Fla. Stat. § 61N-1.013 - Prescription Drugs; Receipt, Storage and Security
(1) Establishments
in which prescription drugs are stored, manufactured, repackaged, kept, held,
used, sold, stored, offered for sale, or exposed for sale, shall be secured
against unauthorized entry or unauthorized access to prescription drugs when
establishment personnel are not present.
(a)
Establishments permitted under Chapter 499, F.S., that are authorized to take
possession of prescription drugs, other than medical oxygen, must be secured by
an alarm system which functionally and practically provides a deterrent to
unauthorized entry to the establishment or the area where the prescription
drugs are held or stored.
(b)
Prescription medical oxygen may be stored outside in an area surrounded by a
fenced enclosure with a lock which must be secure when authorized persons are
not present. Other compressed medical gases must be stored in accordance with
paragraph (a).
(2)
(a) While not being used to make deliveries,
a vehicle of a permittee containing prescription medical oxygen must be parked
at the permitted establishment and either locked inside a fenced compound or
secured by a vehicle alarm system. A vehicle containing prescription medical
oxygen may only be parked at a residence temporarily while the vehicle is
making deliveries or while "on call" for emergency deliveries.
(b) An unused drug delivery vehicle must be
parked inside a building secured by an alarm system that meets the requirements
of section 499.0121, F.S.
(c) A residence cannot be used to store any
prescription drug which has not been dispensed, unless a natural person
residing at that residence is licensed or otherwise authorized to possess
prescription drugs.
(3)
(a) The storage temperature definitions in
the U.S.P. are incorporated by reference herein. If no storage and temperature
requirements are set forth by the manufacturer in the labeling or in the
U.S.P., prescription drugs other than compressed medical gases must be stored
at controlled room temperature. Compressed medical gases, unless otherwise
indicated, may be stored in a manner so that they are protected from freezing
and are not stored at or near excessive heat or open flame.
(b) All establishments permitted under
Chapter 499, F.S., that handle prescription drugs other than medical gases,
must, in the absence of electronic monitoring devices, mount two thermometers
in the immediate area of the stored prescription drugs. For purposes of this
provision, immediate area of the stored prescription drugs is within six (6)
feet of the prescription drugs in storage. One thermometer will be mounted in
the warmest area of the stored prescription drugs and the other thermometer
will be mounted in the coolest immediate area of the stored prescription
drugs.
(c) A record must be
maintained recording the date; time; thermometer one temperature; thermometer
two temperature; and the initials of the person recording the data or reviewing
the data if electronically monitored. This record and temperature reading must
be recorded at least five (5) days each week with the temperature readings
taken between 2:00 p.m. and 4:00 p.m. (EST). Alternate times may be approved by
the department in writing. This record must be kept on file by the facility for
at least two years.
(d) Facility
requirements for the storage and handling of prescription drugs.
1. An applicant for an initial prescription
drug wholesaler permit must have a facility that is large enough to store the
estimated quantity of prescription drugs the applicant intends to possess under
its initial application to comply with the requirements of Section
499.0121(1),
F.S. An applicant for renewal of a prescription drug wholesaler permit must
have a facility that is large enough for the ongoing operations of the
wholesale establishment based on the prior year's volume of activity with
prescription drugs, which may be modified for reasonable fluctuations in
inventory management for the current year. These determinations will be based
on the type of prescription drugs the applicant possesses, or intends to
possess, considering the size of the containers as well as any other products
the applicant possesses or intends to possess. Notwithstanding the contention
that an applicant will distribute all prescription drugs the same day received,
the facility must be large enough to accommodate prescription drugs as set
forth herein in case the drugs are not distributed the same day
received.
2. An applicant for an
initial prescription drug wholesaler permit must have a refrigeration capacity
and freezer capacity large enough to store the estimated quantity of
prescription drugs that might require refrigeration or freezing that the
applicant intends to possess under its initial application to comply with the
requirements of Sections
499.0121(1) and
(3), F.S. and this rule. An applicant for
renewal of a prescription drug wholesaler permit must have a refrigeration
capacity and freezer capacity that is large enough for the ongoing operations
of the wholesale establishment based on the prior year's volume of activity
with prescription drugs that required refrigeration or freezing, which may be
modified for reasonable fluctuations in inventory management for the current
year, to comply with the requirements of Sections
499.0121(1) and
(3), F.S., and this rule. These
determinations will be based on the type of prescription drugs the applicant
possesses, or intends to possess, considering the size of the containers as
well as any other products the applicant possesses or intends to possess that
might require refrigeration or freezing. Notwithstanding the contention that an
applicant will distribute all prescription drugs the same day received, the
refrigeration and freezer capacity must be large enough to accommodate
prescription drugs as set forth herein in case the drugs are not distributed
the same day received.
