441 Pa. 186 | Pa. | 1971
Lead Opinion
Opinion by
Section 8(11) of the Pharmacy Act, Act of September 27, 1961, P. L. 1700, 63 P.S. §390-8(11), makes it unlawful for a pharmacist to advertise the prices of dangerous or narcotic drugs.
Our adjudication begins with an acknowledgment that the day has long passed when the Due Process Clause of the Fourteenth Amendment could be used to indiscriminately strike down state economic regulatory statutes. It is certainly clear that the “vague contours” of due process, see Adkins v. Children’s Hospital, 261 U.S. 525, 567, 568, 43 S. Ct. 394, 405 (1923) (Holmes, J., dissenting), cannot be employed to engulf a State’s efforts to, for example, set minimum hours for work, see Lochner v. New York, 198 U.S. 45, 25 S. Ct. 539 (1905), or set minimum wages for children, see Adkins v. Children’s Hospital, supra, or prohibit employment agencies from collecting fees from employees, see Adams v. Tan
' While this test may mean that in the federal courts the “due process barrier to substantive legislation as to economic matters has been in effect removed,”
Thus Pennsylvania, like other, state “economic laboratories”, see New State Ice Co. v. Liebmann, 285 U.S. 262, 280, 311, 52 S. Ct. 371, 375, 387 (1932) (Brandeis, J., dissenting), has. scrutinized regulatory legislation perhaps more closely than would the Supreme Court of the United States.
Through all these cases we have been guided by the proposition that “a law which purports to be an exercise of the police power must not be unreasonable, unduly oppressive or patently beyond the necessities of
Regulating the advertising of retail drugs is by no means unique to Pennsylvania. The federal government, for example, has regulations pertaining to advertising prescription drugs, although there is no prohibition on advertising the prices of such drugs. See 21 C.F.R. 1.105. In addition, several states have statutes similar to Pennsylvania’s, forbidding pharmacists from advertising the prices of prescription drugs.
The Commonwealth, and amici, urge that we uphold the instant prohibition.
The first reason—diminishing the demand for, and use of, dangerous drugs—is the reason primarily relied upon by the Commonwealth, as well as the trial court: “[T]he promotion and advertising of dangerous drugs and narcotics would certainly to a degree titillate an aberrant person and create an atmosphere of easy availableness”. State Board v. Pastor, 85 Daup. 174, 179 (1966). No one can quarrel with this goal, but closer examination does not demonstrate that the advertising prohibition bears a substantial relation to it.
The sale of “dangerous drugs” is a closely supervised business. All dangerous drugs must be dispensed, if at all, by a prescription,
Therefore, to urge that allowing price advertisements of prescription drugs would increase the use of such drugs, one must assume either (a) that patients are able to pressure doctors into prescribing drugs for
It is this unique purchasing structure, along with the high degree of regulation, which serves to distinguish the retail sale of prescription drugs from the sale of eyeglasses, and the instant case from Ullom v. Boehm, supra, which upheld the prohibition on advertising the price of eyeglasses. Eyeglasses, unlike prescription drugs, may be purchased on a direct demand by the consumer, and may be sold by the retailer on his own authority. Further, no contention was made in TJllom that advertising the price of eyeglasses would stimulate an unhealthy demand. Rather, it was urged, and accepted, that price advertising might lead a dealer to “sell to the public, eye-damaging glasses in order to adhere to an arbitrarily established reduced budget”. Ullom, 392 Pa. at 649, 142 A. 2d at 21-22. In the instant case no one contends that price advertising would lead a pharmacist to sell damaging drugs, for the pharmacist
We must therefore conclude that because of the highly regulated structure of the pharmaceutical profession, and the fact that the consumer cannot choose his purchases, it would appear most unlikely that advertising the prices of retail prescription drugs would, or could, have any impact on the demand or consumption of such drugs. Hence we must find that the first reason advanced cannot support the prohibition.
The second reason advanced to support the prohibition is that price' advertising may encourage price shopping, with a resultant adverse impact on the pharmacist’s “monitoring function”. This is a reason which has been accepted by the courts which have upheld statutes forbidding price advertising of prescription drugs. In Supermarket General Corp. v. Sills, 93 N.J. Super. 326, 341, 225 A. 2d 728, 737 (1966), it was stated that “there may be infrequent instances where a pharmacist does ‘monitor’ the prescription for the purpose of possibly detecting the prescription of an antagonistic drug. Infrequent as such occasions may be, they may justify the enactment. . . .” And in Patterson Drug Co. v. Kingery, 305 F. Supp. 821, 824 (W.D. Va. 1969), the court noted that “[ajlthough monitoring is not completely effective because of the mobility of customers and the availability of nonprescription drugs which may be antagonistic, it is a benefit to the public”.
