Preparing for Major Changes to Prescribing Laws

Exerpted from October 2004 Action Report

Due to recent changes in the law (SB 151, Chapter 406), California's longstanding requirement for state-issued triplicate prescription forms for Schedule II controlled substances was repealed.

In place of the triplicate, prescribers will use a tamper-resistant prescription pad available from private printing companies that have been approved by the Board of Pharmacy and the Department of Justice (DOJ).

This is a reminder that effective January 1, 2005:

• Triplicate prescriptions are no longer valid.
• All written controlled substance prescriptions must be on controlled substance prescription forms. (Note: Oral and fax orders for Schedules III-V are still permitted.)
• Prescribers dispensing Schedule III controlled substances must report those prescriptions to the Department of Justice. (Effective July 1, 2004, prescribers were required to report Schedule II controlled substances prescriptions to DOJ.)

The board has been advised that the state exhausted its supply of triplicate prescription forms earlier than anticipated.

Physicians who run out of triplicates will be able to use an "emergency fill" exemption to write prescriptions for controlled substances.

The Department of Justice recommends that affected physicians invoke the emergency prescription statute (Health and Safety Code section 11167), which permits the use of regular, non-secure prescription forms for Schedule II prescriptions in "an emergency where failure to issue a prescription may result in the loss of life or intense suffering."

To do this, physicians simply write "11167 exemption" on the regular prescription form and submit it to a pharmacy.

The Medical Board strongly urges physicians to make arrangements with an approved security printer to obtain the new tamper-resistant prescription pads as soon as possible. For a current list of approved security printers, go to the Board of Pharmacy Web site at www.pharmacy.ca.gov.

The board has received several calls from physicians who are concerned with the high cost of the new prescription forms being charged by the approved security printers.

Prior to SB 151 becoming law, the Board of Pharmacy diligently researched the printing costs associated with the new forms.

Printers indicated at that time that the prescriptions could be profitably printed for between 3 and 5 cents per prescription for an ordinary script (different sizes or multiple copy forms would increase costs).

The triplicate prescriptions cost about 7 cents per script now, but that does not accurately reflect their costs since the real costs are much higher and the Department of Justice has been subsidizing the expense voluntarily. As more major printing companies enter the market, prices are expected to fall.