Kim Malsam-Rysdon, Secretary of Health

South Dakota Board of Pharmacy

Policy Statement on Starter Packs

The Board of Pharmacy recognizes that “starter packs” of prescriptions drugs are often needed in rural clinics and hospitals to make medications available to patients in a timely manner while providing a method to submit a claim to the patient’s prescription insurance plan.  Because the pharmacy providing the medications retains ownership until the medication is dispensed to the patient, the pharmacist is accountable for proper storage and record keeping.  There are no specific administrative rules for this situation.  However, the Board recommends the following procedures to insure that this practice protects the health and safety of the patient and does not violate any state or federal regulations.

The following procedures are recommended:

  • The medications should be kept in a locked cabinet with access only by licensed health professionals (physicians, PAs, nurses, etc.).
  • Prior to dispensing the medication there must be a written order in the patient’s record.
  • The dispensing process at the clinic / hospital must be under the direct supervision of the prescriber.
  • If the label is prepared by a nurse, the prescriber must verify the drug and the directions. 
  • When possible the directions for the patient should be preprinted on the label by the pharmacist (i.e. Take ___ tablet(s) ____ times daily; Instill 2 drops in ____eye twice daily.)
  • Each container must have an expiration date.
  • The label must include the same information required at any retail pharmacy (i.e. patient’s name, prescriber’s name, name of the drug, date dispensed, etc.)
  • A written information sheet should be provided to the patient for each prescription dispensed.
  • Proper documentation should be provided to the pharmacy in the form of a written prescription. 
  • An inventory list of the medications must be available at the clinic / hospital and at the pharmacy.  The list should include the number of packages of each medication; the number of doses in each package; etc.
  • A log sheet should be maintained to document each time a medication is dispensed from this supply.  The log should include: date, patient, medication and prescriber.
  • The pharmacist or the pharmacist’s designee should conduct a physical inventory of the medications no less often than every 90 days to verify accountability, expiration dates, proper storage conditions, etc.
Adopted 12/12/2008