75R12657 CAG-F                           

         By Berlanga                                           H.B. No. 2571

         Substitute the following for H.B. No. 2571:

         By Berlanga                                       C.S.H.B. No. 2571

                                A BILL TO BE ENTITLED

 1-1                                   AN ACT

 1-2     relating to the substitution of certain drugs by a pharmacist.

 1-3           BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:

 1-4           SECTION 1.  Section 40, Texas Pharmacy Act (Article 4542a-1,

 1-5     Vernon's Texas Civil Statutes), is amended by adding Subsection (m)

 1-6     to read as follows:

 1-7           (m)  Except as provided by this subsection, drug product

 1-8     selection authorized in this section does not apply to the refill

 1-9     of a prescription for a narrow therapeutic index drug.  The board,

1-10     in consultation with the Texas State Board of Medical Examiners,

1-11     shall establish, by rule, a list of narrow therapeutic index drugs

1-12     that are subject to this subsection.  A prescription for a narrow

1-13     therapeutic index drug may be refilled only by using the same drug

1-14     product by the same manufacturer that the pharmacist last dispensed

1-15     under the prescription.  If a pharmacist does not have the same

1-16     drug product by the same manufacturer in stock to refill the

1-17     prescription, the pharmacist may dispense a drug product that is

1-18     generically equivalent if the pharmacist, before dispensing the

1-19     generically equivalent drug product, notifies:

1-20                 (1)  the patient, at the time the prescription is

1-21     dispensed, that a substitution of the prescribed drug product has

1-22     been made; and

1-23                 (2)  the prescribing practitioner of the drug product

1-24     substitution by telephone, facsimile, or mail, at the earliest

 2-1     reasonable time, but not later than 72 hours after dispensing the

 2-2     prescription.

 2-3           SECTION 2.  This Act takes effect September 1, 1997.

 2-4           SECTION 3.  The importance of this legislation and the

 2-5     crowded condition of the calendars in both houses create an

 2-6     emergency and an imperative public necessity that the

 2-7     constitutional rule requiring bills to be read on three several

 2-8     days in each house be suspended, and this rule is hereby suspended.