Huffstutter: Keep Physician-Patient Relationship Healthy in 2015

Huffstutter: Keep Physician-Patient Relationship Healthy in 2015

February 28th, 2015 by By Dr. Joseph Huffstutter in Opinion Columns

A new class of biologic medications is giving a new lease on life for many patients. Biologics are used to treat many conditions -- most prevalently in the areas of oncology, rheumatology, neurology and dermatology. In 2015, a variation of these medications called biosimilars will become available. To realize the full potential of these medications, I strongly support proposed legislation that provides for communication from the pharmacist to the patient and the doctor whenever a pharmacist dispenses a substitution.

Biosimilars and those deemed interchangeable by the FDA hold great promise and will be useful in treating a variety of medical conditions. However, because biologics and biosimilars are unique drugs with different molecular structures, it's important that both the physician and the patient know exactly which drug the patient is taking.

Current legislation before the Tennessee General Assembly (HB 572 and SB 984) would require pharmacists to communicate to physicians which biological product they dispensed. Ultimately, this legislation is about protecting the physician-patient relationship, because physicians need accurate information to monitor patients' progress with disease progression and medication side effects to direct treatment.

The biosimilars that pharmacists may provide as a substitute will be new to the market this year. They are poised to give patients more options and, many hope, to lower prescription drug costs. It's important to realize that these biosimilars are not generics. These drugs, which stem from living cells or tissue, represent powerful medical technology. Physicians frequently prescribe them to patients who suffer from rheumatoid arthritis, multiple sclerosis and some types of cancer.

I think of one of my own patients, a woman who worked in a local school cafeteria and suffered from explosive onset rheumatoid arthritis. Her husband had to carry her in his arms to my office because her arthritis was so bad that she couldn't walk.

Now, after eight years on a biological medicine, this woman leads a different life. Retired from her work in the cafeteria, she and her husband devote themselves to mission work in Third-World countries.

But what if the medication hadn't been a good fit for her? I would have offered an alternative, and then another until we found something that worked. That's the nature of the physician-patient relationship. The physician knows their patients, monitors their progress and response to medications, and collaborates with them to maintain the best health possible.

This legislation supports that aspect of clinical care by making certain that physicians have all the pertinent details -- communication from the pharmacist will ensure a complete and accurate medical record. I can't monitor my patient and determine which medicines work if I'm unsure which medicine my patient is taking.

And while knowing about prescription drug substitutions always helps, with biological medicines and biosimilars it becomes imperative. Whether it's seeing a new side effect emerge or an old symptom disappear, I need to know which medication caused which response. That's why an up-to-date communication protocol between the pharmacist and the physician is so important.

All patients deserve first-rate care from an informed, attentive health care provider. And that's what I want to provide. This legislation will ensure that this happens.

Dr. Joseph Huffstutter is a Chattanooga rheumatologist and serves on the National Physicians Biologics Working Group with the Alliance for Patient Access.

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