BILL ANALYSIS
AB 521
Page 1
ASSEMBLY THIRD READING
AB 521 (Diaz)
As Amended April 22, 2003
Majority vote
HEALTH 14-8 APPROPRIATIONS 17-6
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|Ayes:|Frommer, Chan, Chavez, |Ayes:|Steinberg, Berg, |
| |Chu, Cohn, Goldberg, | |Calderon, Montanez, |
| |Koretz, Hancock, | |Correa, Diaz, Firebaugh, |
| |Montanez, Negrete McLeod, | |Goldberg, Leno, Nation, |
| |Nunez, Ridley-Thomas, | |Negrete McLeod, Nunez, |
| |Salinas, Wolk | |Pavley, Ridley-Thomas, |
| | | |Simitian, Wiggins, Yee |
| | | | |
|-----+--------------------------+-----+--------------------------|
|Nays:|Pacheco, Bates, Dutton, |Nays:|Bates, Daucher, Haynes, |
| |Haynes, Maze, Nakanishi, | |Pacheco, Runner, |
| |Plescia, Richman | |Samuelian |
| | | | |
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SUMMARY : Requires a pharmacist to inform a patient when a drug
poses a substantial risk of harm if the drug is taken in
combination with other medications, including nonprescription
drugs. Specifically, 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 require 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 : According to the Appropriations Committee
analysis, minor, absorbable costs to the Board of Pharmacy
AB 521
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(Board). 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.
COMMENTS : According to the National Council on Patient
Information and Education (NCPIE), an often-overlooked public
health problem is the inappropriate use of medicines. NCPIE
states that in the year 2000, nearly three billion retail
prescriptions were dispensed. According to NCPIE, studies show
that up to half of all prescribed medicines are used improperly,
and as a result, preventable medicine-related illnesses annually
account for over $75 billion in doctors' visits, unnecessary
prescriptions, absences and loss of productivity at work,
increases in emergency room visits, hospitalizations, and
nursing home admissions, and even death.
Board regulations require pharmacists to provide oral
consultation to their patients when requested by the patient or
whenever the pharmacist deems it warranted in the exercise of
his or her professional judgment. In addition, regulations
require consultation whenever a prescription drug has not
previously been dispensed to a patient, or whenever a
prescription drug not previously dispensed to a patient in the
same dosage form, strength or with the same written directions,
is dispensed by the pharmacy. Finally, regulations require that
prior to consultation, a pharmacist must review a patient's drug
therapy and medication record before each prescription drug is
delivered and the review must include screening for severe
potential drug therapy problems. NCPIE emphasizes the important
role of communication between consumers and health care
professionals whenever medicines are prescribed and used. NCPIE
endorses the use of large print written information that answers
questions that patients may have, including what foods, drinks,
other medicines, or activities should be avoided while taking
any given medication. Generally, pharmacists do include written
instructions with each dispensed prescription drug that often
list contraindications and side effects.
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
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to be taking multiple prescription drugs, which increases the
probability of adverse drug reactions. The insert required by
this bill will provide valuable information in a format that can
be easily read.
Analysis Prepared by : John Gilman / HEALTH / (916) 319-2097
FN: 0001001