Wyo. Code R. 059-0001-2
Pharmacy, Board of
Chapter 2: General Practice of Pharmacy Regulations
Effective Date: 03/13/2003 to 04/25/2006
Rule Type: Superceded Rules & Regulations
Reference Number: 059.0001.2.03132003
These regulations are promulgated as authorized by the Act.
The purpose of this regulation is to coordinate the requirements for pharmaceutical care by providing minimum standards, conditions and physical guidelines for facilities and pharmacists in professional settings.
This Chapter applies to any person, partnership, corporation, limited liability company or other entity engaging in the practice of pharmacy within this State.
(a) 'Administer' means the direct application of a drug, whether by injection, inhalation, ingestion, or any other means, to the body of a patient or research subject by:
(i) A practitioner (or by his authorized agent); or
(ii) The patient or research subject at the direction of the practitioner.
(b) 'Board of Pharmacy' or 'Board' means the Wyoming State Board of Pharmacy.
(c) 'Compounding' means and includes the preparation, mixing, or assembling of a drug or device, and the packaging and labeling incident thereto for sale or dispensing:
(i) As the result of a practitioner's prescription drug order or initiative based on the practitioner/patient/pharmacist relationship in the course of their professional practice.
(ii) For the purpose of research, teaching, or chemical analysis, or
(iii) In anticipation of prescription drug orders based on routine, regularly observed prescribing patterns.
However, 'compounding' does not include mixing, reconstituting, or other such acts that are performed in accordance with directions contained in approved labeling provided by the product's manufacturer and other manufacturer directions consistent with that labeling.
(d) 'Confidential Information' means information maintained by the pharmacist in the patient's records or which is communicated to the patient as part of patient counseling, which is privileged and may be released only to the patient or, as the patient directs; to those practitioners and other pharmacists where, in the pharmacist's professional judgment, such release is necessary to protect the patient's health and well being; and to such other persons or governmental agencies authorized by law to investigate controlled substance law violations.
(e) 'Consultant Pharmacist' shall mean a pharmacist who establishes policies and procedures for the distribution and storage of drugs and visits the facility on a regularly scheduled basis, but is not physically present at the facility for a set number of hours on a daily basis.
(f) 'Deliver' or 'Delivery' means the actual, constructive or attempted transfer from one person to another of a drug or device whether or not there is an agency relationship.
(g) 'Device' means an instrument, apparatus, implement, machine, contrivance, implant or other similar or related article, including any component part or accessory, which is required under Federal law to bear the label 'Caution: Federal law restricts this device to sale by or on the order of a physician.'
'Digital Signature' means an electronic identifier that
(i) is intended by the party using it to have the same force and effects as a manual signature;
(ii) is unique to the authorized signer;
(iii) is capable of verification;
(iv) is under the sole control of the authorized signer;
(v) is linked to the prescription in such a manner that if the prescription information is changed, the signature is invalidated; and
(vi) conforms to Wyoming State Board of Pharmacy laws, rules and regulations.
(i) 'Dispense' means to deliver a drug to an ultimate user or research subject by or pursuant to the lawful order of a practitioner, including the prescribing, administering, packaging, labeling, or compounding necessary to prepare the substance for that delivery.
(j) 'Distribute' means the delivery of a drug or device other than by administering or dispensing.
(k) 'Dosage Form' means the physical formulation or medium in which the product is manufactured and made available for use, including but not limited to: tablets, capsules, oral solutions, aerosols, inhalers, gels, lotions, creams, ointments, transdermals and suppositories.
(l) 'Drug' means articles recognized as drugs in any official compendium, or supplement thereto designated for use in the diagnosis, cure, mitigation, treatment or prevention of disease in humans or animals.
(m) 'Electronic transmission' means transmission of the digital representation of information from one computer or other similar electronic device to another computer, which is authenticated by a digital signature; or transmission of the electronic representation of information from one computer or other similar electronic device to a fax machine, which is authenticated by an electronic signature.
(n) 'Electronic signature' means an electronic sound, symbol or process attached to or logically associated with a prescription and executed or adopted by a person with the intent to sign the prescription.
(o) 'Patient confidences' as used in W.S. §33-24-101(c)(iii) means information transmitted by the prescribing practitioner or agent to the pharmacist or agent for purposes of treating the patient and information transmitted by the patient or agent to the pharmacist or agent for purposes of treatment and includes the patient's name, address, medical condition, and drugs lawfully prescribed for him. Provided however the pharmacist may release otherwise confidential information pertaining to the patient's treatment to a minor's parent or guardian, the patient's third party payor or the patient's agent.
(p) 'Labeling' means the process of preparing and affixing a label to any drug container exclusive of the labeling by a manufacturer, packet or distributor. (See Section 11 of these regulations.)
(q) 'Non-resident Pharmacy' means a licensed pharmacy located outside this State where drugs are dispensed and pharmaceutical care is provided to residents within the State.
(r) 'Patient Counseling' means the oral communication by the pharmacist of information, as defined in the rules of the Board, to the patient or caregiver, in order to improve therapy by ensuring proper use of drugs and devices. Patient counseling may be supplemented with printed materials.
(s) 'Pharmaceutical Care' is the provision of drug therapy and other pharmaceutical patient care services intended to achieve outcomes related to the cure or prevention or management of an illness or injury.
(t) 'Pharmacist-in-Charge' or 'PIC' means a pharmacist currently licensed in this State who accepts responsibility for the operation of a pharmacy in conformance with all laws and rules pertinent to the practice of pharmacy and the distribution of drugs.
(u) 'Pharmacy' means any place within this State where drugs are dispensed and pharmaceutical care is provided.
(v) “Pharmacy Technician” means an individual other than an intern, who performs pharmacy functions under the direct supervision of a licensed pharmacist.
(w) “Practitioner” means an individual currently licensed, registered or otherwise authorized by the jurisdiction in which he/she practices to prescribe drugs in the course of professional practice.
(x) “Prescription Drug” or “Legend Drug” means a drug which, under Federal Law, is required to be labeled with one of the following statements:
“Caution: Federal law prohibits dispensing without prescription”;
“Caution: Federal law restricts this drug to use by, or on the order of, a licensed veterinarian”;
“Rx Only”; or
(iv) Is a drug included on the Wyoming Dangerous Substance Listing, as referenced in Wyoming Pharmacy Act Rules and Regulations, Chapter 11, Section 2, and shall be dispensed pursuant to a prescription drug order.
(y) “Prescription Drug Order” means a lawful order of a practitioner for a drug or device for a specific patient.
(z) “State Board”, as used in W.S. §33-24-136(b), shall mean the state boards of medicine, dental examiners, nursing, podiatry, optometry and veterinary medicine of the State of Wyoming and their similar counterpart boards of any of the states of the United States of America.
(aa) “Registered Pharmacist” means an individual currently licensed by this State to engage in the practice of pharmacy.
(bb) “Wholesale Distributor” means any person or firm engaged in wholesale distribution of drugs, including but not limited to manufacturers; repackagers; own-label distributors; private-label distributors; jobbers; brokers; warehouses, including manufacturers’ and distributors’ warehouses, chain drug warehouses and wholesale drug warehouses; independent wholesale drug traders and retail pharmacies that conduct wholesale distributions.
