Current through Register Vol. 51, No. 3, September 1, 2024
RELATES TO:
KRS
217.182,
315.010,
315.0351,
315.121,
315.350,
315.400,
315.402,
315.404,
315.406,
315.408,
315.410,
315.412,
21 U.S.C.
360eee -eee-4
NECESSITY, FUNCTION, AND CONFORMITY:
KRS
315.191(1)(a) authorizes the
board to promulgate administrative regulations to regulate and control all
matters set forth in KRS Chapter 315.
KRS
315.350,
315.402 and
315.406 require the board to
promulgate administrative regulations to regulate wholesalers, medical gas
wholesalers, wholesale distributors, and virtual wholesale distributors of
prescription drugs and drug-related devices. This administrative regulation
establishes the requirements for the regulation of wholesalers, medical gas
wholesalers, wholesale distributors, and virtual wholesale distributors.
Section 1. Definitions.
(1) "Component" means any raw material,
ingredient, or article intended for use in the manufacture of a drug and
drug-related device.
(2)
"Distribution" or "distribute" is defined by
KRS
315.400(5).
(3) "Drug sample" means a unit of a
prescription drug that is not intended to be sold and is intended to promote
the sale of the drug.
(4)
"Illegitimate Product" is defined by
KRS
315.400(11).
(5) "Medical gas wholesaler" is defined by
KRS
315.400(13).
(6) "Product" means a prescription drug in a
finished dosage form for administration to a patient without substantial
further manufacturing, such as capsules, tablets, and lyophilized products
before reconstitution.
(7) "Suspect
product" means a component, prescription drug, or drug-related device for which
there is reason to believe that the component, prescription drug, or
drug-related device:
(a) Is potentially
counterfeit, diverted, or stolen;
(b) Is potentially intentionally adulterated
so that the component, prescription drug, or drug-related device may result in
serious adverse health consequences or death to humans or animals;
(c) Is potentially the subject of a
fraudulent transaction; or
(d)
Appears otherwise unfit for distribution so that the component, prescription
drug, or drug-related device may result in serious adverse health consequences
or death to humans or animals.
(8) "Wholesale distribution" is defined by
KRS
315.400(20).
(9) "Wholesale distributor" is defined by
KRS
315.400(21).
(10) "Wholesaler" is defined by
KRS
315.010(28), and includes
medical gas wholesalers, wholesale distributors, and virtual wholesale
distributors.
(11) "Virtual
wholesale distributor" has the same meaning given in
KRS
315.400(21).
Section 2. Requirements.
(1) A wholesaler engaged in wholesale
distribution in the Commonwealth shall apply for a license from the Board of
Pharmacy in accordance with
KRS
315.350,
315.402,
315.406, and this administrative
regulation.
(2) A surety bond is
required of not less than $25,000, or other equivalent means of security
acceptable to the Board of Pharmacy or a third party recognized by the Board of
Pharmacy such as insurance, an irrevocable letter of credit, or funds deposited
in a trust account or financial institution. This shall be used to secure
payment of any administrative penalties imposed by the Board of Pharmacy and
any fees or costs incurred by the Board of Pharmacy regarding that licensee if
those penalties, fees, or costs are authorized under state law, and the
licensee fails to pay thirty (30) days after the penalty, fee, or costs becomes
final. A separate surety bond or other equivalent means of security is not
required for each company's separate locations or for affiliated companies or
groups if separate locations or affiliated companies or groups are required to
apply for or renew their wholesaler license with the Board of Pharmacy. The
Board of Pharmacy may make a claim against the bond or other equivalent means
of security until one (1) year after the wholesaler's license closes, lapses or
expires, or until sixty (60) days after any administrative or legal proceeding
before or on behalf of the Board of Pharmacy that involves the wholesaler is
concluded, including any appeal, whichever occurs later. The Board of Pharmacy
may waive the bond requirement, if the wholesaler:
(a) Has previously obtained a comparable
surety bond or other equivalent means of security for the purpose of licensure
in another state, where the wholesaler possesses a valid license in good
standing;
(b) Is a publicly held
company;
(c) Is a medical gas
wholesaler; or
(d) Has a license
for the sole purpose of distribution within a health care entity under common
ownership.
(3) A
separate license shall be required for each wholesaler's facility that engages
in wholesale distribution within the Commonwealth regardless of whether joint
ownership or control exists.
(4) An
agent or employee of a licensee shall not be required to obtain a license under
this section if the agent or employee is acting in the usual course of business
or employment.