We do not believe, however, that this asserted reason is sufficient to sustain the prohibition. The Com
Nor can it be said that prohibiting advertising of drug prices bears a substantial relation to the third goal asserted—prevention of deterioration of drugs. As in the case of the monitoring function, the means chosen are so far removed from the goal suggested that one must strain to find the relation. In addition, we note that this problem has been attacked in a more direct fashion. A drug will be deemed “adulterated” if it falls below the requisite standard of strength, quality and purity, see The Drug, Device and Cosmetic Act, 35 P.S. §780-13 (b). Sale of such an adulterated drug is prohibited; see 35 P.S. §780-4(a), and may subject the pharmacist to criminal liability: see 35 P.S. §780-20, as well as the loss of his license, see the Pharmacy Act, 63 P.S. §390-5. With such stringent provisions, the additional prohibition on price advertising would certainly appear to be “patently beyond the necessities of the case”. Gambone, supra.
We thus find that the prohibition in question bears no substantial relation to any of the objects which the. Commonwealth, and amici, assert were sought to be obtained. Even so, we would still hesitate to see the
The need for such information has also recently been emphasized in the Second Interim Report and Recommendations of the Task Force on Prescription Drugs of the United States Department of Health, Education, and Welfare, at 20-21 (August 30,1968) : “There is an obvious need for patients to be able to determine readily the prices charged by the various pharmacies
For all the foregoing reasons, we are drawn to the conclusion that the statute is unconstitutional insofar as it prohibits the advertising of “dangerous drugs”.
The orders of the Superior Court and the Court of Common Pleas of Dauphin County are reversed, and the citation is dismissed.
rhe terms “narcotic drug” and “dangerous drug” are defined in The Drug, Device and Cosmetic Act, Act of September 26, 1961, P. L. 1664, §2, 35 P.S. §780-2 (g) and (h). We note that Section 2(h) (4) defines as “dangerous” all drugs which can be dispensed only with a physician’s prescription. See note 13 infra.
Under Section 5(a)(6) of the Pharmacy Act, 63 P.S. §390-5 (a)(6), the Board may revoke or suspend a pharmacist’s license upon proof that the pharmacist violated any provision of the Pharmacy Act.
The court also found that although the statute forbids advertising “dangerous drugs, narcotics or drugs”, the word “drugs” could not be considered a separate category, “else practically every drugstore advertisement would be illegal”. 85 Dauph. at 181. The propriety of this construction, however, is not before us, the parties not having raised it as error.
The drugs advertised were: for the treatment of diabetes (orinase, insulin, diabinese) ; heart problems (nitroglycerin, coumadin, peritrate, digitalis, digitoxin, diuril, hydródiuril) ; arthritis, rheumatism and/or gout (prednisone, prednisolone, butazolidin, sterazolidin, benemid, medrol) ; blood pressure (esidrix-K, naturetin c K, raudixin, serpasil) ; sedatives, tranquilizers, sleeping pills (doriden, cquanil, meprobamate, miltown, phenobarbital, valium) ; anti-depressants (stelazine, elavil, tofranil) ; pain relievers (fiorinal, darvon) ; anti-appetite (preludia, tenuate, eskatrol) ; anti-histamine (benadryl) ; anti-fungicide (griseofulvin) ; anemia (trinsieon) ; oral contraceptive (ortho-novum) ; menopause (premarin) ; kidney and bladder infection (gantrisin) ; epilepsy (dilantin).
The Board found that phenobarbital and preludin were “dangerous drugs” under Section 2(h)(1) and (2) of The Drug, Device and Cosmetic Act, 35 P.S. §780-2 (h)(1) and (2), since they con-
The court held that insufficient evidence was produced by the Board to support its finding that Sections 2(h)(1) and (2) were violated. As to the eight drugs held to have violated Section 2(h) (4), the court sustained the Board’s finding, noting that the Board’s expert witness “did unequivocally testify that the drugs have toxic effects and a potentiality for harm and require the prescription of licensed physicians under Federal Law”. 88 Dauph. at 278.
An amicus curiae brief was filed on behalf of the States of Colorado, North Dakota and Virginia, and leave was allowed for an Assistant Attorney General from Colorado to participate in oral argument.
Stern, The Problem of Yesteryear—Commerce and Due Process, 4 Vand. L. Rev. 446 (1951), quoted in Essays in Constitutional Law 155 (R. McOloskey, ed., 1957).
For a survey of state court decisions sustaining, and rejecting, state regulatory legislation, see Hetherington, State Economic Regulation and Substantive Due Process of Law, 53 Nw. U. L. Rev. 226, 229-48 (1958).
We note that in Oott none of the parties contended that sucaryl, made with calcium cyclamate, was deleterious to health. See Cott, 380 Pa. at 117, 110 A. 2d at 407.
See, e.g., Md. Code Ann. Art. 43, §266A(c) (iv) ; N. Y. Edue. Law §6804(1) (d); N. J. Stat. Ann. §45:14-12(e) ; Va. Code Ann Sec. 54-524.35(4) (Supp. 1970).
We note that the instant prohibition does not affect advertising directed to other than the “general public”, i.e., to physicians. See Comment, Prescription Drug Pricing in California: An Analysis of Statutory Causes and Effects, 49 Cal. L. Rev. 340, 344-45 (1961).