(cc) “Agreement” means a voluntary agreement, written and signed, between a pharmacist and a prescribing physician that defines a collaborative practice for the purpose of drug therapy management of patients.
(dd) “Collaborative pharmacy practice” means a practice in which a prescribing physician makes a diagnosis, maintains ongoing supervision of patient care and refers the patient to a pharmacist under a protocol allowing the pharmacist to perform patient care functions authorized by the physician under specified conditions or limitations.
(ee) “Drug therapy management” means the review of drug therapy regimen(s) of patients by a pharmacist for the purpose of evaluating and rendering advice to the prescribing physician regarding adjustment of the regimen. Decisions involving drug therapy management shall be made in the best interest of the patient. “Drug therapy management” may include:
(i) Implementing, modifying, and managing drug therapy according to the terms of the agreement and the specific written orders.
(ii) Collecting and reviewing patient drug histories;
(iii) Obtaining and checking vital signs, including but not limited to pulse, temperature, blood pressure, and respiration; and
(iv) Ordering and evaluating the results of laboratory tests directly relating to drug therapy, when performed in accordance with approved protocols applicable to the practice setting.
(ff) “Pharmacist’s collaborative scope of practice” means those duties and limitations of duties agreed upon by a pharmacist and the collaborating physician (subject to Board’s approval and applicable law), and includes the limitations implied by the specialty practiced by the collaborating physician.
“Unit Dose Package” means a package, which contains one unit of medication.
(hh) “Unit of Issue Package” means a package, which provides multiple units of doses separated in a medication card or other similarly designed container.
(ii) “Unit Dose Dispensing System” means a drug distribution system, which is in a pharmacy and uses unit dose packages or unit of issue packages that enable distribution of packaged doses in a manner that preserves the identity and the integrity of the drug until the time of administration.
(jj) “Traditional dispensing System” means a drug package system in which individual doses are not packaged in unit dose packages or unit of issue packages.
(kk) “Prepackage” means to prepare a drug in a container in advance of actual, immediate need for dispensing, prior to the receipt of an order. Such packaging may be in a unit dose or unit of issue package for use in a unit dose dispensing system or in a container suitable for a traditional dispensing system.
(ll) “Repackage” means to prepare a unit dose or unit of issue package or traditional dispensing system package for dispensing pursuant to an existing order.
(mm) “Pharmacy” means an area(s) where prescriptions are filled, counseling occurs, prescription drugs are stored, and patient records and other items required by law for the practice of pharmacy are maintained.
(nn) “Remodeled Pharmacy” means an existing retail pharmacy, which is relocated to a different address, or a pharmacy, which undergoes remodeling at its present location, and the cost of such remodeling is equal to or greater than $25,000.00.
(oo) “Active Pharmacy Practice” means a pharmacist who engages in the practice of pharmacy as defined in W.S. §33-24-124 a minimum of 400 hours per calendar year.
(a) The Board shall utilize those standardized examinations as prepared and administered by the National Association of Boards of Pharmacy. These standardized examinations shall include the following:
(i) North American Pharmacist Licensing Examination (NAPLEX®)
(ii) Multistate Pharmacy Jurisprudence Examination (MPJE™)
(b) Applicants for licensure by examination will be licensed, provided they meet the following requirements.
(i) A properly completed “Pharmacist Licensure by Examination” application as provided by the Board with the proper fee, has been submitted to the Board’s office;
(ii) Pass the NAPLEX® with a minimum score of 75;
(A) Candidates who do not receive a passing grade on the NAPLEX® shall be allowed two (2) retakes for a total of three (3) examinations.
(B) All retakes require payment of fees as required by the National Association of Boards of Pharmacy.
(iii) Pass the MPJE® for Wyoming with a minimum score of 75;
(A) Candidates who do not receive a passing grade on the MPJE™ may retake the examination.
(B) All retakes require payment of fees as required by the National Association of Boards of Pharmacy.
(iv) Meet the required practical experience requirement of 2,000 internship hours as specified in Chapter 3 of the Board’s Rules;
(v) Complete all requirements within two (2) years of the date of application to the Board’s office; and,
(vi) Meet requirements of W.S. §33-24-116.
(c) Applicants who have applied for score transfer of their NAPLEX® exam to Wyoming will be licensed by examination, provided they meet the following requirements.
(i) The NAPLEX® score transferred is 75 or more;
(ii) A properly completed “Pharmacist Licensure by Examination” application as provided by the Board with the proper fee, has been submitted to the Board’s office;
(iii) Pass the Multi State Pharmacy Jurisprudence Exam (MPJE™) for Wyoming with a minimum score of 75;
(A) Candidates who do not receive a passing grade on the MPJE™ may retake the examination.
(B) All retakes require payment of fees as required by the National Association of Boards of Pharmacy.
(iv) Meet the required practical experience requirement of 2,000 internship hours as specified in Chapter 3 of the Board’s Rules;
(v) Complete all requirements within one (1) year of the date of the NAPLEX® exam, which was utilized for the score which was transferred to Wyoming; and
(vi) Meet requirements of W.S. §33-24-116.
(d) No candidate will be licensed until the required practical experience as specified in Chapter 3, Section 3(a) of the Board’s Rules has been met.
(e) Candidates failing to meet all requirements within the time period allowed in Chapter 2, Section 5(b)(v) and Chapter 2, Section 5(c)(v) must file a new application, including payment of all fees or if applicable seek licensure by license transfer as outlined in Chapter 2, Section 6.
(f) The Board reserves the right to require an interview with any applicant seeking licensure by examination to practice pharmacy in Wyoming.
(g) The Board shall charge fees to cover administrative costs, which shall include wall certificate, renewal certificate for current license year, and those costs associated in reviewing test questions for the jurisprudence exam (MPJE™).
Any pharmacist who is licensed by examination and is in good standing in any state which is a member of the National Association of Boards of Pharmacy (NABP) and who desires to be licensed by reciprocity into the State, shall proceed in the manner outlined by the NABP after first submitting the “Preliminary Application for Transfer of Pharmaceutic Licensure” obtained from any state or the NABP.
(a) The Board in its discretion may recognize the qualifications of the applicant as determined by NABP. Persons who have become registered as pharmacists by examinations in other states may be required to satisfy only the requirements which existed in this State at the time they became registered in the other state, provided that the state in which said persons is registered shall under like conditions grant reciprocal registration as pharmacist, without examination, to pharmacists duly registered by examination in this State. The Board reserves the right to reject any applicant pursuant to the Act.
(b) In the event of rejecting an application, the fee paid to the Board will not be refunded.
(c) All candidates for license transfer shall be required to:
(i) File all appropriate applications with the board;
(ii) Pay the required fee;
(iii) Pass the Multi-State Pharmacy Jurisprudence Exam (MPJE™);
(iv) Prove good moral character;
(v) Prove they have been in active pharmacy practice as defined in Chapter
2, Section 4(oo), for the year preceding the date of their application for license transfer. Applicants failing to show proof must complete an internship in Wyoming approved by the Board of no less than 400 hours. An applicant will be considered as successfully completing the internship if the overall score given by the preceptor, utilizing the Wyoming State Board of Pharmacy's 'Intern Evaluation Report' is no less than a 'C'; and
(vi) Meet all requirements under the Act and the Board's Rules.
