BILL ANALYSIS                                                                                                                                                                                                    



                                                                  AB 521
                                                                  Page  1

          ASSEMBLY THIRD READING
          AB 521 (Diaz) 
          As Amended  June 3, 2003
          Majority vote 

           HEALTH              14-8        APPROPRIATIONS      17-6        
           
           ----------------------------------------------------------------- 
          |Ayes:|Frommer, Chan, Chavez,    |Ayes:|Steinberg, Berg,          |
          |     |Chu, Cohn, Goldberg,      |     |Calderon, Montanez,       |
          |     |Hancock, Koretz,          |     |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                 |
          |     |                          |     |                          |
           ----------------------------------------------------------------- 

           SUMMARY  :  Specifies a minimum type size for information provided  
          from a pharmacist to a patient about the harmful effects of a  
          medication.  Specifically,  this bill  :

          1)Requires, at the request of a patient, that a pharmacist use  
            at least 12-point type when providing written information to a  
            patient about the harmful effects of a prescription drug. 

          2)Applies the above requirement effective January 1, 2006.

           EXISTING LAW  requires a pharmacist to inform a patient orally or  
          in writing of the harmful effects of a prescription drug, as  
          specified, if the drug poses substantial risk to the patient  
          when the drug is taken in combination with alcohol or if the  
          drug may impair a person's ability to drive a motor vehicle. 

           FISCAL EFFECT  :  According to the Appropriations Committee  
          analysis, minor, absorbable costs to the Board of Pharmacy.   
          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. 








                                                                  AB 521
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           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 of Pharmacy 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  
          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.

           








                                                                 AB 521
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          Analysis Prepared by  :    John Gilman / HEALTH / (916) 319-2097



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