Virginia Regulatory Town Hall
Department of Health Professions
Board of Pharmacy
Regulations Governing the Practice of Pharmacy [18 VAC 110 ‑ 20]
Implementation of 2021 legislation for pharmacists initiating treatment
Action 5861
General Information
Action Summary Regulations in section 150 of 18VAC110-20 and in section 46 of 18VAC110-21 are amended to include the additional drugs and devices that may be initiated by a pharmacist and the authority to dispense controlled paraphernalia or other supplies or equipment in addition to certain drugs and devices, in accordance with provisions of Chapter 214 of the 2021 Acts of the Assembly. Section 46 was added by an emergency regulatory action in 2020; the additions to implement the 2021 legislation include: 1) Drugs as defined in § 54.1-3401, devices as defined in § 54.1-3401, controlled paraphernalia as defined in § 54.1-3466, and other supplies and equipment available over-the-counter, covered by the patient's health carrier when the patient's out-of-pocket cost is lower than the out-of-pocket cost to purchase an over-the-counter equivalent of the same drug, device, controlled paraphernalia, or other supplies or equipment; 2) Vaccines included on the Immunization Schedule published by the Centers for Disease Control and Prevention or that have a current emergency use authorization from the U.S. Food and Drug Administration; 3) Tuberculin purified protein derivative for tuberculosis testing; and 4) Controlled substances for the prevention of human immunodeficiency virus, including controlled substances prescribed for pre-exposure and post-exposure prophylaxis pursuant to guidelines and recommendations of the Centers for Disease Control and Prevention.
Chapters Affected
  VAC Chapter Name Action Type
Primary 18 VAC 110-20 Regulations Governing the Practice of Pharmacy Amend Existing Regulation
Other chapters
  18 VAC 110 - 21 Regulations Governing the Licensure of Pharmacists and Registration of Pharmacy Technicians Amend Existing Regulation
Executive Branch Review This action will go through the normal Executive Branch Review process.
RIS Project Yes  [6989]
Associated Mandates Pharmacists initiating treatment
New Periodic Review This action will not be used to conduct a new periodic review.
Stages associated with this regulatory action.
Stage ID Stage Type Status
9452 Emergency/NOIRA Stage complete. Emergency regulation superseded by final permanent regulation.
9562 Proposed Stage complete. Comment period ended 01/20/2023.
9921 Final Stage complete. This regulation became effective on 11/08/2023.
Contact Information
Name / Title: Caroline Juran, RPh  / Executive Director
Address: 9960 Mayland Drive
Suite 300
Richmond, VA 23233-1463
Email Address:
Phone: (804)367-4456    FAX: (804)527-4472    TDD: ()-

This person is the primary contact for this chapter.