Senate Bill No. 327–Senators Wiener, Rawson, Washington, Titus, Amodei, Care, Mathews and McGinness
March 17, 2003
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Referred to Committee on Human Resources and Facilities
SUMMARY—Provides for reuse of certain prescription drugs. (BDR 39‑66)
FISCAL NOTE: Effect on Local Government: No.
Effect on the State: No.
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EXPLANATION
– Matter in bolded italics is new; matter
between brackets [omitted material] is material to be omitted.
Green numbers along left margin indicate location on the printed bill (e.g., 5-15 indicates page 5, line 15).
AN ACT relating to drugs; establishing procedures for reusing certain prescription drugs that are dispensed to, but not used by, a patient in a mental health facility, facility for skilled nursing or facility for intermediate care, or an offender incarcerated in an institution or facility operated by the Department of Corrections; and providing other matters properly relating thereto.
THE PEOPLE OF THE STATE OF NEVADA, REPRESENTED IN
SENATE AND ASSEMBLY, DO ENACT AS FOLLOWS:
1-1 Section 1. Chapter 433 of NRS is hereby amended by adding
1-2 thereto a new section to read as follows:
1-3 1. A public or private mental health facility may return a
1-4 prescription drug that is dispensed to a patient of the facility, but
1-5 will not be used by that patient, to the dispensing pharmacy for the
1-6 purpose of reissuing the drug to fill other prescriptions for patients
1-7 in that facility if:
1-8 (a) The drug is not a schedule II drug specified in or pursuant
1-9 to chapter 453 of NRS;
1-10 (b) The drug is dispensed in a unit dose, in individually sealed
1-11 doses or in a bottle that is sealed by the manufacturer of the drug;
1-12 (c) The drug is returned unopened and sealed in the original
1-13 manufacturer’s packaging or bottle;
2-1 (d) The usefulness of the drug has not expired;
2-2 (e) The packaging or bottle contains the expiration date of the
2-3 usefulness of the drug; and
2-4 (f) The name of the patient for whom the drug was originally
2-5 prescribed, the prescription number and any other identifying
2-6 marks are obliterated from the packaging or bottle before the
2-7 return of the drug.
2-8 2. A dispensing pharmacy to which a drug is returned
2-9 pursuant to this section may reissue the drug to fill other
2-10 prescriptions for patients in the same facility if the registered
2-11 pharmacist of the pharmacy determines that the drug is suitable
2-12 for that purpose in accordance with standards adopted by the State
2-13 Board of Pharmacy pursuant to subsection 5.
2-14 3. No drug that is returned to a dispensing pharmacy
2-15 pursuant to this section may be used to fill other prescriptions
2-16 more than one time.
2-17 4. A mental health facility shall adopt written procedures for
2-18 returning drugs to a dispensing pharmacy pursuant to this section.
2-19 The procedures must:
2-20 (a) Provide appropriate safeguards for ensuring that the drugs
2-21 are not compromised or illegally diverted during their return.
2-22 (b) Require the maintenance and retention of such records
2-23 relating to the return of such drugs as are required by the State
2-24 Board of Pharmacy.
2-25 (c) Be approved by the State Board of Pharmacy.
2-26 5. The State Board of Pharmacy shall adopt such regulations
2-27 as are necessary to carry out the provisions of this section
2-28 including, without limitation, requirements for:
2-29 (a) Returning and reissuing such drugs pursuant to the
2-30 provisions of this section.
2-31 (b) Maintaining records relating to the return and the use of
2-32 such drugs to fill other prescriptions.
2-33 Sec. 2. Chapter 449 of NRS is hereby amended by adding
2-34 thereto a new section to read as follows:
2-35 1. A facility for skilled nursing or a facility for intermediate
2-36 care may return a prescription drug that is dispensed to a patient
2-37 of the facility, but will not be used by that patient, to the
2-38 dispensing pharmacy for the purpose of reissuing the drug to fill
2-39 other prescriptions for patients in that facility if:
2-40 (a) The drug is not a schedule II drug specified in or pursuant
2-41 to chapter 453 of NRS;
2-42 (b) The drug is dispensed in a unit dose, in individually sealed
2-43 doses or in a bottle sealed by the manufacturer of the drug;
2-44 (c) The drug is returned unopened and sealed in the original
2-45 manufacturer’s packaging or bottle;
3-1 (d) The usefulness of the drug has not expired;
3-2 (e) The packaging or bottle contains the expiration date of the
3-3 usefulness of the drug; and
3-4 (f) The name of the patient for whom the drug was originally
3-5 prescribed, the prescription number and any other identifying
3-6 marks are obliterated from the packaging or bottle before the
3-7 return of the drug.
