1. Except as otherwise provided in this section, if a practitioner has prescribed a:
(a) Drug by brand name and the practitioner has not indicated, by a method set forth in subsection 5, that a substitution is prohibited, the pharmacist who fills or refills the prescription shall dispense, in substitution, another drug which is available to him or her if the other drug:
(1) Is less expensive than the drug prescribed by brand name;
(2) Is biologically equivalent to the drug prescribed by brand name;
(3) Has the same active ingredient or ingredients of the same strength, quantity and form of dosage as the drug prescribed by brand name; and
(4) Is of the same generic type as the drug prescribed by brand name.
(b) Biological product and the practitioner has not indicated, by a method set forth in subsection 5, that a substitution is prohibited, the pharmacist who fills or refills the prescription shall dispense, in substitution, another biological product which is available to him or her if the other biological product:
(1) Is an interchangeable biological product for the biological product prescribed; and
(2) Is less expensive than the biological product prescribed by brand name.
2. If the pharmacist has available to him or her more than one drug or interchangeable biological product that may be substituted for the drug prescribed by brand name or biological product prescribed, the pharmacist shall dispense, in substitution, the least expensive of the drugs or interchangeable biological products that are available to him or her for substitution.
3. Before a pharmacist dispenses a drug or biological product in substitution for a drug prescribed by brand name or biological product prescribed, the pharmacist shall:
(a) Advise the person who presents the prescription that the pharmacist intends to dispense a drug or biological product in substitution; and
(b) Advise the person that he or she may refuse to accept the drug or biological product that the pharmacist intends to dispense in substitution, unless the pharmacist is being paid for the drug by a governmental agency.
4. If a person refuses to accept the drug or biological product that the pharmacist intends to dispense in substitution, the pharmacist shall dispense the drug prescribed by brand name or biological product prescribed, unless the pharmacist is being paid for the drug or biological product by a governmental agency, in which case the pharmacist shall dispense the drug or biological product in substitution.
5. A pharmacist shall not dispense a drug or biological product in substitution for a drug prescribed by brand name or biological product prescribed if the practitioner has indicated that a substitution is prohibited using one or more of the following methods:
(a) By oral communication to the pharmacist at any time before the drug or biological product is dispensed.
(b) By handwriting the words "Dispense as Written" on the form used for the prescription, including, without limitation, any form used for transmitting the prescription from a facsimile machine to another facsimile machine. The pharmacist shall disregard the words "Dispense as Written" if they have been placed on the form used for the prescription by preprinting or other mechanical process or by any method other than handwriting.
(c) By including the words "Dispense as Written" in any prescription that is given to the pharmacist by electronic transmission pursuant to NRS 639.23535 and the regulations of the Board or in accordance with NRS 439.581 to 439.595, inclusive, and the regulations adopted pursuant thereto, including, without limitation, an electronic transmission from a computer equipped with a facsimile modem to a facsimile machine or from a computer to another computer pursuant to the regulations of the Board.
6. The provisions of this section also apply to a prescription issued to a person by a practitioner from outside this State if the practitioner has not indicated, by a method set forth in subsection 5, that a substitution is prohibited.
7. The provisions of this section do not apply to:
(a) A prescription drug or biological product that is dispensed to any inpatient of a hospital by an inpatient pharmacy which is associated with that hospital;
(b) A prescription drug that is dispensed to any person by mail order or other common carrier by an Internet pharmacy which is certified by the Board pursuant to NRS 639.23288 and authorized to provide service by mail order or other common carrier pursuant to the provisions of this chapter; or
(c) A prescription drug or biological product that is dispensed to any person by a pharmacist if the substitution:
(1) Would violate the terms of a health care plan that maintains a mandatory, exclusive or closed formulary for its coverage for prescription drugs and biological products; or
(2) Would otherwise make the transaction ineligible for reimbursement by a third party.
(Added to NRS by 1979, 1348; A 1981, 393, 1374; 1985, 2005; 2003, 1213; 2011, 1764; 2017, 634; 2019, 2211)
Structure Nevada Revised Statutes
Chapter 639 - Pharmacists and Pharmacy
NRS 639.0015 - "Advanced practice registered nurse" defined.
NRS 639.0017 - "Biological product" defined.
NRS 639.002 - "Board" defined.
NRS 639.003 - "Certificate" defined.
NRS 639.004 - "Chart order" defined.
NRS 639.005 - "Chemical" defined.
NRS 639.0051 - "Collaborative drug therapy management" defined.