(d) The Board shall not issue a pharmacist license by license transfer until all conditions under Chapter 2, Section 6 (c) have been met.
(e) All applications for transfer of licensure (reciprocity) shall expire one (1) year from date of issue by NABP if not filed with the Board and licensure completed.
(f) The Board reserves the right to require an interview with any applicant seeking licensure by license transfer to practice pharmacy in Wyoming.
Section 7. Minimum Structural and Equipment Requirements to Operate a Retail Pharmacy.
(a) All retail pharmacies operating in Wyoming must meet the following requirements.
(i) The pharmacy shall include a sink with a hot and cold water supply, exclusive of restroom facilities, with adequate sewage disposal.
(ii) The pharmacy shall be properly lighted and ventilated. The temperature of the pharmacy shall be maintained within a range compatible with the proper storage of pharmaceuticals.
(iii) The pharmacy shall have adequate shelving and there shall be adequate counter on which to work and the working surface shall be kept clear and uncluttered at all times for the preparation or compounding of prescriptions to meet the requirements of the pharmacy. Any pharmacy where compounding prescriptions occurs must meet the structural and equipment requirements identified in Chapter 13 of the Board's rules.
(iv) A Facsimile machine or similar electronic equipment capable of producing an identical document shall be located in the pharmacy.
(v) A separate refrigerator located in the pharmacy, which is sufficient in capacity to serve the needs of the pharmacy that is equipped with a thermometer and providing a storage temperature of 36-46 degrees Fahrenheit (2-8 degrees Centigrade). The use of such refrigerator shall be limited to the storage of drugs. If a freezer compartment is utilized, it must maintain a temperature of -14 to -4 degrees Fahrenheit (-20 to -10 degrees Centigrade).
(vi) Class A prescription balance or electronic scale with 10 mg sensitivity.
(vii) A professional reference library (text or electronic format) that shall include the following:
(A) Current Wyoming pharmacy laws;
(B) Current edition of Facts and Comparisons or a comparable reference accepted by the Board;
(C) Current drug interaction text which provides at a minimum, quarterly updates;
(D) Wyoming State Board of Pharmacy News, maintained in a binder; and
(E) The current edition with supplements of the FDA 'orange book' or an alternate reference that provides the same information as the FDA 'orange book'.
(viii) Pharmacies must maintain adequate security to deter theft of drugs by personnel or public. Security requirements for new or remodeled pharmacies must meet the requirements of Chapter 2, Section 7 (b)(ii)(D). No person other than pharmacist, intern or technician employed by the pharmacy shall be permitted in the pharmacy without the express consent of the pharmacist-in-charge;
(A) If the pharmacy is located in a facility in which the public has access and the pharmacy's hours of operation are different from the rest of the facility, pharmacy must be designed so that it can be securely locked and made inaccessible when the pharmacy is not open.
(ix) The pharmacy shall be arranged in an orderly fashion and kept clean. All required equipment shall be clean and in good operating condition;
(x) If automated counting devices are utilized, the pharmacy shall have a method to calibrate and verify the accuracy of the automated counting device; and shall verify the accuracy and document doing so on a quarterly basis.
(xi) A sequential numbering machine or electronic data device for the consecutive numbering of all prescriptions must be maintained along with appropriate printing equipment to produce prescription drug labels.
(xii) In addition to the requirements identified in Chapter 2, Section 7 (a) of these regulations all pharmacies involved in the preparation of sterile compounded products must meet the requirements of Chapter 13, Section 10 of the Board's rules.
(b) In addition to the requirements of Chapter 2, Section 7, except for a change of ownership of an existing pharmacy, an individual or business who opens a new pharmacy or remodels an existing pharmacy after July 1, 2001 shall meet the following requirements.
(i) Provide a set of blueprints or other acceptable documents, which indicate physical layout of planned or remodeled pharmacy to the Board no later than thirty calendar days prior to commencing construction or remodeling of the pharmacy.
(ii) The proposed new pharmacy or pharmacy to be remodeled must meet the following minimum standards.
(A) The pharmacy shall consist of no less than 250 square feet;
(B) The pharmacy shall include an identified counseling area, which is apart from the cash register and offers sufficient privacy for counseling. Pharmacies, which do not provide prescription services to "walk-in" customers, are not required to have a counseling area;
(C) Located within or adjacent to the pharmacy, but not counted in the square footage requirement of the pharmacy, shall be restroom facilities. If the restroom facilities are located in the pharmacy, access shall be limited to pharmacy staff only;
(D) Access to the pharmacy shall be secured as follows;
(I) If the pharmacy is located within another business, which does not have identical hours of operation, the pharmacy shall be secured with solid core or metal doors with a deadbolt and a locking doorknob. If glassed areas are utilized, then adequate intrusion detectors must be in place. Pharmacy walls must extend to the roof or provide security acceptable to the Board. The pharmacy shall meet all other applicable federal or state regulations concerning security access.
(II) Those pharmacies not included in (I) must be secured with solid core, metal, or safety glass exterior doors secured with a deadbolt, and must utilize an adequate intrusion detector. If the pharmacy shares a common wall with another business, this wall must extend to the roof. The pharmacy shall meet all other applicable federal or state regulations concerning security access.
(E) A separate refrigerator, sufficient in capacity to serve the needs of the pharmacy staff, shall be available for storage of employee's food or beverage. This refrigerator shall be identified for "Employee Use Only"; and
(F) All prescription data shall be processed utilizing electronic data processing equipment, and shall be sequentially numbered. There shall be adequate computer terminals and printers available to process anticipated prescription volume for the new or remodeled pharmacy.
(c) Upon written request and for good cause, the Board may waive any of the requirements of Chapter 2, Section 7 of the Board's Rules. A waiver that is granted under this section shall only be effective when issued by the Board in writing.
An application for registration to operate, maintain, open or establish a pharmacy or prescription department shall be made on a form provided by the Board prior to the opening of said pharmacy or prescription department.
(a) Prior to the issuing of the registration to operate a pharmacy or prescription department, the Board will inspect the pharmacy for minimum standards including space, fixtures, sanitation, reference library, technical equipment and security.
(b) The facility application shall list the names of all licensed pharmacists employed specifically identifying the pharmacist-in-charge (PIC). The pharmacist-in-charge determines which employees shall have keys to the pharmacy.
(c) The Board shall be notified with every change of pharmacist-in-charge (PIC). A controlled substance inventory is required when there is a change in the pharmacist-in-charge, at the time of the change. This inventory shall include the signatures of both the outgoing and incoming PIC. If the inventory cannot be conducted with both pharmacists, then the incoming PIC shall conduct an inventory. A copy of the controlled substance inventory shall be forwarded to the Board's office within fifteen (15) days of conducting the inventory. Pharmacists and interns must report any change of address or place of employment to the Board within fifteen (15) days of the change.
(d) Every pharmacy license shall expire on June thirtieth (30th) of each year and shall be renewed annually by filing an application together with a fee set by the Board no later than that date.
(e) When a pharmacy changes ownership, the original license becomes void and a new license must be secured by the new owner or owners. A new license is required even if there is no change in the name of the pharmacy or in the registered pharmacist in charge of the pharmacy.
