BILL REQ. #:  Z-0577.1 

Read first time 02/05/09.   Referred to Committee on Health & Long-Term Care.

     AN ACT Relating to authorizing state purchased health care programs to maximize appropriate prescription drug use in a cost-effective manner; amending RCW 69.41.190.

BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF WASHINGTON:

Sec. 1   RCW 69.41.190 and 2006 c 233 s 1 are each amended to read as follows:
     (1) Except as provided in subsection (2) of this section, any pharmacist filling a prescription under a state purchased health care program as defined in RCW 41.05.011(2) shall substitute, where identified, a preferred drug for any nonpreferred drug in a given therapeutic class((, unless the)). When a substitution is made, the dispensing pharmacist shall notify the endorsing practitioner of the specific drug and dose dispensed.
     (2) If an endorsing practitioner has indicated on the prescription that the nonpreferred drug must be dispensed as written, or if the prescription is for a refill of an antipsychotic, antidepressant, chemotherapy, antiretroviral, or immunosuppressive drug, or for the refill of a immunomodulator/antiviral treatment for hepatitis C for which an established, fixed duration of therapy is prescribed for at least twenty-four weeks but no more than forty-eight weeks, ((in which case)) then, except as provided under subsection (3) of this section, the pharmacist shall dispense the prescribed nonpreferred drug.
     (((2) When a substitution is made under subsection (1) of this section, the dispensing pharmacist shall notify the prescribing practitioner of the specific drug and dose dispensed.))
     (3) State purchased health care programs shall maximize appropriate prescription drug use through strategies including, but not limited to:
     (a) Adopting restrictions on a pharmacist's authority to fill a prescription with instructions to dispense as written, in order to address inappropriate variation among practitioners in prescribing patterns or the use of specific instructions to dispense as written;
     (b) Designating generic products in a previously reviewed drug class as preferred, without additional review by a pharmacy and therapeutics committee established pursuant to RCW 70.14.050;
     (c) Requiring generic products be dispensed as the first course of treatment, when available;
     (d) Designating over-the-counter drugs as preferred; and
     (e) Restricting the practice of prescribing pharmaceuticals for a purpose outside the scope of their approved labels.