(5) A license shall
not be issued or renewed unless the applicant demonstrates or continues to
demonstrate acceptable operational procedures, including:
(a) Adequate operational, maintenance, and
storage conditions to ensure proper lighting, ventilation, temperature and
humidity control, sanitation, space, and security as per label requirements or
official United States Pharmacopoeia (USP) compendium requirements, USP Chapter
659, Packaging and Storage Requirements. Appropriate manual, electromechanical
or electronic temperature and humidity recording equipment, devices, or logs
shall be utilized to document proper storage of prescription drugs and
drug-related devices;
(b)
Separation and quarantine of deteriorated, damaged, outdated, misbranded,
adulterated or otherwise recalled prescription drugs and drug-related devices
until they are destroyed or returned;
(c) Providing accurate and precise records of
all prescription drugs and drug-related devices sold, purchased, traded,
delivered, handled, stored, or received and any other information pertinent to
the distribution or disposition; and
(d) Providing proof of registration with the
U.S. Drug Enforcement Administration (DEA) and shall comply with all DEA
regulations, if applicable.
(6) Wholesale distributors and virtual
wholesale distributors shall comply with all requirements outlined in the Drug
Supply Chain Security Act (DSCSA),
21 U.S.C.
360eee-360 eee-4.
(7) Wholesalers shall establish a system to:
(a) Quarantine and investigate suspect
product to determine if it is illegitimate; and
(b) Notify U.S. Food and Drug Administration
(FDA), if applicable, the Board of Pharmacy and the recipient or recipients of
illegitimate product, if illegitimate product is found.
(8) A virtual wholesale distributer shall be
exempt from the following, subsection(5)(a) and (b) of this section, and
Section 5(1)(a) and (b), and (2)(a) and (b) of this administrative
regulation.
Section 3.
Qualifications for License.
(1) The Board of
Pharmacy shall consider, at a minimum, the following factors in reviewing the
qualifications of persons who engage in wholesale distribution of prescription
drugs and drug-related devices within the Commonwealth:
(a) Any convictions of the applicant under
any federal, state, or local laws relating to drugs, including drug samples and
controlled substances;
(b) Any
felony convictions of the applicant under federal, state, or local
laws;
(c) The applicant's past
experience in the distribution of prescription drugs and drug-related devices,
including drug samples and controlled substances;
(d) The furnishing by the applicant of false
or fraudulent material in any application made in connection with the
distribution of prescription drugs and drug-related devices;
(e) Suspension or revocation by federal,
state, or local government of any license or permit currently or previously
held by the applicant for distribution of any prescription drugs and
drug-related devices, including drug samples and controlled
substances;
(f) Compliance with the
requirements under any previously granted license or permit, if any;
and
(g) Compliance with
requirements to maintain or make available to the Board of Pharmacy or to
federal, state, or local law enforcement officials those records required under
this administrative regulation.
(2) The Board of Pharmacy may deny a license
to an applicant if it determines that the granting of that license would not be
in the public interest based on health and safety considerations.
(3) A license shall not be issued pursuant to
this administrative regulation unless the applicant has furnished proof
satisfactory to the Board of Pharmacy:
(a)
That the applicant is in compliance with all applicable federal, state, and
local laws and regulations relating to drugs; and
(b) That the applicant is equipped as to
land, buildings, and security to properly carry on the business described in
the application.
(4) A
license issued pursuant to this administrative regulation failing to comply
with the provisions of
KRS
315.350,
315.400,
315.402,
315.404,
315.406,
315.408,
315.410,
315.412, or this administrative
regulation may result in action under
KRS
315.121.
Section 4. Application, Fees, Renewals.
(1) An application for a license shall be
submitted to the Board of Pharmacy on the Application for a License to Operate
as a Wholesaler.
(2) An application
shall be accompanied by the annual fee set forth in
201 KAR 2:050.
(3) An application shall include:
(a) The name, full business address, and
telephone number of the licensee;
(b) All trade or business names used by the
licensee;
(c) Addresses, telephone
numbers, and the names of contact persons for all facilities used by the
licensee for the storage, handling, and distribution of prescription drugs and
drug-related devices;
(d) The type
of ownership or operation (i.e. partnership, corporation, or sole
proprietorship);
(e) The name or
names of the owner and operator of the licensee, including;
1. If a person, the name and Social Security
number of the person;
2. If a
partnership, the name and Social Security number of each partner, and the name
of the partnership;
3. If a
corporation, the name, Social Security number and title of each corporate
officer and director, the corporate names, and the name of the state of
incorporation; and
4. If a sole
proprietorship, the full name and Social Security number of the sole proprietor
and the name of the business entity;
(f) A list of all licenses and permits issued
to the applicant by any other state that authorizes the applicant to purchase
or possess prescription drugs and drug-related devices; and
(g) Proof of surety bond or
equivalent.
