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HB127 INTRODUCED
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HB127
CXSZUJQ-1
By Representatives Brown, Oliver, Moore (P), Fidler, Lamb,
DuBose, Rehm, Bolton, Estes, Barnes, Sells, Standridge,
Marques, Mooney, Yarbrough
RFD: Health
First Read: 13-Jan-26
PFD: 07-Jan-26
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CXSZUJQ-1 12/23/2025 JC (L)JC 2025-2312
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PFD: 07-Jan-26
SYNOPSIS:
Existing law prohibits the State Board of
Medical Examiners and the Medical Licensure Commission
from taking action against the license of a physician
when the physician recommends or prescribes a medical
treatment that is off-label.
This bill would give pharmacists the same
protection by prohibiting the Board of Pharmacy from
suspending, revoking, or refusing to renew the license
of a pharmacist who either recommends the off-label use
of a drug or fills a prescription for the off-label use
of a drug.
This bill would prohibit any entity that
furnishes pharmacy services from terminating or taking
adverse action against a pharmacist for recommending
the off-label use of a drug or filling a prescription
for the off-label use of a drug, and would provide a
civil action for a pharmicist who is so terminated or
disciplined.
This bill would prohibit a pharmacy benefits
manager from taking any action against a pharmacist or
his or her employing pharmacy in retaliation for
recommending, or filling a prescription for, the
off-label use of a drug.
This bill would also permit over-the-counter
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This bill would also permit over-the-counter
sale of both Ivermectin and Hydroxychloroquine.
A BILL
TO BE ENTITLED
AN ACT
Relating to drug dispensing; to prohibit the State
Board of Pharmacy or an employer from taking action against a
pharmacist who recommends the off-label use of a drug or who
dispenses a drug for off-label use on the prescription of a
health care professional; to provide a cause of action against
an employer who takes action against a pharmacist for
recommending or dispensing a drug for off-label use; to
provide an exception; to prohibit a pharmacy benefits manager
from retaliating against a pharmacist or the employing
pharmacy for recommending or dispensing a drug for off-label
use; and to permit the sale of Ivermectin and
Hydroxychloroquine without a prescription.
BE IT ENACTED BY THE LEGISLATURE OF ALABAMA:
Section 1. (a) For the purposes of this section, the
following terms have the following meanings:
(1) BOARD. The State Board of Pharmacy.
(2) EMPLOYER. Any person that owns or manages a
pharmacy as defined in Section 34-23-1, Code of Alabama 1975,
and which retains, supervises, or terminates pharmacists.
(3) HEALTH CARE PROFESSIONAL. Any of the following
individuals:
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individuals:
a. A physician licensed to practice medicine in this
state.
b. A physician assistant licensed by the State Board of
Medical Examiners of the State of Alabama.
c. A certified registered nurse practitioner or a
certified nurse midwife certified by the Board of Nursing.
(4) LICENSE. The same meaning as defined in Section
34-23-1, Code of Alabama 1975.
(5) OFF-LABEL MEDICATION. The use of a drug, biological
product, or device approved by the United States Food and Drug
Administration (FDA) in any manner other than the use approved
by the FDA.
(b) The board may not revoke, suspend, fail to renew,
or take any other adverse action against a pharmacist's
license based solely on either of the following:
(1) The pharmacist's recommendation of an off-label
medication for the treatment of a disease, condition, or
symptom.
(2) The pharmacist's dispensing of a prescription of an
off-label medication which is ordered by a health care
professional.
(c)(1) An employer may not terminate, discipline, or
take any other adverse action against an employee pharmacist
based solely on either of the following:
a. The pharmacist's recommendation of an off-label
medication for the treatment of a disease, condition, or
symptom.
b. The pharmacist's dispensing of a prescription of an
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b. The pharmacist's dispensing of a prescription of an
off-label medication which is ordered by a health care
professional.
(2)a. A pharmacist who is terminated or suffers adverse
action by his or her employer for recommending or dispensing
an off-label medication under subdivision (1) may bring an
action for injunctive relief against the employer in the
circuit court of the county in which the off-label medication
was recommended or dispensed.
b. The court in such an action may award injunctive
relief, including ordering reinstatement of the pharmacist to
his or her job position, back pay, costs of the action, and
reasonable attorney fees.
(d) Notwithstanding subsections (b) and (c), a
pharmacist may not dispense a prescription for an off-label
medication when the off-label use has not been adequately
tested on humans and the potential harm has not been
determined.
(e) This section shall not apply to the prescribing,
administration, or dispensing of any controlled substances, as
defined in Section 20-2-2, Code of Alabama 1975.
Section 2. (a) A pharmacy benefits manager (PBM) or a
PBM affiliate, both as defined in Section 27-45A-3, Code of
Alabama 1975, may not penalize or retaliate against a
pharmacist or a pharmacist's employing pharmacy for
recommending or dispensing a prescription of an off-label
medication as defined in, and in accordance with, Section 1,
including, but not limited to, any of the following:
(1) Canceling or refusing to renew a contract.
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(1) Canceling or refusing to renew a contract.
(2) Taking legal action for breach of contract.
(3) Taking any action otherwise prohibited under
Chapter 45A of Title 27, Code of Alabama 1975.
(4) Initiating an audit under The Pharmacy Audit
Integrity Act, Article 8, Chapter 23, Title 34, Code of
Alabama 1975.
(b) This section shall not apply to the prescribing,
administration, or dispensing of any controlled substances, as
defined in Section 20-2-2, Code of Alabama 1975.
Section 3. Notwithstanding any other provision of law
to the contrary, the following drugs are authorized for sale
or purchase in this state without a prescription or
consultation with a health care professional:
(1) Ivermectin suitable for human use.
(2) Hydroxychloroquine.
Section 4. This act shall become effective on October
1, 2026.
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