§59-353.20.2. Varying amounts of prescription refills - Pharmacist
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discretion – Permissible dispensing without a prescription.
A. Except as provided in subsection C of this section, unless the prescriber has specified on the prescription that dispensing a prescription for a maintenance medication in an initial amount followed by periodic refills is medically necessary, a pharmacist may exercise his or her professional judgment to dispense varying quantities of medication per fill-up to the total number of dosage units as authorized by the prescriber on the original prescription including any refills.
B. Subsection A of this section shall not apply to scheduled medications or any medications for which a report is required under the controlled substance database. Dispensing of medication based on refills authorized by the physician on the prescription shall be limited to no more than a ninety-day supply of the medication.
C. 1. A pharmacist may dispense without a prescription one or more devices or medications as medically necessary to prevent the death of or serious harm to the health of a patient if the following conditions are met:
a. the pharmacy which the pharmacist owns or at which the
pharmacist is employed has a current record of a
prescription for the medication or device prescribed
in the name of the patient who is requesting it, but
the prescription has expired and a refill requires
authorization from the licensed practitioner who
issued the prescription and neither the patient nor
the pharmacist was able to obtain the refill after
reasonable attempts were made to obtain such refill
and the pharmacist documents such attempts on a form
prescribed by the State Board of Pharmacy,
b. the failure of the pharmacist to dispense the
medication or device reasonably could result in the
death of or serious harm to the health of the patient,
c. the device or medication is listed on the formulary
described in paragraph 4 of this subsection,
d. the patient has been on a consistent medication
therapy as demonstrated by records maintained by the
pharmacy, and
e. the amount of the medication or device dispensed is
for a reasonable amount of time; provided, if the
patient or pharmacist is unable to obtain a refill
prescription from the patient's licensed practitioner
before the amount prescribed to prevent death or
serious harm to the health of the patient is depleted,
the pharmacist may dispense an additional amount of
the medication or device not more than once in an
amount consistent with past prescriptions of the
patient.
2. The standard of care required of a pharmacist licensed in this state who is acting in accordance with the provisions of this subsection shall be the level and type of care, skill and diligence that a reasonably competent and skilled pharmacist with a similar background and in the same or similar locality would have provided under the circumstance.
3. Any pharmacist licensed in this state who in good faith dispenses one or more medications or devices to a patient pursuant to the provisions of this subsection shall not be liable for any civil damages or subject to criminal prosecution as a result of any acts or omissions except for committing gross negligence or willful or wanton acts committed in dispensing or failure to dispense the medication or device.
4. The State Board of Pharmacy shall develop and update as necessary an inclusionary formulary of potentially life-saving prescription medications and devices, not to include controlled dangerous substances, for the purposes of this subsection. Such medications and devices shall include but not be limited to:
a. insulin and any devices or supplies necessary for the
administration of insulin,
b. glucometers and any devices or supplies necessary for
the operation of the glucometer, and
c. rescue inhalers.
5. Dispensing in accordance with this subsection shall be deemed dispensing under a legal prescription for purposes of the Pharmacy Audit Integrity Act, Section 356 et seq. of this title.
D. Upon receipt of a valid Schedule II opioid prescription issued pursuant to the provisions of Section 2-309I of Title 63 of the Oklahoma Statutes, a pharmacist shall fill the prescription to the specified dose, and shall not be permitted to fill a different dosage than what is prescribed. However, the pharmacist maintains the right not to fill the valid opioid prescription. Added by Laws 2017, c. 234, § 3, eff. Nov. 1, 2017. Amended by Laws 2019, c. 137, § 1, eff. Nov. 1, 2019; Laws 2019, c. 428, § 5, emerg. eff. May 21, 2019.