| 1 | A bill to be entitled |
| 2 | An act relating to pedigree papers; amending s. 499.003, |
| 3 | F.S.; clarifying that a pedigree paper may be in paper or |
| 4 | electronic form; revising the record requirements for |
| 5 | pedigree papers; amending s. 499.0121, F.S.; removing the |
| 6 | expiration dates of certain provisions relating to the |
| 7 | establishment and maintenance of prescription drug |
| 8 | distribution records; providing an effective date. |
| 9 |
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| 10 | Be It Enacted by the Legislature of the State of Florida: |
| 11 |
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| 12 | Section 1. Paragraph (b) of subsection (31) of section |
| 13 | 499.003, Florida Statutes, is amended to read: |
| 14 | 499.003 Definitions of terms used in ss. 499.001- |
| 15 | 499.081.--As used in ss. 499.001-499.081, the term: |
| 16 | (31) "Pedigree paper" means: |
| 17 | (b) Effective July 1, 2006, a document in a paper or |
| 18 | electronic form approved by the Department of Health and |
| 19 | containing information that records each distribution of any |
| 20 | given legend drug, from sale by a pharmaceutical manufacturer, |
| 21 | through acquisition and sale by any wholesaler or repackager, |
| 22 | until final sale to a pharmacy or other person administering or |
| 23 | dispensing the drug. The information required to be included on |
| 24 | a legend drug's pedigree paper must at least detail the amount |
| 25 | of the legend drug, its dosage form and strength, its lot |
| 26 | numbers, the name and address of each owner of the legend drug |
| 27 | and his or her signature, its shipping information, including |
| 28 | the name and address of each person certifying delivery or |
| 29 | receipt of the legend drug, and a certification that the |
| 30 | recipient has authenticated the pedigree papers. It must also |
| 31 | include the name, address, telephone number and, if available, |
| 32 | e-mail contact information of each wholesaler involved in the |
| 33 | chain of the legend drug's custody. The department shall adopt |
| 34 | rules and a form relating to the requirements of this paragraph |
| 35 | no later than 90 days after the effective date of this act. |
| 36 | Section 2. Paragraphs (d), (e), and (h) of subsection (6) |
| 37 | of section 499.0121, Florida Statutes, are amended to read: |
| 38 | 499.0121 Storage and handling of prescription drugs; |
| 39 | recordkeeping.--The department shall adopt rules to implement |
| 40 | this section as necessary to protect the public health, safety, |
| 41 | and welfare. Such rules shall include, but not be limited to, |
| 42 | requirements for the storage and handling of prescription drugs |
| 43 | and for the establishment and maintenance of prescription drug |
| 44 | distribution records. |
| 45 | (6) RECORDKEEPING.--The department shall adopt rules that |
| 46 | require keeping such records of prescription drugs as are |
| 47 | necessary for the protection of the public health. |
| 48 | (d)1. Each person who is engaged in the wholesale |
| 49 | distribution of a prescription drug, and who is not an |
| 50 | authorized distributor of record for the drug manufacturer's |
| 51 | products, must provide to each wholesale distributor of such |
| 52 | drug, before the sale is made to such wholesale distributor, a |
| 53 | written statement under oath identifying each previous sale of |
| 54 | the drug back to the last authorized distributor of record, the |
| 55 | lot number of the drug, and the sales invoice number of the |
| 56 | invoice evidencing the sale of the drug. The written statement |
| 57 | must accompany the drug to the next wholesale distributor. The |
| 58 | department shall adopt rules relating to the requirements of |
| 59 | this written statement. This paragraph does not apply to a |
| 60 | manufacturer unless the manufacturer is performing the |
| 61 | manufacturing operation of repackaging prescription drugs. |
| 62 | 2. Each wholesale distributor of prescription drugs must |
| 63 | maintain separate and distinct from other required records all |
| 64 | statements that are required under subparagraph 1. and paragraph |
| 65 | (e). |
| 66 | 3. Each manufacturer of a prescription drug sold in this |
| 67 | state must maintain at its corporate offices a current list of |
| 68 | authorized distributors and must make such list available to the |
| 69 | department upon request. |
| 70 | 4. Each manufacturer shall file a written list of all of |