(4) All
licenses shall:
(a) Expire on September 30
following date of issuance; and
(b)
Be renewable annually thereafter upon submission of the Renewal Application to
Operate as a Wholesaler accompanied by the renewal fee set forth in
201 KAR 2:050 and shall be
nontransferable.
Section
5. Standards.
(1) Facilities.
(a) All facilities in which prescription
drugs and drug-related devices are held for wholesale distribution, stored,
sold, offered for sale, exposed for sale, or kept for sale shall be of suitable
size, construction, and location to facilitate cleaning, maintenance, and
proper operations.
(b) All
facilities shall meet all applicable federal, state, and local standards. The
facility shall quarantine prescription drugs and drug-related devices that are
outdated, damaged, deteriorated, misbranded, recalled, or adulterated, or that
are in immediate or sealed secondary containers that have been
opened.
(c) A facility shall not be
located in a residence.
(d) A
facility shall be located apart and separate from a pharmacy permitted by the
Board of Pharmacy, with the exception of a medical gas wholesaler.
(2) Security.
(a) A wholesaler shall be equipped with an
alarm system to detect entry after hours.
(b) A wholesaler shall ensure that access
from outside wholesaler's premises is well controlled and reduced to a minimum.
This includes the installation of adequate lighting at the outside perimeter of
the premises.
(c) Internal security
policies shall be developed to provide reasonable protection against theft and
diversion by limiting access to areas where prescription drugs and drug-related
devices are held to authorized personnel. These policies shall provide
protection against tampering with computers or electronic records.
(d) A licensee shall employ adequate
personnel with the education and experience necessary to safely and lawfully
engage in the wholesale distribution of prescription drugs and drug-related
devices.
(3)
Recordkeeping requirements for companies handling prescription drugs and
drug-related devices exempt from the DSCSA.
(a) Inventories and other records regarding
the receipt and distribution or disposition of prescription drugs and
drug-related devices shall be maintained and readily available for inspection
or photocopying by the Board of Pharmacy and authorized law enforcement
officials for a period of six (6) years. These records shall include:
1. The proprietary and established name of
the prescription drug and related device, if applicable;
2. The dosage, if applicable;
3. The size of the container, if
applicable;
4. The number of
containers;
5. The lot number or
control number of the prescription drug and related device, if
applicable;
6. The business name
and address of all parties involved in each receipt and distribution or
disposition of the prescription drug and related device, starting with the
manufacturer; and
7. The date of
each receipt and distribution or disposition of the prescription drug and
related device.
(b)
Records described in this section that are kept at the inspection site or that
can be readily retrievable within forty-eight (48) hours by computer or other
electronic means shall be readily available for authorized inspection during
the retention period. Records kept at a central location apart from the
inspection site and not electronically retrievable shall be made available for
inspection within two (2) working days of a request by the Board of Pharmacy or
an authorized official of a federal, state, or local law enforcement
agency.
(c) Wholesalers shall
maintain an ongoing list of verified persons or businesses with whom they do
business.
(d) A wholesaler may sell
or distribute prescription drugs and drug-related devices only to the
following, except as provided in
KRS
315.0351(2) and
315.404:
1. A currently licensed wholesaler;
2. A currently licensed third party logistics
provider;
3. A currently permitted
pharmacy;
4. A currently licensed
outsourcing facility;
5. A
currently licensed practitioner;
6.
A currently permitted repackager;
7. A currently licensed hospital, but only
for use by or in that hospital pursuant to
KRS
217.182(1);
8. A person in charge of a laboratory, but
only for use in that laboratory for scientific and medical research purposes
pursuant to KRS
217.182(1); or
9. Any other appropriately licensed or
permitted facility in the jurisdiction in which it is located.
(e) A wholesaler may acquire
prescription drugs and drug-related devices only from the following, except as
provided in KRS
315.404:
1.
A currently permitted manufacturer;
2. A currently permitted
repackager;
3. A currently licensed
wholesaler; or
4. A currently
licensed third-party logistics provider.