In the case of a corporation, limited liability company or partnership holding a pharmacy license, the Board shall be notified and a new license applied for anytime the majority of stock in the corporation is sold or a majority of the partners of the partnership or members of the limited liability company change. This shall constitute new ownership. Requirements for the ownership are the same as outlined in this section.
(f) A pharmacy license registers the pharmacy to which it is issued only at the location specified on the application and is not transferable.
(g) All licenses and certificates issued by the Board shall be displayed in a prominent place within the facility and always in view to the public.
(h) When a pharmacy licensed by the Board permanently ceases operation for any reason, the Board is to be notified immediately and the pharmacist-in-charge is responsible for securing all drugs and records in the pharmacy and following other guidelines as directed by the Board - including, but not limited to: (1) Notification of all patients and availability of patient records; (2) notification of the Drug Enforcement Administration and inventory and transfer or destruction of all controlled substances; and (3) proper distribution, transfer or destruction of all other legend drugs;
(i) If closure is permanent, remove from inside and outside the area all references of 'Drug', 'Drugstore', 'Pharmacy' or other terms that might indicate or signify by any advertising medium that such establishment is a licensed pharmacy; and surrender retail pharmacy license and Wyoming controlled substances registration to the Board office. Federal DEA registration and all unused DEA Form 222 shall be marked 'Void' and returned to DEA.
Every licensed pharmacy must be in the continuous daily charge of a registered pharmacist. A pharmacist shall be designated as the pharmacist-in-charge and shall have direct control of the pharmaceutical affairs of said pharmacy. A pharmacist may not serve as the pharmacist-in-charge unless said pharmacist is physically present in the pharmacy a minimum of 32 hours per week, or 80 percent of the time the store is open if opened less than 40 hours per week.
A pharmacist may not serve as pharmacist-in-charge for more than one pharmacy at any one time. The name of the pharmacist-in-charge shall be designated in the application of the pharmacy for license and in each renewal thereof. A pharmacist may seek a waiver from the Board to serve as a pharmacist-in-charge for more than one pharmacy, provided those requirements for number of hours physically present in the pharmacy are met.
(a) A corporation or other non-pharmacist owner must comply strictly with the above provisions and provide a pharmacist-in-charge who will have complete control over the pharmaceutical affairs of said pharmacy.
(b) Responsibility as the pharmacist-in-charge includes requiring that all federal and State pharmacy laws and regulations are complied with and enforced. It shall be the duty of the pharmacist-in-charge to report all pharmacy violations within their facility to the Board.
(c) Additional responsibilities of the pharmacist-in-charge shall be to:
(i) Establish policies and procedures for the procurement, storage, compounding and dispensing of pharmaceuticals.
(ii) Supervise the professional employees of the pharmacy.
(iii) Supervise the non-professional employees of the pharmacy.
(iv) Establish and supervise the record keeping for and security of all pharmaceuticals.
(v) Report any loss or theft of drugs to the Board and other authorities.
(vi) Ensure that all staff: registered pharmacists, interns, pharmacy technicians-in-training and certified pharmacy technicians have valid licenses or registrations in good-standing and that all certificates are on display.
(vii) Ensure that all pharmacy licenses, including state and federal controlled substances registrations are valid and posted.
(viii) Develop and implement a procedure for drug recall.
(ix) Be in full and actual charge of such pharmacy and responsible for whatever goes on in it.
(x) Develop a written policy for delivery of prescription drugs during non-pharmacy hours which shall include but not be limited to:
(A) An arrangement made ahead of time with the customer that delivery will occur under these circumstances;
(B) An arrangement which guarantees that the offer to counsel, and if accepted, counseling will occur on all new prescriptions;
(C) An arrangement which guarantees the security of the drugs and the confidentiality for the customer.
(D) A plan which provides that such delivery is used only when required by the customer and not used in all instances for delivery after closing hours.
(d) Every pharmacy shall have at least one registered pharmacist on duty and physically present in the pharmacy area at all times that the prescription department is open for the transaction of business.
If the pharmacist is absent from a licensed pharmacy, the prescription department must be locked and kept so until that pharmacists' return and a sign saying - "Prescription Department Closed - No Registered Pharmacist on Duty" shall be conspicuously posted.
(e) No pharmacy shall be permitted to operate without a pharmacist-in-charge. The Board shall be notified in writing of any newly designated pharmacist-in-charge. The Board shall record the PIC change and issue a corrected copy of the license.
Section 10. Transfer of Prescription Orders Between Prescription Drug Outlets.
A prescription label or a written copy of a prescription order from another pharmacy may be used for informational purposes only and shall not be considered to be a valid prescription order. A pharmacist who receives such a label or prescription order copy shall either contact the prescribing practitioner for authorization to dispense the prescription, or, alternatively, shall comply with (a) through (j) of this Section.
(a) A pharmacist may transfer prescription order information for the purpose of refilling a prescription subject to the following requirements. The information is communicated directly by one pharmacist to another pharmacist, or the information may be electronically transferred between pharmacies. Pharmacies electronically transferring information must satisfy all information requirements of a transferred prescription which is communicated directly by one pharmacist to another pharmacist, including those requirements as identified in W.S. §33-24-136a.
(b) The transferring pharmacist shall:
(i) Write the word "void" across the face of the original prescription order to make the order invalid or electronically document that the prescription has been voided;
(ii) Record on the reverse side of the invalidated prescription order or electronically document:
(A) His/her name;
(B) The name of the receiving pharmacist;
(C) The name of the receiving pharmacy;
(D) The address of the receiving pharmacy and (E) The date of the transfer.
(F) In the case of a controlled substance in schedule III through V, the Drug Enforcement Administration registration number of the receiving pharmacy.
(c) The pharmacist receiving the transferred prescription order information shall reduce the transferred information to writing; write the word “transfer” or a word of similar import on the face of the transferred prescription order or electronically document that the prescription has been transferred, and provide all information required by law or regulation to be on the prescription order, including:
(f) The pharmacist at the receiving pharmacy at the time of the dispensing of the transferred prescription, shall inform the patient that the prescription order is now invalid at the pharmacy from which it was transferred.
(g) A transferring pharmacy which utilizes a computer for recordkeeping of prescription order transactions shall comply with all requirements of this regulation including invalidation of the prescription order and deactivation of the order in the computer.
(h) Nothing in this regulation shall be deemed to permit the transfer of a prescription order for a schedule II controlled substance.
(i) A prescription order for a controlled substance in schedule III through V may be transferred only one time, that transfer being from the pharmacy where the prescription was originally filled. It shall not be further transferred by, or to, any other pharmacy.
(j) A prescription order for a non-controlled prescription drug may be transferred from one pharmacy to another pharmacy only so long as there are refills remaining and each pharmacy can establish that a valid refill existed at the time of dispensing.
(a) All original or refill prescription drug containers utilized in a traditional dispensing system shall be labeled as follows: name of the patient, brand or generic name of the drug product dispensed unless otherwise specified; the name, address and phone number of the pharmacy; the practitioner's name; the serialized number of the prescription; the date the prescription was filled or refilled; directions for use, including accessory cautionary information as required for patient safety; the identifying initials of the dispensing pharmacist and any other information required by federal or state law.
