338.010. Practice of pharmacy defined--auxiliary personnel--written protocol required, when--nonprescription drugs--rulemaking authority--therapeutic plan requirements.
Practice of pharmacy defined--auxiliary personnel--written protocolrequired, when--nonprescription drugs--rulemakingauthority--therapeutic plan requirements.
338.010. 1. The "practice of pharmacy" means the interpretation,implementation, and evaluation of medical prescription orders, includingreceipt, transmission, or handling of such orders or facilitating thedispensing of such orders; the designing, initiating, implementing, andmonitoring of a medication therapeutic plan as defined by the prescriptionorder so long as the prescription order is specific to each patient forcare by a pharmacist; the compounding, dispensing, labeling, andadministration of drugs and devices pursuant to medical prescription ordersand administration of viral influenza, pneumonia, shingles and meningitisvaccines by written protocol authorized by a physician for persons twelveyears of age or older as authorized by rule or the administration ofpneumonia, shingles, and meningitis vaccines by written protocol authorizedby a physician for a specific patient as authorized by rule; theparticipation in drug selection according to state law and participation indrug utilization reviews; the proper and safe storage of drugs and devicesand the maintenance of proper records thereof; consultation with patientsand other health care practitioners about the safe and effective use ofdrugs and devices; and the offering or performing of those acts, services,operations, or transactions necessary in the conduct, operation, managementand control of a pharmacy. No person shall engage in the practice ofpharmacy unless he is licensed under the provisions of this chapter. Thischapter shall not be construed to prohibit the use of auxiliary personnelunder the direct supervision of a pharmacist from assisting the pharmacistin any of his duties. This assistance in no way is intended to relieve thepharmacist from his responsibilities for compliance with this chapter andhe will be responsible for the actions of the auxiliary personnel acting inhis assistance. This chapter shall also not be construed to prohibit orinterfere with any legally registered practitioner of medicine, dentistry,podiatry, or veterinary medicine, or the practice of optometry inaccordance with and as provided in sections 195.070 and 336.220, RSMo, inthe compounding or dispensing of his own prescriptions.
2. Any pharmacist who accepts a prescription order for a medicationtherapeutic plan shall have a written protocol from the physician whorefers the patient for medication therapy services. The written protocoland the prescription order for a medication therapeutic plan shall comefrom the physician only, and shall not come from a nurse engaged in acollaborative practice arrangement under section 334.104, RSMo, or from aphysician assistant engaged in a supervision agreement under section334.735, RSMo.
3. Nothing in this section shall be construed as to prevent anyperson, firm or corporation from owning a pharmacy regulated by sections338.210 to 338.315, provided that a licensed pharmacist is in charge ofsuch pharmacy.
4. Nothing in this section shall be construed to apply to orinterfere with the sale of nonprescription drugs and the ordinary householdremedies and such drugs or medicines as are normally sold by those engagedin the sale of general merchandise.
5. No health carrier as defined in chapter 376, RSMo, shall requireany physician with which they contract to enter into a written protocolwith a pharmacist for medication therapeutic services.
6. This section shall not be construed to allow a pharmacist todiagnose or independently prescribe pharmaceuticals.
7. The state board of registration for the healing arts, undersection 334.125, RSMo, and the state board of pharmacy, under section338.140, shall jointly promulgate rules regulating the use of protocols forprescription orders for medication therapy services and administration ofviral influenza vaccines. Such rules shall require protocols to includeprovisions allowing for timely communication between the pharmacist and thereferring physician, and any other patient protection provisions deemedappropriate by both boards. In order to take effect, such rules shall beapproved by a majority vote of a quorum of each board. Neither boardshall separately promulgate rules regulating the use of protocols forprescription orders for medication therapy services and administration ofviral influenza vaccines. Any rule or portion of a rule, as that term isdefined in section 536.010, RSMo, that is created under the authoritydelegated in this section shall become effective only if it complies withand is subject to all of the provisions of chapter 536, RSMo, and, ifapplicable, section 536.028, RSMo. This section and chapter 536, RSMo, arenonseverable and if any of the powers vested with the general assemblypursuant to chapter 536, RSMo, to review, to delay the effective date, orto disapprove and annul a rule are subsequently held unconstitutional, thenthe grant of rulemaking authority and any rule proposed or adopted afterAugust 28, 2007, shall be invalid and void.
8. The state board of pharmacy may grant a certificate of medicationtherapeutic plan authority to a licensed pharmacist who submits proof ofsuccessful completion of a board-approved course of academic clinical studybeyond a bachelor of science in pharmacy, including but not limited toclinical assessment skills, from a nationally accredited college oruniversity, or a certification of equivalence issued by a nationallyrecognized professional organization and approved by the board of pharmacy.
9. Any pharmacist who has received a certificate of medicationtherapeutic plan authority may engage in the designing, initiating,implementing, and monitoring of a medication therapeutic plan as defined bya prescription order from a physician that is specific to each patient forcare by a pharmacist.
10. Nothing in this section shall be construed to allow a pharmacistto make a therapeutic substitution of a pharmaceutical prescribed by aphysician unless authorized by the written protocol or the physician'sprescription order.
(RSMo 1939 § 10005, A.L. 1951 p. 737, A.L. 1989 S.B. 39, A.L. 1990 H.B. 1287, A.L. 2007 S.B. 195, A.L. 2009 S.B. 296)Prior revisions: 1929 § 13140; 1919 § 4712; 1909 § 5764
(2006) Definition of "practice of pharmacy" does not include retail sale of veterinary prescription drugs used for treating animals. United Pharmacal Co. v. Missouri Board of Pharmacy, 208 S.W.3d 907 (Mo.banc).