Authorizes pharmacists to perform collaborative drug therapy management with physicians in certain settings

Summary of specific provisions

Section 1 amends section 6801 of the education law to expand the practice of pharmacy to include collaborative drug therapy management.

Section 2 adds a new section 6801-a to the education law creating a demonstration program to authorize the collaborative management of drug therapy by pharmacists. Under this ·new section, pharmacists working in certain licensed health care facilities (teaching hospitals, including diagnostic centers, treatment centers of hospital-based out-patient departments) would be authorized to review, evaluate and modify drug therapy in accordance with a written agreement or protocol with a physician. Such agreement or protocol shall be consistent with the policies of the facility in which the physician and pharmacist practice. In order to undertake collaborative drug therapy management, pharmacists would be permitted to modify and manage drug regimens, order and evaluate clinical laboratory tests related to the management of drug therapy, and order or perform other routine patient monitoring functions consistent with and pursuant to these written agreements or protocols. Physicians who enter into these written agreements or protocols with pharmacists would be employed by or affiliated with the same health care entity with which the pharmacists are employed or affiliated.

Participation in collaborative drug therapy management agreements or protocols would be voluntary for the physician, pharmacist and facility. The patient or such patient's authorized representative has the right to choose not to participate in such protocols or agreements. If the patient or authorized representative consents, it shall be noted on the patient's medical record and shall also be disclosed to the patient's primary physician or nurse practitioner. Additionally, if the patient or the patient's authorized representative chooses to no longer participate in such management, at any time, it shall be noted on the patient's medical record.

Section 3 amends subdivision 2 of section 6827 of the education law to require pharmacists participating in collaborative drug therapy management to complete at least five hours of acceptable formal continuing education in the area of collaborative drug therapy management protocols.

Section 4 requires the state education department, in consultation with the health department, to prepare or arrange for the preparation

of a report on the implementation of collaborative drug therapy management (CDTM) in the state and shall make recommendations regarding extension, alteration and/or expansion of this demonstration program.

Section 5 establishes the effective date which is 120 days after it shall have become a law and shall expire 3 years after such effective date.

Justification

Adverse drug reactions or adverse drug events (ADR;s or ADE's) are now reported to be the fourth leading cause of death in the United State, behind only heart disease, cancer and stroke. In 1995, it was estimated that ADR's caused 106,000 deaths per year. The most updated information on ADR's suggests that these earlier estimates may actually understate the problem. A recent comprehensive study of medication errors estimated that as many as 2.7 million medication errors Occur each year in American hospitals, adversely affecting 130,000 patients. Studies have shown that at least 28% of these errors were preventable. Nearly half of the errors made were the result of errors in the prescribing process.

These errors are not only potentially dangerous to patients, they are extremely costly to the health care system, resulting in additional and unnecessary expenditures of as much as $177 billion per year. Of this amount, seventy percent was attributed to unnecessary hospital admissions or prolonged hospital stays due to medication errors.

Moreover, pharmacist-provided drug information services, adverse drug reaction monitoring, drug protocol management and medical rounds participation by pharmacists has shown to make a statistically significant contribution to the reduction of medication errors. Each of these components can only fully take place in New York State with the enactment of this legislation. Currently 43 other states allow pharmacists to engage in collaborative drug therapy management protocols and agreements.

Prior legislative history

2007-08 A.3933-B/S.2426-B Referred to Higher Education/Passed Senate 2005-06 A.5891 Reported to Codes/Senate Rules 2003-04 A.5579-A Referred to Higher Education

Fiscal implications

Given the high costs associated with medication errors, this bill will result in significant savings in health care expenditures, including reducing Medicaid costs, Child Health Plus and Family Health Plus expenditures for New York State.

Effective date

120 days after it shall have become a law and shall expire 3 years after such effective date.