The definition of dangerous drugs in The Drug, Device and Cosmetic Act, 35 P.S. §780-2 (h) makes no reference to prescription. Subsections (h) (1) and (h) (2) merely list a series of drugs by name, and Subsection (h) (3) provides that additional drugs may be designated as “dangerous” after certain findings by the
However, 35 P.S. §780-4 (x) prohibits “[t]he sale at retail or dispensing of any dangerous drug to any person, except to one authorized by law to sell, dispense, prescribe or possess such drugs, unless upon the written or oral prescription of a person licensed by law to prescribe such drug . . .” (Emphasis added.)
35 P.S. §780-2(h) (4) also defines as “dangerous” all drugs which may be dispensed only with a physician’s prescription. See 21 Ü.S.C. §353(b) (1) (B) : “A drug Intended for use by man which . . . because of its toxicity or other potentiality for harmful effect, or the method of its use, or the collateral measures necessary to its use, is not safe for use except under the supervision of a practitioner licensed by law to administer such drugs . . . shall be dispensed only (i) upon a written prescription of a practitioner licensed by law to administer such drugs, or (ii) upon an oral prescription of such practitioner which is reduced promptly to writing and filed by the pharmacist, or (iii) by refilling any such written or oral prescription if such refilling is authorized by the prescriber. . . .” Section 353(b)(4) provides that such drugs will bear the legend “Caution: Federal law prohibits dispensing without a prescription”.
Further examination of 21 U.S.O. §§353(b) (1) (A) (B) and 352(d) reveals that drugs in the first and third categories of the statutory definition of “dangerous drugs”, 35 P.S. §780-2, may, as a matter of federal law, be dispensed only by prescription.
In Florida Board of Pharmacy v. Webb’s City, Inc., 219 So. 2d 681 (Fla. 1969), the Florida Supreme Court, on the authority of Btadnih, held that a statute forbidding such advertising was likewise unconstitutional.
American Federation of Labor v. American Sash & Door Co., 335 U.S. 538, 542, 553, 69 S. Ct. 258, 260, 265 (1949) (Frankfurter, J., concurring).
This is not to say, nor do any of tbe parties contend, that the goal of this statute is to regulate the retail prices of prescription drugs. Compare Olin Mathieson Chemical Corp. v. White Cross Stores, Inc., 414 Pa. 95, 199 A. 2d 266 (1964). See also Commonwealth ex rel. Woodside v. Sun Ray Drug Co., 383 Pa. 1, 17, 116 A. 2d 833, 841 (1955) : “ ‘The stifling of competition through an exercise of the State’s police power is never justifiable except that it be done, and actually be, in the public interest. . . .’”
The Task Force also noted (at 23) : “The present patchwork of State pharmacy laws, regulations, and codes of ethics obviously reflects attempts to cope with a variety of pharmacy problems on a piecemeal basis. Whether they are aimed at the protection of the public health or the prevention of competition—fair or unfair—is not clear in all cases”.
Dissenting Opinion
Dissenting Opinion by
At the outset I should like to state my understanding of the thrust of the Majority Opinion. Today the majority finds violative of due process only that portion of Section 8(11) of the Pharmacy Act, Act of September 27, 1961, P. L. 1700, 63 P.S. §390-8(11) prohibiting the advertisement of “dangerous drugs”.
The cornerstone of the Majority Opinion is the “unique purchasing structure” of the prescription drug industry whereby such drugs are available only upon a written or oral prescription from a duly licensed medical practitioner and filled by a licensed pharmacist. Thus, the majority is able to erect the required prescription as a bulwark against drug abuse; to do otherwise, the majority concludes, would impugn the professional integrity of either doctors or pharmacists. It may be true that the incidence of legitimate drug taking will not be increased but one must pause to consider the effect of the majority’s decision on the incidence of illegitimate drug consumption.
In an increasingly drug-oriented society it cannot be gainsaid that such advertising might very well “titillate an aberrant person”. Considering the thesis of many popular writers that advertising agencies can sell any product, including politicians, could not this prescription drug advertising have the side effect, albeit unintentional, of popularizing the illegal use of drugs? The blatant, multi-media advertising of prescription drugs that can be anticipated may very well have the effect of placing society’s stamp of approval on any and all drug usage. While it may be argued, owing to the already widespread use of narcotics, that my position would add but one more cup of water to the sea, such advertising may also be the straw to break society’s back. Thus, it is my belief that the majority’s
I further disagree with the majority’s dismissal of this Court’s rationale in Ullom v. Boehm, 392 Pa. 643, 142 A. 2d 19 (1958), because of the “unique purchasing structure” of prescription drugs. In distinguishing TJllom, the majority pays no heed to the spirit or essence of the TJllom opinion insofar as that case impugned the profession of optometry by recognizing the legislative determination to remove “from dealers the temptation to sell to the public, eye-damaging glasses in order to adhere to an arbitrarily established reduced budget”. 392 Pa. at 648-49, 142 A. 2d at 21. For some unarticulated reason the majority does not choose to demean pharmacists whereas this Court has already impugned optometrists. Just as an optometrist may sell “eye-damaging glasses in order to adhere to an arbitrarily established reduced budget”, so may a pharmacist sell prescription drugs without a prescription in order that his volume of drug sales at reduced prices will cover his costs.
For these reasons, I dissent and would affirm the revocation.