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Panel approves measure to let Board of Pharmacy permit therapeutic interchange

Virginia General Assembly Health Professions Subcommittee · February 20, 2026
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Summary

SB 418, which would let the Virginia Board of Pharmacy adopt regulations allowing therapeutic interchange of drugs with equivalent therapeutic effect, was reported out by the subcommittee 10-0 after supporters described regulatory safeguards and a floor amendment.

Senator Favola told the subcommittee SB 418 permits the Board of Pharmacy to promulgate regulations allowing therapeutic interchange—substituting a therapeutically equivalent product when appropriate—to improve access and continuity of therapy. The sponsor noted practitioners retain the ability to prevent substitution by indicating "no substitute" on prescriptions.

Amy Perrin Seibert, representing the Virginia College of Emergency Physicians, said stakeholders worked on a floor amendment to ensure appropriate clinical safeguards and thanked the sponsor for the change. "We really appreciate the ability to, in certain circumstances, not be able to do a substitution in case a specific drug is indicated for a different type of disease," Seibert said.

Committee members offered brief supportive remarks and moved to report the bill as amended. The clerk recorded a vote of 10-0 recommending SB 418 be reported out of committee. The bill directs the Board of Pharmacy to adopt the regulatory framework and does not itself set substitution rules beyond authorizing regulations and preserving prescriber control.