AR SB386

Requires prescribers to explicitly authorize therapeutic drug substitutions on individual prescriptions, with substitutions limited to lower-cost therapeutically equivalent drugs.

Mandates pharmacists verbally discuss any suggested substitution with the patient before dispensing and inform the patient of their right to refuse the substitution.

Requires pharmacists to notify patients that therapeutically equivalent drugs do not contain identical active ingredients and disclose all differences in dosage and frequency between the prescribed and substitute drug.

Requires pharmacists to send written or electronic notice of any substitution to the prescriber within 24 hours after the drug is dispensed.

Excludes medications treating serious mental health conditions (anti-anxiety, antidepressants, antipsychotic agents, and mood stabilizing/anticonvulsant medications) from therapeutic class substitution rules.