Pseudoephedrine ban mixed bag for pharmacies

With 1,825 incidents, Missouri once again led the nation in 2012 methamphetamine production. Including all meth labs, dumpsites or chemical and glassware seizures, Missouri tallied 240 more incidents than No. 2 ranked Tennessee, according to the U.S. Drug Enforcement Agency.

While the report is a significant drop from Missouri’s recorded 2,075 incidents in 2011, southwest Missouri officials say it doesn’t mean the problem is getting any better.

Unable to pass legislation at the state level to further restrict meth-making materials, known as precursor drugs, local communities are taking action into their own hands.

Already law in more than 35 cities across Missouri including Branson, Hollister and Popular Bluff, the city of Ozark is the latest municipality to pass a pseudoephedrine ban restricting the precursor drug to prescription-only sales, a potential boon for local pharmacies.

“We know this is not going to fix the problem in Missouri, but it is our responsibility to look after the residents of Ozark,” said Mayor Shane Nelson of the 5-0 June 17 vote by city aldermen. “Of the five pharmacies in Ozark, Hixson Drug and Price Cutter already don’t sell it over the counter. We just took it one step further.”

Available in over-the-counter medications such as Sudafed, Claritin-D and Advil Cold & Sinus to treat allergy and sinus complications, the sale of pseudoephedrine is already regulated by the state.

“When the state-regulated pseudoephedrine became a trackable, behind-the-counter medication a couple years ago, we opted to pull our nonprescription sales,” said Kevin Howard, owner of Ozark-based Hixson Drug. “There hasn’t been a large change for us. I’d say only about 3 percent of our total prescription sales come from pseudoephedrine.”

Ozark-based Family Pharmacy CEO Lynn Morris said his stores didn’t require a prescription, but did refuse service to suspicious buyers.

“About 98 percent of people who come in my store were buying Sudafed for the right reason because they know we don’t sell it to just anybody,” said Morris, who also serves as a state representative. “I asked the alderman to give us more time at the state level to work something out, but I support what they felt they had to do for Ozark residents.”

Rather than lose business on over-the-counter sales, Morris said his three Ozark locations could potentially profit from the ban when adding in the traditional dispensing cost.

“If we have to put a label on it, it costs,” he said, noting typical pharmaceutical dispensing fees range from $4 to $10 per prescription to cover labor and other associated costs such as the $1 orange-plastic vial.

Morris said a $5 over-the-counter medication could cost as much as $16 in Ozark under the new law. However, he said he expects to see increased sales at other non-Ozark Family Pharmacy locations where no prescription is needed. Morris said it’s too soon to tell if the ban will increase profits at Family Pharmacy’s Ozark locations.

“Pseudoephedrine isn’t a large part of our sales. We are a prescription pharmacy primarily,” he said.

Not only an added step for pharmacists, CoxHealth Chief Medical Officer Dr. Dan Sontheimer said the ban could lead to additional work for the health care provider’s Ozark clinic office staff.

“I think nine out of 10 people will just be able to call in a prescription and won’t have to be seen by the doctor,” he said, noting a patient would have to have been seen recently by a doctor and have no other conditions preventing its use. “But there may be added work in coordinating the prescriptions and for those few who will require an office visit.”

Sontheimer said he believes most insurance plans will cover the prescription.

While Ozark is the latest to hop the pseudoephedrine prescription bandwagon, it’s certainly not the only city. Springfield City Council is set to discuss a prescription-only pseudoephedrine bill at it July 15 meeting. However, Councilman Doug Burlison wants to make the decision a vote of the people.

“The Springfield City Council is marching down the wrong path,” Burlison said in a release. “A prescription mandate for pseudoephedrine would only add to the list of prohibitive policies that punish law-abiding citizens as opposed to the meth criminals who exist today.”

Nixa Mayor Sam Clifton said the city considered a similar ban in winter 2012, but held off passing any laws in favor of allowing the matter to be handled at a state level.

“Now that Ozark has passed a ban and it looks like Springfield will, Nixa could become a hotspot,” Clifton said. “I have no doubt that this will be an issue we must consider again in the near future.”

In the meantime, Clifton said the Nixa Police Department is closely monitoring pseudoephedrine sales within the city.

Missouri House Bills 365 and 991, which sought to make the controversial drug prescription only, failed to leave the House chamber. A third bill, HB 218 cosigned by Morris, sought similar changes and was approved by the House, but failed to leave committee in the Senate.

“It’s top of my list next session,” Morris said. “I’ve already talked to the governor and he said he would sign my bill.”