(b) Effective January 1, 2004 all original or refill prescription drug containers utilized in a traditional dispensing system shall be labeled with its physical description, including any identification code that may appear on the tablets and capsules. A waiver will be granted for new drugs for the first 120 days on the market and 90 days on drugs for which the national reference file has no description on file.
(b) All unit dose or unit of issue packaging shall be labeled as follows:
(i) Brand name and/or generic name of the prescription drug;
(ii) Strength;
(iii) Manufacturers lot number; and
(iv) Manufacturers expiration date, if prepackaged or repackaged by the pharmacy, the expiration date shall be the lessor of the manufacturers expiration date or twelve (12) months from the date of prepackaging or repackaging.
(a) The Consumer Product Safety Commission enforces the Poison Prevention Packaging Act (PPPA) which requires that all prescription medication shall be dispensed in child-resistant packaging.
(b) Unless the prescription drug is expressly exempted from the federal regulations, the drug must be dispensed in a child-resistant package. Exceptions to this requirement do exist as follows:
(i) The purchaser may request either a one time or a blanket waiver from the requirement. A one-time request shall be documented on the prescription or patient profile records by the pharmacist.
(ii) The physician, at the request of the patient, may request a one-time waiver. However, the physician cannot request a blanket waiver.
(c) Child-resistant prescription containers cannot be reused for refills of prescriptions. However, glass containers may be reused, provided that a new safety closure is used.
The following information shall be recorded in a readily retrievable manner when a prescription is refilled: date refilled, quantity, and pharmacist's initials. If a refill was not authorized on the original prescription or if no refills remain, the pharmacist may contact the prescriber to obtain a new prescription. If authorization is obtained, the name of the practitioner authorizing this prescription, and if applicable, the name of the agent transmitting the prescription must be recorded as well the number of refills authorized.
Both the supervising pharmacist and the intern must initial any prescription or prescription refilled by the intern.
Any prescription shall be considered null and void when the pharmacist learns that the professional relationship between a practitioner and patient has been terminated for any reason.
(a) Pharmacies (Hospital or Retail) are prohibited from accepting from patients or their agent any dispensed prescription drug for redispensing. However, prescription drugs may be accepted for redispensing, if all the following are met;
(i) Pharmacies may accept previously dispensed drugs for return from locations that employ persons who are licensed to administer drugs, and the prescription drugs were maintained under the control of those persons licensed to administer drugs;
(ii) Prescription drugs shall only be returned to the pharmacy from which originally dispensed;
(iii) The pharmacist-in-charge of the pharmacy accepting the prescription drugs for redispensing shall ensure that conditions of transportation to, storage at the location, and during the return from the location, are such as to prevent deterioration and/or contamination by any means that would affect the efficacy and/or toxicity of the product to be redispensed; and
(iv) Prescription drugs accepted for redispensing must have been initially dispensed as a unit dose package or unit of issue package.
(b) The following prescription drugs shall not under any circumstances be returned to the pharmacy for redispensing;
(i) Any prescription drug declared to be a controlled substance under state or federal law or regulation;
(ii) Any prescription drug dispensed in other than a unit dose package or unit of issue package, and/or
(iii) Any prescription drug not labeled in accordance with Chapter 2, Section 11.
(c) When prescription drugs are returned, the following shall apply:
(i) Prescription drug products in manufacturer's unit dose or unit of issue packages may be redispensed as often as necessary, provided that the integrity of the product and package are maintained, and the product remains in date.
(ii) Prescription drug products which have been prepackaged or repackaged into unit dose packages and unit of issue package in the pharmacy may be redispensed one time only, provided that the integrity of the product and package are maintained, and then only in the package in which originally dispensed, except as provided in (iii) below. Partially used unit of issue packages may not be emptied and the drugs removed and repackaged, nor may additional units of medication be added to partially used unit of issue packages.
(iii) Drug products, which have been prepackaged or repackaged into unit of issue packages may be removed from such packages, for dispensing in a traditional dispensing system. These drug products shall remain in their prepackaged unit of issue package until actual dispensing in a traditional dispensing system.
(d) In hospitals, which have a licensed institutional pharmacy, the pharmacy may accept prescription drugs for redispensing or reissue from all areas of the hospital under the effective control of professionally qualified personnel. The labeling of such drugs shall meet the requirements of Chapter 2, Section 11 and the packaging shall meet the requirements of Chapter 2, Section 4.
(e) When a drug has been packaged and prepared pursuant to a prescription order, but has not been delivered to either another location or to the ultimate consumer, it may be returned to stock. A record shall be made on the prescription memorandum and the pharmacy's computer indicating a return to stock and the date of such return.
Section 16. Scope of Practice.
A prescription written outside the scope of practice of the prescribing practitioner shall not be considered a valid prescription.
Section 17. Identification of a Patient.
(a) The pharmacist or employee under supervision must verify the identity of the person receiving any drug at the time it is dispensed to that person. This may be done by visual recognition. If identity is not established by visual recognition, a driver's license or similar identification form is considered acceptable documentation.
(b) The name of the person receiving the dispensed drug is to be recorded on the prescription document, patient profile or signature log if an agent and not the patient receives the drug.
(c) This section shall not apply to pharmacies that mail prescriptions to their patients. A note shall be entered on the prescription or patient's profile with the name and address of where the medication was mailed. Additionally, the date of such mailing shall be entered.
Section 18. Reinstatement of Registered Pharmacist License After Failure to Renew, Returning from Inactive Status, Issuance of Duplicate License.
(a) If a person requests the reinstatement of their registered pharmacist license when said license has lapsed only for failure to pay renewal fees, the person shall:
(i) Write a letter requesting consideration of reinstatement; (ii) Pay all back renewal fees, including annual fines, up to a maximum fee; (iii) Provide approved continuing education certificates up to a maximum required for five years; (iv) Provide at least two (2) recent letters attesting to good character; (v) Provide proof that pharmacist has been active in the practice of pharmacy and in good-standing in the state where practicing.
(b) Minimum Competency for an Inactive Pharmacist Shall be Established to the Satisfaction of the Board.
When a registered pharmacist has been out of the practice of pharmacy for an extended period of time and wishes to reactivate that license, the Board shall determine on an individual basis the requirements needed to reactivate that license.
The requirements may include some or all of the following:
(i) Approved continuing education certificates for period in question up to a maximum of five years;
(ii) Pass a jurisprudence exam;
(iii) Any past license fees shall be paid including annual fines, up to a maximum of five (5) years.
(iv) Internship under direct supervision may be required. Internship period may vary depending upon how long the individual was out of practice.
(v) Individual shall produce at least two (2) recent letters of character reference.
(c) Duplicate licenses may be issued upon request when licensee's name changes or the license become damaged or destroyed. There shall be a fee charged for the duplicate license.
Section 19. Prescriptions in General.
(a) To be valid the prescription as defined in W.S. §33-24-136(b) shall contain the following information:
(i) Name of patient;
(ii) Name and strength of drug;
(iii) Quantity to be dispensed;
(iv) Directions for using the drug;
(v) Date of issuance by practitioner;
(vi) Prescriptions for controlled substances shall include the DEA number and address of prescribing practitioner and address of the patient.
