SB 418 Virginia Senate · 2026 Regular Session

Therapeutic interchange; authorizes pharmacists to perform, adaptation of prescriptions.

Summary
Therapeutic interchange and adaptation. Authorizes pharmacists to perform therapeutic interchanges by substituting a drug with another drug in the same therapeutic class when such substitution lowers the cost or is cost-neutral to the patient or the prescribed drug is in a drug shortage and the substitution conforms to Board of Pharmacy regulations. The bill directs the Board of Pharmacy to determine which therapeutic classes of drugs shall be eligible for therapeutic interchange and which classes shall be prohibited. The bill also authorizes pharmacists to adapt prescriptions by changing the dosage form or quantity of a medication or by completing missing information on a prescription when there is evidence to support such change.
Bill status signed all 5 stages cleared
Introduction
Jan 2026
Committee Review
Feb 2026
Senate Passage
Mar 2026
House of Delegates Passage
Mar 2026
Signed into Law
Apr 2026
Introduced Jan 13, 2026 Signed Apr 13, 2026
Maddy AI version diff · 2 comparisons

What changed between versions

Engrossed Enrolled · 1 edit · Mar 4, 2026
MINOR
The bill was finalized as an Enrolled version, which primarily involves formatting adjustments and the addition of official approval markings. The substantive policy text regarding therapeutic interchange and prescription adaptation remains identical to the previous Engrossed version, with no changes to the rules governing pharmacists or prescribers.
TECHNICAL

The document structure was updated from a draft 'Engrossed' format to a formal 'Enrolled' format, including the addition of approval stamps and page numbering, while the actual legal text of the bill remained unchanged.

Floor votes · Senate Feb 6, 2026 · House of Delegates Feb 27, 2026

How they voted

380
Passed · 1 other
Total votes 39
Feb 6, 2026
D Democratic20
20 Yea
100% Yea
R Republican19
18 Yea 1
94% Yea
Vote distribution
All Yea All Nay Mixed No data
Full legislative history

Actions timeline

Total actions
33
Key actions
12
Committee
7
Amendments
4
Apr 13, 2026
Signed into law
Approved by Governor-Chapter 888 (effective 7/1/2026)
executive
Mar 4, 2026
Upper · Passed
Signed by President
upper
Mar 4, 2026
Lower · Passed
Signed by Speaker
lower
Mar 4, 2026
Upper · Passed
Bill text as passed Senate and House (SB418ER)
upper
Feb 27, 2026
Lower · Passed
Passed House (87-Y 8-N 0-A)
lower
Feb 24, 2026
Lower · Passed
Reported from Health and Human Services (19-Y 3-N)
lower
Feb 19, 2026
Lower · Passed
Subcommittee recommends reporting (10-Y 0-N)
lower
Feb 16, 2026
Committee
Assigned sub: Health Professions
lower
Feb 13, 2026
Committee
Referred to Committee on Health and Human Services
lower
Feb 10, 2026
Upper · Passed
Read third time and passed Senate (40-Y 0-N 0-A)
upper
Feb 9, 2026
Introduced
Engrossed by Senate as amended (Voice Vote)
upper
Feb 9, 2026
Upper · Passed
Senator Favola Amendment agreed to
upper
Feb 9, 2026
Introduced
Reading of amendment waived (Voice Vote)
upper
Feb 9, 2026
Introduced
Floor offered Senator Favola Amendment
upper
Feb 6, 2026
Upper · Passed
Passed by for the day
upper
Feb 6, 2026
Upper · Passed
Passed by for the day (Voice Vote)
upper
Feb 5, 2026
Upper · Passed
Reported from Education and Health (14-Y 0-N)
upper
Jan 30, 2026
Committee
Assigned Education sub: Health Professions
upper
Jan 13, 2026
Committee
Referred to Committee on Education and Health
upper
1 primary · 0 co-sponsors

Sponsors

Role
Legislator
Party
State
District
P
Photo of Barbara Favola
Barbara Favola
DDemocratic
VA
40