State approaches to therapeutic interchange in community pharmacy settings: Legislative and regulatory authority

Thomas Vanderholm, Donald Klepser, Alex J. Adams

Research output: Contribution to journalReview articlepeer-review

4 Scopus citations


Therapeutic interchange is the act of switching a prescribed drug for another drug in the same therapeutic class that is believed to be therapeutically similar but may be chemically different. Therapeutic interchange is different from generic substitution in that it does not occur between therapeutically equivalent products; instead, products are substituted for those that are likely to have a substantially equivalent therapeutic effect generally at a lower cost. Therapeutic interchange is common in institutional settings across the United States but rarely occurs in community pharmacy settings without a pharmacist first contacting the original prescriber and requesting a new prescription in order to facilitate a change. As of 2018, Arkansas, Idaho, and Kentucky have passed laws to enable therapeutic interchange in community pharmacy settings. In general, these laws require the original prescriber to opt-in to allow therapeutic interchange, and the pharmacist generally must leverage the formulary of the patient’s health plan to guide decision making within the same therapeutic class. These 3 states require that the pharmacist notify the original prescriber of any interchange in order to ensure a complete and accurate medication record. When appropriately structured, state laws enabling therapeutic interchange in community pharmacy settings allow pharmacists to use their medication expertise to save valuable time and enhance patient care while reducing health care costs.

Original languageEnglish (US)
Pages (from-to)1260-1263
Number of pages4
JournalJournal of Managed Care and Specialty Pharmacy
Issue number12
StatePublished - Dec 1 2018

ASJC Scopus subject areas

  • Pharmacy
  • Pharmaceutical Science
  • Health Policy


Dive into the research topics of 'State approaches to therapeutic interchange in community pharmacy settings: Legislative and regulatory authority'. Together they form a unique fingerprint.

Cite this