BILL ANALYSIS                                                                                                                                                                                                    



                                                                  SB 971
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          Date of Hearing:   June 22, 2010

                            ASSEMBLY COMMITTEE ON HEALTH
                              William W. Monning, Chair
                     SB 971 (Pavley) - As Amended:  June 15, 2010

           SENATE VOTE  :   34-0
           
          SUBJECT  :   Bleeding disorders: blood clotting products.

           SUMMARY  :   Establishes requirements governing entities that  
          provide blood clotting products for home use in the treatment of  
          hemophilia and other bleeding disorders and designates the Board  
          of Pharmacy to administer and enforce these provisions.   
          Specifically,  this bill  :   

          1)Makes various legislative findings and declarations relating  
            to establishing standards of service for entities that deliver  
            blood clotting products for home use and promoting timely  
            access to a full range of essential, cost effective,  
            lifesaving, blood clotting products and high-quality services  
            for home use for persons with hemophilia and other bleeding  
            disorders.

          2)Establishes various definitions for purposes of this bill.   
            Defines "blood clotting product" as an intravenously  
            administered medicine manufactured from human plasma or  
            recombinant biotechnology techniques, approved for  
            distribution by the federal Food and Drug Administration  
            (FDA), that is used for the treatment and prevention of  
            symptoms associated with bleeding disorders.

          3)Defines "provider of blood clotting products" as all of the  
            following pharmacies that dispense blood clotting factors for  
            home use: 

             a)   Hospital and health system pharmacies, except those that  
               dispense blood clotting products due only to emergency,  
               urgent care, or inpatient encounters, or discharge an  
               inpatient with a supply of blood clotting products for home  
               use;
             b)   Pharmacies affiliated with hemophilia treatment centers;  

             c)   Specialty home care pharmacies; and,
             d)   Retail pharmacies.








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          4)Requires each provider of blood clotting products for home use  
            to meet all of the following requirements:

             a)   Have sufficient knowledge and understanding of bleeding  
               disorders to accurately follow the instructions of the  
               prescribing physician and ensure high-quality service for  
               the patient, as specified;

             b)   Have access to a provider with sufficient clinical  
               experience serving people with bleeding disorders that  
               enables the provider to know when patients have an  
               appropriate supply of clotting factor on hand and about  
               proper storage and refrigeration of clotting factors;

             c)   Have access to knowledgeable pharmacy staffing on call  
               24 hours a day, to initiate emergency requests for clotting  
               factors, maintain 24-hour on call service seven days a week  
               for every day of the year, adequately screen phone calls  
               for emergencies, and acknowledge all phone calls within one  
               hour or less;

             d)   Have the ability to obtain all brands of blood clotting  
               products approved by the FDA, as specified, provided  
               manufacturer supply exists and payer authorization is  
               obtained;

             e)   Supply all necessary ancillary infusion equipment and  
               supplies with each prescription, as needed;

             f)   Store and ship, or otherwise deliver, all blood clotting  
               products in conformity with all state and federally  
               mandated standards, as specified;

             g)   Provide home nursing services either directly or through  
               a qualified third party with experience in treating  
               bleeding disorders, when deemed necessary by the treating  
               physician, and coordinate pharmacy services with the third  
               party provider;

             h)   Adhere to various shipping and delivery requirements for  
               blood clotting products and ancillary infusion equipment  
               upon receiving approved authorization for nonemergency and  
               emergency prescriptions, provided manufacturer supply  
               exists, as specified;








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             i)   Provide patients who have ordered their products with a  
               designated contact phone number for reporting problems with  
               a delivery and respond to these calls within a reasonable  
               time period;

             j)   Notify patients of federal recalls and withdrawals of  
               blood clotting products and ancillary infusion equipment  
               within 24 hours of the provider receiving notification and  
               participate in the National Patient Notification System for  
               blood clotting product recalls;

             aa)  Provide language interpretive services over the phone or  
               in person, as needed by the patient;

             bb)  Have a detailed plan for meeting the requirements of  
               this bill in the event of a natural or manmade disaster or  
               other disruption of normal business operations;

             cc)  Properly collect, remove, and dispose of medical waste  
               in accordance with current law governing medical waste;

             dd)  Provide appropriate and necessary recordkeeping and  
               documentation as required by state and federal law and  
               retain copies of the patient's prescriptions; and,

             ee)  Comply with the privacy and confidentiality requirements  
               of the Health Insurance Portability and Accountability Act  
               of 1996.

          5)Directs the Board of Pharmacy (Board) to administer and  
            enforce the requirements of this bill.

           



          EXISTING LAW  : 

          1)Establishes the Board within the Department of Consumer  
            Affairs to regulate the practice of pharmacy and the licensing  
            of pharmacies and pharmacists.

          2)Specifies certain requirements regarding the proper storage,  
            handling, dispensing, and disposal of drugs, staff training  








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            protocols, drug and supply inventory, labeling, and  
            maintenance of patient confidentiality.

          3)Allows pharmacists to perform certain procedures under  
            specified conditions, including, among other things,  
            administering drugs and biologics, such as blood clotting  
            products, by injection, pursuant to a prescriber's order.

