Chapter 146
2025 -- H 5855 SUBSTITUTE A
Enacted 06/24/2025

A N   A C T
RELATING TO FOOD AND DRUGS -- RHODE ISLAND FOOD, DRUGS, AND COSMETICS ACT

Introduced By: Representatives McGaw, Edwards, Giraldo, Cotter, Handy, Boylan, Furtado, Caldwell, Stewart, and Voas

Date Introduced: February 28, 2025

It is enacted by the General Assembly as follows:
     SECTION 1. Section 21-31-16.1 of the General Laws in Chapter 21-31 entitled "Rhode
Island Food, Drugs, and Cosmetics Act" is hereby amended to read as follows:
     21-31-16.1. Substitution of generic drugs and biological products Substitution of
generic drugs, biological products, devices and supplies, and therapeutically equivalent
products by a pharmacist.
     (a) Drug product selection. The director shall permit substitution of less expensive generic,
chemical, or brand-name drugs and pharmaceuticals, excluding biological products, considered by
the director as therapeutically equivalent and interchangeable with specific, brand-name drugs and
pharmaceuticals, if they are found to be in compliance with § 21-31-16 and standards set forth by
the United States Food and Drug Administration under §§ 505 and 507 of the Federal Food, Drug,
and Cosmetic Act, 21 U.S.C. §§ 355 and 357. The director shall may consider, but not be limited
to, the determination of the United States Food and Drug Administration, or its successor agency,
as published under §§ 505 and 507 of the Federal Food, Drug, and Cosmetic Act. The director shall
provide for the distribution of copies of lists of prescription drug products that the director deems,
after evaluation, not to be therapeutically equivalent, and revisions to the lists, among physicians
and pharmacists licensed and actively engaged in practice within the state, and other appropriate
individuals, and shall supply a copy to any person on request. The list shall be revised from time to
time so as to include new, pertinent information on approved prescription-drug products, reflecting
current information as to standards for quality, safety, effectiveness, and therapeutic equivalence.
     (b) Appropriations. The director shall provide necessary space, personnel, and material to
carry out the provisions of this section.
     Drug products deemed to be therapeutically equivalent are outside of brand/generic
switches or biological interchangeable products.
     (1) Pharmacists substituting therapeutically equivalent products shall document the change
on the prescription and notify the prescribing provider of the change within seven (7) calendar days.
     (2) Pharmacists shall not be mandated to substitute therapeutically equivalent products nor
are patients required to accept a medication substitution.
     (3) Therapeutic interchange applies to initial starts or “first fills” as well as those continuing
care.
     (c) Liability. There shall be no civil liability incurred, and no cause of action of any nature
shall arise, against the director, designated agents, or employees, as a result of the listing or
omission of drugs or pharmaceuticals or biological products for product selection therapeutic
substitution.
     (d) Annual reports. The director shall make annual reports to the general assembly by
February 10 of each year showing a list of approved prescription-drug products with therapeutic
equivalence and approved prescription interchangeable biological products, and an estimate of the
average savings to the general public.
     (e)(d) Pharmacists. When a pharmacist dispenses a therapeutically equivalent drug product
or pharmaceutical or interchangeable biological product, there shall be no additional liability
imposed on the prescriber who authorizes that product selection, or on the pharmacist performing
therapeutic substitution or dispensing the product selection from a physician’s oral or written order.
     (f)(e) Enforcement provisions. It is made the duty of the department of health, its agents
designated by the director of health, and of all peace officers within the state to enforce all
provisions of this section and of §§ 5-19.1-19, 5-37-18 — 5-37-18.2, and 21-31-3.
     (g)(f) Biological-product selection. The director shall permit substitution of a less-
expensive an equivalent biological product, as defined in § 5-19.1-2, for a another prescribed
biological product only if said less-expensive biological product is an interchangeable biological
product as defined in § 5-19.1-2. The director shall maintain on the Rhode Island state department
of health website, a link to the current list of each biological product determined by the United
States Food and Drug Administration to be an interchangeable biological product.
     (g) Device product selection. The director shall permit substitution of a device, or supply
as defined in § 5-19.1-2, for a prescribed product only if said product is approved for the same
indication, use, and if applicable, formulation. In the event that a class of devices monitor
differently (i.e., single reading vs. continuous), the interchanged device must monitor in the same
fashion. Such examples suitable for interchange include, but are not limited to, supplies and devices
used to monitor glucose, administer insulin or another pharmacologic product.
     SECTION 2. This act shall take effect on January 1, 2026.
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LC001847/SUB A
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