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Committee advances bill letting pharmacists substitute therapeutically equivalent drugs to reduce delays
Summary
Senate Bill 482 would expand pharmacists’ authority to substitute therapeutically equivalent products (not just generic equivalents). Sponsors and pharmacists said the change reduces delays and prevents treatment interruptions; committee held the bill for revision after testimony.
PROVIDENCE, R.I. — The Senate Committee on Health and Human Services considered Senate Bill 482 on March 20, a measure that would explicitly permit pharmacists to substitute therapeutically equivalent drugs and therapeutically equivalent devices or supplies at the point of dispensing.
Sponsor Senator Lauria told the committee the change would allow pharmacists to make clinically appropriate interchanges — for example, switching among proton pump inhibitors or selecting a therapeutically equivalent inhaler — without delaying therapy while waiting for the prescriber to reissue a prescription. “This would allow the pharmacist to make that therapeutic equivalent change,” Lauria said, adding that the Department of Health would produce a list of therapeutically equivalent products and that safeguards could exclude non‑equivalent devices such as different types of continuous glucose monitors.
Pharmacists and pharmacy students testified in favor. Chris Federico of the Rhode Island Pharmacists Association said the bill is an update to existing substitution law and would reduce care delays caused by insurance coverage, stock shortages or formulary differences. Madison Hartling, a Pharm.D. candidate with community pharmacy experience, described a case in which formulary coverage and timing of provider signatures delayed a patient’s medication by several days; she said the ability to substitute a therapeutically equivalent product would have provided faster access.
Committee action: Senators voted to hold Senate Bill 482 after testimony; lawmakers requested collaboration between the Department of Health, the medical society and pharmacy associations on lists of therapeutically equivalent products and on guardrails to preserve patient safety.
Why it matters: Witnesses said therapeutic substitution would reduce missed or delayed treatment, particularly in urgent or out‑of‑office scenarios (weekends, holidays, vacations) and would reduce administrative burden on provider offices and pharmacies. Opponents were not recorded in testimony on this bill during the hearing.
Next steps: The committee asked for technical language and stakeholder input on the Department of Health’s list and a process for clinical consultation; the measure was held for amendment.