3.
Prescription drugs obtained in "limited quantities" for research and
development ("R&D") purposes under Sections
499.01(3) and
(4)(b), F.S., and paragraph
61N-1.001(2)(n),
F.A.C., must be physically segregated from all other products intended for
manufacturing, compounding, dispensing, or administration. In a manufacturer's
establishment, these drugs must also be stored and maintained in a separate and
clearly designated area.
(4) Quarantine.
(a) A quarantine section shall be clearly
marked and designated separate and apart from any other place where drugs are
stored so that products therein shall not be confused with usable products
being held for sale. Any prescription drug stored outside the quarantine area
is a product held for sale or other distribution.
(b) The requirement of Section
499.0121(5)(b),
F.S., that prescription drugs must be quarantined if damage has occurred to the
immediate or sealed outer or sealed secondary containers means: a prescription
drug must be quarantined if obvious damage, determined by a visual inspection
of the exterior of the product's packaging, has occurred to any part of the
packaging that is or may be in direct contact with the dosage form of the drug
or any additional part of the packaging which is provided to prevent
adulteration of the drug in addition to "containing" the product.
(c) A person who handles both prescription
drugs and over-the-counter drugs or medical devices may have one quarantine
section; however, the storage requirements for prescription drugs must be
followed.
(5)
Examination of Prescription Drugs; Physical Product and Records.
(a)
1.
Every person receiving prescription drugs other than the consumer receiving
dispensed prescription drugs pursuant to Chapter 465, F.S., has a duty to
examine the product to prevent acceptance of prescription drugs that are unfit
for distribution or use. The extent of the examination should be predicated on
the conditions surrounding the transaction, including but not limited to any
previous sales of the product, i.e., purchase and delivery is not direct from
the manufacturer; the conditions of transport; and environmental conditions to
which the product may have been subjected.
2. A wholesaler, chain pharmacy warehouse, or
person authorized to administer or dispense a prescription drug that physically
receives a prescription drug must verify that the prescription drug received
matches the prescription drug identified on the corresponding pedigree. The
corresponding pedigree document shall contain all of the required information
described in Section 499.01212(2)(a) or
(b), F.S. as applicable, including the
information required in the forms described in subsection
61N-1.012(3),
F.A.C., for those distributions that are not eligible for the use of the direct
purchase pedigree.
(b)
Upon receipt, each outside shipping container must be visually examined for
identity and to prevent the acceptance of misbranded drugs, adulterated drugs
or prescription drugs that are otherwise unfit for distribution. If visual
examination of the shipping container or other conditions surrounding the
transaction suggest possible misbranding or adulteration, the person has a duty
to examine further the contents or conditions of sale.
(c) Prescription Drug Wholesalers must employ
personnel who can perform product examinations. Once the Prescription Drug
Wholesaler has inspected the shipped drugs and elected to accept them, the
wholesaler is responsible for the condition of the drugs. Until that time, the
shipper or manufacturer remains responsible for delivering a prescription drug
product in acceptable condition, unless responsibilities are modified by
contract.
(d) Authentication.
1. A prescription drug wholesaler may use
any, all, or any combination of the following methods to authenticate each
transaction on a pedigree paper and must maintain the corresponding
documentation regarding the authentication for the method used:
a. Receipt of an invoice (or shipping
document) from the seller to the purchaser, which may have the prices redacted.
Documentation requirements include at a minimum a copy of the invoice or
shipping document. If this method is used to authenticate a pedigree, the
wholesaler must review the document received for signs of tampering,
incompleteness, or inconsistency with other invoices or shipping documents from
that manufacturer or wholesaler, and must randomly verify the authenticity of
the invoice or shipping document with the seller or shipping point reflected on
that document using one of the methods in sub-subparagraph b., c., or d.,
below. Each wholesaler shall establish and adhere to policies and procedures
for the random verification of the authenticity of the invoices or shipping
documents according to statistically valid standards.
b. Telephone call to the seller.
Documentation requirements include a signed statement by the person placing the
telephone call identifying the person's name and position title representing
the seller who provides the information, the date the information was provided,
and verification of the sales transaction between the parties, including
verification of the date of the transaction and the quantity of prescription
drugs involved in the transaction.
c. Email communication with the seller.
