Relating to a pharmacist's authority to dispense ivermectin without a prescription.

Contracts

• PBM Agreements: Most Pharmacy Benefit Manager contracts require a valid prescription from a recognized provider with an NPI. Unless PBMs update adjudication logic, these claims will likely reject or trigger audits. Default to Cash/Self-Pay models immediately to avoid chargebacks.
• Employment Agreements: Review pharmacist contracts and policy manuals. Determine if your organization will mandate this service or leave it to the pharmacist's professional discretion.

Hiring/Training

• Clinical Protocol Training: Staff must be trained on the specific TSBP screening questionnaire (once released). This is not a "cash and carry" transaction; it requires a documented clinical assessment.
• Workflow Allocation: Adjust staffing models to account for the increased time per transaction required for patient counseling and screening, which exceeds standard dispensing time.

Reporting & Record-Keeping

• Liability Documentation: To qualify for the civil and criminal immunity granted by Sec. 446.001(b), you must prove you acted in a "reasonably prudent manner." You must implement a mandatory Patient Intake/Screening Form that mirrors the TSBP protocol.
• Labeling: Update Pharmacy Management Software (PMS) to list the pharmacist or the standing order as the prescriber on the vial label.

Fees & Costs

• Pricing Strategy: Establish a flat cash price that includes both the medication cost and a clinical consultation fee to cover the pharmacist's assessment time, as insurance reimbursement is unlikely at launch.
• Insurance Review: Verify that your professional liability insurance policy covers "protocol-based dispensing" or "pharmacist prescriptive authority."