VirginiaSB4182026 Regular SessionSenateWALLET

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

Sponsored By: Barbara A. Favola (Democratic)

Signed by Governor

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

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

Virginia patients get more prescription options

Virginia pharmacists can switch a prescription to another drug in the same treatment class. In the pharmacist’s judgment, the replacement must have similar treatment effects and side effects at an equivalent dose. The switch must lower or leave unchanged the patient’s cost, except during a listed drug shortage. A shortage qualifies when listed by the FDA or the American Society of Health-System Pharmacists. During a switch, pharmacists can change the drug name, strength, directions, or amount to match the replacement. They can also change the medicine’s form when that serves the patient’s best interest, with directions ensuring an equivalent amount. They can change the quantity when the prescribed amount or package size is unavailable commercially or an allowed form change requires it. Pharmacists can fill in missing prescription details when evidence supports the change. After a drug switch, they must notify the prescriber within 24 hours. Prescribers can block substitution by checking “Dispense as Written.” The Board of Pharmacy must issue rules identifying allowed and prohibited treatment classes, and pharmacists must follow those rules.

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. Acts of Assembly Chapter text (CHAP0888)

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

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

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

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

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

    3/4/2026Senate
  8. Enrolled

    3/4/2026Senate
  9. Signed by President

    3/4/2026Senate
  10. Signed by Speaker

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

    2/27/2026House
  12. Read third time

    2/27/2026House
  13. Read second time

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

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

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

    2/16/2026House
  17. Read first time

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

    2/13/2026House
  19. Placed on Calendar

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

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

    2/10/2026Senate
  22. Floor offered

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

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

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

    2/9/2026Senate

Bill Text

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