3-8 2. A dispensing pharmacy to which a drug is returned
3-9 pursuant to this section may reissue the drug to fill other
3-10 prescriptions for patients in the same facility if the registered
3-11 pharmacist of the pharmacy determines that the drug is suitable
3-12 for that purpose in accordance with standards adopted by the State
3-13 Board of Pharmacy pursuant to subsection 5.
3-14 3. No drug that is returned to a dispensing pharmacy
3-15 pursuant to this section may be used to fill other prescriptions
3-16 more than one time.
3-17 4. A facility for skilled nursing or facility for intermediate
3-18 care shall adopt written procedures for returning drugs to a
3-19 dispensing pharmacy pursuant to this section. The procedures
3-20 must:
3-21 (a) Provide appropriate safeguards for ensuring that the drugs
3-22 are not compromised or illegally diverted during their return.
3-23 (b) Require the maintenance and retention of such records
3-24 relating to the return of drugs to dispensing pharmacies as are
3-25 required by the State Board of Pharmacy.
3-26 (c) Be approved by the State Board of Pharmacy.
3-27 5. The State Board of Pharmacy shall adopt such regulations
3-28 as are necessary to carry out the provisions of this section
3-29 including, without limitation, requirements for:
3-30 (a) Returning and reissuing such drugs pursuant to the
3-31 provisions of this section.
3-32 (b) Maintaining records relating to the return and the use of
3-33 such drugs to fill other prescriptions.
3-34 Sec. 3. Chapter 639 of NRS is hereby amended by adding
3-35 thereto the provisions set forth as sections 4 and 5 of this act.
3-36 Sec. 4. 1. The Board shall prepare an annual report
3-37 concerning drugs that are returned or transferred to pharmacies
3-38 pursuant to sections 1, 2 and 5 of this act and are reissued to fill
3-39 other prescriptions. The report must include, without limitation:
3-40 (a) The number of drugs that are returned to dispensing
3-41 pharmacies.
3-42 (b) The number of drugs that are reissued to fill other
3-43 prescriptions.
3-44 (c) An estimate of the amount of money saved by reissuing
3-45 such drugs to fill other prescriptions.
4-1 (d) Any other information that the Board deems necessary.
4-2 2. The report must be:
4-3 (a) Available for public inspection during regular business
4-4 hours at the office of the Board; and
4-5 (b) Posted on a website or other Internet site that is operated or
4-6 administered by or on behalf of the Board.
4-7 Sec. 5. 1. A prescription drug that is dispensed by a
4-8 pharmacy to an offender incarcerated in a correctional institution,
4-9 but will not be used by that offender, may be returned to that
4-10 dispensing pharmacy for the purpose of reissuing the drug to fill
4-11 other prescriptions for offenders incarcerated in that correctional
4-12 institution if:
4-13 (a) The drug is not a schedule II drug specified in or pursuant
4-14 to chapter 453 of NRS;
4-15 (b) The drug is dispensed in a unit dose, in individually sealed
4-16 doses or in a bottle that is sealed by the manufacturer of the drug;
4-17 (c) The drug is returned unopened and sealed in the original
4-18 manufacturer’s packaging or bottle;
4-19 (d) The usefulness of the drug has not expired;
4-20 (e) The packaging or bottle contains the expiration date of the
4-21 usefulness of the drug; and
4-22 (f) The name of the patient for whom the drug was originally
4-23 prescribed, the prescription number and any other identifying
4-24 marks are obliterated from the packaging or bottle before the
4-25 return of the drug.
4-26 2. A pharmacy to which a drug is returned pursuant to this
4-27 section may reissue the drug to fill other prescriptions for
4-28 offenders incarcerated in the same correctional institution if the
4-29 registered pharmacist of the pharmacy determines that the drug is
4-30 suitable for that purpose in accordance with standards adopted by
4-31 the Board pursuant to subsection 5.
4-32 3. No drug that is returned to a dispensing pharmacy
4-33 pursuant to this section may be used to fill other prescriptions
4-34 more than one time.
4-35 4. The director of a correctional institution shall adopt
4-36 written procedures for returning drugs to a dispensing pharmacy
4-37 pursuant to this section. The procedures must:
4-38 (a) Provide appropriate safeguards for ensuring that the drugs
4-39 are not compromised or illegally diverted during their return.