| 71 | the manufacturer's authorized distributors of record with the |
| 72 | department. A manufacturer shall notify the department not later |
| 73 | than 10 days after any change to the list. The department shall |
| 74 | publish a list of all authorized distributors of record on its |
| 75 | website. |
| 76 | 5. For the purposes of this subsection, the term |
| 77 | "authorized distributors of record" means a wholesale |
| 78 | distributor with whom a manufacturer has established an ongoing |
| 79 | relationship to distribute the manufacturer's products. |
| 80 | Effective March 1, 2004, an ongoing relationship is deemed to |
| 81 | exist when a wholesale distributor, including any affiliated |
| 82 | group, as defined in s. 1504 of the Internal Revenue Code, of |
| 83 | which the wholesale distributor is a member: |
| 84 | a. Is listed on the manufacturer's current list of |
| 85 | authorized distributors of record. |
| 86 | b. Annually purchases not less than 90 percent of all of |
| 87 | its purchases of a manufacturer's prescription drug products, |
| 88 | based on dollar volume, directly from that manufacturer and has |
| 89 | total annual prescription drug sales of $100 million or more. |
| 90 | c. Has reported to the department pursuant to s. |
| 91 | 499.012(3)(g)2. that the wholesale distributor has total annual |
| 92 | prescription drug sales of $100 million or more, and has a |
| 93 | verifiable account number issued by the manufacturer authorizing |
| 94 | the wholesale distributor to purchase the manufacturer's drug |
| 95 | products directly from that manufacturer and that wholesale |
| 96 | distributor makes not fewer than 12 purchases of that |
| 97 | manufacturer's drug products directly from the manufacturer |
| 98 | using said verifiable account number in 12 months. The |
| 99 | provisions of this sub-subparagraph apply with respect to a |
| 100 | manufacturer that fails to file a copy of the manufacturer's |
| 101 | list of authorized distributors of record with the department by |
| 102 | July 1, 2003; that files a list of authorized distributors of |
| 103 | record which contains fewer than 10 wholesale distributors |
| 104 | permitted in this state, excluding the wholesale distributors |
| 105 | described in sub-subparagraph b.; or that, as a result of |
| 106 | changes to the list of authorized distributors of record filed |
| 107 | with the department, has fewer than 10 wholesale distributors |
| 108 | permitted in this state as authorized distributors of record, |
| 109 | excluding the wholesale distributors described in sub- |
| 110 | subparagraph b. |
| 111 |
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| 112 | A wholesale distributor that satisfies the requirements of sub- |
| 113 | subparagraph b. or sub-subparagraph c. shall submit to the |
| 114 | department documentation substantiating its qualification |
| 115 | pursuant to sub-subparagraph b. or sub-subparagraph c. The |
| 116 | department shall add those wholesale distributors that the |
| 117 | department has determined have met the requirements of sub- |
| 118 | subparagraph b. or sub-subparagraph c. to the list of authorized |
| 119 | distributors of record on the department's website. |
| 120 | 6. This paragraph expires July 1, 2006. |
| 121 | (e)1. Notwithstanding paragraph (d), each person who is |
| 122 | engaged in the wholesale distribution of a specified drug must |
| 123 | provide to each wholesale distributor of such specified drug: |
| 124 | a. Upon any sale, a written statement that: |
| 125 | (I) If the establishment is not a member of an affiliated |
| 126 | group: "This establishment purchased the specific unit of the |
| 127 | specified drug directly from the manufacturer"; or |
| 128 | (II) If the establishment is a member of an affiliated |
| 129 | group: "This establishment or a member of my affiliated group |
| 130 | purchased the specific unit of the specified drug directly from |
| 131 | the manufacturer"; or |
| 132 | b. Before the wholesale distribution, a written statement, |
| 133 | under oath, that identifies each previous sale of the specific |
| 134 | unit of the specified drug back to the manufacturer of the |
| 135 | specified drug, the lot number of the specific unit of the |
| 136 | specified prescription drug, and the sales invoice number of the |
| 137 | invoice evidencing each previous sale of the specific unit of |
| 138 | the specified drug. The written statement identifying all sales |
| 139 | of such specific unit of the specified drug must accompany the |
