Utah Code 58-17b-606. Restrictive drug formulary prohibited
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(1) As used in this section:
Terms Used In Utah Code 58-17b-606
- Department: means the Department of Commerce. See Utah Code 58-1-102
- Drug: means :(26)(a)(i) a substance recognized in the official United States Pharmacopoeia, official Homeopathic Pharmacopoeia of the United States, or official National Formulary, or any supplement to any of them, intended for use in the diagnosis, cure, mitigation, treatment, or prevention of disease in humans or animals;(26)(a)(ii) a substance that is required by any applicable federal or state law or rule to be dispensed by prescription only or is restricted to administration by practitioners only;(26)(a)(iii) a substance other than food intended to affect the structure or any function of the body of humans or other animals; and(26)(a)(iv) substances intended for use as a component of any substance specified in Subsections (26)(a)(i) through (iv). See Utah Code 58-17b-102
- Practitioner: means an individual currently licensed, registered, or otherwise authorized by the appropriate jurisdiction to prescribe and administer drugs in the course of professional practice. See Utah Code 58-17b-102
- Prescribe: means to issue a prescription:
(62)(a) orally or in writing; or(62)(b) by telephone, facsimile transmission, computer, or other electronic means of communication as defined by division rule. See Utah Code 58-17b-102- Prescription: means an order issued:
(63)(a) by a licensed practitioner in the course of that practitioner's professional practice or by collaborative pharmacy practice agreement; and(63)(b) for a controlled substance or other prescription drug or device for use by a patient or an animal. See Utah Code 58-17b-102- Prescription drug: means a drug that is required by federal or state law or rule to be dispensed only by prescription or is restricted to administration only by practitioners. See Utah Code 58-17b-102
- State: when applied to the different parts of the United States, includes a state, district, or territory of the United States. See Utah Code 68-3-12.5
- United States: includes each state, district, and territory of the United States of America. See Utah Code 68-3-12.5
(1)(a) “Generic form” means a prescription drug that is available in generic form and has an A rating in the United States Pharmacopeia and Drug Index.(1)(b) “Legend drug” has the same meaning as prescription drug.(1)(c) “Restrictive drug formulary” means a list of legend drugs, other than drugs for cosmetic purposes, that are prohibited by the Department of Health and Human Services from dispensation, but are approved by the Federal Food and Drug Administration.(2) A practitioner may prescribe legend drugs in accordance with this chapter that, in his professional judgment and within the lawful scope of his practice, he considers appropriate for the diagnosis and treatment of his patient.(3) Except as provided in Subsection (4), the Department of Health and Human Services may not maintain a restrictive drug formulary that restricts a physician’s ability to treat a patient with a legend drug that has been approved and designated as safe and effective by the Federal Food and Drug Administration, except for drugs for cosmetic purposes.(4) When a multisource legend drug is available in the generic form, the Department of Health and Human Services may only reimburse for the generic form of the drug unless the treating physician demonstrates to the Department of Health and Human Services a medical necessity for dispensing the nongeneric, brand-name legend drug.(5) The Department of Health and Human Services pharmacists may override the generic mandate provisions of Subsection (4) if a financial benefit will accrue to the state.(6) This section does not affect the state’s ability to exercise the exclusion options available under the Federal Omnibus Budget Reconciliation Act of 1990.