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):
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End of life diagnosis AND
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DMHC form completed with all pertinent information except medications tried/failed section need not be completed AND
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The form must be marked the drug is for patient self-administration AND
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Physician documented the patient completed the waiting period process and that the patient signed the final attestation AND
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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:
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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]:
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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
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The pharmacist or physician should instruct patients to take the lethal dose on an empty stomach to increase the rate of absorption
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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
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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
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Medications requests will receive a onetime approval
Last review date: July 25, 2016