(vii) Recognizable signature of the practitioner;
(viii) In the case of an oral order the name of the authorized agent if conveyed by other than the prescribing practitioner.
(b) All oral orders shall be recorded on a written prescription memorandum and filed in accordance with W.S. §33-24-136(a).
(c) Prescriptions may be transmitted to the pharmacist in written form; orally, including by telephone; by telephonic facsimile (FAX); and electronic transmission. Schedule II Controlled Substance prescriptions may be transmitted by FAX if they meet the conditions as outlined in Chapter 2, Section 20 (c). Controlled substance prescriptions may be transmitted electronically only to the extent allowed by federal law and Wyoming law.
(d) Prescriptions received from out of state practitioners are valid only to the extent a practitioner licensed in Wyoming may prescribe that medication in Wyoming.
The patient shall have the exclusive right to freedom of choice for any pharmacy to dispense their prescription orders. No agreement between prescriber and pharmacy shall require that prescription orders be transmitted from the prescriber to only that pharmacy.
The pharmacist shall be required to determine the accuracy and authenticity of all prescriptions received. Practitioners or their agents shall provide voice verification, when requested by the pharmacist. If refused the prescription shall not be filled.
Section 20. Transmission of Prescriptions by Telephonic Facsimile Machines (FAX).
Prescriptions transmitted by FAX shall include all of the features listed in Section 19 (a) including the practitioner's recognizable signature.
(a) Other requirements for FAX prescriptions include:
(i) A notation that this is a FAX prescription.
(ii) Telephone number and FAX number of the practitioner.
(iii) Name, address, telephone number and FAX number of pharmacy to which the prescription is being FAXed.
(iv) Date and time of FAX, if not otherwise programmed into transmission.
(v) Name of individual acting as practitioner's agent, if other than practitioner.
The originating FAX prescription shall be put into practitioner's patient file. It shall not be given to the patient.
All FAX machines which are to be used in transmitting prescriptions shall be programmed with FAX identification number, so that document received will show the sender's FAX identification number.
(b) The FAX machine for any receiving pharmacy shall be in the prescription department to protect patient confidentiality and shall utilize non-fading paper. Alternatively a non-fading photo copy or manually written copy of the FAXed prescription shall be stapled to the FAX copy.
A log of prescription orders received by FAX must be maintained for the two year period required for written prescription orders. The log shall contain the time and date of each transmission and the FAX I.D. number of the transmitter.
(c) Prescriptions for Schedule III, IV, and V controlled substances may be transmitted by FAX. Schedule II controlled substance prescriptions may be transmitted by FAX, if the schedule II controlled substance prescription meets one of the following conditions:
(i) A prescription for a schedule II narcotic substance to be compounded for the direct administration to a patient by parenteral, intravenous, intramuscular, subcutaneous or intraspinal infusion or;
(ii) A prescription written for a schedule II substance for a resident of a Long Term Care Facility or;
(iii) A prescription written for a schedule II substance for a “terminally ill” patient. The pharmacist shall so annotate a FAXED schedule II prescription as being for a “terminally ill” patient.
(d) The FAX copy received by the pharmacist shall be deemed the original prescription order and shall be maintained as required by statute.
(e) A FAXed prescription may be dispensed only by the pharmacy receiving the FAX.
Section 21. Prescription Refill Information.
(a) Prescription refill permission may be obtained in written, FAX or electronic form, or by oral verification including telephone.
(b) If prescription refill authorization is obtained by FAX, it shall be initialed by the authorizing practitioner on the document. All other requirements for valid prescriptions shall apply, including pharmacist’s responsibility to determine authenticity of information obtained by FAX.
Section 22. Telephonic Facsimile Machines (FAX) in General.
(a) Using FAX equipment to circumvent documentation, authenticity, verification or other standards of pharmacy practice shall be considered unprofessional conduct.
Section 23. Therapeutic Equivalents.
Therapeutic equivalents do not include therapeutic substitutions. Therapeutic equivalent is defined in W.S. §33-24-147(a)(v). Therapeutic substitution is that class of drug having the same or similar action, but not the identical composition.
Pharmaceuticals which are considered to be therapeutic substitution instead of generic substitution, shall not be used for retail/non-resident pharmacies. A hospital pharmacy using a formulary may reach a written agreement with members of the medical staff under which therapeutic substitution is permitted for use of formulary drugs.
Section 24. Specific Requirements for Licensure of Non-Resident Pharmacies to Ship Prescription Drugs into the State.
(a) Any pharmacy operating from outside the State which ships, mails or delivers, in any manner, a dispensed prescription drug or legend drug to a patient in Wyoming shall obtain and hold a non-resident pharmacy license and, if applicable, a controlled substance registration.
(b) Said pharmacy license and controlled substance registration shall be on forms supplied by the Board and shall be accompanied by the following information. Applicant shall:
(i) submit a copy of the pharmacy license from the state of residence; (ii) submit a copy of the latest inspection report from the state of residence; (iii) submit a copy of current D.E.A. registration;
(iv) submit list of partners, members or principal officers and registered agent for service of process, if any;
(v) submit list of all registered pharmacists, specifying pharmacist-in-charge.
(c) Pharmacy license and controlled substance registrations shall be renewed annually by July 1st to continue doing business in the State.
(d) The Board office shall be notified of any change in ownership or the pharmacist-in-charge.
(e) Each non-resident pharmacy shall comply with statutory or regulatory requirements of the Board, including, but not limited to:
The “Wyoming Drug Identification Act” and the Wyoming Generic Substitution Act.
(f) Each non-resident pharmacy shall maintain records of all prescriptions dispensed to patients in the State in readily retrievable form.
(g) Each non-resident pharmacy shall maintain pharmacy hours that permit the timely dispensing of prescriptions to patients in the State and provide a toll-free telephone service to facilitate communication between patients in this State and a pharmacist who has access to the patients' records.
Counseling shall be accomplished on new prescriptions orally and/or by written information accompanying the dispensed prescription.
(h) The Board may revoke, deny or suspend the licensure and registration of any non-resident pharmacy for violations of the Act - W.S. §33-24-152 and Board regulations, Chapter 2, Section 24.
Section 25. Fees (including Exam, Re-exam, License, License Renewal, Registration, Registration renewal, and late fees);
(a) The Board shall charge the following fees as indicated:
(i) Pharmacist licensure by examination or reexamination shall be seventy five dollars ($75.00) plus The National Association of Boards of Pharmacy's (NABP) fee for the North American Pharmacist Licensure Examination (NAPLEX) and the Multistate Pharmacy Jurisprudence Examination (MPJE).
(ii) Pharmacist licensure by reciprocity shall be two hundred dollars ($200.00) plus NABP's fee for licensure transfer application and the MPJE.
(iii) Pharmacist licensure renewal shall be seventy-five dollars ($75.00) per year.
(iv) Pharmacy intern licensure shall be fifteen dollars ($15.00) and shall be renewed every 12 months. Renewal fee shall be ten dollars ($10.00).
(v) Pharmacy technician licensure fee shall be thirty-five dollars ($35.00).
(vi) Pharmacy technician-in-training permit shall be fifteen dollars ($15.00).
(vii) Pharmacy technician renewal fee shall be thirty-five dollars ($35.00) per year.
