BILL ANALYSIS                                                                                                                                                                                                    



                                                                  AB 521
                                                                  Page  1

          Date of Hearing:   May 14, 2003

                        ASSEMBLY COMMITTEE ON APPROPRIATIONS
                              Darrell Steinberg, Chair

                     AB 521 (Diaz) - As Amended:  April 22, 2003 

          Policy Committee:                              HealthVote:14-8

          Urgency:     No                   State Mandated Local Program:  
          Yes    Reimbursable:              No

           SUMMARY  

          This bill:

          1)Broadens an existing requirement that pharmacists inform  
            patients, orally or in writing, of the harmful effects of a  
            prescription drug if the drug poses substantial risk to the  
            patient when taken with alcohol, to also requires such notice  
            when the drug is taken in combination with other medications,  
            including prescription and nonprescription drugs. 

          2)Requires the notice, if provided in writing, to be printed in  
            at least 12-point type whenever the drug poses a substantial  
            risk of harm to the person consuming the drug if taken in  
            combination with alcohol or other medications, including  
            prescription and nonprescription drugs. 

          3)Makes the changes made by this bill operative January 1, 2005.

           FISCAL EFFECT  

          1)Minor, absorbable costs to the Board of Pharmacy.

          2)Unknown increased costs-likely less than $150,000-to  
            state-contracting pharmacies, health plans and pharmacy  
            benefit managers to revise their forms to meet the 12-point  
            type requirement, and to include additional information about  
            the interaction of the prescribed prescription drug with other  
            prescription and non-prescription drugs.  This information can  
            be provided orally or in writing.  

           COMMENTS  









                                                                  AB 521
                                                                  Page  2

           1)Purpose  .  According to the author, this bill is necessary  
            because the inappropriate use of prescription drugs is a  
            problem that is particularly acute for the elderly.  The  
            elderly use more prescription drugs than any other age group  
            and are more likely to take multiple prescription drugs, which  
            increases the probability of adverse drug reactions.  The  
            additional information required by this bill will provide  
            valuable information in a format that can be more easily read.  


           2)Background  .  Existing law requires the pharmacist to inform  
            the patient (orally or in writing) if the prescribed drug  
            poses a substantial risk to the person consuming the drug when  
            taken in combination with alcohol, or if the drug may impair a  
            person's ability to drive a motor vehicle.  This bill would  
            broaden that notice to include when the drug is taken in  
            combination with other medications, including both  
            prescription and nonprescription drugs.  Existing regulations  
            require pharmacists to provide oral consultation to the  
            patient or the patient's agent in any care setting whenever  
            there is a new prescription for a patient, or whenever a new  
            dosage or strength is dispensed by the pharmacy. 

           3)Opposition  .  The California Pharmacists Association (CPhA)  
            argues that this bill will impose significant new costs on  
            pharmacies without a commensurate benefit to the public.  CPhA  
            believes that this issue can be better addressed by greater  
            enforcement of the existing consultation requirements on  
            pharmacists and by greater awareness of this requirement on  
            the part of consumers. 



           Analysis Prepared by  :    Scott Bain / APPR. / (916) 319-2081