Senate Bill No. 387–Senator Titus

 

CHAPTER..........

 

AN ACT relating to drugs; requiring the Board of Medical Examiners and the State Board of Pharmacy to post on the Internet certain information relating to manufacturers of drugs; revising provisions relating to the substitution of generic drugs for drugs prescribed by brand name; and providing other matters properly relating thereto.

 

THE PEOPLE OF THE STATE OF NEVADA, REPRESENTED IN

SENATE AND ASSEMBLY, DO ENACT AS FOLLOWS:

 

    Section 1. Chapter 630 of NRS is hereby amended by adding

thereto a new section to read as follows:

    The Board shall post on a website or other Internet site that is

operated or administered by or on behalf of the Board:

    1.  A general description of the basic elements of the

Compliance Program Guidance for Pharmaceutical

Manufacturers that is published by the Office of Inspector

General of the United States Department of Health and Human

Services, or links to websites or other Internet sites that are

operated or administered by or on behalf of the Office of Inspector

General where such information may be obtained;

    2.  A general description of the process for reporting unlawful

or unethical conduct by pharmaceutical manufacturers to the

Office of Inspector General, or links to websites or other Internet

sites that are operated or administered by or on behalf of the

Office of Inspector General where such information may be

obtained; and

    3.  A current telephone number for the Office of Inspector

General.

    Sec. 2.  Chapter 639 of NRS is hereby amended by adding

thereto a new section to read as follows:

    The Board shall post on a website or other Internet site that is

operated or administered by or on behalf of the Board:

    1.  A general description of the basic elements of the

Compliance Program Guidance for Pharmaceutical

Manufacturers that is published by the Office of Inspector

General of the United States Department of Health and Human

Services, or links to websites or other Internet sites that are

operated or administered by or on behalf of the Office of Inspector

General where such information may be obtained;

    2.  A general description of the process for reporting unlawful

or unethical conduct by pharmaceutical manufacturers to the

Office of Inspector General, or links to websites or other Internet

sites that are operated or administered by or on behalf of the

Office of Inspector General where such information may be

obtained; and

    3.  A current telephone number for the Office of Inspector

General.

    Sec. 3.  NRS 639.2583 is hereby amended to read as follows:

    639.2583  [If]

    1.  Except as otherwise provided in this section, if a

practitioner has prescribed a drug by brand name and the

practitioner has not indicated , by a method set forth in subsection

5, that a substitution is prohibited, [a pharmacist:

    1.  Shall, in a case where he is being paid for the drug by a

governmental agency; and

    2.  May, in any other case, fill] the pharmacist who fills or

refills the prescription [with] shall dispense, in substitution, another

drug which is available to him[, is] if the other drug:

    (a) Is less expensive than the drug prescribed[, is] by brand

name;

    (b) Is biologically equivalent[, has] to the drug prescribed by

brand name;

    (c) Has the same active ingredient or ingredients of the same

strength, quantity and form of dosage as the drug prescribed by

brand name; and [is]

    (d) Is of the same generic type as the drug prescribed[. The

pharmacist may also make such a substitution if the prescription was

written] by brand name.

    2.  If the pharmacist has available to him more than one drug

that may be substituted for the drug prescribed by brand name, the

pharmacist shall dispense, in substitution, the least expensive of

the drugs that are available to him for substitution.

    3.  Before a pharmacist dispenses a drug in substitution for a

drug prescribed by brand name, the pharmacist shall:

    (a) Advise the person who presents the prescription that the

pharmacist intends to dispense a drug in substitution; and

    (b) Advise the person that he may refuse to accept the drug

that the pharmacist intends to dispense in substitution, unless the

pharmacist is being paid for the drug by a governmental agency.

    4.  If a person refuses to accept the drug that the pharmacist

intends to dispense in substitution, the pharmacist shall dispense

the drug prescribed by brand name, unless the pharmacist is being

paid for the drug by a governmental agency, in which case the

pharmacist shall dispense the drug in substitution.

    5.  A pharmacist shall not dispense a drug in substitution for a

drug prescribed by brand name if the practitioner has indicated

that a substitution is prohibited using one or more of the following

methods:

    (a) By oral communication to the pharmacist at any time

before the drug is dispensed.

    (b) By handwriting the words “Dispense as Written” on the

form used for the prescription, including, without limitation, any

form used for transmitting the prescription from a facsimile

machine to another facsimile machine. The pharmacist shall

disregard the words “Dispense as Written” if they have been

placed on the form used for the prescription by preprinting or

other mechanical process or by any method other than

handwriting.

    (c) By including the words “Dispense as Written” in any

prescription that is given to the pharmacist by electronic

transmission pursuant to the regulations of the Board, including,

without limitation, an electronic transmission from a computer

equipped with a facsimile modem to a facsimile machine or from a

computer to another computer pursuant to the regulations of the

Board.

    6.  The provisions of this section also apply to a prescription

issued to a person by a practitioner from outside this state [and

indicates] if the practitioner has not indicated, by a method set

forth in subsection 5, that a substitution [may be made.] is

prohibited.

    7.  The provisions of this section do not apply to:

    (a) A prescription drug that is dispensed to any inpatient of a

hospital by an inpatient pharmacy which is associated with that

hospital;

    (b) A prescription drug that is dispensed to any person by mail

order or other common carrier by an Internet pharmacy which is

certified by the Board pursuant to NRS 639.23288 and authorized

to provide service by mail order or other common carrier pursuant

to the provisions of this chapter; or

    (c) A prescription drug that is dispensed to any person by a

pharmacist if the substitution:

        (1) Would violate the terms of a health care plan that

maintains a mandatory, exclusive or closed formulary for its

coverage for prescription drugs; or

        (2) Would otherwise make the transaction ineligible for

reimbursement by a third party.

    Sec. 4.  NRS 639.2589 is hereby amended to read as follows:

    639.2589  1.  The form used for any prescription which is

issued or intended to be filled in this state must contain a line for the

signature of the [prescriber, the printed words “dispense only as

written” and a box near that statement for the purpose of indicating

that a substitution may not be made.] practitioner.

    2.  Substitutions may be made in filling prescriptions contained

in the orders of a physician, or of an advanced practitioner of

nursing who is a practitioner, in a facility for skilled nursing or

facility for intermediate care. [Each page of the document which

contains the order must be printed with the words: “The biological

equivalent of drugs ordered may be dispensed unless initialed by the

prescriber here” and a box must be provided near that statement for

the purpose of indicating that a substitution may not be made.]

    3.  Substitutions may be made in filling prescriptions ordered

on a patient’s chart in a hospital if the hospital’s medical staff has

approved a formulary for specific generic substitutions.

    Sec. 5.  NRS 639.259 is hereby amended to read as follows:

    639.259  No employer of a pharmacist may require the

pharmacist to dispense any specific generic drug in substitution for

another drug if[:] the:

    1.  Substitution is not permitted by the prescription as signed by

a practitioner; [or]

    2.  Substitution would be against the professional judgment of

the pharmacist[.] ; or

    3.  Substitution would violate any provision of NRS 639.2583

to 639.2599, inclusive.

    Sec. 6.  NRS 639.2585 is hereby repealed.

 

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