VirginiaSB4182026 Regular SessionSenateWALLET

Therapeutic interchange; authorizes pharmacists to perform, adaptation of prescriptions.

Sponsored By: Barbara A. Favola (Democratic)

Became Law

Summary

Therapeutic interchange and adaptation. Authorizes pharmacists to perform therapeutic interchanges by substituting a drug with another drug in the same therapeutic class when such substitution lowers the cost or is cost-neutral to the patient or the prescribed drug is in a drug shortage and the substitution conforms to Board of Pharmacy regulations. The bill directs the Board of Pharmacy to determine which therapeutic classes of drugs shall be eligible for therapeutic interchange and which classes shall be prohibited. The bill also authorizes pharmacists to adapt prescriptions by changing the dosage form or quantity of a medication or by completing missing information on a prescription when there is evidence to support such change.

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Bill Overview

Analyzed Economic Effects

2 provisions identified: 1 benefits, 0 costs, 1 mixed.

New exceptions for drug and biosimilar substitutions

Virginia keeps the general ban on switching a prescribed drug or biologic without the prescriber’s OK. The law now allows exceptions. Pharmacists may give a therapeutically equivalent drug or make a permitted therapeutic interchange or adaptation. They may also dispense an interchangeable biosimilar when state law allows it.

Pharmacists can switch to similar, cheaper drugs

In Virginia, a pharmacist can replace your drug with a similar one in the same class. They can only do this if it costs you less or the same, or during a shortage listed by the FDA or ASHP. The pharmacist may change the name, strength, directions, quantity, or dosage form to give the same total amount, and may complete missing details when supported. Your prescriber can block any change by marking “Dispense as Written.” If a switch is made, the pharmacist must tell your prescriber within 24 hours. The Board of Pharmacy sets which drug classes are allowed or banned for interchange.

Sponsors & Cosponsors

Sponsor

  • Barbara A. Favola

    Democratic • Senate

Cosponsors

There are no cosponsors for this bill.

Roll Call Votes

All Roll Calls

Yes: 209 • No: 11

House vote 2/27/2026

Passed House

Yes: 87 • No: 8

House vote 2/24/2026

Reported from Health and Human Services

Yes: 19 • No: 3

House vote 2/19/2026

Subcommittee recommends reporting

Yes: 10 • No: 0

Senate vote 2/10/2026

Read third time and passed Senate Block Vote

Yes: 40 • No: 0

Senate vote 2/9/2026

Senator Favola Amendment agreed to

Yes: 0 • No: 0

Senate vote 2/9/2026

Reading of amendment waived (Voice Vote)

Yes: 0 • No: 0

Senate vote 2/6/2026

Passed by for the day Block Vote (Voice Vote)

Yes: 0 • No: 0

Senate vote 2/6/2026

Constitutional reading dispensed Block Vote (on 1st reading)

Yes: 39 • No: 0

Senate vote 2/5/2026

Reported from Education and Health

Yes: 14 • No: 0

Actions Timeline

  1. Acts of Assembly Chapter text (CHAP0888)

    4/13/2026Governor
  2. Approved by Governor-Chapter 888 (effective 7/1/2026)

    4/13/2026Governor
  3. Governor's Action Deadline 11:59 p.m., April 13, 2026

    3/10/2026Governor
  4. Enrolled Bill communicated to Governor on March 10, 2026

    3/10/2026Senate
  5. Fiscal Impact Statement from Department of Planning and Budget (SB418)

    3/4/2026Senate
  6. Bill text as passed Senate and House (SB418ER)

    3/4/2026Senate
  7. Enrolled

    3/4/2026Senate
  8. Signed by President

    3/4/2026Senate
  9. Signed by Speaker

    3/4/2026House
  10. Passed House (87-Y 8-N 0-A)

    2/27/2026House
  11. Read third time

    2/27/2026House
  12. Read second time

    2/26/2026House
  13. Reported from Health and Human Services (19-Y 3-N)

    2/24/2026House
  14. Subcommittee recommends reporting (10-Y 0-N)

    2/19/2026House
  15. Assigned sub: Health Professions

    2/16/2026House
  16. Read first time

    2/13/2026House
  17. Referred to Committee on Health and Human Services

    2/13/2026House
  18. Placed on Calendar

    2/13/2026House
  19. Fiscal Impact Statement from Department of Planning and Budget (SB418)

    2/11/2026Senate
  20. Read third time and passed Senate Block Vote (40-Y 0-N 0-A)

    2/10/2026Senate
  21. Floor offered

    2/9/2026Senate
  22. Senator Favola Amendment agreed to

    2/9/2026Senate
  23. Reading of amendment waived (Voice Vote)

    2/9/2026Senate
  24. Engrossed by Senate as amended (Voice Vote)

    2/9/2026Senate
  25. Read second time

    2/9/2026Senate

Bill Text

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