PURPOSE: This rule defines the minimum standards for a vacuum tube drug delivery system utilized in licensed pharmacies.

1. (1) Vacuum tube systems are for use in the delivery of drugs to the patient or his/her agent.

   1. (A) Any drug delivery system that utilizes a vacuum tube to deliver drugs outside of a licensed pharmacy must be designed and engineered in such a way as to ensure security of all drugs and that drugs are delivered correctly and efficiently to the intended recipient.

   2. (B) Only systems that are dedicated for the delivery of drugs from a location within a licensed pharmacy to another location specific for drug delivery and are not connected, combined or attached to other systems shall be used. Multiple or switchable stations where the delivery of drugs could occur at more than one destination outside of the pharmacy are prohibited.

      1. 1. When the pharmacy is closed or there is no pharmacist

on duty, the vacuum tube system must be turned off and no drugs shall be delivered to consumers during these time periods.

1. (C) Any pharmacy, which cannot maintain a direct and identifiable line of sight with the consumer, must maintain a video camera and audio system to provide for effective communication between pharmacy personnel and consumers. It must be a system that will allow for the appropriate exchange of oral as well as written communications to facilitate patient counseling and other matters involved in the correct transaction or provision of drugs.

   1. 1. Video monitors used for the proper identification of

persons receiving prescription drugs shall be a minimum of twelve inches (12") wide.

1. 2. Both the video monitor and the audio system must be

in good working order or operations utilizing the vacuum tube system shall cease until appropriate corrections or repairs are made to the system(s).

1. 3. Backlighting or other factors that may inhibit video or

audio performance must be taken into account when using such systems to identify recipients of prescription drugs. Positive identification of recipients must be made before any drug is delivered.

1. (2) Any vacuum tube delivery system already installed in a pharmacy prior to September 1, 1998, will not be required to comply with this rule; except that, should the vacuum tube delivery system or any part thereof require replacement, change, or upgrading after September 1, 1998, the system or any part of the system being replaced, changed, or upgraded shall comply with the minimum standards set forth in this rule. This exemption does not relieve a pharmacy of its duty to maintain adequate security measures as required by Chapter 195, RSMo, 19 CSR 30-1, or the rules of the board; nor does it relieve pharmacists from their duty to provide patient counseling as required by 20 CSR 2220-2.190.

AUTHORITY: section 338.280, RSMo 2016, and section 338.140, RSMo Supp. 2019.* This rule originally filed as 4 CSR 220-2.800. Original rule filed Aug. 21, 1998, effective Feb. 28, 1999. Moved to 20 CSR 2220-2.800, effective Aug. 28, 2006. Amended: Filed May 13, 2019, effective Nov. 30, 2019. *Original authority: 338.140, RSMo 1939, amended 1981, 1989, 1997, 2011, 2019 and 338.280, RSMo 1951, amended 1971, 1981.