Missouri Board of Pharmacy Meeting: My Experience

I had the opportunity to attend a Missouri Board of Pharmacy meeting last week and I had no clue what to expect. It was eye-opening on how many people are involved in the well-being of pharmacy. Various topics were discussed at the meeting and for more information you can visit the Board’s website to see the complete agenda.1 The most interesting part of the meeting to me was when the board discussed the strategic planning for 2014. During this time period the public was able to voice their opinions and concerns.

MPA's July rotation student, Ashely Buehler, UMKC School of Pharmacy, Columbia campus.

MPA’s July rotation student, Ashely Buehler, UMKC School of Pharmacy, Columbia campus.

There were 10 things on the agenda for strategic planning and I will go into more detail about some of them below.1

1.)   Hospital Working Group:

The Board presented with this question “Does the Board want to continue active meetings of the Hospital Working Group?”1

2.)   Automatic Refills:

The Board presented with this question “Should the Board require additional safeguards prior to shipping automatic refills (i.e. – patient consent, patient notification)?”1 This topic was brought up due to the concern of sending refills to patients when the medication is unwanted or has been discontinued.1 Typically, automatic refills are used and implemented to help with adherence for patients.1 Centers for Medicare & Medicaid Services (CMS) wants beneficiaries to give consent for each new and refill prescription as they have been receiving more complaints about beneficiaries receiving medications they did not want.1 Overall, this topic brought about two sides different sides to argue. First, it was mentioned at the meeting the concern of decreasing adherence if automatic refills have more safeguards. Then, the second concern is voiced by CMS that patients are taking medications that have been discontinued or unwanted, which can increase health care costs.1 There was also issues expressed during the meeting about dangerous outcomes from patients taking medications that were discontinued.

3.)   Compounding for Office Use:

The Board requested that a discussion be held.1

4.)   Prescription Labeling:

The Board presented with this question “Should the Board amend Missouri law to clarify which pharmacy should be designated on the prescription label?”1 This is a concern when a prescription is filled in a different location than where the prescription is being picked up, for example a central fill pharmacy. The current statute about labeling (338.059) is phrased “the name and address of the pharmacy,” which does not specify which pharmacy.1 The Board discussed which pharmacy they believe should be liable and responsible, which would then be the pharmacy that should be on the label. A professional present in the meeting stated that Ohio had good phrasing on which pharmacy should be on the label if there was a central fill pharmacy used. The Ohio administrative code is 4729-5-16 that discusses the prescription label state rules.2

5.)   Charitable Services:

The Board presented with this question “Should the Board amend Missouri law to allow pharmacists to dispense prescriptions on the premises of a public health office or other charitable organization?”1

6.)   Automated Prescription Self-Service Devices:

The Board presented with this question “Would the Board like [to] address automated prescription self-service devices?”1 Since technology is advancing quickly today there have been discussions about having automated devices that receive prescriptions. Currently, the statute 338.095 is phrased as “it shall be an unauthorized practice of pharmacy and hence unlawful for any person other than the patient or the patient’s authorized representative to accept a prescription presented to be dispensed unless that person is located on a premises licensed by the board as a pharmacy.”1 Many ideas were discussed on how to move forward with this technology. California has implemented these automated prescription self-service devices with specific requirements for each device.3 Some of these requirements include, it can only be used for refill prescriptions, the device can identify the patient and only release the prescription to that specific patient, and has a telephone to talk with a pharmacy if necessary.3

7.)   Patient Safety Working Group:

The Board wanted to review the patient safety working group recommendations.1 “In 2013, the Missouri Board of Pharmacy initiated a statewide patient safety campaign entitled ‘MoSafeRx.’”1 In order to make this program work the Board created the patient safety working group and they defined what patient safety actually meant.1 Patient safety is defined as “the prevention and reduction of unnecessary harm caused by or associated with healthcare/pharmaceutical care.”1 The recommendation topics the working group determined were enhancing communication among healthcare professionals, enhancing communication among regulatory agencies, pharmacy technician training, quality assurance, scope of practice, and education and outreach.1

8.)   Revenue Sharing Agreements:

The Board presented with this question “Should the Board amend Missouri law to address prescription revenue sharing agreements between pharmacists and prescribers?”1

9.)   Drug Quality and Security Act:

The Board is concerned with implementation and has multiple questions to go along with this topic.1 These questions included 1

  • “How does the Board want to license outsourcers?”
  • “How does the Board want to license 3PLs?”
  • “Should we establish different inspection standards for outsourcers?”
  • “Can an outsourcer/pharmacy share the same space?”
  • “Discipline for compliance with federal requirements?”

10.) Sharing Pharmacy Space:

The Board presented with this question “Should the Board address sharing of pharmacy space with other healthcare providers [and] can a pharmacy store drugs for other healthcare providers?”1 This topic was brought up with the main concern of healthcare professionals storing medications in a pharmacy. An example mentioned at the meeting is when nurses store vaccines in a refrigerator in the pharmacy. The concern is should this be allowed and who accepts the responsibility of those particular drugs. The Board plans to look further into how to handle these situations.

Overall, I am glad I got the chance to attend a Missouri Board of Pharmacy meeting. It was a great experience and I was able to better understand the process of how rules and regulations get decided. I suggest that if you have the chance to attend a meeting to give it a whirl. The next Missouri Board of Pharmacy meeting will be held on October 16, 2014.4

Ashley Buehler
UMKC School of Pharmacy at MU
PharmD Candidate 2015
MPA Rotation Student, July 2014

Resources

1Revised meeting notice Missouri board of pharmacy. (2014, July 14). Retrieved from http://pr.mo.gov/boards/pharmacy/meetings/2014-07-15.pdf

24729-5-16 Labeling of drugs dispensed on prescription. (n.d.). Retrieved from http://codes.ohio.gov/oac/4729-5-16

3Board of pharmacy initial statement of reasons. (n.d.). Retrieved from http://www.pharmacy.ca.gov/laws_regs/1713_reasons.pdf

4Meeting information. (n.d.). Retrieved from http://pr.mo.gov/pharmacists-meetings.asp

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