HB 1618 Modifies provisions relating to the disposal of unused controlled substances

Current Bill Summary

- Prepared by Senate Research -


SCS/HCS/HB 1618 - This act modifies provisions of law relating to pharmacy, including: (1) limitations on prescribing opioids; (2) the disposal of unused controlled substances; (3) the Advisory Council on Rare Diseases and Personalized Medicine; (4) vaccine protocols; and (5) prescriptions.

LIMITATIONS ON PRESCRIBING OPIOIDS (Sections 195.010 and 195.080)

This act limits certain initial prescriptions of opioid controlled substances to no more than a 7-day supply for the treatment of acute pain. Prior to prescribing the opioid, a practitioner shall consult with the patient regarding the quantity of the opioid and the patient's option to fill the prescription in a lesser quantity, as well as inform the patient of the risks associated with the prescribed opioid. If, in the practitioner's medical judgment, more than a 7-day supply is required to treat the patient, the practitioner may issue a prescription for the quantity needed after noting in the patient's medical record the condition triggering the necessity for a greater quantity and that a nonopioid was not appropriate. The provisions of this act shall not apply to prescriptions for a patient who is currently undergoing treatment for chronic pain or cancer, is receiving hospice or palliative care, is a resident of a long-term care facility, or is receiving treatment for substance abuse or opioid dependence.

No pharmacy or pharmacist shall be liable or subject to disciplinary action for dispensing or refusing to dispense medication pursuant to an otherwise valid prescription that exceeds these prescribing limits.

These provisions are substantially similar to provisions in the truly agreed to and finally passed CCS/HCS/SS/SCS/SB 826 (2018) and SCS/SB 825 (2018).

DISPOSAL OF UNUSED CONTROLLED SUBSTANCES (Sections 195.070 and 195.265)

Under this act, a Drug Enforcement Agency-authorized collector or drug take back program, in accordance with federal regulations, may accept unused controlled substances from ultimate users, hospice or home health care providers to the extent permissible by federal law, or any person lawfully entitled to dispose of a decedent ultimate user's property as specified in the act, even if the authorized collector did not originally dispense the drug. This provision shall supersede and preempt any local drug disposal ordinance or regulation.

Additionally, the Department of Health and Senior Services shall develop an education and awareness program regarding drug disposal, including the development of a web-based resource and promotional activities.

This provision has an emergency clause.

This provision is substantially similar to a provision in the truly agreed to and finally passed CCS/HCS/SS/SCS/SB 826 (2018), the truly agreed to and finally passed CCS/HCS/SCS/SB 718 (2018), and the truly agreed to and finally passed CCS/HCS/SB 951 (2018).

ADVISORY COUNCIL ON RARE DISEASES AND PERSONALIZED MEDICINE (Section 208.183)

This act establishes an "Advisory Council on Rare Diseases and Personalized Medicine" in the MO HealthNet Division to assist the Drug Utilization Review Board when making recommendations or determinations regarding prior authorization and reauthorization criteria for rare disease drugs and other topics relating to rare diseases. The act specifies the council's membership and requires the council to meet no later that February 28, 2019. The council's recommendations to the Board shall be in writing. All members of the Council shall sign a conflict of interest statement each year and at least 20% of the members shall not have a conflict of interest with any insurer, pharmaceutical benefits manager, or pharmaceutical manufacturer.

This provision is identical to a provision in the truly agreed to and finally passed CCS/HCS/SS/SCS/SB 826 (2018), the truly agreed to and finally passed SS/HB 1953 (2018), the truly agreed to and finally passed CCS/HCS/SCS/SB 718 (2018), and SCS/SB 995 (2018) and substantially similar to HB 2407 (2018).

VACCINE PROTOCOLS (Section 338.010)

This act modifies the minimum age for the administration of certain vaccines from 12 years of age to 7 years of age or the Centers for Disease Control and Prevention recommendations, whichever is higher. The rules regulating the use of protocols for the administration of viral influenza vaccines shall no longer be jointly promulgated by the State Board of Registration for the Healing Arts and the State Board of Pharmacy, but shall be promulgated solely by the State Board of Pharmacy.

The act adds to the practice of pharmacy the administration of viral influenza vaccines by written protocol authorized by a physician for a specific patient.

Additionally, a pharmacist shall inform the patient that the administration of the vaccine will be entered into the ShowMeVax system. The patient shall attest to the inclusion of such information in the system by signing a form provided by the pharmacist or may indicate that he or she does not want such information entered into the system.

These provisions are identical to SCS/SB 776 (2018) and substantially similar to provisions in the truly agreed to and finally passed CCS/HCS/SS/SCS/SB 826 (2018).

PRESCRIPTIONS (Section 338.056)

This act modifies current law regarding written prescriptions to permit a pharmacist who receives a prescription for a brand name drug or biological product to select a less expensive generically equivalent drug or interchangeable biological product unless requested otherwise by the patient or prescribing practitioner who indicates that substitution is prohibited, as specified in the act. If an oral prescription is involved, the practitioner or practitioner's agency shall instruct the pharmacist if a generic drug or interchangeable biological product shall not be substituted.

This provision is substantially similar to a provision in the truly agreed to and finally passed CCS/HCS/SS/SCS/SB 826 (2018) and HB 2395 (2018).

SARAH HASKINS


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