BILL ANALYSIS                                                                                                                                                                                                    



                                                          AB 141
                                                          Page  1

Date of Hearing:  March 23, 1999

                  ASSEMBLY COMMITTEE ON HEALTH 
                     Martin Gallegos, Chair
         AB 141 (Knox) - As Introduced:  January 11, 1999
  
SUBJECT  :  Pharmacies: study of medication errors.

  SUMMARY  :   Requires the Board of Pharmacy (Board) to conduct a  
study of the incidence of medication errors in pharmacies and to  
issue a report of its findings from the study to the Legislature  
by December 1, 2002.  Specifically,  this bill  : 

1)Requires the Board to conduct a study of the incidence of  
  medication errors in pharmacies in California, employing a  
  methodology that uses "test" prescriptions, as defined,  
  distributed to a statistically significant cross section of  
  pharmacies in the state.

2)Defines "test" prescription to be a prescription that is  
  prepared solely for the purposes of this study and not for the  
  actual medical needs of a patient, and requires all "test"  
  prescription drugs, after examination for purposes of the  
  study, to be forwarded to the Board to remain in the Board's  
  custody until destroyed.

3)Requires the Board, in designing the study, to confer with the  
  scientific and academic community to ensure that the study is  
  based on sound scientific and analytic principles.

4)Permits the Board to contract with outside entities to collect  
  and analyze data necessary for the study.

5)States that the purpose of the study is to measure the  
  frequency and describe the type of medication errors occurring  
  in California, to improve patient safety, and to identify  
  broader issues that may become the basis for instituting  
  profession-wide standards and changes.

6)Requires the Board to issue a report of its findings from the  
  study to the Legislature by December 1, 2002, and sunsets the  
  provisions of this bill on January 1, 2003.

  EXISTING LAW  establishes the Board of Pharmacy within the  
Department of Consumer Affairs, and charges the Board with the  








                                                          AB 141
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administration and enforcement of laws pertaining to the  
practice of pharmacy.

  FISCAL EFFECT  :  Unknown

  COMMENTS  :   

  1)PURPOSE OF THE BILL  .  The author introduced this bill at the  
  request of the Engineers and Scientists of California (ESC),  
  the Region 8 States Council of the United Food and Commercial  
  Workers (UFCW), and the California Pharmacists Association  
  (CPhA).  According to ESC and UFCW, there is strong evidence  
  that prescription error rates have increased dramatically, and  
  point to a study published in the February 1998 issue of the  
  journal  Lancet  .  This study found that deaths due to  
  medication errors in the United States more than doubled  
  between 1983 and 1993.  

  CPhA argues in support that this bill would focus the concern  
  of the Board on the issue of prescription errors in  
  California.  CPhA states that while studies exist reinforcing  
  evidence that prescription error rates are increasing, it is  
  important to specifically examine the degree of this problem  
  in California.

  2)SUPPORT  .  The Consumer Federation of California states in  
  support that this bill will require the Board to be more  
  cognizant of the existence and causes of increasing  
  prescription error rates in California, and that consumers  
  will ultimately benefit from increased awareness of  
  prescription error rates in California.  The California Nurses  
  Association also supports this bill, arguing that reducing  
  medication errors to a minimum should be one of the prime  
  regulatory objectives of the Board.

  3)PRIOR LEGISLATION  .  A similar bill requiring a study of  
  prescriptions errors, AB 1889 (Knox), was vetoed in 1998.   
  Among the points raised in the veto message, the Governor  
  stated that AB 1889's reference to "placebo" prescriptions was  
  inappropriate, and that a study should use "fictitious,"  
  rather than "placebo," prescriptions.  This bill addresses  
  that concern by using "test" prescriptions, rather than the  
  "placebo" prescriptions of AB 1889.  The Governor also  
  suggested that a study of this problem could be done by  
  national organizations rather than the Board of Pharmacy.








                                                          AB 141
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  REGISTERED SUPPORT / OPPOSITION  :   

  Support  

California Pharmacists Association (co-sponsor)
Engineers and Scientists of California (co-sponsor)
Region 8 States Council of the United Food and Commercial  
Workers (co-sponsor)
California Nurses Association
Consumer Federation of California

  Opposition  

None on file
  
Analysis Prepared by  :  Vincent D. Marchand / HEALTH / (916)  
319-2097