Amend SB 609 by adding the following appropriately numbered
SECTION and renumbering the remaining SECTIONS of the bill
accordingly:
      SECTION ____.  Section 40, Texas Pharmacy Act (Article
4542a-1, Vernon's Texas Civil Statutes), is amended Subsection (m)
to read as follows:
      (m)  Except as provided by this subsection, drug product
selection authorized in this section does not apply to the refill
of a prescription for a narrow therapeutic index drug.  The board,
in consultation with the Texas State Board of Medical Examiners,
shall establish, by rule, a list of narrow therapeutic index drugs
that are subject to this subsection.  A prescription for a narrow
therapeutic index drug may be refilled only by using the same drug
product by the same manufacturer that the pharmacist last dispensed
under the prescription.  If a pharmacist does not have the same
drug product by the same manufacturer in stock to refill the
prescription, the pharmacist may dispense a drug product that is
generically equivalent if the pharmacist, before dispensing the
generically equivalent drug product, notifies:
            (1)  the patient, at the time the prescription is
dispensed, that a substitution of the prescribed drug product has
been made; and
            (2)  the prescribing practitioner of the drug product
substitution by telephone, facsimile, or mail, at the earliest
reasonable time, but not later than 72 hours after dispensing the
prescription.