Understanding Oregon's Public Health and Pharmacy Formulary Advisory Committee

Pharmacists are engaging in a broader array of clinical activities, often necessitating prescriptive authority. As a result, in 2017, Oregon passed House Bill 2397, which directed the Oregon Board of Pharmacy (OBOP) to form the Public Health and Pharmacy Formulary Advisory Committee (PHPFAC). This multidisciplinary committee is charged with making recommendations to the OBOP on a formulary of drugs and devices that a pharmacist may prescribe and dispense pursuant to a diagnosis by a qualified health care provider. The formulary compendium, implemented through statewide protocols, currently provides a pathway for pharmacists to prescribe medications for cough and cold, preventative care, smoking cessation, travel, human immunodeficiency virus postexposure prophylaxis, noncomplicated vulvovaginal candidiasis, and an array of devices and supplies. It also allows a pharmacist to extend a patient's prescription to avoid therapy interruption. Implementation has been delayed as statutory language required clarification, and it has been challenged by limited reimbursement for clinical consultation. However, the PHPFAC framework provides a novel approach to expand pharmacist prescriptive authority without ongoing legislative action. It also provides a mechanism to engage the pharmacy community in discussions surrounding pharmacist prescribing. Future work is needed to address barriers to implementation.