(viii) Resident retail pharmacy license and renewals shall be one hundred dollars ($100.00) per year.
(ix) Non-resident pharmacy license and renewals shall be two hundred dollars ($200.00) per year.
(x) A prescription drug manufacturer, distributor, reverse distributor, or wholesaler license and renewals shall be two hundred dollars ($200.00) per year. Oxygen manufacturer or distributor license and renewals shall be one hundred dollars ($100.00) per year.
(xi) Institutional pharmacy license and renewals shall be one hundred dollars ($100.00) per year.
(b) The Board shall assess a late fee in addition to the license or registration renewal fee of licensees or registrants as follows:
(i) A pharmacist whose license renewal application is postmarked or hand delivered to the Board's office after December 31 shall be assessed a late fee of seventy-five dollars ($75.00) in addition to the license renewal fee;
(ii) A pharmacy technician whose license renewal application is postmarked or hand delivered to the Board's office after December 31 shall be assessed a late fee of thirty-five dollars ($35.00) in addition to the license renewal fee;
(iii) A resident retail pharmacy whose license renewal application is postmarked or hand delivered to the Board's office after June 30 shall be assessed a late fee of two hundred dollars ($200.00) in addition to the license renewal fee;
(iv) A non-resident pharmacy whose license renewal application is postmarked or hand delivered to the Board's office after June 30 shall be assessed a late fee of three hundred dollars ($300.00) in addition to the license renewal fee; and
(v) A manufacturer, distributor, or wholesaler of prescription drug products (drugs or oxygen) whose license renewal application is postmarked or hand delivered to the Board's office after June 30 shall be assessed a late fee of two hundred dollars ($200.00) in addition to the license renewal fee.
(vi) An institutional pharmacy whose license renewal application is postmarked or hand delivered to the Board's office after June 30 shall be assessed a late fee of two hundred dollars ($200.00) in addition to the license renewal fee.
(a) Nursing Homes, Hospices, Extended Care Facilities, or Intermediate Care Facilities licensed by the Department of Health may be issued a permit, by the Board of Pharmacy, to maintain an emergency supply of drugs, both scheduled and non-scheduled, subject to approval by the Board. The drugs maintained in the emergency drug supply shall remain the property of the pharmacy to whom the permit was jointly issued.
(i) The pharmacy servicing the facility or facilities listed in Section 26(a) shall make application to the Board, on an application provided by the Board. The Board may issue a permit, if the conditions of Section 26 are met, in the name of the facility and the pharmacy authorizing the storage and use of a emergency drug supply at the facility. This registration shall be valid until June 30 of each year. The permit must be renewed annually.
(ii) The fee for the permit shall be fifteen dollars ($15.00) annually.
(iii) The permit may be revoked by the Board if conditions as outlined in this section are not followed, or for other violations of the Wyoming Pharmacy Act or Wyoming Controlled Substance Act and/or rules and regulations promulgated under said Acts.
(b) The number of drugs provided by a pharmacy to a facility listed in Section 26(a) shall be limited to forty eight (48). Additional quantities require submission of an application listing the additional drugs requested with justification, and must be approved by the Board. The number of doses of each drug available shall be limited to thirty (30) doses of any separate drug dosage form in each emergency supply.
(c) The facility and the pharmacy servicing the facility shall develop and implement written policies and procedures to ensure safety, accuracy, accountability, security, patient confidentiality, and maintenance of the quality, potency, and purity of the emergency drug supply. Copies of the most recent policy and procedure manual shall be on file at both the facility and the pharmacy servicing the facility.
(i) The emergency drug supply policy and procedure’s manual shall be reviewed and approved annually, during the anniversary month of when the original permit was issued by the Board, by the pharmacist-in-charge of the pharmacy servicing the facility and the facility’s director of nursing.
(e) The emergency drug supply may only be stocked and restocked by a pharmacist licensed by this Board or a technician under his supervision. Discrepancies in controlled substance inventories shall be documented and reported to the Board of Pharmacy, within seven days of discovery.
(f) Drugs administered from the emergency drug supply shall be limited to the following:
(i) A new drug order given by a prescriber for a patient of the facility for administration prior to the next scheduled delivery from the pharmacy, or 72 hours, whichever is less. The drugs shall be administered only upon authorization by a pharmacist and after the pharmacist has reviewed the prescriber’s order and patient’s profile for potential contraindications and adverse drug reactions.
(ii) Drugs that a prescriber has ordered for a patient on an as-needed basis, if the utilization and administration of those drugs are subject to ongoing review by a pharmacist.
(iii) Drugs designated by the patient care policy committee or similar facility committee as an “emergency drug” may be administered from the emergency drug supply pursuant to the order of a prescriber for emergency or immediate administration to a patient of the facility. Within 72 hours after administration under this paragraph, the case shall be reviewed by a pharmacist.
(g) If the pharmacy servicing the facility discontinues their service, the Board must be notified and the permit surrendered. If the new pharmacy provider desires to maintain an emergency drug supply, they must make application to the Board.
(h) Facilities described in Section 26(a) are exempt from the provisions of Section 26 provided the pharmacy providing their emergency drug supply is physically located at the same site as the facility and this pharmacy possesses a DEA registration and is licensed by the Wyoming State Board of Pharmacy.
Section 27. Reinstatement of a Revoked or Suspended Pharmacist, Pharmacy Technician License.
(a) A pharmacist or pharmacy technician whose license has been revoked or suspended by the Board may file an application, supplied by the Board, requesting a hearing to present evidence to show why his pharmacist or pharmacy technician license should be reinstated subject to the following:
(i). A pharmacist or pharmacy technician whose license was revoked by the Board, may not file an application requesting a hearing until twelve (12) months has elapsed from the date the order revoking his pharmacist or pharmacy technician license has become final;
(ii) A pharmacist or pharmacy technician whose license was suspended by the Board, may not file an application requesting a hearing until one half (1/2) of the suspension so ordered by the Board has elapsed, or the order of suspension has become final, whichever is later;
(iii) A pharmacist shall submit an application fee of two hundred fifty dollars ($250.00), and pay for the cost of the hearing if the Board issues an order denying reinstatement. The $250.00 application fee shall be submitted with the application and is nonrefundable.
(iv) A pharmacy technician shall submit an application fee of one hundred twenty five dollars ($125.00), and pay for the cost of the hearing if the Board issues an order denying reinstatement. The $125.00 application fee shall be submitted with the application and is nonrefundable.
(v) The applicant must complete all questions and provide all information as requested on the application.
(vi) Incomplete applications and fee will be returned, and a hearing date will not be set by the Board.
(vii) In the application the pharmacist or the pharmacy technician shall authorize any health professional who has examined or treated the applicant to disclose his diagnosis and the reasons for it to the Board and the Board's staff.
(b) Applications received by the Board, will be reviewed by the Executive Director. The Executive Director shall:
(i) Review the application for completeness. If information or attachments are missing, the application and fee will be returned to the applicant with a letter stating the reason(s) for the rejection.
(ii) If the application is complete, the Executive Director in consultation with the Board's inspector, an ex-officio member of the Board, and legal counsel shall make a decision if the evidence submitted supports reinstatement or not. A hearing shall be scheduled by the Executive Director. The Executive Director will notify the applicant whether the Board's staff will support or oppose the request for reinstatement.