NRS 639.0052 - "Collaborative practice agreement" defined.
NRS 639.00525 - "Collaborative practice of pharmacy" defined.
NRS 639.0053 - "Compound" and "compounding" defined.
NRS 639.006 - "Conviction" defined.
NRS 639.0061 - "Course of treatment" defined.
NRS 639.0065 - "Dispense" defined.
NRS 639.007 - "Drug" and "medicine" defined.
NRS 639.0071 - "Drug sample" defined.
NRS 639.0073 - "Fill" defined.
NRS 639.0074 - "Hospital" defined.
NRS 639.008 - "Hypodermics" defined.
NRS 639.0082 - "Initial prescription" defined.
NRS 639.0085 - "Institutional pharmacy" defined.
NRS 639.00855 - "Interchangeable biological product" defined.
NRS 639.0086 - "Intern pharmacist" defined.
NRS 639.00865 - "Internet pharmacy" defined.
NRS 639.0087 - "Managing pharmacist" defined.
NRS 639.009 - "Manufacturer" defined.
NRS 639.0095 - "Nuclear pharmacist" defined.
NRS 639.0097 - "Nuclear pharmacy" defined.
NRS 639.0105 - "Parenteral solutions" and "parenterals" defined.
NRS 639.0113 - "Pharmaceutical technician" defined.
NRS 639.0115 - "Pharmaceutical technician in training" defined.
NRS 639.012 - "Pharmacy" defined.
NRS 639.0123 - "Pharmacy in a correctional institution" defined.
NRS 639.0125 - "Practitioner" defined.
NRS 639.013 - "Prescription" defined.
NRS 639.0143 - "Radiopharmaceutical" defined.
NRS 639.0144 - "Recovery center" defined.
NRS 639.0145 - "Refill" defined.
NRS 639.015 - "Registered pharmacist" defined.
NRS 639.0151 - "Remote site" defined.
NRS 639.0153 - "Satellite consultation site" defined.
NRS 639.01531 - "Self-administered hormonal contraceptive" defined. [Effective January 1, 2022.]
NRS 639.01535 - "Telehealth" defined.
NRS 639.0154 - "Telepharmacy" defined.
NRS 639.0155 - "Wholesale distribution" defined.
NRS 639.016 - "Wholesaler" defined.
NRS 639.018 - Inapplicability of chapter to certain veterinary biologic products.
NRS 639.020 - Creation; number and appointment of members.
NRS 639.030 - Qualification and terms of members; oath; vacancies; grounds for removal from office.
NRS 639.060 - Biennial report to Governor.
NRS 639.065 - Annual report concerning immunizations administered by pharmacists.
NRS 639.067 - Posting of information relating to pharmaceutical manufacturers on website.
NRS 639.070 - General powers; regulations.
NRS 639.071 - Regulations: Institutional pharmacies.
NRS 639.072 - Regulations: Pharmacies in correctional institutions.
NRS 639.0725 - Regulations: Internet pharmacies.
NRS 639.0747 - Regulations: Registered pharmacists collecting specimens.
NRS 639.090 - Enforcement of chapter; inspections.
NRS 639.093 - Communication with other public agencies; immunity.
NRS 639.095 - Board to furnish free copies of law and regulations to applicants and registrants.
NRS 639.097 - Injunctive relief.
NRS 639.120 - Qualifications of applicants to become registered pharmacists.
NRS 639.134 - Registration of pharmacist without examination; reciprocity.
NRS 639.138 - Denial of application: Notice.
NRS 639.139 - Denial of application: Procedure for reconsideration.
NRS 639.150 - Display of certificates, licenses and permits; regulations.
NRS 639.160 - Notice of new place of practice.
NRS 639.170 - Fees; costs of special meetings; regulations.
NRS 639.190 - Issuance of certificate of registration as pharmacist after forfeiture.
NRS 639.200 - Issuance of duplicate certificates and receipts for renewal.
NRS 639.211 - Mental illness: Immediate suspension of right to practice.
NRS 639.213 - Legislative declaration.
NRS 639.2171 - Legislative findings and declaration.
NRS 639.2177 - License; regulations.
NRS 639.231 - Application for and issuance of license.
NRS 639.232 - Limitations on issuance of licenses.
NRS 639.2324 - Institutional pharmacies: Requirements for operation.
NRS 639.2327 - Maintenance of stocks of drugs by certain facilities.
NRS 639.23277 - Remote sites and satellite consultation sites: Location; operation; regulations.