          4)Prohibits pharmacies from leaving, picking up, accepting, or  
            delivering prescriptions to any place not licensed as a retail  
            pharmacy, including a patient's residence or workplace, or a  
            licensed health facility, with certain exceptions, as  
            specified.

          5)Establishes the Genetically Handicapped Persons Program  
            (GHPP), administered by the Department of Health Care Services  
            (DHCS), to provide for the medical care of adults with certain  
            genetic diseases, including hemophilia.

          6)Establishes the FDA to regulate the manufacture of  
            pharmaceuticals derived from blood and blood components, such  
            as blood clotting products, including establishing standards  
            for those products for shipping, storage, and delivery,  
            inspecting the products, approving them for use by patients,  
            and recalling products that may be defective or potentially  
            harmful.

           FISCAL EFFECT  :   According to the Senate Appropriations  
          Committee, pursuant to Senate Rule 28.8, negligible state costs.  
           

           COMMENTS  :   

           1)PURPOSE OF THIS BILL  :   According to the author, this bill  
            will impose statewide standards for the proper storage and  
            delivery of blood clotting factor, a prescribed biologic that  
            is infused several times per week by people with hemophilia  
            and other bleeding disorders.  The author notes that the  
            preferred method of treatment for hemophilia is intravenous  
            injection or infusion of prescribed blood clotting products,  
            along with case management and specialized medical care at a  
            federally designated regional hemophilia treatment center  
            (HTC).  The author states that pharmacies and other entities  
            specializing in the delivery of blood clotting products and  
            related equipment, supplies, and services for home use  








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            represent a growing segment of providers in California but  
            there are currently no formal standards of service in  
            California to regulate them.  The author asserts that this  
            bill is intended to establish critical life-saving standards  
            in law for the benefit of people with hemophilia and other  
            bleeding disorders while ensuring that the current cost  
            effective model of care is maintained for future generations.

           2)BLEEDING DISORDERS  .  Hemophilia is a rare, hereditary bleeding  
            disorder affecting approximately 4,000, mostly male,  
            Californians.  It is a chronic, lifelong, incurable yet  
            treatable disease marked by the absence blood proteins, called  
            clotting factors, that work to stop bleeding.  Lack of  
            clotting factor causes hemophiliacs to bleed for longer  
            periods of time and generally results in internal bleeding,  
            primarily in muscles and joints.  Without treatment,  
            hemophilia can cause pain, severe joint damage, disability,  
            and early death.  Von Willebrand disease is another bleeding  
            disorder caused by a deficiency or defect of a blood clotting  
            protein called von Willebrand factor.  It is considered less  
            severe than hemophilia and is estimated to affect 360,000  
            Californians.   

           3)BLOOD CLOTTING PRODUCTS  .  Hemophilia and other bleeding  
            disorders are treated by replacing the missing clotting factor  
            in the blood through injections of additional blood clotting  
            factors into the bloodstream.  Clotting factors used to treat  
            hemophilia are approved by the FDA and can only be used with a  
            prescription.  Clotting factors are found in whole blood,  
            plasma, and recombinant factors, which are made in a  
            laboratory and do not involve human blood products.  A number  
            of blood clotting products, made by a variety of  
            pharmaceutical manufacturers, may be prescribed to temporarily  
            replace the missing clotting factors in order to prevent or  
            contain bleeding episodes.  Proper administration of blood  
            clotting products requires the use of ancillary supplies and  
            equipment, including syringes, tourniquets, gauze, and alcohol  
            swabs.  Blood clotting products are generally expensive, and  
            require special storage and handling as they are sensitive to  
            extreme exposure to light.    

           4)PUBLIC PROGRAMS  .  As of July 1, 2010, pharmacies providing  
            blood clotting factors to patients in the Medi-Cal Program,  
            the California Children's Services Program, and GHPP must sign  
            contracts with the state indicating that they agree to meet  








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            standards similar to the standards set forth in this bill.   
            According to information from DHCS, these specialty contracts  
            for blood factor products require participating providers to  
            meet various performance obligations with regard to pharmacy  
            provider staff knowledge; storage, handling, and delivery of  
            clotting factor concentrates and ancillary supplies;  
            processing of prescription orders; hours of operation and  
            access to staff; and, recordkeeping, billing, and product  
            recalls.  The author contends that this bill will ensure that  
            the standards in these contracts are codified in statute to  
            ensure that pharmacies have proper safeguards in place to  
            provide for the safety and well-being of publicly- and  
            privately-insured patients in California who have hemophilia  
            or other bleeding disorders.   

