Pharmacists urge removal of Section 17 from S.2, say it would strip professional judgment and risk patient safety

Brian Clark, chief executive officer of the South Carolina Pharmacy Association, and practicing pharmacists told the Senate Medical Affairs subcommittee that Section 17 of S.2 would unduly restrict pharmacists' professional judgment and could endanger patients.

Clark testified that while the association is neutral on S.2 overall, it “must express strong opposition to section 17.” He said the provision would “severely restrict a pharmacist's ability to exercise professional judgment by limiting their ability to refuse to fill a prescription except under narrowly defined circumstances.” Clark described pharmacists as “the last line of defense in ensuring patient safety,” outlining routine checks for drug interactions, contraindications and dosing based on kidney or liver function.

The witnesses gave examples to illustrate their concerns. Clark warned that dispensing a medicine such as ivermectin for an unapproved use (he cited COVID‑19 as an example) without clinical review could cause severe drug interactions or harm to a patient taking other medicines such as warfarin. He said the change would “strip pharmacists of their ability to intervene, leaving patients vulnerable to preventable harm.”

Renarda (RJ) Jones, a pharmacist, co‑owner of MediSave Pharmacy in Camden and CEO of P Sen Incorporated, said insurers and plan sponsors often rely on pharmacists to use clinical judgment at point of sale and that removing that discretion would alter how utilization edits are set. She cited a federal Office of Inspector General analysis (2015–2019) that found plan sponsors paid $86,200,000 for prescriptions used for non‑medically accepted indications and said that history shows payer edits and pharmacist judgment interact to protect patients and program integrity.

Jones also described how prior‑authorization rules implemented by plans to block use of drugs for excluded indications (for example, some GLP‑1 medications used for weight loss) can lead to access problems for patients who have the labeled indication and require additional administrative steps to obtain therapy.

Both Clark and Jones urged deletion of Section 17. Clark asked the committee to “amend S.2 by deleting section 17 and preserve pharmacists' ability to exercise their professional judgment to protect the safety of South Carolinians.” Jones said the provision “constricts the professional judgment” of pharmacists by enumerating only certain circumstances for refusal to fill.

Committee members pressed witnesses for detail; one senator asked whether the association had proposed alternative language, and witnesses said they had provided written materials and were willing to submit draft amendment language for staff and sponsors to consider. No formal committee action or vote on Section 17 was recorded at the hearing.

Ending: The subcommittee accepted written follow‑up from the pharmacy witnesses and indicated it would continue deliberations with staff and bill sponsors before deciding whether to revise Section 17.