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ARIZONA STATE SENATE
Fifty-Fourth Legislature, Second Regular Session
pharmacists; dispensing authority; hormonal contraceptives
Purpose
Permits a pharmacist to dispense a self-administered hormonal contraceptive under a standing prescription drug order and establishes dispensing guidelines and rulemaking requirements.
Background
The Arizona State Board of Pharmacy
(Board) regulates the practice of pharmacy and the distribution, sale and
storage of prescription medications, prescriptive devices and nonprescription
medications (A.R.S.
§ 32-1904). Current statute permits pharmacists to dispense, pursuant to a
standing order, naloxone hydrochloride or any other opioid antagonist that is
approved by the Food and Drug Administration (FDA) to a person who is at risk
of experiencing an opioid-related overdose or to a family member or community
member who is in a position to assist that person, consistent with protocols
specified by Board Rules. A standing order is a signed prescription
order that authorizes the pharmacist to dispense naloxone hydrochloride or any
other opioid antagonist for emergency purposes and that is issued by an licensed
medical practitioner (A.R.S. §§ 32-1968;
32-1979;
and 36-2266).
Prior to dispensing an opioid antagonist under a standing order, a pharmacist
must complete an opioid prevention and treatment training program that
includes:
1) how to recognize the symptoms of an opioid-related overdose; 2) how to
respond to a suspected opioid-related overdose; 3) how to administer all
preparations of an opioid antagonist; and
4) information needed by an individual to whom an opioid antagonist is
dispensed (A.A.C.
R4-23-407.1).
On November 11, 2017, the Director of the Department of Health Services (DHS) issued a standing order that allows any Arizona-licensed pharmacist to dispense one of the three forms of naloxone to any individual without a prescription. The DHS standing order was reissued on November 7, 2018 (DHS).
In 2010, the U.S. Centers for Disease Control and Prevention published the first U.S. Medical Eligibility Criteria for Contraceptive Use (U.S. MEC) to provide recommendations on safe use of contraceptive methods for women with various medical conditions and other characteristics. The U.S. MEC was updated in 2016 to assist health care providers in counseling women, men and couples about contraceptive method choice and to include additional recommendations (U.S. CDC).
There is no anticipated fiscal impact to the state General Fund associated with this legislation.
Provisions
1.
Authorizes a pharmacist to dispense a self-administered hormonal
contraceptive to a patient who is at least 18 years old under a standing
prescription drug order without any other
patient-specific prescription drug order.
2. Permits a prescriber who is licensed to prescribe a self-administered hormonal contraceptive, including a DHS employee acting in the prescriber's capacity, to issue a standing prescription drug order authorizing the dispensing of a self-administered hormonal contraceptive.
3. Directs the Board, in conjunction with DHS, to consult with a national professional organization specializing in obstetrics and gynecology to adopt rules establishing standard procedures for dispensing self-administered hormonal contraceptives under a standing order that require a pharmacist to:
a) obtain a completed nationally recognized self-screening risk assessment from each patient before dispensing a self-administered hormonal contraceptive to the patient; and
b) provide each patient with information about the self-administered hormonal contraceptive that is dispensed to the patient.
4.
Immunizes, from any civil damages for acts or omissions resulting from
dispensing a
self-administered hormonal contraceptive under a standing order, a pharmacist
or prescriber acting reasonably and in good faith in dispensing or prescribing
the self-administered hormonal contraceptive.
5. Applies all state and federal laws governing insurance coverage of contraceptive drugs, devices, products and services to self-administered hormonal contraceptives that are prescribed or dispensed pursuant to a standing order.
6. Specifies that self-administered hormonal contraceptive standing order requirements do not apply to valid patient-specific hormonal contraceptive prescriptions issued by an authorized prescriber and dispensed by a pharmacist.
7. Defines self-administered hormonal contraceptive as a self-administered hormonal contraceptive that is approved by the FDA to prevent pregnancy, including an oral hormonal contraceptive, a hormonal contraceptive vaginal ring and a hormonal contraceptive patch.
8. Becomes effective on the general effective date.
Prepared by Senate Research
February 10, 2020
CRS/AB/kja