BILL ANALYSIS                                                                                                                                                                                                    �



                                                                  SB 205
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          SENATE THIRD READING
          SB 205 (Corbett)
          As Amended August 19, 2013
          Majority vote

           SENATE VOTE  :23-9  
           
           HEALTH              12-6        BUSINESS & PROFESSIONS          
          9-3                 
           
           ----------------------------------------------------------------- 
          |Ayes:|Pan, Ammiano, Atkins,     |Ayes:|Bonilla, Bocanegra,       |
          |     |Bonta, Chesbro, Gomez,    |     |Campos, Dickinson,        |
          |     |Roger Hern�ndez,          |     |Eggman, Gordon, Holden,   |
          |     |Gonzalez, Mitchell,       |     |Mullin, Ting              |
          |     |Nazarian,                 |     |                          |
          |     |V. Manuel P�rez,          |     |                          |
          |     |Wieckowski                |     |                          |
          |     |                          |     |                          |
          |-----+--------------------------+-----+--------------------------|
          |Nays:|Logue, Maienschein,       |Nays:|Jones, Maienschein, Wilk  |
          |     |Mansoor, Nestande,        |     |                          |
          |     |Wagner, Wilk              |     |                          |
          |     |                          |     |                          |
           ----------------------------------------------------------------- 
           APPROPRIATIONS      12-5                                        
            
           
           -------------------------------- 
          |Ayes:|Gatto, Bocanegra,         |
          |     |Bradford,                 |
          |     |Ian Calderon, Campos,     |
          |     |Eggman, Gomez, Hall,      |
          |     |Holden, Pan, Quirk, Weber |
          |     |                          |
          |-----+--------------------------|
          |Nays:|Harkey, Bigelow,          |
          |     |Donnelly, Linder, Wagner  |
          |     |                          |
           -------------------------------- 
           SUMMARY  :  Deletes and recasts existing law on labeling  
          requirements for prescription containers; and, requires,  
          beginning January 1, 2016, the following information currently  
          required to be included on the label of a prescription  








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          container, to be printed in 12-point sans serif typeface:  1)  
          the manufacturer's trade or generic name of the drug and the  
          name of the manufacturer, as specified; 2) directions for the  
          use of the drug; 3) name of the patient or patients; 4) strength  
          of the drug or drugs dispensed; and, 5) the condition or purpose  
          for which the drug was prescribed if the condition or purpose is  
          indicated on the prescription.  Makes other technical and  
          clarifying changes. 

           EXISTING LAW  :  

          1)Provides for the practice of pharmacy and the licensing and  
            regulation of pharmacies and pharmacists by the Board of  
            Pharmacy (Board) within the Department of Consumer Affairs.

          2)Specifies certain requirements regarding the dispensing and  
            furnishing of dangerous drugs and devices and prohibits a  
            person from furnishing any dangerous drug or device except as  
            prescribed by a physician, dentist, podiatrist, optometrist,  
            or veterinarian.

          3)Requires that each prescription dispensed by a pharmacist must  
            be in a container meeting state and federal specifications and  
            correctly labeled, as specified, including:

             a)   Unless otherwise ordered by the prescriber, the  
               manufacturer's trade name of the drug or the generic name  
               and the name of the manufacturer, as specified;

             b)   The directions for the use of the drug;

             c)   The name of the patient or patients;

             d)   The name of the prescriber, as specified;

             e)   The date of issue;

             f)   The name and address of the pharmacy and prescription  
               number or other means of identifying the prescription;

             g)   The strength of the drug or drugs dispensed;

             h)   The quantity of the drug or drugs dispensed;









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             i)   The expiration date of the effectiveness of the drug  
               dispensed;

             j)   The condition or purpose for which the drug was  
               prescribed if the condition or purpose is indicated on the  
               prescription; and,

             aa)  The physical description of the dispensed medication,  
               including its color, shape, and any identification code  
               that appears on the tablets or capsules.

           EXISTING REGULATIONS  :

          1)Requires labels on drug containers dispensed to patients in  
            California to conform to the following format:

             a)   Each of the following must be clustered into one area of  
               the label that comprises at least 50% of the label and be  
               printed in at least 10-point sans serif typeface, or, if  
               requested by the consumer, at least a 12-point typeface,  
               and listed in the following order:

               i)     Name of the patient;

               ii)    Name of the drug and strength of the drug;

               iii)   Directions for the use of the drug; and, 

               iv)    The condition or purpose for which the drug was  
                 prescribed if the condition or purpose is indicated on  
                 the prescription.

             b)   Requires for added emphasis, the label to highlight in  
               bold typeface or color, or use blank space to set off the  
               items listed in 1) a) above.

             c)   Requires the remaining elements that are required to be  
               printed on a label, as well as any other items of  
               information appearing on the label or the container, to be  
               printed so as not to interfere with the legibility or  
               emphasis of the primary elements specified in 1) a) above.   


          2)Requires the Board to collect and publish on its Web site  








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            examples of labels conforming to these requirements to aid  
            pharmacies in label design and compliance.

          3)Requires a pharmacy to have policies and procedures in place  
            to help patients with limited or no English proficiency  
            understand the information on the label as specified in 1) a)  
            above in the patient's language.  Requires the pharmacy's  
            policies and procedures to be specified in writing and to  
            include, at a minimum, the selected means to identify the  
            patient's language and to provide interpretive services in the  
            patient's language.  Requires the pharmacy, at a minimum, to  
            provide interpretive services in the patient's language, if  
            interpretive services in such language are available, during  
            all hours that the pharmacy is open, either in person by  
            pharmacy staff or by use of a third-party interpretive service  
            available by telephone at or adjacent to the pharmacy counter.
           
          FISCAL EFFECT  :  According to the Assembly Appropriations  
          Committee, negligible state fiscal effect.

           COMMENTS  :  According to the author, "seniors are having  
          difficulty reading the small print on their prescription labels  
          and, for those who take multiple medications, their inability to  
          read the label puts them in serious danger."  The author states  
          that among adults 65 years of age or older, 40% take five to  
          nine medications and 18% take 10 or more medications and that  
          taking these incorrectly or mixed with other medications can  
          cause adverse drug events that can lead to injury and death.   
          The author also notes that The New England Journal of Medicine  
          estimates that between 2007 and 2009, there were more than  
          260,000 emergency room visits for adverse drug events in the  
          United States by adults 65 years of age or older.  Of those,  
          almost 100,000 required emergency hospitalizations, and nearly  
          two-thirds of those hospitalizations were due to unintentional  
          overdoses.  The author points out that making prescription  
          medical container labels easier for patients to read is a simple  
          way to help avoid dosing or medication errors due to a patient's  
          inability to read the label.  


           Analysis Prepared by  :    Rosielyn Pulmano / HEALTH / (916)  
          319-2097 










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