65.2-603.1 - Use of therapeutically equivalent drug products required.
§ 65.2-603.1. Use of therapeutically equivalent drug products required.
A. As used in this section, "therapeutically equivalent drug products"means drug products that (i) contain the same active ingredients, (ii) areidentical in strength or concentration, dosage form, and route ofadministration, and (iii) are classified as being therapeutically equivalentby the U.S. Food and Drug Administration pursuant to the definition of"therapeutically equivalent drug products" set forth in the most recentedition of Approved Drug Products with Therapeutic Equivalence Evaluations,known as the Orange Book.
B. Notwithstanding the provisions of § 54.1-3408.03, and except as providedin subsection C, any pharmacist filling a prescription for medication for aworkers' compensation claimant shall dispense a therapeutically equivalentdrug product for the prescribed name-brand drug product. If a therapeuticallyequivalent drug product does not exist or the usual and customary retailprice charged by the pharmacist for the therapeutically equivalent drugproduct is higher than that of the prescribed name-brand drug product, thepharmacist shall dispense the prescribed name-brand drug product.
C. A prescriber may specify on the prescription "brand medically necessary"if there is a medical reason why the claimant should not have theprescription filled with a therapeutically equivalent drug product. A requestby the claimant that a name-brand drug product be prescribed shall notconstitute a sufficient reason under this section for the prescriber tospecify "brand medically necessary" on the prescription. If the prescriberspecifies on the prescription "brand medically necessary," the pharmacistshall fill the prescription with the name-brand drug product prescribed. Ifthe prescriber calls the prescription in to the pharmacy by telephone andverbally tells the pharmacist "brand medically necessary," the pharmacistshall note on the prescription that the prescriber stated "brand medicallynecessary" and then fill the prescription with the name-brand drug productprescribed. The cost of any medication prescribed by any authorized treatingphysician and covered pursuant to this section to treat injuries or diseasesthat result from a compensable claim shall not be the responsibility of theclaimant unless the claimant obtained the prescription through fraud.
D. An act in compliance with the provisions of this section shall not bedeemed to be a prohibited act under § 54.1-3457.
(2009, cc. 333, 559.)