Modifies provisions relating to pharmaceutical drugs and devices

Added definitions for 'Declared state disaster or emergency', 'Disaster period', and 'Nonprofit pharmacy' to clarify terms used in the new emergency provisions.

Established eligibility criteria for nonprofit pharmacies to ship drugs out-of-state, requiring them to be licensed in good standing and authorized by the destination state.

Added requirements for nonprofit pharmacies to comply with all emergency rules in the destination state and applicable federal laws during the disaster period.

Authorized the Board of Pharmacy to waive compliance with existing Missouri rules and regulations for nonprofit pharmacies responding to active disasters.

The number of new sections enacted to replace repealed statutes was reduced from five to three, changing the section numbers from 338.010, 338.012, 338.206, 338.208, and 338.312 to just 338.010, 338.012, and 338.206.

A new provision was added to the definition of 'practice of pharmacy' allowing pharmacists to order and administer FDA-approved vaccines as of January 1, 2026, while explicitly excluding specific vaccines such as cholera, rabies, and yellow fever.

The text was updated to remove a bracketed exclusion for vaccines approved after January 1, 2023, effectively expanding the scope of vaccines pharmacists can handle to those approved on or after January 1, 2026.

Redundant headers indicating 'Senate Committee Substitute' and 'Perfected' status were removed to streamline the document formatting.

Added a new Section 338.010 that defines the 'practice of pharmacy' to include specific activities like vaccine ordering, nicotine replacement therapy, and HIV postexposure prophylaxis.

Added a new Section 338.010, Subsection 9, which explicitly states that pharmacists cannot diagnose or independently prescribe pharmaceuticals.

Added a new Section 338.010, Subsection 8, stating that health carriers cannot require physicians to enter into written protocols with pharmacists for medication therapy services.

Changed the bill header from 'Senate Committee Substitute' to 'Senate Substitute' and updated the bill number from 5598S.03C to 5598S.05P.

Added a new Section 338.010, Subsection 6, clarifying that nothing in the section prevents non-pharmacist entities from owning a pharmacy as long as a licensed pharmacist is in charge.

All text regarding the sale, purchase, and quantity limits of drugs containing ephedrine, phenylpropanolamine, or pseudoephedrine was removed.

New eligibility was added allowing pharmacists with specific authority to provide medication therapy services for influenza, group A streptococcus, and COVID-19.

New requirements were established permitting pharmacists to prescribe certain Class I and II medical devices used in the home, subject to future joint rules by the pharmacy and healing arts boards.

The deadline for the new medical device rules to be effective was changed from six months to six months after the act's effective date, with a specific invalidation date of August 28, 2026, if constitutional challenges arise.

Increased the total amount of pseudoephedrine products an individual can purchase in a single day from 3.6 grams to 3.6 grams (clarified) and in a twelve-month period from 43.6 grams to 61.2 grams, while reducing the single-transaction limit to 7.2 grams.

Removed the specific language allowing pharmacists to provide influenza, streptococcus, and COVID-19 medication therapy services under a statewide standing order.

Added provisions allowing pharmacists to prescribe durable medical equipment and repealed previous sections to enact new rules on pharmaceutical devices.

Changed the rulemaking deadline from six months after August 28, 2023, to six months after the effective date of the act.