HB 1155 revise certain provisions concerning wholesale...
State of South Dakota
|
EIGHTY-SECOND SESSION
LEGISLATIVE ASSEMBLY,
2007
|
553N0410
|
HOUSE BILL
NO.
1155
|
Introduced by:
Representatives Van Etten, Boomgarden, Heineman, Jerke, Kirkeby, Lucas,
Miles, Rave, Steele, and Weems and Senators Hansen (Tom), Dempster,
Gant, Maher, and Olson (Ed)
|
FOR AN ACT ENTITLED, An Act to
revise certain provisions concerning wholesale drug
distributors.
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF SOUTH DAKOTA:
Section
1.
That
§
36-11A-1
be amended to read as follows:
36-11A-1.
Terms used in this chapter mean:
(1)
"Authentication," to affirmatively verify before any wholesale distribution of a
prescription drug occurs that each transaction listed on the pedigree has occurred;
(2)
"Board," the State Board of Pharmacy;
(3) "Chain pharmacy warehouse," a physical location for prescription drugs that acts as
a central warehouse and performs intracompany sales or transfers of such drugs to
a group of chain pharmacies that have the same common ownership and control;
(4) "Co-licensed product," a prescription drug in which two or more parties have the
right to engage in the manufacturing or marketing, or both, of such drug;
(2)
(5)
"Drug," "prescription drug," any
human
drug
, including any biological product,
except for blood and blood components intended for transfusion or biological
products that are also medical devices
required by federal law or
federal
regulation
to be dispensed only by a prescription, including finished dosage forms and
active
ingredients
bulk drug substances
subject to § 503(b) of the Federal Food, Drug and
Cosmetic Act
as amended through January 1, 1991
;
(3)
(6)
"Drug coupon," a form which may be redeemed at no cost or at reduced cost for a
prescription drug;
(7) "Drug Enforcement Agency," the Drug Enforcement Agency of the United States
Department of Justice;
(4)
(8)
"Drug sample," a unit of a prescription drug that is not intended to be sold and is
intended to promote the sale of the drug;
(9) "Facility," a facility of a wholesale distributor where prescription drugs are stored,
handled, repackaged, or offered for sale;
(5)
(10)
"Manufacturer,"
anyone who is engaged in manufacturing, preparing,
propagating, compounding, processing, packaging, repackaging or labeling of
a prescription drug
a person licensed or approved by the federal Food and
Drug Administration to engage in the manufacture of drugs or devices
;
(6)
(11)
"Out-of-state wholesale drug distributor," a wholesale drug distributor with no
physical facilities located in this state;
(7)
(12)
"Pharmacy," a place registered by the board under chapter 36-11 in which
prescription drugs are sold at retail
;
(13) "Pedigree," a document or electronic file containing information that records each
distribution of any given prescription drug;
(14) "Repackage," repackaging or otherwise changing the container, wrapper, or labeling
to further the distribution of a prescription drug excluding that completed by the
pharmacist responsible for dispensing the drug to the patient;
(15) "Repackager," a person who repackages
.
Section
2.
That chapter
36-11A
be amended by adding thereto a NEW SECTION to read
as follows:
For the purposes of this chapter, an authorized distributor of record is a wholesale distributor
with whom a manufacturer has established an ongoing relationship to distribute the
manufacturer's prescription drug. An ongoing relationship is deemed to exist between such
wholesale distributor and a manufacturer when the wholesale distributor, including any
affiliated group of the wholesale distributor, as defined in Section 1504 of the Internal Revenue
Code, complies with any one of the following:
(1) The wholesale distributor has a written agreement currently in effect with the
manufacturer evidencing such ongoing relationship; and
(2) The wholesale distributor is listed on the manufacturer's current list of authorized
distributors of record, which is updated by the manufacturer on no less than a
monthly basis.
Section
3.