Documentation requirements include a copy of the email that identifies the
person's name and position title representing the seller who provides the
information, the date the information was provided, and verification of the
sales transaction between the parties, including verification of the date of
the transaction and the quantity of prescription drugs involved in the
transaction.
d. Verification of the
transaction per a web-based system established by the seller or an independent
person that is secure from intentional or unintentional tampering or
manipulation to conceal an accurate and complete history of the prescription
drug transaction(s). Documentation requirements include a written
representation from the seller or independent person that the seller or
independent person, as applicable, is responsible for the information included
on the web site and has adequate security on the information posted to prevent
unauthorized tampering, manipulation, or modification of the information and a
copy of the (dated) web site page that confirms the sales transaction between
the parties, including the date of the transaction and the quantity of
prescription drugs involved in the transaction.
e. Receipt of a legible and unaltered copy of
a previous transaction's pedigree paper that had been signed under oath at the
time of the previous transaction to support the transaction to which the
pedigree paper relates. If this method is used to authenticate a pedigree, the
wholesaler must review the document received for signs of tampering,
incompleteness, or inconsistency, and must randomly verify the authenticity of
pedigrees using one of the methods in sub-subparagraph b., c., or d. above.
Each wholesaler shall establish and adhere to policies and procedures for the
random verification of the authenticity of these copies of pedigrees according
to statistically valid standards.
f. Receipt of a pedigree in an electronic
form from an automated system that complies with this sub-subparagraph that was
successfully opened and decrypted by an automated system that complies with
this sub-subparagraph. In order to rely on receipt of an electronic pedigree
without employing additional authentication methods as set forth in
sub-subparagraphs a.-e.
(I) The system used to
digitally sign and electronically authenticate the electronic pedigree must at
a minimum support the following digital signature standards or future revisions
governed by the National Institute of Standard and Technology (NIST):
(A) FIPS 140-2 validated cryptographic module
which is hereby adopted by reference.
(B) FIPS 186-2 validated digital signature
system which is hereby adopted by reference.
(C) FIPS 180-2 validated hash function which
is hereby adopted by reference.
(II) The system must employ controls to
ensure the security and integrity of the private key so that it cannot be
accessed by someone other than the certificate holder. At a minimum, the system
must:
(A) Control the activation of the
private key with an authentication mechanism.
(B) Employ a ten-minute inactivity time
period after which the certificate holder must re-authenticate to access the
private key.
(C) When the signing
module is deactivated, clear the plain text private key from the system memory
to prevent the unauthorized access to, or use of, the private key.
(III) The system must communicate
with the Certification Authority directory, either each time authentication and
validation steps in sub-subparagraph (IX) below occur or at least on a daily
basis to download information to perform the authentication and validation
which will occur on that day.
(IV)
The system must have a time system that is within five minutes of the official
NIST time source and date and time stamp any and all digital
signatures.
(V) The system must
archive digitally signed files unaltered, including the original hashes and
reference to the public keys, in a manner that facilitates retrieval of the
record consistent with the recordkeeping requirements.
(VI) The system must prevent issuance of an
outgoing pedigree paper if the total quantity of prescription drugs distributed
in all pedigrees exceeds the quantity of prescription drugs received in the
corresponding incoming electronic pedigree.
(VII) The system must maintain a history file
of any outgoing electronic pedigree that is subsequently voided or altered and
notify the recipient that the pedigree sent to it was voided or
altered.
(VIII) The system must
maintain a history file of any incoming notification received pursuant to
sub-sub-subparagraph (VII) above that a pedigree was voided or altered and
prevent the issuance of an outgoing pedigree using a pedigree that was voided
or altered.
(IX) The system must
verify or perform the following:
(A) Each
transaction on the electronic pedigree must be digitally signed using
certificates issued through a public key infrastructure system authorized by
the department.
(B) The electronic
pedigree must contain each prior transaction digitally signed and unaltered,
including the original hash and reference to the public key, with the new
transaction information appended to the new document and the entire resulting
pedigree digitally signed, including the resulting hash and reference to the
public key.
(C) The system must
check the certificate expiration date of each signed transaction and compare it
against the date and time that the transaction was signed to determine that the
certificate has not or had not expired at the time the record was
signed.
(D) The system must check
the digital signature for each signed transaction against the Certificate
Authority's directory and the Certificate Revocation List and verify whether
the certificate holder is or was authorized to sign electronic pedigrees at the
time the transaction was signed.
(E) The system must decrypt each digital
signature for each signed transaction in the pedigree using each sender's
public key and compare it against the message digest to determine that the
record has not been altered since it was originally signed.
(F) The system must require that all
authentication and validation steps in the preceding paragraphs are carried out
prior to allowing the acceptance of the transaction. The system should not
allow the further processing of any transaction that has failed to pass any
authentication or validation step.
