We have a letter dated June 10 from William S. Apple and the Executive Committee of the Board of Trustees of the American Pharmaceutical Association (APhA). The letter quarreled with a recent EDITORIAL in The Journal that cautioned physicians against granting advance blanket consent to retail pharmacists to substitute drugs different from those prescribed.1 Publication of the letter in The Journal was requested.
We have no intention of publishing the polemic, as the authors have already circulated it to the news media. Nevertheless, we welcome the opportunity to reiterate our support of the laws that protect patients from pharmacists who might choose to violate their professional obligation to fill prescriptions with the drugs the prescriber intends.
Manifold reasons for this stance have appeared in these pages before.2,3 Drug substitution can create a spectrum of trouble ranging from minor mischief to therapeutic disaster.
To summarize what was said before,