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SB 239 - Pharmacy Practice Act - pharmacies shipping into state comply

Thomas, Don R (54th)	Starr, Terrell (44th)	Thomas, Nadine (10th)

Status Summary	SC:	H&HS	HC:		FR:	03/01/99	LA:	02/15/00	S - Unfavorably Reported

First Reader Summary

A bill to amend Chapter 4 of Title 26 of the Official Code of Georgia Annotated, the "Georgia Pharmacy Practice Act," so as to provide that pharmacies located outside of this state which ship prescription products into this state shall comply with all provisions of such chapter; to provide that the State Board of Medical Examiners and the State Board of Pharmacy shall jointly compile a list of narrow therapeutic index drugs.

Code Sections - 26-4-13/ 26-4-81.1

SB 239 99                                          LC 21 5439 
 
      SENATE BILL 239 
 
      By:  Senators Thomas of the 54th, Starr of the 44th, 
           Thomas of the 10th and others 
 
                        A BILL TO BE ENTITLED 
                               AN ACT 
 
 
  1- 1  To amend Chapter 4 of Title 26 of the Official Code of 
  1- 2  Georgia Annotated, the "Georgia Pharmacy Practice Act," so 
  1- 3  as to provide that pharmacies located outside of this state 
  1- 4  which ship prescription products into this state shall 
  1- 5  comply with all provisions of such chapter; to provide that 
  1- 6  the State Board of Medical Examiners and the State Board of 
  1- 7  Pharmacy shall jointly compile a list of narrow therapeutic 
  1- 8  index drugs; to provide for certain drugs which shall appear 
  1- 9  on such list; to provide that a pharmacist shall not 
  1-10  substitute a generic drug for any drug on such list when 
  1-11  refilling a prescription; to repeal conflicting laws; and 
  1-12  for other purposes. 
 
  1-13       BE IT ENACTED BY THE GENERAL ASSEMBLY OF GEORGIA: 
 
  1-14                           SECTION 1. 
 
  1-15  Chapter 4 of Title 26 of the Official Code of Georgia 
  1-16  Annotated, the "Georgia Pharmacy Practice Act," is amended 
  1-17  by inserting immediately following Code Section 26-4-12 a 
  1-18  new Code section to read as follows: 
 
  1-19    "26-4-13. 
 
  1-20    Any pharmacy located outside of this state which ships 
  1-21    prescription products into this state shall comply with 
  1-22    all provisions of this chapter." 
 
  1-23                           SECTION 2. 
 
  1-24  Said chapter is further amended by striking in its entirety 
  1-25  subsection (a) of Code Section 26-4-81, relating to the 
  1-26  substitution of generic drugs for brand name drugs, and 
  1-27  inserting in lieu thereof the following: 
 
  1-28    "(a) In accordance with this Code section, and except as 
  1-29    otherwise provided in Code Section 26-4-81.1,  a 
  1-30    pharmacist may substitute a drug with the same generic 
  1-31    name in the same strength, quantity, dose, and dosage form 
  1-32    as the prescribed brand name drug product which is, in the 
 
 
 
                                 -1- 
 
 
 
  2- 1    pharmacist's reasonable professional opinion, 
  2- 2    pharmaceutically equivalent." 
 
  2- 3                           SECTION 3. 
 
  2- 4  Said chapter is further amended by inserting immediately 
  2- 5  following Code Section 26-4-81 a new Code section to read as 
  2- 6  follows: 
 
  2- 7    "26-4-81.1. 
 
  2- 8    (a) The State Board of Medical Examiners and the State 
  2- 9    Board of Pharmacy shall jointly formulate and publish a 
  2-10    list of narrow therapeutic index drugs, as defined in 21 
  2-11    Code of Federal Regulations, Section 320.33 (c), which, in 
  2-12    addition to meeting any criteria for a narrow therapeutic 
  2-13    index drug contained in federal regulations, meet all of 
  2-14    the following criteria: 
 
  2-15      (1) Require careful patient titration under the 
  2-16      supervision of a physician to establish the proper 
  2-17      dosage; 
 
  2-18      (2) Require routine laboratory monitoring of the patient 
  2-19      to maintain the proper dosage; 
 
  2-20      (3) Require monitoring to prevent improper dosage which 
  2-21      can lead to life-threatening adverse events; and 
 
  2-22      (4) Require therapy beyond 30 days. 
 
  2-23    (b) The list compiled pursuant to subsection (a) of this 
  2-24    Code section shall include, at a minimum, carbabmazepine, 
  2-25    digoxin, levothyroxine, phenytoin, valproic acid, and 
  2-26    warfarin. 
 
  2-27    (c) A pharmacist shall refill any drug included in the 
  2-28    list compiled pursuant to subsection (a) of this Code 
  2-29    section using the same drug produced by the same 
  2-30    manufacturer that the pharmacist last dispensed under the 
  2-31    prescription, unless the pharmacist first notifies the 
  2-32    practitioner and the practitioner gives his or her 
  2-33    consent, which notification and consent the pharmacist 
  2-34    shall document. For purposes of this subsection, a new 
  2-35    prescription written at the expiration of a prescription 
  2-36    which continues the patient's therapy on a narrow 
  2-37    therapeutic index drug shall be treated as a refill." 
 
  2-38                           SECTION 4. 
 
  2-39  This Act shall become effective upon its approval by the 
  2-40  Governor or upon its becoming law without such approval. 
 
 
                                 -2- 
 
 
 
  3- 1                           SECTION 5. 
 
  3- 2  All laws and parts of laws in conflict with this Act are 
  3- 3  repealed. 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
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