AB 15 GOES INTO EFFECT JUNE 9, 2016:

PA requests will be accepted on or after June 9, 2016

Qualified Patients:

The requirements of the law are (patient requirements):

  • 18 years of age or older
  • Able to make and communicate health care decisions
  • A California resident, verified through a driver's license or other state identification, voter registration or tax return
  • Has a terminal illness—a disease that will, within reasonable medical judgment, produce death in six months
  • Has made 3 voluntary requests, two oral (separated by 15 days between) and one written, which must be signed by two witnesses
  • Patient must sign a "final attestation" form before ingesting the drug, saying they are fully informed of the consequences and alternatives

Documentation Required (Approved Usage Guidelines):

  • End of life diagnosis AND

  • DMHC form completed with all pertinent information except medications tried/failed section need not be completed AND

  • The form must be marked the drug is for patient self-administration AND

  • Physician documented the patient completed the waiting period process and that the patient signed the final attestation AND

  • Request includes names of the following physicians:“Attending physician”, who writes the prescription, and a "consulting physician," who confirms the diagnosis, prognosis and the patient's capability to make an informed decision

Coverage Not Authorized:

  • When all of the documentation requirements stated above are not included with the request

Most Commonly Prescribed Drugs, Dosing Regimen, And Authorization Limit [note - these are examples - prior authorization consideration is based on the evidence-supported prescriber selected therapies and completion of all required documentation as stated above]:

  • Secobarbital is the medication most commonly prescribed for physician-assisted suicide, followed by pentobarbital. The lethal dose prescribed is typically 9 g of secobarbital in capsules or 10 g of pentobarbital liquid, to be consumed at one time

    • The pharmacist or physician should instruct patients to take the lethal dose on an empty stomach to increase the rate of absorption

    • The typical dose of pentobarbital as an oral hypnotic for adults is 100–200 mg at bedtime, and that of secobarbital is 100 mg orally at bedtime

    • Patients receiving the lethal dose of secobarbital or pentobarbital may be instructed to take an antiemetic (e.g., metoclopramide) about one hour before ingesting the barbiturate to prevent nausea and vomiting

  • Medications requests will receive a onetime approval


 

Last review date: July 25, 2016

Rite Aid Pharmacy Patients: All Rite Aid pharmacies nationwide are closing! Please be on the lookout for information from Rite Aid pharmacies about their bankruptcy and store closures. Call your Rite Aid pharmacy for questions about your prescriptions and new pharmacy options. WHA is here to help as well. Contact Us via Phone