Current through Register Vol. 50, No. 9, September 20, 2024
A.
Prescription dispensing means the issuance, by a licensed pharmacist, of one or
more doses of medication in a suitable container, properly labeled for
subsequent administration, and shall consist of the following procedures or
practices:
1. receiving and interpretation of
the prescription order;
2.
assembling the drug products and an appropriate container;
3. preparing the prescription by compounding,
mixing, counting, or pouring;
4.
affixing the proper label to the final container;
5. patient counseling as required;
and
6. transfer of
possession.
B.
Equivalent Drug Product Interchange
1. The
pharmacist shall not select an equivalent drug product when the prescriber
prohibits interchange by any one of the following methods.
a. On a prescription generated in written
form, the prescriber shall handwrite a mark in a check box labeled "Dispense as
Written", or the abbreviation "DAW", or both, and shall manually sign the
prescription form.
i. For prescriptions
reimbursable by the state Medicaid program, the prescriber shall handwrite the
words "Brand Necessary" or "Brand Medically Necessary" on the prescription form
or on a sheet of paper attached to the prescription form.
b. On a prescription generated in oral or
verbal form, the prescriber (or the prescribers agent) shall indicate a
specific brand name drug or product is ordered by the practitioner, and the
pharmacist shall note such information on the file copy of the
prescription.
c. On a prescription
generated in electronic form, the prescriber shall indicate "Dispense as
Written", "DAW", or "Brand Medically Necessary."
2. Where the prescriber has indicated that an
equivalent drug product interchange is prohibited, then a non-licensed,
non-certified, or non-registered agent of the pharmacy shall not inquire as to
a patients desire for an equivalent drug product interchange.
3. In the event the prescriber has not
prohibited equivalent drug product interchange in the manner described above,
the pharmacist may select an equivalent drug product for dispensing, provided
the patient has been informed of, and has consented to, the proposed cost
saving interchange.
4. When the
pharmacist selects a biological product rated as interchangeable for the
product ordered by the prescriber, the dispensing pharmacist (or his designee)
shall communicate to the prescriber by any means, but no later than five
business days following the dispensing date, the specific product dispensed to
the patient, including the name of the product and the manufacturer. However,
no such communication to the prescriber is required when:
a. the prescriber prohibited interchange in
the manner described above;
b.
there is no product rated as interchangeable or therapeutically equivalent;
or
c. the product dispensed is a
refill not changed from the product dispensed on the prior filling of the
prescription.
C. Unless otherwise allowed by law, drugs
dispensed on prescription to a patient shall not be accepted for return,
exchange, or re-dispensing by any pharmacist or pharmacy after such drugs have
been removed from the pharmacy premises where they were dispensed.
D. When a patient or his designee wishes to
return previously dispensed prescription drugs to a pharmacy for disposal, the
pharmacy shall inform the patient or his designee of the disposal mechanisms
available to him. In the event the pharmacy elects to accept such previously
dispensed products for disposal, the pharmacy shall comply with the following
requirements:
1. From the time of receipt of
such products until the time of disposal, the pharmacy shall quarantine such
products to keep them separate from its active dispensing stock and shall take
appropriate security measures to prevent the theft or diversion of such
products.
2. The pharmacy shall
comply with the provisions of 21 CFR § 1317 or its successor for the pharmacy's
disposal of controlled substances and other non-hazardous waste
pharmaceuticals.
3. The pharmacy
shall comply with the provisions of 40 CFR § 261 or its successor for the
pharmacy's disposal of hazardous waste pharmaceuticals.
AUTHORITY NOTE:
Promulgated in accordance with
R.S.
37:1182.