| 140 | specific unit of the specified drug for each subsequent |
| 141 | wholesale distribution of the specific unit of the specified |
| 142 | drug to a wholesale distributor. |
| 143 |
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| 144 | The department shall adopt rules to administer the requirements |
| 145 | of these written statements. |
| 146 | 2. As used in this paragraph, the term "specified drug" |
| 147 | means a specific prescription drug on the list of drugs adopted |
| 148 | by the department by rule. |
| 149 | 3.a. A drug may be placed on the list of specified drugs |
| 150 | if the department has seized or issued a stop sale notice on the |
| 151 | prescription drug because of the adulteration, counterfeiting, |
| 152 | or diversion of the prescription drug from the legal channels of |
| 153 | distribution for prescription drugs, or the United States Food |
| 154 | and Drug Administration, a manufacturer, a wholesale |
| 155 | distributor, a law enforcement agency, or a government agency |
| 156 | responsible for regulating the sale or distribution of |
| 157 | prescription drugs in another state has notified the department |
| 158 | in writing or through a website operated by one of said entities |
| 159 | that the prescription drug has been adulterated, counterfeited, |
| 160 | or diverted from the legal channels of distribution for |
| 161 | prescription drugs; and the prescription drug satisfies one of |
| 162 | the following criteria: |
| 163 | (I) The prescription drug is included among the top 150 |
| 164 | prescription drugs for which the state has incurred the highest |
| 165 | amount of Medicaid claims in the most recently ended state |
| 166 | fiscal year; |
| 167 | (II) The prescription drug is available for normal |
| 168 | prescription use in dosages or strengths that have a wholesale |
| 169 | cost of $200 or more; |
| 170 | (III) The prescription drug is used extensively for |
| 171 | patients with human immunodeficiency virus, acquired immune |
| 172 | deficiency syndrome, cancer, or other serious, life-threatening |
| 173 | conditions, where drug nonresponsiveness would not be considered |
| 174 | to be medically unusual; |
| 175 | (IV) The prescription drug is an injectable drug; |
| 176 | (V) The prescription drug is subject to a special, limited |
| 177 | distribution process and is not generally sold to wholesale |
| 178 | distributors by the manufacturer of the prescription drug; |
| 179 | (VI) The department has found not less than five instances |
| 180 | where statements required pursuant to paragraph (d) for the |
| 181 | prescription drug were not passed on other than because of |
| 182 | unintentional oversight, or have been passed on by or to a |
| 183 | wholesale distributor and such statements were fraudulent; or |
| 184 | (VII) A shipment of a prescription drug has been reported |
| 185 | to a law enforcement agency as having been stolen or as missing. |
| 186 | b. A prescription drug may be placed on the list of |
| 187 | specified drugs if the prescription drug satisfies any three of |
| 188 | the seven criteria set forth in sub-sub-subparagraphs (I)-(VII). |
| 189 | However, a prescription drug may not be included on the list of |
| 190 | specified drugs if the prescription drug is unlikely to be |
| 191 | counterfeited or diverted from the legal channels of |
| 192 | distribution for prescription drugs. |
| 193 | c. Before the department begins the rulemaking process to |
| 194 | place a drug on the list of specified drugs, except when the |
| 195 | department files a rule under the procedure specified in sub- |
| 196 | subparagraph e., the Drug Wholesaler Advisory Council created in |
| 197 | s. 499.01211 shall consider whether a prescription drug should |
| 198 | be included on or added to the list of specified drugs using the |
| 199 | criteria enumerated in sub-subparagraph a. or sub-subparagraph |
| 200 | b. and provide a written recommendation adopted by majority vote |
| 201 | to the secretary of the department concerning each such drug. |
| 202 | This paragraph does not apply to any list of prescription drugs |
| 203 | on which the department has begun rulemaking prior to this |
| 204 | paragraph becoming law. |
| 205 | d. When a prescription drug is added to the list of |
| 206 | specified drugs, the requirements of this paragraph shall be |
| 207 | effective as to the prescription drug beginning 60 days after |
| 208 | the effective date of the rule adding the prescription drug to |
