Rep. Bob Nutting, R-Oakland, represents House District 66 in the Maine Legislature and served as speaker of the Maine House of Representatives during the 125th Legislature. A retired pharmacist, he practiced in hospital, independent and chain pharmacy settings throughout Maine for more than 40 years.
When I started as a pharmacist more than 40 years ago, the tools of the trade included a prescription, a pill counter and a reference book. The information we needed to do our jobs safely came primarily from printed materials. That was the best available option at the time, and we made it work. A lot has changed since then, and it’s time our federal regulations caught up.
Today, the pharmacy I knew in those early years would be almost unrecognizable. Electronic health records connect providers across an entire care team. Digital prescribing systems have replaced handwritten slips. Drug interaction software flags potential problems before a medication ever reaches a patient. In hospital settings, automated dispensing systems track every dose. The pharmacist’s role has grown more sophisticated, and the technology supporting it has grown more powerful.
Through all of that change, one requirement has remained frozen in place. Federal law still mandates that pharmaceutical manufacturers print physical prescribing information inserts and package them with every medication. These documents, written for healthcare professionals rather than patients, can run dozens of pages and take months to produce and distribute.
By the time they arrive at a pharmacy, the information they contain may already be out of date. And in my experience, they are rarely consulted. Pharmacists and physicians today access prescribing information through digital databases that are updated the moment the FDA issues new guidance or revises a warning.
I spent four decades helping patients in Maine understand their medications. It was critical that I stay current on prescribing information for medications, particularly when safety updates were issued quickly. Once we entered the digital age, I did not flip through a paper insert to do it. I used the same kind of online tools that pharmacists across the country rely on today. The printed materials had become, in practical terms, beside the point.
This is not a criticism of how the system was originally designed. Paper inserts served a real purpose when they were introduced. But medicine has moved forward, and the regulations governing how prescribing information is distributed have not kept pace.
The shift to electronic prescribing offers the most relevant parallel. When digital systems were first introduced for controlled substances, many providers were uncertain about the transition. What followed instead was a meaningful improvement across the board. Pharmacists and physicians adapted because the technology made their work better. Electronic labeling represents the same kind of straightforward progress.
Under an electronic labeling system, prescribing information would be distributed digitally and updated in real time. When the FDA approves a revised dosage recommendation or a new safety warning, providers would have access immediately rather than waiting for the next production cycle. Importantly, this legislation applies only to the prescribing information distributed to healthcare professionals.
In Maine, where many communities depend on a single pharmacy or a small regional hospital to meet the full range of their healthcare needs, efficiency is absolutely crucial. Pharmacists do not need to sift through reams of paper inserts. Rather, they need to spend their time serving patients. That is especially true in rural areas, where the local pharmacist is often the most accessible healthcare resource for miles around. Anything that makes that pharmacist’s work more accurate and more efficient makes care better for everyone who depends on them.
I’ve also spent years in the Maine Legislature, so I understand that progress is often made by simply reducing barriers to innovation. Electronic labeling does just that. It reduces wasted paper across the pharmaceutical supply chain, ensures that providers are working from the most current information available and asks patients to give up nothing in exchange.
Sen. Susan Collins has built a career on approaching health policy with genuine care and pragmatism. I would encourage her to support federal electronic labeling legislation. After more than 40 years behind the pharmacy counter in Maine, I can say that this change is long overdue, and that the patients we serve will be better off because of it.