4-40 (b) Require the maintenance and retention of such records
4-41 relating to the return of such drugs as are required by the Board.
4-42 (c) Be approved by the Board.
4-43 5. The Board shall adopt such regulations as are necessary to
4-44 carry out the provisions of this section including, without
4-45 limitation, requirements for:
5-1 (a) Returning and reissuing such drugs pursuant to the
5-2 provisions of this section.
5-3 (b) Maintaining records relating to the return and the use of
5-4 such drugs to fill other prescriptions.
5-5 6. As used in this section, “correctional institution” means an
5-6 institution or facility operated by the Department of Corrections.
5-7 Sec. 6. NRS 639.267 is hereby amended to read as follows:
5-8 639.267 1. As used in this section, “unit dose” means that
5-9 quantity of a drug which is packaged as a single dose.
5-10 2. A pharmacist who provides a regimen of drugs in unit doses
5-11 to a patient in a facility for skilled nursing or facility for
5-12 intermediate care as defined in chapter 449 of NRS may credit the
5-13 person or agency which paid for the drug for any unused doses. The
5-14 pharmacist may return the drugs to the [issuing] dispensing
5-15 pharmacy, which may reissue the drugs to fill other prescriptions[.]
5-16 in accordance with the provisions of section 2 of this act.
5-17 3. Except schedule II drugs specified in or pursuant to chapter
5-18 453 of NRS[,] and except as otherwise provided in sections 1, 2
5-19 and 5 of this act, unit doses packaged in ampules or vials which do
5-20 not require refrigeration may be returned to the pharmacy which
5-21 dispensed them. The Board shall, by regulation, authorize the return
5-22 of any other type or brand of drug which is packaged in unit doses if
5-23 the Food and Drug Administration has approved the packaging for
5-24 that purpose.
5-25 Sec. 7. NRS 639.282 is hereby amended to read as follows:
5-26 639.282 1. Except as otherwise provided in NRS 639.267[,]
5-27 and sections 1, 2 and 5 of this act, it is unlawful for any person to
5-28 have in his possession, or under his control, for the purpose of
5-29 resale, or to sell or offer to sell or dispense or give away, any
5-30 pharmaceutical preparation, drug or chemical which:
5-31 (a) Has been dispensed pursuant to a prescription or chart order
5-32 and has left the control of a registered pharmacist or practitioner;
5-33 (b) Has been damaged or subjected to damage by heat, smoke,
5-34 fire or water, or other cause which might reasonably render it unfit
5-35 for human or animal use;
5-36 (c) Has been obtained through bankruptcy or foreclosure
5-37 proceedings, or other court action, auction or other legal or
5-38 administrative proceedings, except when the pharmaceutical
5-39 preparation, drug or chemical is in the original sealed container;
5-40 (d) Is no longer safe or effective for use, as indicated by the
5-41 expiration date appearing on its label; or
5-42 (e) Has not been properly stored or refrigerated as required by
5-43 its label.
5-44 2. The provisions of subsection 1 do not apply if the person in
5-45 whose possession the pharmaceutical preparation, drug or chemical
6-1 is found also has in his possession a valid and acceptable
6-2 certification of analysis attesting to the purity and strength of the
6-3 pharmaceutical preparation, drug or chemical and attesting to the
6-4 fact that it can be safely and effectively used by humans or animals.
6-5 The preparation, drug or chemical must not be sold or otherwise
6-6 disposed of until the certification required by this subsection has
6-7 been presented to and approved by the Board.
6-8 3. In the absence of conclusive proof that the preparation, drug
6-9 or chemical can be used safely and effectively by humans or
6-10 animals, it must be destroyed under the direct supervision of a
6-11 member or an inspector of the Board, or two persons designated as
6-12 agents by the Board who include an inspector of a health care board,
6-13 a licensed practitioner of a health care board or a peace officer of an
6-14 agency that enforces the provisions of chapters 453 and 454 of NRS.
6-15 4. As used in this section, “health care board” includes the
6-16 State Board of Pharmacy, the State Board of Nursing, the Board of
6-17 Medical Examiners and the Nevada State Board of Veterinary
6-18 Medical Examiners.
6-19 Sec. 8. This act becomes effective on July 1, 2003, for the
6-20 purpose of adopting policies and regulations necessary to carry out
6-21 the provisions of this act, and on October 1, 2003, for all other
6-22 purposes.
6-23 H