| 209 | the list, except when the department files a rule under the |
| 210 | procedure specified in sub-subparagraph e. |
| 211 | e.(I) Notwithstanding chapter 120, if the Attorney General |
| 212 | or Statewide Prosecutor certifies to the secretary of the |
| 213 | department that a prescription drug should be added to the list |
| 214 | of specified drugs by emergency rule, the department may proceed |
| 215 | to add such drug to the list of specified drugs and the |
| 216 | emergency rule shall be effective for a period of 1 year from |
| 217 | the date on which the emergency rule is filed, if the department |
| 218 | begins the rulemaking process to adopt a permanent rule to place |
| 219 | the drug on the list of specified drugs not later than 90 days |
| 220 | after the date on which the emergency rule was filed. An |
| 221 | emergency rule adding a drug to the list of specified drugs may |
| 222 | not be renewed. |
| 223 | (II) A prescription drug may be placed on the list of |
| 224 | specified drugs through the procedure provided in this sub- |
| 225 | subparagraph when: |
| 226 | (A) The prescription drug satisfies any two of the |
| 227 | criteria specified in sub-subparagraph a. or sub-subparagraph |
| 228 | b.; or |
| 229 | (B) The prescription drug satisfies any one of the |
| 230 | criteria specified in sub-subparagraph a. or sub-subparagraph b. |
| 231 | if the prescription drug has not yet become available for |
| 232 | wholesale distribution or has been available for wholesale |
| 233 | distribution for not more than 60 days. |
| 234 | (III) Notwithstanding chapter 120, any emergency rule that |
| 235 | places a prescription drug on the list of specified drugs may be |
| 236 | challenged as being an invalid exercise of the delegated |
| 237 | legislative authority only if the department lacks any |
| 238 | substantial competent evidence that the prescription drug |
| 239 | satisfied the criteria required pursuant to sub-sub-subparagraph |
| 240 | (I) or sub-sub-subparagraph (II). Not later than 7 days after |
| 241 | any request by any person, the department shall provide such |
| 242 | person with the substantial competent evidence that justifies |
| 243 | the department's adoption of an emergency rule placing a |
| 244 | prescription drug on the list of specified drugs. |
| 245 | (IV) The department shall notify all prescription drug |
| 246 | wholesalers and out-of-state prescription drug wholesalers by |
| 247 | electronic means, facsimile, or United States mail and on the |
| 248 | bureau's website when any emergency rule is adopted which places |
| 249 | a prescription drug on the list of specified drugs. Not later |
| 250 | than 7 days after the department adopts an emergency rule |
| 251 | placing a prescription drug on the list of specified drugs, |
| 252 | wholesalers shall provide the department with the lot numbers |
| 253 | and quantities of such prescription drug which the wholesaler |
| 254 | owns or has in transit on the date that the department adopted |
| 255 | the emergency rule placing the prescription drug on the list of |
| 256 | specified drugs. |
| 257 | (V) The requirements of subparagraph 1. do not apply to |
| 258 | those lot numbers and quantities of a prescription drug which |
| 259 | are included on a report filed pursuant to sub-sub-subparagraph |
| 260 | (IV), and paragraph (d) shall apply to those lot numbers and |
| 261 | quantities of the prescription drug. In addition to the |
| 262 | requirements of paragraph (d), any wholesale distributor selling |
| 263 | a prescription drug included on a report filed pursuant to sub- |
| 264 | sub-subparagraph (IV) shall provide any wholesaler purchasing |
| 265 | the prescription drugs with a statement under oath that the |
| 266 | prescription drugs are among those included on a report filed |
| 267 | pursuant to sub-sub-subparagraph (IV) and with a copy of the |
| 268 | report filed by the wholesale distributor with the department |
| 269 | for those prescription drugs. |
| 270 | f. Not less than annually, the council and department |
| 271 | shall evaluate whether each prescription drug included on the |
| 272 | list of specified drugs should remain on the list. In |
| 273 | determining whether a prescription drug should remain on the |
| 274 | list of specified drugs, the council and department must |
| 275 | consider: |
| 276 | (I) The availability of generic forms of the drug. |
| 277 | (II) Changes in the price of the drug since the |
| 278 | prescription drug was placed on the list. |
| 279 | (III) The current status of the drug that caused the |
