SB 875, 2016 (Amended Section - as Truly Agreed)
338.056. 1. Except as provided in subsection 2 of this
section, the pharmacist filling prescription orders for drug
products prescribed by trade or brand name may select another
drug product with the same active chemical ingredients of the
same strength, quantity and dosage form, and of the same generic
drug or interchangeable biological product type, as determined
by the United States Adopted Names and accepted by the Federal
Food and Drug Administration. Selection pursuant to this section
is within the discretion of the pharmacist, except as provided
in subsection 2 of this section. The pharmacist who selects the
drug or interchangeable biological product to be dispensed
pursuant to this section shall assume the same responsibility
for selecting the dispensed drug or biological product
as would be incurred in filling a prescription for a drug or
interchangeable biological product prescribed by generic
or interchangeable biologic name. The pharmacist shall
not select a drug or interchangeable biological product
pursuant to this section unless the product selected costs the
patient less than the prescribed product.
2. A pharmacist who receives a prescription for a brand name drug or biological product may, unless requested otherwise by the purchaser, select a less expensive generically equivalent or interchangeable biological
product under the following circumstances:
(1) If a written prescription is involved, the prescription form used shall have two signature lines at opposite ends at the bottom of the form. Under the line at the right side shall be clearly printed the words: "Dispense as Written". Under the line at the left side shall be clearly printed the words "Substitution Permitted". The prescriber shall communicate the instructions to the pharmacist by signing the appropriate line. No prescription shall be valid without the signature of the prescriber on one of these lines;
(2) If an oral prescription is involved, the practitioner or the practitioner's agent, communicating the instructions to the pharmacist, shall instruct the pharmacist as to whether or not a therapeutically equivalent generic drug or interchangeable biological product may be substituted. The pharmacist shall note the instructions on the file copy of the prescription.
3. All prescriptions written in the state of Missouri by practitioners authorized to write prescriptions shall be on forms which comply with subsection 2 hereof.
4. Notwithstanding the provisions of subsection 2 of this section to the contrary, a pharmacist may fill a prescription for a brand name drug by substituting a generically equivalent drug or interchangeable biological product when [generic] substitution is allowed in accordance with the laws of the state where the prescribing practitioner is located.
5. Violations of this section are infractions.