(X)
(A) The
manufacturer must initiate the pedigree; or, until such time as the
manufacturer initiates a pedigree to the wholesaler, the wholesaler that
purchased the prescription drug from the manufacturer must imbed a copy of the
sales invoice or the manufacturer's EDI transmission or Advance Ship Notice
(ASN) that contains all required data elements for a complete audit trail as
set forth in Rule 61N-1.012, F.A.C., related to
that wholesaler's acquisition of the prescription drug from the manufacturer.
Price information related to the transaction may be redacted from the imbedded
copy of the sales invoice, the EDI transmission, or the ASN.
(B) If a pedigree complies with all
provisions within sub-subparagraph f. except for sub-sub-sub-subparagraph
(X)(A), above, then a prescription drug wholesaler must use another method
authorized by this rule to authenticate the distribution from the manufacturer
to the first wholesaler. Subsequent distributions may be authenticated in
accordance with sub-subparagraph f.
I. If a
pedigree cannot be authenticated because of a clerical error, the pedigree must
be corrected by the sender.
II. If
a pedigree cannot be authenticated and the reason is other than a clerical
error, or the reason cannot be satisfactorily ascertained based on preliminary
investigation, the prescription drug for which the pedigree cannot be
authenticated must be quarantined and the department notified within 3 business
days.
III. A purchasing wholesaler
may use a written contract between the purchasing wholesaler and its wholesale
supplier, which is a primary wholesaler as defined in Section
499.012(1)(d),
F.S., that requires that all prescription drugs distributed to the purchasing
wholesaler by the wholesale supplier must be purchased by the wholesale
supplier from the manufacturer. If this method is used to authenticate a
pedigree, the purchasing wholesaler shall establish and adhere to policies and
procedures for the random verification of the authenticity of the pedigrees
that disclose the supplier wholesaler purchased the prescription drug from the
manufacturer according to statistically valid standards.
IV. The following persons in Florida that are
authorized to purchase or possess prescription drugs are not required to
authenticate a pedigree paper received from a person authorized by law to
distribute prescription drugs to that person:
A. A licensed pharmacy, unless it is also
permitted as a retail pharmacy wholesaler and will engage in the wholesale
distribution of that drug, or unless it is a member of an affiliated group and
will distribute a prescription drug purchased or received directly from a
prescription drug wholesaler that is not also a member of its affiliated group
to another member of its affiliated group;
B. A medical practitioner; or
C. A restricted prescription drug distributor
- health care entity.
V.
In order to authenticate pedigrees, a manufacturer of a prescription drug that
is sold or distributed in Florida must make available upon request information
relevant to authenticating a pedigree for that drug regardless of whether the
prescription drug was sold directly by the manufacturer to a person in
Florida.
VI. Any wholesaler or
repackager required under Chapter 499, F.S., to receive a pedigree paper must
authenticate the pedigree pursuant to Section
499.0121(4),
F.S., notwithstanding the absence of a pedigree paper or authentication by
persons in the distribution chain not subject to the requirements of Chapter
499, F.S.
(6) Any establishment that is
permitted as a prescription drug wholesaler or repackager must notify the
department in writing within three working days of discovery of a significant
loss or theft of prescription drugs. Whether a loss or theft is significant is
to be based on the prescription drug wholesaler's written policies and
procedures that may take into account the actual quantity in relation to the
type or size of the business; any pattern of losses or thefts; and local trends
or other indicators of the diversion potential. Notification to the Drugs,
Devices and Cosmetic Program may be made by facsimile to (850)414-8240 and must
include at a minimum, identification of the permitted establishment reporting
the loss or theft; a complete identification of the prescription drug(s)
involved, including but not limited to the name of the manufacturer or
distributor reflected on the label of the products, the dosage form, strength,
container size, the quantity of each, the lot numbers if known; a brief
description of the circumstances surrounding the theft or loss; and a contact
person's name and telephone number to provide additional information.
(7) Due Diligence Inspection. With respect to
the inspection required under Section
499.0121(12)(e),
F.S., a prescription drug wholesaler may rely on a due diligence inspection
performed by a person that is independent of both wholesalers for purposes of
the requirement in Section
499.0121(12)(e),
F.S.
Notes
Rulemaking Authority 499.0121, 499.05 FS. Law Implemented 499.006, 499.007, 499.01, 499.0121, 499.052 FS.
New 7-8-84, Amended 1-30-85, Formerly 10D-45.535, Amended 11-26-86, 7-1-96, Formerly 10D-45.0535, Amended 1-26-99, 4-17-01, 1-1-04, 1-19-06, 11-18-07, Formerly 64F-12.013, Amended 11-16-15.
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