North Dakota § 43-15-31.7 - Therapeutic substitution

§ 43-15-31.7. Therapeutic substitution

1. A pharmacist whose practice is physically located within this state may substitute a drug for a therapeutically equivalent drug, except for antidepressants, antipsychotics, chemotherapy agents, schedule II controlled substances, biological products, and narrow therapeutic index drugs, as limited by this section. Therapeutic equivalence may be established by clinical publications comparing dosages of drugs in a therapeutic class. 2. A pharmacist may not substitute a drug for a therapeutically equivalent drug if: a. The prescriber indicates no substitution is to be made; or b. The board has determined a therapeutically equivalent drug should not be substituted and notified pharmacists of that determination. 3. Before dispensing a therapeutically equivalent drug, a pharmacist shall: a. Verbally discuss the suggested substitution with the patient, including informing the patient that the therapeutically equivalent drug does not contain the identical active ingredient present in the prescribed drug and any differences in dosage and frequency between the prescribed drug and the therapeutically equivalent drug; b. Inform the patient of the patient's right to refuse the substitution; and c. Determine whether the substitution would provide a cost benefit to the patient or provide access if the prescribed drug is not available. 4. The pharmacist shall send notice of the substitution to the prescriber by electronic communication within twenty-four hours of dispensing the drug to the patient. 5. The prescribing provider is not liable for a substitution made by a pharmacist under this section.