| 280 | department to place the prescription drug on the list of |
| 281 | specified drugs. |
| 282 |
|
| 283 | The council shall provide a written recommendation adopted by |
| 284 | majority vote to the secretary of the department concerning each |
| 285 | drug that the council recommends be removed from the list of |
| 286 | specified drugs. |
| 287 | 4. This paragraph does not apply to a manufacturer; |
| 288 | however, a repackager must comply with this paragraph. |
| 289 | 5. This paragraph expires July 1, 2006. |
| 290 | (h)1. This paragraph applies only to an affiliated group, |
| 291 | as defined by s. 1504 of the Internal Revenue Code of 1986, as |
| 292 | amended, which is composed of chain drug entities, including at |
| 293 | least 50 retail pharmacies, warehouses, or repackagers, which |
| 294 | are members of the same affiliated group, if the affiliated |
| 295 | group: |
| 296 | a. Discloses to the department the names of all its |
| 297 | members; and |
| 298 | b. Agrees in writing to provide records on prescription |
| 299 | drug purchases by members of the affiliated group not later than |
| 300 | 48 hours after the department requests such records, regardless |
| 301 | of the location where the records are stored. |
| 302 | 2. Each warehouse within the affiliated group must comply |
| 303 | with all applicable federal and state drug wholesale permit |
| 304 | requirements and must purchase, receive, hold, and distribute |
| 305 | prescription drugs only to a retail pharmacy or warehouse within |
| 306 | the affiliated group. Such a warehouse is exempt from providing |
| 307 | a pedigree paper in accordance with paragraphs (d) and (e) to |
| 308 | its affiliated group member warehouse, provided that: |
| 309 | a. Any affiliated group member that purchases or receives |
| 310 | a prescription drug from outside the affiliated group must |
| 311 | receive a pedigree paper if the prescription drug is distributed |
| 312 | in or into this state and a pedigree paper is required under |
| 313 | this section and must authenticate the documentation as required |
| 314 | in subsection (4), regardless of whether the affiliated group |
| 315 | member is directly subject to regulation under this chapter; and |
| 316 | b. The affiliated group makes available to the department |
| 317 | on request all records related to the purchase or acquisition of |
| 318 | prescription drugs by members of the affiliated group, |
| 319 | regardless of the location where the records are stored, if the |
| 320 | prescription drugs were distributed in or into this state. |
| 321 | 3. If a repackager repackages prescription drugs solely |
| 322 | for distribution to its affiliated group members for the |
| 323 | exclusive distribution to and among retail pharmacies that are |
| 324 | members of the affiliated group to which the repackager is a |
| 325 | member: |
| 326 | a. The repackager must: |
| 327 | (I) In lieu of the written statement required by paragraph |
| 328 | (d) or paragraph (e), for all repackaged prescription drugs |
| 329 | distributed in or into this state, state in writing under oath |
| 330 | with each distribution of a repackaged prescription drug to an |
| 331 | affiliated group member warehouse or repackager: "All repackaged |
| 332 | prescription drugs are purchased by the affiliated group |
| 333 | directly from the manufacturer or from a prescription drug |
| 334 | wholesaler that purchased the prescription drugs directly from |
| 335 | the manufacturer."; |
| 336 | (II) Purchase all prescription drugs it repackages: |
| 337 | (A) Directly from the manufacturer; or |
| 338 | (B) From a prescription drug wholesaler that purchased the |
| 339 | prescription drugs directly from the manufacturer; and |
| 340 | (III) Maintain records in accordance with this section to |
| 341 | document that it purchased the prescription drugs directly from |
| 342 | the manufacturer or that its prescription drug wholesale |
| 343 | supplier purchased the prescription drugs directly from the |
| 344 | manufacturer. |
| 345 | b. All members of the affiliated group must provide to |
| 346 | agents of the department on request records of purchases by all |
| 347 | members of the affiliated group of prescription drugs that have |
| 348 | been repackaged, regardless of the location where the records |
| 349 | are stored or where the repackager is located. |
| 350 | 4. This paragraph expires July 1, 2006. |
| 351 | Section 3. This act shall take effect July 1, 2005. |