Mail-order Law question

[Pharmer241]

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Ok, so I hope someone on here can help me.
Basically I am trying to find the answer to a question that I thought would be a lot easier to find.　

In regards to mail-order pharmacies, what dispensing laws do they have to follow?　 Is it the state they are dispensing from, or the state they are dispensing to?　 I read through the Illinois Pharmacy Practice Act and I read the section about mail-order pharmacy and while it talks about getting a "Nonresident special pharmacy registration" it does not go into detail about what that entails.　 Specifically I am looking into generic dispensing laws, and whether mail-order pharmacies not located in Illinois have to follow our laws, or the law of the state they are dispensing from.
　
Anyone have any thoughts? Or where I should be looking, other than hoping to get a response back from the state board?

Thanks​

 

[Pojman]

I dont know much about mail order law... But, I bet that ImmunoPharmD can tell you a thing or two about mail order brides.

 

[All4MyDaughter]

I think it's generally the laws of the state in which they are located and the laws of the state to which they are shipping. This may not be true of every state. I know that mail order companies that ship into my home state must have their PIC licensed here.

 

[Pharmer241]

I think it's generally the laws of the state in which they are located and the laws of the state to which they are shipping. This may not be true of every state. I know that mail order companies that ship into my home state must have their PIC licensed here.

But what state's laws override the other? In relation to my question about Synthroid substitution, lets say the mail order pharmacy is located in South Carolina (which doesn't allow automatic substitution of Synthroid) to Illinois (which does) and a prescription comes in for Synthroid with now indication of a DAW

 

[genesis09]

To do a DAW in IL, you have to check the no substitution box. If they do not, then even if they write in the body of script, DAW, you can still substitute.

 

[Ackj]

They don't follow OBRA '90, that's for sure.

 

[MountainPharmD]

They don't follow OBRA '90, that's for sure.

Yes they do. OBRA 90 does not mandate or require face to face counseling. It requires patient counseling be made available. Mail order pharmacies supply a 1-800 number the patient can call if they have questions which is OBRA 90 compliant. I would argue a patient has a much better chance of getting real counseling through mail order than they do at your local prescription factory CVS or Walgreens.

 

[Ackj]

Yes they do. OBRA 90 does not mandate or require face to face counseling. It requires patient counseling be made available. Mail order pharmacies supply a 1-800 number the patient can call if they have questions which is OBRA 90 compliant. I would argue a patient has a much better chance of getting real counseling through mail order than they do at your local prescription factory CVS or Walgreens.

Why don't brick and mortars adopt that option then? Ring up at the register, and get the patient out of there. Call the 1800 number on the pamphlet if you have a question, if not, see you next refill. Of course the problem is that patients don't know what they don't know.

 

[Wheresmyaricept]

To do a DAW in IL, you have to check the no substitution box. If they do not, then even if they write in the body of script, DAW, you can still substitute.

There really should be a federal law on this because it varies so greatly from state to state. In my state, in order to fill for DAW, it needs to be written "brand name medically necessary" in the doctor's own handwriting. We get scripts from out of state that have a do not substitute box checked, but we can't accept that. I would like to think the reverse happens at mail order facilities. But I think universal prescribing laws would be helpful, now that mail order facilities are usually out of state and would help answer the OP's question.

 

[fattunesy]

Why don't brick and mortars adopt that option then? Ring up at the register, and get the patient out of there. Call the 1800 number on the pamphlet if you have a question, if not, see you next refill. Of course the problem is that patients don't know what they don't know.

They are. That is one of the concepts behind the Power concept at Walgreens. Prescriptions are mainly filled offsite and shipped tot he store, or for on site prescriptions t tech enters a script, it is verified remotely, it is filled by a tech, the filled prescription is shown to a camera, it is verified remotely, patient receives medication and is told if they have questions they can use the phone available. Some states have requirements that a pharmacist must be present, so this wouldn't work, but some states do not.

After some of Power's failures the next iteration is the Wellness Store, where a pharmacist sits at a desk with an iPad to consult people and help them make OTC choices, occasionally helping out in the pharmacy directly if ti gets very busy. Of course this means fewer pharmacist hours are necessary to provide "coverage" but that is just happy bonus! (/s) When the most expensive part of a pharmacy is the pharmacist, the chains will do what they can to lower their biggest expenses.