(f) Wholesalers shall maintain a system for
the mandatory reporting of any theft, suspected theft, diversion, or other
significant loss of any prescription drug and related device to the Board of
Pharmacy, and if applicable, the FDA and DEA.
(4) Written policies and procedures,
requirements for companies handling prescription drugs and drug-related devices
exempt from the DSCSA.
(a) A wholesaler shall
establish, maintain, and adhere to written policies and procedures, which shall
be followed for the receipt, security, storage, inventory, distribution, and
disposition of prescription drugs and drug-related devices
(b) There shall be written policies and
procedures for identifying, recording, and reporting losses or
thefts.
(c) There shall be written
policies and procedures to assure that the wholesaler prepares for, protects
against, and handles crisis situations that affect the security or operation of
the facility. These crises shall include fires, floods, or other natural
disasters, and situations of local, state, or national emergency.
(d) There shall be written policies and
procedures for managing and correcting all errors or inaccuracies in
inventories.
(e) There shall be
written policies and procedures to assure that any outdated stock or any stock
with an expiration date that, in the wholesaler's view, does not allow
sufficient time for repacking or resale shall be segregated from other stock
and shall be prepared for return to the manufacturer or otherwise destroyed,
and this shall be documented.
(f)
There shall be written policies and procedures by which the wholesaler
exercises control over the shipping and receiving of all stock within the
operation.
(g) There shall be
written policies and procedures for investigating suspect product and reporting
illegitimate product to the Board of Pharmacy and the FDA pursuant to the
DSCSA, if applicable.
(5) Returned, damaged, and outdated
prescription drugs and drug-related devices. A wholesaler shall maintain and
follow a written policy and procedure to assure the proper handling and
disposal of returned goods. If conditions under which a prescription drug or
related device has been returned cast doubt on the drug's safety, identity,
strength, quality, or purity, then the drug or related device shall be
destroyed, or returned, unless examination, testing, or other investigation
proves that the drug or drug-related device meets appropriate standards of
safety, identity, strength, quality, and purity. In determining whether the
conditions under which a prescription drug or related device has been returned
cast doubt on the drug's or related device's safety, identity, strength,
quality, or purity, the wholesaler shall consider, among other things, the
conditions under which the drug or related device has been held, stored, or
shipped before or during its return and the condition of the drug or related
device and its container, carton, or labeling, as a result of storage or
shipping.
(6) Handling recalls. A
wholesaler shall establish, maintain, and adhere to a written policy and
procedure for handling recalls and withdrawals of prescription drugs and
drug-related devices. The policy and procedure shall cover all recalls and
withdrawals of drugs and drug-related devices due to:
(a) Any voluntary action on the part of the
manufacturer;
(b) The direction of
the FDA, or any other federal, state, or local government agency; and
(c) Replacement of existing.
(7) Procedures
(a) A visual examination of all materials
received or shipped shall be made to guarantee product identity and to
reasonably guard against acceptance or delivery of damaged, contaminated,
tampered, or otherwise unfit stock.
(b) Procedures for distribution of approved
stock shall provide for a rotation whereby the expiration date is taken into
consideration when distributing inventory.
(c) A wholesaler shall be subject to the
provisions of any applicable federal, state, or local laws or regulations that
relate to prescription drug and related device salvaging or
reprocessing.
Section
6. Violations.
(1) A wholesaler
shall not distribute prescription drugs and drug-related devices directly to a
consumer or a patient, except as provided in
KRS
315.0351(2).
(2) A wholesaler shall not operate in a
manner that endangers the public health.
(3) Violations of any of these provisions
shall be grounds for action under
KRS
315.121.
Section 7. Incorporation by Reference.
(1) The following material is incorporated by
reference:
(a) "Application for a License to
Operate as a Wholesaler", June 2023;
(b) "Renewal Application to Operate as a
Wholesaler", June 2023; and
(c)
"USP Chapter 659 Packaging and Storage Requirements", April 1, 2021.
(2) This material may be
inspected, copied, or obtained, subject to applicable copyright law, at the
Kentucky Board of Pharmacy, State Office Building Annex, Suite 300, 125 Holmes
Street, Frankfort, Kentucky 40601-8024. Monday through Friday, 8 a.m. to 4:30
p.m. or on the Board's Web site at
https://pharmacy.ky.gov/Businesses/Pages/Wholesale-Distributors.aspx.
STATUTORY AUTHORITY:
KRS
315.010,
315.191(1)(a),
315.350,
315.402,
315.406