NASP’s Letter to Attorney General Ford regarding the Nevada Board of Pharmacy Reinterpretation of N.R.S. 639.100(1)(a)
Dear Attorney General Ford:
I write today on behalf of the National Association of Specialty Pharmacy (NASP) and our specialty pharmacy members that operate in the state of Nevada. It is our understanding that the Nevada Attorney General has been requested by the Nevada State Board of Pharmacy (“the Board”) to review the following question: Does Nevada law require pharmacists dispensing drugs to be licensed? This question follows the Board’s July 2021 opinion letter that reinterpreted N.R.S. 639.100(1)(a) so that now each pharmacist that works at a non-resident pharmacy must obtain a license from the Board. Previously, the regulation was interpreted so that only the non-resident pharmacy as a whole was required hold the licensure in Nevada, not each pharmacist.
In light of this new regulatory interpretation, and as you review this question, we believe that it is important for you to understand the impact that this rule will have on non-resident specialty pharmacy practice, and ultimately patients who require access to specialty medications in Nevada.
NASP represents the entire spectrum of the specialty pharmacy industry including the nation’s leading specialty pharmacies and practicing pharmacists; nurses and technicians; small and midsize pharmacy benefit managers (PBMs); pharmaceutical and biotechnology manufacturers of specialty drugs; group purchasing organizations; wholesalers and distributors; integrated delivery systems and health plans; patient advocacy organizations; and technology, logistics and data management companies. NASP define a specialty pharmacy as a state licensed and registered pharmacy that is accredited by an independent, third-party accreditor and solely or largely provides medication and patient medication management services to patients with complex and chronic diseases requiring expensive and challenging treatment with complex medication therapies. Specialty pharmacists that work in Nevada have unique expertise in supporting patients with conditions like cancer, multiple sclerosis, cystic fibrosis, and HIV/AIDS.
Regulation Interpretation of Non-Resident Pharmacies Issued by the Board:
On July 22, the Board began informing NASP members that operate as non-resident specialty pharmacies in Nevada that the state had recently changed their interpretation of the state’s regulation of non-resident pharmacies. Under the new interpretation, any pharmacist compounding or dispensing any prescription for a patient located in Nevada must obtain a license and register with the Board.
The interpretation of the regulation constitutes a significant shift in policy and has significant negative and consequential impacts on pharmacies and patients. The interpretation was issued independent of any public notice and comment period. N.R.S 233B.061 states that when engaging in rulemaking, including interpretation of a regulation, “all interested persons must be afforded a reasonable opportunity to submit data, views or arguments upon a proposed regulation, orally or in writing.” Furthermore, N.R.S 233B.0603 also requires that a notice of intent be shared with the public if adopting or amending an existing regulation, and that the notice of intent must include a statement of the estimated economic effect of the regulation on the business which it is to regulate. The Board did not engage in a public comment period, not did they issue a notice of intent to review an existing relation, in violation of the state’s rulemaking requirements.