           5)HTCs  .  In 1974 Congress authorized the national network of  
            HTCs to provide access to comprehensive specialized care for  
            individuals with bleeding disorders.  HTCs use  
            interdisciplinary teams with specialized training that include  
            hematologists, pediatricians, nurses, social workers, physical  
            therapists, orthopedists, and dentists, to provide case  
            management services and coordinate care with primary care  
            providers and specialists, such as genetic counselors and  
            obstetrician/gynecologists.  About 90% of severe hemophilia  
            patients seen at HTCs self-infuse their clotting factors and  
            HTCs specialize in patient education on self-care.  HTCs  
            operate in accordance with goals established by the U.S.  
            Department of Health and Human Services Maternal and Child  
            Health Bureau, and the Centers for Disease Control and  
            Prevention (CDC), as well as standards established by the  
            National Hemophilia Foundation.  There are 11 HTCs throughout  
            California primarily affiliated with university-based  
            hospitals, including the Lucile Packard Children's Hospital of  
            Stanford, and the University of California Medical Centers at  
            Davis, San Diego, and San Francisco.  The CDC reports that the  
            care provided at HTCs significantly improves the prevention of  
            complications for persons with bleeding disorders; mortality  
            rates are 40% lower among patients who use HTCs compared to  
            those who do not. 

           6)SPECIALIZED PHARMACIES  .  Many blood clotting product providers  
            in the state are specialty care pharmacies.  These pharmacies  
            specialize in providing treatments and supplies to individuals  
            with particular chronic diseases.  Generally, they focus their  
            services on targeted patient populations, rather than the  








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            needs of the general public.  Specialty care pharmacies are  
            subject to the same statutory and regulatory requirements as  
            traditional pharmacies, but they do not need to meet  
            additional licensing requirements in order to provide their  
            specialized services.  These types of pharmacies usually ship  
            or deliver blood clotting products to the homes of individuals  
            with hemophilia and other clotting disorders and, when  
            necessary, they provide or arrange for nursing services to  
            patients who need assistance with infusing the blood factor  
            products.

           7)PRIOR LEGISLATION  .

             a)   SB 1594 (Steinberg) of 2008 would have imposed  
               requirements on providers of blood clotting products for  
               home use that are used to treat hemophilia and other  
               bleeding disorders.  SB 1594 died on the Senate  
               Appropriations Committee Suspense File.

             b)   AB 2408 (Negrete McLeod), Chapter 777, Statutes of 2007,  
               revises the scope of professional practice for pharmacists  
               to include authorization for pharmacists to administer  
               drugs and biologics by injection pursuant to a prescriber's  
               order.

           8)SUPPORT  .  Providers, manufacturers of blood clotting products,  
            and patient advocacy groups support this bill because it would  
            establish crucial standards of care for health care entities  
            that deliver blood factor products to people with hemophilia  
            and other life-threatening blood disorders in the home  
            setting.  The California Medical Association writes that many  
            pharmacies and other entities specializing in the delivery of  
            these products for home use are not licensed by the state or  
            located at HTCs and this bill will ensure that all providers  
            of these products are subject to the same quality and service  
            standards that will benefit consumers.  Herndon Pharmacy, a  
            specialty care pharmacy, states that this bill accomplishes  
            the goal of making sure that HTCs and specialty care  
            pharmacies that provide blood clotting factors store it  
            properly and have sufficient supplies available to patients at  
            any given time.  CSL Behring, a maker of plasma-derived and  
            recombinant therapies, writes that individuals with blood  
            disorders need to receive timely access to the full range of  
            blood clotting therapies and the standards specified in this  
            bill will help make treatment for these patients  








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            cost-effective and reduce mortality and bleeding-related  
            hospitalization.  Finally, the sponsor of this bill, the  
            Hemophilia Council of California points out that the state has  
            a long history of ensuring that patients have access to care  
            delivered by medical professionals with vast experience  
            treating bleeding disorders and this bill will ensure that  
            patients get the same high quality care and service from  
            pharmacy providers.

           9)OPPOSITION  .  Kaiser Permanente opposes this bill because it  
            would set a precedent to make all products available for all  
            chronic care patients, such as diabetics and asthmatics, for  
            example.  Kaiser notes that whenever a new FDA approved  
            pharmaceutical proves to be superior in safety and efficacy to  
            what is on Kaiser's formulary, the new proven pharmaceutical  
            is added.  Kaiser adds that its physicians have the ability,  
            independent of health plan approval, to prescribe off the  
            formulary if they feel it is in the best interest of the  
            patient.  The Department of Consumer Affairs also objects to  
            this bill, arguing that it is unclear what problem this bill  
            seeks to remedy given that it is the Department's  
            understanding that, at present, the general level of service  
            and care received by bleeding disorder patients is high; and,  
            furthermore, the bulk of the provisions of this bill are  
            already due to be included in applicable Medi-Cal contracts.

           10)DOUBLE REFERRAL  .  This bill is double referred.  Should it  
            pass this committee, it will be referred to the Assembly  
            Committee on Business, Professions and Consumer Protection.

           REGISTERED SUPPORT / OPPOSITION  :   

           Support 
           
          Hemophilia Council of California (sponsor)
          California Medical Association
          CSL Behring
          Federal Hemophilia Treatment Center - Region IX
          Grifols Inc.
          Herndon Pharmacy
          National Hemophilia Foundation
          Plasma Protein Therapeutics Association

           Opposition 
           








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          Kaiser Permanente
          Department of Consumer Affairs
           
           
           Analysis Prepared by  :    Cassie Rafanan / HEALTH / (916)  
          319-2097