Today's Law As Amended


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AB-2265 Pharmacy: dispensing controlled substances: lockable vials.(2021-2022)



As Amends the Law Today


SECTION 1.
 (a) The Legislature finds and declares as follows:
(1) The federal Poison Prevention Packaging Act of 1970 (PPPA) requires child resistant caps for prescription medications, and these requirements have not been updated in the subsequent 50 years.
(2) After the PPPA was implemented, deaths in children five years of age and younger went down by 1.4 per million. This represented a reduction in the rate of fatalities, up to 45 percent, from projections of deaths without the presence of childproof packaging.
(3) Pilfering is the leading source of youth opioid abuse.
(4) Each year, nearly 600,000 children between 12 and 17 years of age initiate prescription drug abuse by pilfering medication from an adult in their home.
(5) Between 1999 and 2016, prescription and illicit drug poisonings saw an increased mortality rate of 268 percent.
(6) During the first year of the pandemic, opioid abuse in California rose 44.6 percent while in the nation as a whole it rose 30 percent.
(7) Locking pill vials have been shown to reduce or eliminate pilfering.
(8) Locking pill vials are inexpensive, costing less than $2 each, and the costs are expected to come down significantly.
(9) Long-term return on investment of locking pill vials in saved medical costs is anticipated to be over 80 percent.
(b) It is therefore the intent of the Legislature in enacting this act to do all of the following:
(1) Expand safety precautions for the administration of controlled substances in Schedule II and Schedule IIN of the federal Controlled Substances Act (21 U.S.C. Sec. 801 et seq.).
(2) Require a pharmacist who dispenses in solid oral dosage form a controlled substance in Schedule II or Schedule IIN of the federal Controlled Substances Act to dispense the substance in a lockable vial, except as specified.
(3) Require the manufacturer of a controlled substance covered by this act to reimburse a pharmacy for the cost of the vial and services rendered and dispensing costs.
(4) Require the California State Board of Pharmacy to establish reasonable minimum and maximum amounts of reimbursement to a pharmacy for the cost of the vial and services rendered and dispensing costs.
(5) Ensure that the cost of administering controlled substances in lockable vials does not increase costs to patients and insurers.

SEC. 2.

 Article 12.5 (commencing with Section 4178) is added to Chapter 9 of Division 2 of the Business and Professions Code, to read:

Article  12.5. California Safe Dispensing Act
4178.
 (a) This article shall be known, and may be cited, as the California Safe Dispensing Act.
(b) This article shall become operative on June 30, 2023.
4178.1.
 (a) As used in this article, “lockable vial” means a prescription locking vial that qualifies as a “safe storage product” as defined in paragraph (2) of subdivision (a) of Section 4106.5 that is made of materials classified as “generally recognized as safe” under Title 21 of the Code of Federal Regulations and meets the applicable standards specified in Part 1700 of Title 16 of the Code of Federal Regulations.
(b) Except as provided in subdivision (d), a pharmacist who dispenses in solid oral dosage form a controlled substance in Schedule II or Schedule IIN of the federal Controlled Substances Act (21 U.S.C. Sec. 801 et seq.) shall do all of the following:
(1) Dispense the controlled substance in a lockable vial.
(2) Provide a copy of the Opioid Factsheet for Patients published by the federal Centers for Disease Control and Prevention.
(3) Provide the patient with information regarding the online assistance or toll-free telephone number made available by the vendor providing the lockable vial pursuant to subdivision (f).
(c) (1) Except as provided in paragraph (2), a patient, the patient’s parent or legal guardian if the patient is a minor or otherwise unable to authorize medical care, or the conservator of the patient if the conservator has been given the power to make health care decisions for the patient, shall choose the code for the lockable vial.
(2) In the case of medications prescribed to a minor who may consent to services specified in Chapter 3 (commencing with Section 6920) of Part 4 of Division 11 of the Family Code, the minor shall choose the code for the lockable vial.
(d) (1) A pharmacist shall not dispense a controlled substance in Schedule II or Schedule IIN of the federal Controlled Substances Act in a lockable vial directly to a patient who, to the pharmacist’s knowledge, would have difficulty opening the lockable vial.
(2) A pharmacist is not required to dispense a controlled substance in Schedule II or Schedule IIN of the federal Controlled Substances Act in a lockable vial in any of the following circumstances:
(A) The prescription, dispensation, and administration of the controlled substance occurs in a hospital or other inpatient care facility.
(B) The patient, including a patient who is a minor who may consent to services specified in Chapter 3 (commencing with Section 6920) of Part 4 of Division 11 of the Family Code, or the patient’s representative who is authorized pursuant to subdivision (c) to choose the code for the lockable vial requests to their prescriber or the pharmacist that the patient’s medication not be dispensed in a lockable vial.
(C) The prescriber indicated on the prescription that the patient requested not to receive their medication in a lockable vial.
(e) (1) The manufacturer of a controlled substance covered by this section shall reimburse the pharmacy within 30 days of receiving a claim for the acquisition cost of lockable vials used by the pharmacy to dispense controlled substances covered by this section.
(2) The manufacturer of a controlled substance covered by this section shall compensate the pharmacy within 30 days of receiving the claim for dispensing costs and services rendered, including any patient consultation and instruction or any other professional services rendered to comply with this section. A pharmacy technician or other pharmacy staff may complete all tasks in this section that are not otherwise prohibited by law.
(3) (A) A manufacturer of a controlled substance that fails to reimburse a pharmacy within the time period and for the amount specified in this subdivision is liable for a civil penalty of one thousand dollars ($1,000) per day for each day the manufacturer is delinquent in reimbursing the pharmacy.
(B) The civil penalty shall be assessed and recovered in a civil action brought by the board in the name of the people of the State of California.
(C) Assessment of a civil penalty, at the request of the manufacturer of the controlled substance that was assessed the penalty, may be reviewed on appeal and the penalty may be reduced or waived for good cause.
(4) By October 1, 2023, the board shall establish reasonable minimum and maximum amounts of reimbursement that include the cost of the vial and services rendered and dispensing costs.
(f) Any vendor that contracts with a pharmacy to provide a lockable vial shall make available at all times assistance online or through a toll-free telephone number for patient use.
(g) (1) A prescriber, or the prescriber’s professional corporation or other business entity, or a pharmacist or pharmacy corporation, who prescribes or dispenses a controlled substance dispensed in a lockable vial shall not be liable for any adverse consequences that result from either of the following:
(A) The failure of any lockable vial to prevent unauthorized access.
(B) A patient not being able to access medication in a lockable vial.
(2) This subdivision does not affect a person’s liability under existing law for damages caused by defective products, or as a result of willful or wanton misconduct, recklessness, or gross negligence.
(h) The board may adopt regulations to carry out this article.
(i) (1) The board shall assess a fine in an amount to be determined by the board for a violation of this section by a pharmacist.
(2) The board may choose not to take administrative action against a pharmacy if it determines that compliance with this section would create a financial hardship on the pharmacy or that the pharmacy was temporarily out of stock of lockable vials after taking reasonable steps to ensure an adequate supply for all dispensations of Schedule II or Schedule IIN controlled substances.
(j) Section 4321 shall not apply to a violation of this section.
4178.2.
 This article does not apply to correctional pharmacies, correctional clinics, or patients of the Department of Corrections and Rehabilitation.