Nebraska Statutes 38-28,111. Drug product selection; when; pharmacist; duty
(1) A pharmacist may drug product select except when:
Terms Used In Nebraska Statutes 38-28,111
- Administration: means the act of (1) administering, (2) keeping a record of such activity, and (3) observing, monitoring, reporting, and otherwise taking appropriate action regarding desired effect, side effect, interaction, and contraindication associated with administering the drug or device. See Nebraska Statutes 38-2807
- Board: means the Board of Pharmacy. See Nebraska Statutes 38-2808
- Caregiver: means any person acting as an agent on behalf of a patient or any person aiding and assisting a patient. See Nebraska Statutes 38-2809
- Dispensing: includes (a) dispensing incident to practice, (b) dispensing pursuant to a delegated dispensing permit, (c) dispensing pursuant to a medical order, and (d) any transfer of a prescription drug or device to a patient or caregiver other than by administering. See Nebraska Statutes 38-2817
- Drug product: means any drug or device as defined in section Nebraska Statutes 38-2818.02
- Drug product select: means to dispense, without the practitioner's express authorization, an equivalent drug product or an interchangeable biological product in place of the brand-name drug or the biological product contained in a medical order of such practitioner. See Nebraska Statutes 38-2818.03
- Electronic transmission: means transmission of information in electronic form. See Nebraska Statutes 38-2821
- Facsimile: means a copy generated by a system that encodes a document or photograph into electrical signals, transmits those signals over telecommunications lines, and reconstructs the signals to create an exact duplicate of the original document at the receiving end. See Nebraska Statutes 38-2823
- Interchangeable biological product: means a biological product that the federal Food and Drug Administration:
(1) Has licensed and has determined meets the standards for interchangeability pursuant to Nebraska Statutes 38-2825.02
- Pharmacist: means any person who is licensed by the State of Nebraska to practice pharmacy. See Nebraska Statutes 38-2832
- Practitioner: means a certified registered nurse anesthetist, a certified nurse midwife, a dentist, an optometrist, a nurse practitioner, a physician assistant, a physician, a podiatrist, or a veterinarian. See Nebraska Statutes 38-2838
- Prescription: means an order for a drug or device issued by a practitioner for a specific patient, for emergency use, or for use in immunizations. See Nebraska Statutes 38-2840
(a) A practitioner designates that drug product selection is not permitted by specifying in the written, oral, or electronic prescription that there shall be no drug product selection. For written or electronic prescriptions, the practitioner shall specify “no drug product selection”, “dispense as written”, “brand medically necessary”, or “no generic substitution” or the notation “N.D.P.S.”, “D.A.W.”, or “B.M.N.” or words or notations of similar import to indicate that drug product selection is not permitted. The pharmacist shall note “N.D.P.S.”, “D.A.W.”, “B.M.N.”, “no drug product selection”, “dispense as written”, “brand medically necessary”, “no generic substitution”, or words or notations of similar import on the prescription to indicate that drug product selection is not permitted if such is communicated orally by the prescribing practitioner; or
(b) A patient or designated representative or caregiver of such patient instructs otherwise.
(2) A pharmacist shall not drug product select unless:
(a) The drug product, if it is in solid dosage form, has been marked with an identification code or monogram directly on the dosage unit;
(b) The drug product has been labeled with an expiration date;
(c) The manufacturer, distributor, or packager of the drug product provides reasonable services, as determined by the board, to accept the return of drug products that have reached their expiration date; and
(d) The manufacturer, distributor, or packager maintains procedures for the recall of unsafe or defective drug products.
(3) If a pharmacist receives a prescription for a biological product and chooses to dispense an interchangeable biological product for the prescribed product, the pharmacist must advise the patient or the patient’s caregiver that drug product selection has occurred.
(4) Within three business days after the dispensing of a biological product, the dispensing pharmacist or the pharmacist’s designee shall make an entry of the specific product provided to the patient, including the name of the product and the manufacturer. The communication shall be conveyed by making an entry that is electronically accessible to the prescriber through an interoperable electronic medical records system, electronic prescribing technology, a pharmacy benefit management system, or a pharmacy record. Entry into an electronic records system described in this subsection is presumed to provide notice to the prescriber. Otherwise, the pharmacist shall communicate the biological product dispensed to the prescriber using facsimile, telephone, electronic transmission, or other prevailing means, except that communication shall not be required if (a) there is no interchangeable biological product approved by the federal Food and Drug Administration for the product prescribed or (b) a refill prescription is not changed from the product dispensed on the prior filling.