pharmacists should proceed in light of conflicting state and federal laws and regulations. It is highly unfair for state and federal governments to threaten aggressive action against pharmacists who are just trying to serve their patients within new legal boundaries that are still taking shape," stated NCPA CEO B. Douglas Hoey, RPh, MBA.

According to the NCPA's interpretation, the guidance warns pharmacists who reportedly refuse to dispense certain medicines used to terminate a pregnancy but which are also used to treat other conditions, such as rheumatoid arthritis, that they could be in violation of the federal civil rights laws.

The organization responded that the practice of pharmacy is regulated by the states, and few of those have provided direction on when pharmacists should or should not dispense reproductive drugs.

"States must issue clear guidance, and that needs to be an urgent priority," Dr. Hoey stated. "Pharmacists are trying to take care of their patients and now they shouldn't be in the crossfire."

The new guidance followed an executive order by President Joe Biden ensuring access to reproductive healthcare in response to a Supreme Court decision overturning Roe v. Wade.The HHS stated it was issuing guidance to about 60,000 U.S. retail pharmacies "reminding them of their obligations under federal civil rights laws. The guidance makes clear that as recipients of federal financial assistance, including Medicare and Medicaid payments, pharmacies are prohibited under law from discriminating based on race, color, national origin, sex, age, and disability in their programs and activities. This includes supplying prescribed medications; making determinations regarding the suitability of prescribed medications for a patient; and advising a patient about prescribed medications and how to take them. The action is the latest step in the HHS' response to protect reproductive health care."

"We are committed to ensuring that everyone can access healthcare, free of discrimination," added HHS Secretary Xavier Becerra. "This includes access to prescription medications for reproductive health and other types of care."

The American Pharmacists Association (APhA) says the guidance takes away a pharmacist's professional judgment to make "determinations regarding the suitability of a prescribed medication for a patient; or advising patients about medications and how to take them." In the press release, the APhA added, "The implications of the guidance have the potential to cause widespread unintended consequences beyond reproductive health care services."

Ilisa BG Bernstein, PharmD, JD, APhA interim executive VP and CEO, responded, "While we understand the intent, without consultation with our nation's pharmacists, OCR hastily issued this guidance which attacks and undermines the fundamental responsibilities and professional judgment of the pharmacist. It only adds more confusion to an already complicated legal and regulatory landscape post-Dobbs that pharmacists must navigate every day to help our patients."

Dr. Bernstein says it is not yet clear whether the federal guidance preempts state law, explaining, "When dispensing medications, according to this guidance, pharmacists in certain states may be in legal jeopardy and forced to question whether they will face conflicting state or federal penalties when providing care to their patients. It puts them between a rock and a hard place."

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