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Model Resolutions

RESOLUTION CONCERNING DRUG SUBSTITUTIONS

CMA House 2003 Resolution Author, Thomas W. LaGrelius MD, Delegate

Title: Drug substitutions email address [email protected]

Whereas: At least two California hospitals (Stanford Hospital and Torrance Memorial Medial Center) have instituted medical staff rules that allow the hospital administration to automatically substitute one chemically distinct drug (Avalox) for another other chemically distinct drugs (Levaquin and Tequin) without the advance knowledge or permission of the ordering physician and

Whereas: CMA legal has opined emphatically that this practice is illegal under various statutes that prohibit such drug substitutions (except for identical generics which is permitted if the prescribing doctor does not write "do no substitute" in the order) and

Whereas: The California Board of Pharmacy has closed it's legal opinion service in January, 2002 for lack of funds to pay for the service and now advises petitioners to get and pay for such opinions privately and

Whereas: Two medical staffs have failed to challenge hospital administration lawyers who sited pharmacy laws dealing with drug change sequences authorized in protocols as justification for this practice, and

Whereas: Such protocols were designed to simplify practice for physicians who choose to order protocol use if individually desired, not permit automatic chemically distinct drug substitutions according to CMA legal, the CMA's EVP and the CMA's Chief Lobbiest.

Resolved: CMA take any and all steps necessary to disseminate, clarify and enforce its opinion that automatic chemically distinct drug substitutions in hospitals without the written advance consent of the ordering doctor are illegal and

Resolved: That CMA and CMA legal be authorized by the House to assist physicians in reversing the implementation and blocking the spread and clarifying the illegality of such automatic drug substitutions in hospitals