Honorable Calvin K.Y. Say

Speaker, House of Representatives

Twenty-Second State Legislature

Regular Session of 2004

State of Hawaii

Sir:

Your Committee on Consumer Protection and Commerce, to which was referred H.B. No. 2798 entitled:

begs leave to report as follows:

The purpose of this bill is to allow qualified pharmacists to administer:

The Board of Pharmacy and MedImmune, Inc., testified in support of the bill. The Hawaii Medical Association (HMA) stated concerns.

Your Committee finds that pharmacists are currently permitted, pursuant to a physician's order, to administer drugs in three ways: orally, topically, or by injection. Pharmacists are currently permitted, without a physician's order, to administer immunizations by injection to persons 18 years of age or older. This bill adds intranasal delivery of drugs, and intranasal and oral delivery of immunizations.

Your Committee heard proponents of the bill testify that allowing oral and nasal delivery would improve the effectiveness of immunization programs by increasing the participation of persons who are afraid of needles. They also opined that the oral and nasal delivery of attenuated live viruses do not pose a danger to the community.

However, HMA testified that, while it is appropriate to administer immunization by injection without a physician's order, oral and nasal delivery should require a physician's order. HMA stated that these methods of delivery are associated with immunizations that use live, but attenuated, viruses. These weakened viruses still have the potential to affect persons with compromised immune systems. HMA also testified that the intranasal vaccination for the influenza virus was only recently approved by the Food and Drug Administration in 2003, and more time is needed to assess the vaccine's safety.

Your Committee is convinced that adding oral and intranasal vaccine delivery systems is warranted, and will provide an alternative means of protecting the public when vaccines delivered by injection are in short supply. However, there may be additional safeguards that should be reflected in the statute.

Your Committee has amended this bill by:

As affirmed by the record of votes of the members of your Committee on Consumer Protection and Commerce that is attached to this report, your Committee is in accord with the intent and purpose of H.B. No. 2798, as amended herein, and recommends that it pass Third Reading in the form attached hereto as H.B. No. 2798, H.D. 1.