Section 639.Sec. 4.1 - NEW1. The protocol prescribed pursuant to section 2.5 of Senate Bill No. 190, chapter 504, Statutes of Nevada 2021, at page 3268 (NRS 639.28077), consists of compliance with subsections 2 to 8, inclusive.2. Before initially dispensing a self-administered hormonal contraceptive to a patient under the protocol, a pharmacist must:(a) Provide the patient with the risk assessment questionnaire prescribed in section 5 in accordance with subsection 2 of section 3 of Senate Bill No. 190, chapter 504, Statutes of Nevada 2021, at page 3269 (NRS 639.28078), and, if the patient completes the questionnaire, discuss the results of the questionnaire with the patient; and(b) Utilize a treatment algorithm to determine whether it is safe to dispense a selfadministered hormonal contraceptive to the patient. The treatment algorithm must include, without limitation:(1) Training and education of the patient concerning the self-administered hormonal contraceptive and possible alternatives to the self-administered hormonal contraceptive;(2) Assessing any risks to the patient posed by the self-administered hormonal contraceptive;(3) Evaluating the patient using the criteria adopted by reference in section 3;(4) Conducting a health and history screening of the patient;(5) Screening to determine whether the patient is or may be pregnant;(6) Screening the patient for disease;(7) Determining whether the patient is taking other medications and, if so, evaluating the potential interaction between the self-administered hormonal contraceptive and the other medications;(8) Evaluating the blood pressure of the patient;(9) Soliciting and considering the preferences of the patient concerning treatment; and(10) Formulating a plan for treatment of the patient and discussing the plan with the patient.3. If, after satisfying the requirements of subsection 2, a pharmacist determines that it is unsafe to dispense a self-administered hormonal contraceptive to the patient, the pharmacist must not dispense the self-administered hormonal contraceptive and must:(a) Refer the patient to his or her attending provider of health care or another qualified provider of health care for further consultation and treatment; and(b) Provide the patient with a copy of the record required by subsection 4 of section 3 of Senate Bill No. 190, chapter 504, Statutes of Nevada 2021, at page 3269 (NRS 639.28078).4. If, after satisfying the requirements of subsection 2, a pharmacist determines that it is safe to dispense a self-administered hormonal contraceptive to the patient, the pharmacist must:(a) Provide the patient with information concerning the self-administered hormonal contraceptive being dispensed, which must include, without limitation, the information described in paragraph (b) of subsection 3 of section 3 of Senate Bill No. 190, chapter 504, Statutes of Nevada 2021, at page 3269 (NRS 639.28078), and information concerning:(1) Proper dosage of the self-administered hormonal contraceptive;(2) The effectiveness of the self-administered hormonal contraceptive;(3) The importance of obtaining recommended tests and screening from the attending provider of health care of the patient or another qualified provider of health care who specializes in women's health;(4) The effectiveness of long-acting, reversible contraceptives as an alternative to selfadministered hormonal contraceptives;(5) When to seek emergency medical services as a result of administering a selfadministered hormonal contraceptive; and(6) The risk of acquiring a sexually transmitted infection and ways to reduce that risk;(b) Provide the patient with a copy of the record required by subsection 4 of section 3 of Senate Bill No. 190, chapter 504, Statutes of Nevada 2021, at page 3269 (NRS 639.28078); and(c) Dispense an appropriate self-administered hormonal contraceptive to the patient in a container with a label that clearly shows:(1) The date on which the self-administered hormonal contraceptive was dispensed;(2) The name and address of the patient;(3) The serial number assigned to the record of the self-administered hormonal contraceptive in accordance with paragraph (a) of subsection 8;(4) The number of recommended doses of the self-administered hormonal contraceptive that are being dispensed in the container;(5) Specific directions for use of the self-administered hormonal contraceptive;(6) The proprietary or generic name of the self-administered hormonal contraceptive;(7) The strength of the self-administered hormonal contraceptive; and(8) The expiration date of the self-administered hormonal contraceptive.5. A pharmacy that initially dispenses self-administered hormonal contraceptives under the protocol shall maintain:(a) A written or electronic record of each risk assessment questionnaire completed by a patient of the pharmacy pursuant to paragraph (a) of subsection 2 for at least 2 years after the date of completion; and(b) The written or electronic record required by subsection 8.6. A pharmacist who dispenses a self-administered hormonal contraceptive under the protocol shall not dispense to a patient more than a 12-month supply of the self-administered hormonal contraceptive. If the pharmacist initially dispenses to the patient less than a 12-month supply, the pharmacist may refill the self-administered hormonal contraceptive under the protocol until the patient has received a 12-month supply. If the patient requests a refill after the patient has received a 12-month supply, the pharmacist must comply with the requirements of the protocol set forth in subsections 2, 3 and 4.7. Subject to the limitations set forth in subsection 6, a pharmacist who has not complied with the requirements of section 2 may refill the supply of a selfadministered hormonal contraceptive initially dispensed under the protocol if the pharmacist has access to an electronic record of the risk assessment questionnaire completed pursuant to paragraph (a) of subsection 2. When dispensing the refill, such a pharmacist shall:(a) Review and discuss the results of the risk assessment questionnaire with the patient;(b) Answer any questions that the patient may have concerning the self-administered hormonal contraceptive; and(c) Take the actions described in paragraphs (a) and (c) of subsection 4.8. A pharmacy that dispenses a self-administered hormonal contraceptive under the protocol, including, without limitation, a pharmacy that refills the supply of a selfadministered hormonal contraceptive pursuant to subsection 7, shall maintain a written or electronic record of each self-administered hormonal contraceptive dispensed by the pharmacy for at least 2 years after the date on which the self-administered hormonal contraceptive was dispensed. The record must: (a) Be assigned a serial number;(b) Include, without limitation, the information required by paragraph (a) of subsection 3 of section 3 of Senate Bill No. 190, chapter 504, Statutes of Nevada 2021, at page 3269 (NRS 639.28078); and(c) Be maintained in the same manner as other records of prescriptions dispensed by the pharmacy.Nev. Admin. Code § 639.Sec. 4.1
Added to NAC by Bd. of Pharmacy by R036-21A, eff. 2/28/2022NRS 639.070 and section 2.5 of Senate Bill No. 190, chapter 504, Statutes of Nevada 2021, at page 3268 (NRS 639.28077) .