New Hampshire Code of Administrative Rules
Ph - N.H. Pharmacy Board
Chapter Ph 700 - STANDARDS OF PRACTICE
Part Ph 703 - DISPENSING OF DRUGS AND DEVICES
Section Ph 703.05 - Drug Product Selection

Universal Citation: NH Admin Rules Ph 703.05

Current through Register No. 40, October 3, 2024

(a) Unless instructed otherwise by the person receiving the drug pursuant to the prescription, a pharmacist filling a prescription for a drug product prescribed by its trade or brand name may select a therapeutically equivalent drug product with the same established name, active ingredient, strength, quantity, and dosage form as the drug product identified in the prescription.

(b) Therapeutically equivalent drugs shall include only those drug products listed in "Approved Prescription Drug Products with Therapeutic Equivalence Evaluations" Published by the United States Department of Health and Human Services, according to RSA 146-B:2, I, or any written notification or confirmation from the federal Food and Drug Administration (FDA) that a drug product is a therapeutically equivalent drug product.

(c) The pharmacist shall not select an equivalent drug product:

(1) If the prescriber handwrites "medically necessary" on the written prescription;

(2) If when ordering a prescription orally, the prescriber specifies that the prescribed drug is medically necessary; or

(3) If the prescription is electronically transmitted, the prescriber includes a statement on the face of the prescription indicating medically necessary.

(d) The pharmacist shall not select an equivalent drug product unless its price to the purchaser or payor is less than the price of the prescribed drug product.

(e) Unless the prescriber instructs otherwise, the label for every drug product dispensed shall include the product's trade or brand name, if any, or its established generic name and the name of the manufacturer, packer or distributor, using abbreviations such as the National Drug Code (NDC) number if necessary. In the interest of public health and safety, the pharmacist may, when dispensing a generic drug, include the brand name on the prescription label following the generic name. The brand name, however, shall be preceded or followed with the word "sub", indicating substituted for, or "I.C.", indicating interchanged for or "generic for".

(f) A pharmacist shall adapt drugs:

(1) By changing the quantity of medication prescribed if:
a. The prescribed quantity or package size is not commercially available;

b. The change in quantity is related to a change in dosage form, strength, or therapeutic interchange;

c. The change is intended to dispense up to the total amount authorized by the prescriber including refills; or

d. The change extends a maintenance drug for the limited quantity necessary to coordinate a patient's refills in a medication synchronization program;

(2) By changing dosage form of the prescription if it is in the best interest of patient care, so long as the prescriber's directions are also modified to equate to an equivalent amount of drug dispensed as prescribed;

(3) By completing missing information on a prescription if there is evidence to support the change; and

(4) The adaptation is documented in the patient's record.

(g) A pharmacist may perform therapeutic substitutions if:

(1) The pharmacist filling a prescription for a specific drug substitutes a drug in the same therapeutic class, the patient agrees to the substitution, and the substitution is made to replace a drug that is on back order ensures formulary compliance with the patient's health insurance plan or in the case of an uninsured patient to the lower cost drug while maintaining safety; or

(2) The pharmacist is used by a long-term-care facility and the therapeutic interchange or a therapeutically equivalent selection for a patient, during the patient's stay at the facility, has been approved for the patient in accordance with written guidelines and procedures developed by the facility that in conjunction with the pharmacist and is current and readily available to the pharmacist at the pharmacy.

#2118, eff 8-12-82: ss by #2260, eff 1-5-83; ss by #2914, eff 11-27-84; ss by #4600, eff 8-1-89; ss by #6094-B, INTERIM, eff 9-21-95, EXPIRED, 1-19-96

New. #6181-B, eff 2-5-96, EXPIRED: 2-5-04

New. #8316, eff 3-26-05

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