(c) The Board's Staff may require the applicant to submit to a health examination by a health professional chosen by the Board Staff. The health professional shall report on his examination to the Board's staff and may testify at a hearing on reinstatement. Cost for the examination shall be the responsibility of the applicant.
(d) To be reinstated, a pharmacist must prove that he has been rehabilitated so that further violation of the Board's statutes and/or rules is not likely to occur, and that he is competent to practice pharmacy. The Board may, as a condition to establish competency, require successful completion of one or more of the following:
(i) Complete the North American Pharmacist Licensure Examination (NAPLEX) with a minimum score of 75;
(ii) Complete the Multistate Pharmacy Jurisprudence Examination (MPJE) with a minimum score of 75; and/or
(iii) Complete an internship, not to exceed 2000 hours, as prescribed by the Board.
(e) To be reinstated, a pharmacy technician must prove that he has been rehabilitated so that further violation of the Board's statutes and/or rules is not likely to occur, and that he is competent to function as a pharmacy technician. The Board, as a condition to establish competency, may require successful completion of pharmacy technician examination.
(a) A pharmacist planning to engage in collaborative practice shall have on file at his place of practice a written signed agreement approved by the Board. The agreement allows the pharmacist, acting within the pharmacist's collaborative scope of practice, to conduct drug therapy management approved by a prescribing physician acting within the scope of the physician's current practice.
(b) The agreement shall include:
(i) The names of the prescribing physician and the pharmacist who are parties to the agreement;
(ii) The specific types of drug therapy management decisions that the pharmacist is allowed to make, which shall include:
(A) The types of diseases, drugs, or drug categories involved, and the extent of drug therapy management allowed in each case;
(B) The methods, procedures, decision criteria, and plan the pharmacist is to follow when conducting drug therapy management; and
(C) The procedures the pharmacist is to follow in the course of conducting drug therapy management, including documentation of decisions made and a plan or appropriate mechanism for communication and reporting to the prescribing physician concerning specific decisions made. Documentation shall occur in the prescribing physician's patient medical chart and shall also occur in the pharmacist's patient medical chart located within the pharmacist practice site.
(iii) A method for the prescribing physician to monitor compliance with the agreement and clinical outcomes when drug therapy management by the pharmacist has occurred and to intercede when necessary;
(iv) A provision that allows the prescribing physician to override the agreement whenever he deems it necessary or appropriate;
(v) A provision allowing the physician, pharmacist, and patient or patient's agent, parent, or guardian to cancel the agreement at any time by written notice to all parties. The pharmacist shall retain the original notice of cancellation for two (2) years; and
(vi) The signatures of the pharmacist and the prescribing physician who are entering into the collaborative practice agreement, and the dates when signed.
(c) Drug therapy management shall occur only for a particular patient pursuant to a specific written order from the prescribing physician. The written order shall conform to the format established by the Board of Pharmacy and shall include the following as a minimum.
(i) Patient's name, gender, date of birth, height, and weight;
(ii) Allergies;
(iii) Medical diagnoses;
(iv) All current medication(s) including current dosages (include OTC and prescription products);
(v) Pertinent lab values;
(vi) Drug therapy management authorized (including any lab test);
(vii) Method of communicating information between pharmacist and physician;
(viii) Frequency of physician follow-up;
(ix) Date order will be renewed (specific order must be renewed annually); and,
(x) Signatures of physician, pharmacist, and patient or the patient's agent, parent, or guardian and date signed.
(d) A pharmacist providing drug therapy management for a patient, shall obtain written consent from the patient or the patient's agent, parent or guardian prior to providing this service. Drug therapy management shall not be implemented for a particular patient, if the patient or the patient's agent, parent or guardian, refuses to give written consent after being informed of the responsibility for payment.
(e) At a minimum, the written agreement shall be reviewed/renewed annually. If necessary, the agreement may be revised. The Board of Pharmacy must approve all revisions, once signed by the pharmacist and the prescribing physician, prior to implementation.
(f) The Board shall review and approve all agreements including revisions prior to implementation. This shall be accomplished as follows:
(i) The Board shall appoint a Collaborative Practice Advisory Committee. This Committee shall be composed of five (5) members. Composition shall be two (2) pharmacists currently licensed by the Board and in active practice in Wyoming, one of whom is a current member of the Board of Pharmacy, two (2) physicians currently licensed by the Wyoming State Board of Medicine and in active practice in Wyoming, one of whom is a current member of the Board of Medicine, and the Board of Pharmacy's Executive Director.
(ii) A pharmacist who has developed an agreement shall forward five copies of the signed agreement to the Board of Pharmacy. The Executive Director shall convene the Collaborative Practice Advisory Committee to review pending agreements. The Committee shall have authority to recommend approval or rejection of the agreement.
(iii) The recommendation of the Collaborative Practice Advisory Committee shall be reported to the Board of Pharmacy at their next regularly scheduled meeting or as needed. The Board of Pharmacy's decision will be delivered to the pharmacist and prescribing practitioner within ten days of the Board's decision.
(iv) The pharmacist submitting an agreement or revisions to an approved agreement to the Board of Pharmacy shall not practice under the agreement until notified of approval by the Executive Director.
(g) A pharmacist and prescribing physician entering into an agreement must be currently licensed by their respective Board and authorized to practice in the State of Wyoming.
(h) Nothing in this Section shall be interpreted to permit a pharmacist to accept delegation of a physician's authority outside the limits included in W.S. §33-26-202 of the Medical Practice Act and the Board of Medicine's regulations.
Section 29. Electronic Prescription Transmission.
All prescription drug orders communicated by way of electronic transmission shall fulfill these requirements to be valid:
Be transmitted to a licensed pharmacy of the patient's choice, exactly as transmitted by the prescribing practitioner or designated agent, with no intervening person or entity having access to the prescription;
Identify the transmitter's phone number for verbal confirmation, the time and date of transmission, and the identity of the pharmacy intended to receive the transmission, as well as any other information required by federal or state laws and regulations;
(iii) Be transmitted by an authorized practitioner using a digital signature unique to the practitioner, if the transmission is from computer to computer; or be transmitted by an authorized practitioner using an electronic signature, unique to the practitioner, if transmitted from computer to fax machine;
(iv) The electronic transmission shall be deemed the original prescription drug order provided it is readily retrievable through the pharmacy computer system, and meets those requirements as outlined in W.S. 33-24-136. The electronic transmission shall be maintained for two years from the date of last use; and
(v) Contain all other information as required by state or federal law.
The pharmacist shall exercise professional judgement regarding the accuracy, validity, and authenticity of the prescription communicated by electronic transmission, consistent with existing federal or state laws and regulations.
All electronic equipment for receipt of prescriptions communicated by way of electronic transmission shall be maintained to prevent unauthorized access.
(d) Hard copy prescriptions presented to the patient, which are generated from electronic media utilizing an electronic signature shall be applied to paper that utilizes security features that will ensure that the prescription is not subject to any form of copying and/or alterations.
(e) However, prescriptions may be transmitted from fax to fax as allowed in Chapter 2, Section 20 of these regulations.