NRS 639.23286 - Pharmacy located outside Nevada: Substitution of drug; toll-free telephone service.
NRS 639.233 - License required.
NRS 639.2345 - Sale of veterinary drugs: Permit required; regulations; exemption.
NRS 639.2355 - Practitioner liable for prescription orally transmitted by agent.
NRS 639.236 - Numbering, filing and retention of prescriptions; inspection of files; regulations.
NRS 639.2392 - Controlled substance or dangerous drug: Records.
NRS 639.2393 - Controlled substance or dangerous drug: Limitations.
NRS 639.2394 - Controlled substance or dangerous drug: Exercise of judgment by pharmacist.
NRS 639.2395 - Early refills for topical ophthalmic products authorized under certain circumstances.
NRS 639.2396 - Specific authorization; limitations.
NRS 639.2397 - Rescission of authorization.
NRS 639.241 - Accusation: Form, contents and signature.
NRS 639.243 - Statement to Respondent: Contents.
NRS 639.244 - Notice of Defense: Form; effect of failure to file.
NRS 639.245 - Notice of hearing.
NRS 639.246 - Subpoenas; payment of witness fees and expenses.
NRS 639.247 - Hearing: Procedure.
NRS 639.248 - Hearing: Use of hearsay evidence.
NRS 639.251 - Decision; order.
NRS 639.253 - Order following rehearing.
NRS 639.2535 - Judicial review.
NRS 639.2565 - Reinstatement of suspended certificate.
NRS 639.257 - Reinstatement of revoked certificate, license or permit.
NRS 639.2576 - Immunity from civil action for assisting administrative proceeding.
NRS 639.258 - Filing of complaint.
NRS 639.2583 - General requirements governing substitution; procedure; limitations; exceptions.
NRS 639.2595 - Liability of pharmacist or practitioner.
NRS 639.2597 - Use of list of biologically equivalent drugs or interchangeable biological products.
NRS 639.263 - False or misleading advertising.
NRS 639.264 - Prohibition against unearned rebate, refund or other consideration for referrals.
NRS 639.265 - Pharmacists may trade or exchange drugs if necessary for business.
NRS 639.266 - Communication of information to patient or person caring for patient.
NRS 639.275 - Computer or other electronic device provided to practitioner by pharmacy or insurer.
NRS 639.2801 - Requirements for labeling containers for prescribed drugs.
NRS 639.2802 - Availability of information concerning prices of prescriptions.
NRS 639.2803 - Dispensing specific drugs when choice of drugs available.
NRS 639.2804 - Filling prescriptions for amygdalin and procaine hydrochloride.
NRS 639.2806 - Parenteral solutions: Limitation on sale and dispensing.
NRS 639.2807 - Parenteral solutions: Compounding, packaging and labeling; regulations.
NRS 639.281 - False representations.
NRS 639.2815 - Fraudulent or excessive charge or claim under program of public assistance; penalty.
NRS 639.2825 - Unlawful to sell, furnish or fit contact lens; exception.
NRS 639.284 - Unlawful dispensing and sales; penalties.
NRS 639.2845 - Selling or dispensing of procaine hydrochloride.
NRS 639.285 - Unlawful sales by unlicensed persons; penalties.
NRS 639.286 - Violation of Board’s regulations.
NRS 639.288 - Unlawful sales by wholesalers and manufacturers.
NRS 639.289 - Inspection of premises by Board.
NRS 639.2893 - Practicing or offering to practice without license: Reporting requirements of Board.
NRS 639.2895 - Practicing or offering to practice without license: Penalties.
NRS 639.300 - Recovery of penalties; conduct of actions and prosecutions by district attorney.
NRS 639.310 - Criminal penalty.
NRS 639.400 - "Product that is a precursor to methamphetamine" defined.
NRS 639.410 - Sales of products that are precursors to methamphetamine.
NRS 639.430 - Real-time, stop sale system: Conditions for approval; regulations.
NRS 639.510 - Protection of certain information obtained by Board.
NRS 639.515 - Bond or other form of security required; exceptions.
NRS 639.535 - Statement of prior sales" or "statement" defined.
NRS 639.540 - Duties of Board; requirements concerning use, form and contents of statement.
NRS 639.545 - Prohibited transactions.
NRS 639.555 - Additional unlawful acts.
NRS 639.575 - Information regarding other wholesalers.
NRS 639.580 - Evidence regarding due diligence; prohibited business relationships.
NRS 639.585 - On-site inspections; agreements with other wholesalers.