Washington State
House of Representatives
Office of Program Research
BILL
ANALYSIS
Health Care & Wellness Committee
HB 2116
Brief Description: Expanding prescriptive authority for pharmacists.
Sponsors: Representatives Thai, Slatter, Senn, Reed, Ormsby, Macri, Gregerson, Fosse and Wylie.
Brief Summary of Bill
  • Requires the Pharmacy Quality Assurance Commission to adopt rules identifying the drugs and devices that a pharmacist may prescribe in the absence of previously established and approved written guidelines or protocols.  
Hearing Date: 1/24/24
Staff: Kim Weidenaar (786-7120).
Background:

Practice of Pharmacy.

A pharmacist is a professional licensed by the Department of Health to engage in the practice of pharmacy, which includes:

  • interpreting prescription orders;
  • compounding, dispensing, labeling, administering, and distributing drugs and devices;
  • monitoring drug therapy and use;
  • initiating or modifying drug therapy in accordance with written guidelines or protocols previously established and approved for their practice by a practitioner authorized to prescribe drugs;
  • participating in drug utilization reviews and drug product selection;
  • storing and distributing drugs and devices and maintaining proper records; and
  • providing information on legend drugs which may include the advising of therapeutic values, hazards, and the uses of drugs and devices.

 

The practice of pharmacy includes the initiation or modification of drug therapy in accordance with written guidelines or protocols previously established and approved for the pharmacist's practice by a practitioner authorized to prescribe drugs.  The written guideline or protocol, also known as a Collaborative Drug Therapy Agreement (CDTA), is defined as an agreement in which any practitioner authorized to prescribe legend drugs delegates to a pharmacist or group of pharmacist's authority to conduct specified prescribing functions.  The CDTA must include:  the parties subject to the agreement; a time period not to exceed two years during which the written guidelines or protocol will be in effect; and the type of prescriptive authority decisions which the pharmacist or pharmacists are authorized to make.

 

Legend Drugs.

Legend drugs are any drugs which are required by state law or regulation of the Pharmacy Quality Assurance Commission (Commission) to be dispensed on prescription only or are restricted to use by practitioners only.  A controlled substance means a drug or substance included in Schedules I through V, with some exceptions.  Drugs and substances are placed on schedules based on their potential for abuse, medical use, and safety.  
Summary of Bill:

By July 1, 2026, the Commission must adopt rules identifying specific drugs and devices or types or classes of drugs and devices that a pharmacist may prescribe in the absence of previously established and approved written guidelines or protocols.  The rules may also establish the types of patients or circumstances in which a pharmacist may or may not prescribe or order drugs or devices and any required education, training, or continuing education that must be completed prior to prescribing or ordering drugs or devices.  The prescribing and ordering of drugs and devices as authorized by the Commission in rule is added to the definition of the practice of pharmacy.

 

The list of providers who may prescribe legend drugs and controlled substances is amended to reflect the expansion of pharmacist prescribing as authorized by rule.
Appropriation: None.
Fiscal Note: Requested on January 18, 2024.
Effective Date: The bill contains multiple effective dates. Please see the bill.