Ethics

Access to prescription drugs: How the doctor’s role is changing

Physicians were once the primary gatekeepers to prescription medications, as their risk-benefit assessment dictated whether patients would be able to obtain drug treatments. Now, though, escalating prices, formulary restrictions, and more clinicians with prescription-writing authority have entered the picture. Understanding these changes and exploring different strategies can help improve access to medications that patients need.

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The August issue of the AMA Journal of Ethics® (@JournalofEthics) features numerous perspectives on access to prescription medications and gives you an opportunity to earn CME credit.

Articles include:

How Should Physicians Steward Limited Resources While Ensuring That Patients Can Access Needed Medicines?” Louisiana has a subscription model for hepatitis C treatment, but costly medications challenge states’ capacities to cover patients.

How Should Medical Education Better Prepare Physicians for Opioid Prescribing?” Case-based teaching, longitudinal application, and training in ethical deliberation can better prepare physicians to responsibly prescribe and manage opioids.

Evolving Medicaid Coverage Policy and Rebates.” Ethics questions arise about the usefulness of a system that pegs Medicaid drug spending to net prices negotiated by others in the market.

Are Medicaid Closed Formularies Unethical?” Closed formularies can be justified when they enable spending on other socially valuable aims, but they can single out poor patients.

Listen and learn

In the journal’s August podcast, expert Aaron S. Kesselheim, MD, MPH, a professor of medicine at Harvard Medical School, discusses what a fair price is for a drug that you would die without.

Dr. Kesselheim also covers how drugs are priced, and what legislative and market-based methods for curbing rising drug prices could look like. Listen to previous episodes of the podcast, “Ethics Talk,” or subscribe in iTunes or other services.

Related Coverage

How are prescription drug prices determined?

Earn CME 

The AMA Journal of Ethics CME module, “Should a Law Governing the Pharmaceutical Market Be Ethically Examined Based on Its Intent or Its Practical Applications?”, is designated by the AMA for a maximum of 1 AMA PRA Category 1 Credit™. 

The module is part of the AMA Ed Hub™, an online platform that brings together high-quality CME, maintenance of certification, and educational content—in one place—with relevant learning activities, automated credit tracking and reporting for some states and specialty boards. 

Learn more about AMA CME accreditation. 

Submit manuscripts and artwork

The journal’s editorial focus is on commentaries and articles that offer practical advice and insights for medical students and physicians. Submit a manuscript for publication. The journal also invites original photographs, graphics, cartoons, drawings and paintings that explore the ethical dimensions of health or health care.

The AMA Journal of Ethics Conley Art of Medicine Contest and Conley Ethics Essay Contest for medical students, residents, and fellows are now open.

A look ahead

Upcoming issues of the AMA Journal of Ethics will focus on ethics of global health “immersion” in health professions education and insights on value and values from decision science for clinical ethics. Sign up to receive email alerts when new issues are published.