Washington News: 2009 State Legislative Review

July 1, 2009 5:15 pm Topics: Tamper resistant prescription and Medication therapy management

Published in the July 2009 Washington State Board of Pharmacy Newsletter

To access the full text of the following bills, visit http://apps.leg.wa.gov/billinfo/.

SHB 1041 Occupational Therapy Medications

• Occupational therapists may purchase, store, and administer topical and transdermal prescription medications used in occupational therapy. Some medications may be applied through iontophoresis and phonophoresis (electrical current and ultrasound). The law exempts pharmacists from liability for adverse reactions. Occupational therapists cannot purchase, store, or administer controlled substances. Any drugs purchased from a pharmacy would be done by invoice. Occupational therapists do not have prescriptive authority.

HB 2014 Tamper-Resistant Prescription Pads

• The law requires every prescription written by a licensed practitioner in this state be on a tamper-resistant prescription pad or paper approved by the Board of Pharmacy.
• Effective July 1, 2010, all prescriptions written in Washington must be on tamper-resistant prescription paper affixed with a seal of approval by the Board of Pharmacy.
• A pharmacist cannot dispense a prescription that is not written on tamper-resistant paper, except when providing emergency supplies. All prescriptions given directly to the patient must be written on tamper-resistant paper and manually signed.
• Electronically transmitted, telephone, or facsimile prescriptions are exempt from this requirement.
• Practice settings such as hospitals and correctional facilities are exempt from the tamper-resistant pad/paper requirement so long as the patient does not have the opportunity to handle the written order.
• Tamper-resistant prescriptions must meet specific industryrecognized characteristics. They must have features designed to prevent the following:
• unauthorized copying of a completed or blank prescription form;
• erasing or modifying the information written on the prescription form by the practitioner; and
• the use of counterfeit prescription forms.

ESSB 5892 State Purchased Health Care

The new law amends the evidence-based prescription drug program for state agencies that purchase prescription drugs directly or through reimbursement to pharmacies. The intent is to maximize appropriate prescription drug use in a cost-effective manner. This legislation included an emergency clause effective May 19, 2009.

• State purchased health care programs may impose limited restrictions on an endorsing practitioner’s authority to write prescriptions to dispense as written.
• When a less expensive generic product in a drug class previously reviewed by the Pharmacy and Therapeutics Committee becomes available, the state can immediately designate an equally effective generic drug as a preferred drug. The same process can be followed for over-the-counter products.
• The program can impose limited restrictions on a practitioner’s authority to write “dispense as written” for a patient’s first course of treatment within a therapeutic class of drugs.
• The generic may be provided for the first course if there is a therapeutic alternative generic product and the drug utilization review (DUR) board has reviewed the appropriateness.
• The endorsing practitioner may request the brand name for the first course of treatment when medically necessary, using the prior authorization process.
• The program may impose limited restrictions on a practitioner’s authority to write “dispense as written” for off-label use of a product when a less expensive product is available and the DUR board has reviewed the appropriateness. The practitioner may request off-label use through the exception process.
• Department of Human Services prior authorization process must provide a response within 24 hours and allow for at least a 72-hour supply of the requested drug. Refills of nonpreferred drugs and anti-epileptic drugs are identified as a protected refill.

SSB 5252 City and County Jails’ Policy Regarding Medication Management

The new law requires city and county correctional facilities to develop policies and procedures to train and permit non-practitioner jail personnel to administer medications to inmates. A section of the law requires the Washington Association of Sheriffs and Police Chiefs (WASPC) to convene a work group to develop model policies for medication management in these facilities. The Board will be represented on the work group if WASPC opts to proceed without funding. The Department of Health will annually review medication practices in five jails and provide technical assistance.