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Ohio News: Physician Assistant Prescribing
Published in the May 2008 Ohio State Board of Pharmacy Newsletter
Physician assistant (PA) prescribing is here. Many of you have already seen prescriptions issued by PAs and have called the Board office to verify the validity of the prescriptions. The State Medical Board of Ohio rules on PA prescribing were effective on October 31, 2007, and the Medical Board began issuing certificates shortly thereafter. The formulary for PA prescribing (which may be further limited by the supervising physician) was not approved until February 28, 2008. Drug Enforcement Administration (DEA) would not issue DEA numbers to the PAs until the formulary was approved. The formulary may be found on the Medical Board’s Web site at http://med.ohio.gov/pdf/rules/Formulary_appendix_2-28-08.pdf.
PAs must have a Certificate to Prescribe (CTP) before they may begin issuing prescriptions for patients. Just as with the advanced practice nurses, the PA’s CTP number must be included on each prescription written. In addition, of course, the PA must include his or her DEA number on all controlled substance prescriptions issued. By the time this Newsletter is published, some of the PAs should have received their DEA number from the DEA.
The PA formulary is similar to the formulary for the advanced practice nurses. The PA and his or her supervising physician are responsible for knowing what drugs the PA may or may not prescribe. Pharmacists are not expected to review the formulary before filling each and every PA prescription received. However, pharmacists should be aware of a few basic facts:
- PAs may not write for any Schedule II controlled substance.
- PAs may not write for controlled substance anorexiants (eg, phentermine).
- PAs may not write for most antineoplastic agents.
- The supervising physician’s name does not need to be on the prescription. The PA is the prescriber and the label of the dispensed prescription should bear the PA’s name and title.
- If there is ever a question about a PA’s authority to write for a drug, please check the formulary, call the PA, call the supervising physician (if you know who that is), or call the Medical Board or the Board of Pharmacy office.
Just as you have done with the advanced practice nurses and all other limited practitioners (dentists, podiatrists, etc), pharmacists should continue to use good judgment when filling prescriptions written by PAs. The majority of them will be doing their best to practice within their scope and will not be intending to circumvent the laws and rules. If you happen to find a PA who does not feel that the prescribing rules were made for him or her and you are not successful at changing the PA’s mind, please let us know.