That chapter
36-11A
be amended by adding thereto a NEW SECTION to read
as follows:
For the purposes of this Act, drop shipment is the sale of a prescription drug to a wholesale
distributor by the manufacturer of the prescription drug, or that manufacturer's co-licensed
product partner, that manufacturer's third party logistics provider, or that manufacturer's
exclusive distributor, whereby the wholesale distributor or chain pharmacy warehouse takes title
but not physical possession of such prescription drug and the wholesale distributor invoices the
pharmacy or chain pharmacy warehouse, or other person authorized by law to dispense or
administer such drug to a patient, and the pharmacy or chain pharmacy warehouse or other
authorized person receives delivery of the prescription drug directly from the manufacturer, or
that manufacturer's third party logistics provider, or that manufacturer's exclusive distributor.
Section
4.
That chapter
36-11A
be amended by adding thereto a NEW SECTION to read
as follows:
For the purposes of this Act, a manufacturer's exclusive distributor is any person who
contracts with a manufacturer to provide or coordinate warehousing, distribution, or other
services on behalf of a manufacturer and who takes title to that manufacturer's prescription drug,
but who does not have general responsibility to direct the sale or disposition of the
manufacturer's prescription drug. Such manufacturer's exclusive distributor must be licensed as
a wholesale distributor under this Act, and to be considered part of the normal distribution
channel must also be an authorized distributor of record.
Section
5.
That chapter
36-11A
be amended by adding thereto a NEW SECTION to read
as follows:
For the purposes of this Act, a normal distribution channel is a chain of custody for a
prescription drug that goes from a manufacturer of the prescription drug, or from that
manufacturer to that manufacturer's co-licensed partner, or from that manufacturer to that
manufacturer's third-party logistics provider, or from that manufacturer to that manufacturer's
exclusive distributor to:
(1) A pharmacy to a patient or other designated persons authorized by law to dispense
or administer such drug to a patient;
(2) A wholesale distributor to a pharmacy to a patient or other designated persons
authorized by law to dispense or administer such drug to a patient;
(3) A wholesale distributor to a chain pharmacy warehouse to that chain pharmacy
warehouse's intracompany pharmacy to a patient or other designated persons
authorized by law to dispense or administer such drug to a patient; or
(4) A chain pharmacy warehouse to the chain pharmacy warehouse's intracompany
pharmacy to a patient or other designated persons authorized by law to dispense or
administer such drug to a patient.
Section
6.
That chapter
36-11A
be amended by adding thereto a NEW SECTION to read
as follows:
For the purposes of this Act, a third party logistics provider is any person who contracts with
a prescription drug manufacturer to provide or coordinate warehousing, distribution, or other
services on behalf of a manufacturer, but does not take title to the prescription drug or have
general responsibility to direct the prescription drug's sale or disposition. Such third party
logistics provider must be licensed as a wholesale distributor under this Act, and to be
considered part of the normal distribution channel must also be an authorized distributor of
record.
Section
7.
That chapter
36-11A
be amended by adding thereto a NEW SECTION to read
as follows:
For the purposes of this Act, a wholesale distributor is any person engaged in the wholesale
distribution of prescription drugs, including manufacturers; repackagers; own-label distributors;
private-label distributors; jobbers; brokers; warehouses, including manufacturers' and
distributors' warehouses; manufacturer's exclusive distributors; authorized distributors of record;
drug wholesalers or distributors; independent wholesale drug traders; specialty wholesale
distributors; third party logistics providers; retail pharmacies that conduct wholesale
distribution; and chain pharmacy warehouses that conduct wholesale distribution. To be
considered part of the normal distribution channel such wholesale distributor must also be an
authorized distributor of record.
Section
8.
That chapter
36-11A
be amended by adding thereto a NEW SECTION to read
as follows:
For the purposes of this Act, wholesale distribution is distribution of prescription drugs to
persons other than a consumer or patient, but does not include:
(1) Intracompany sales of prescription drugs, meaning any transaction or transfer
between any division, subsidiary, parent or affiliated or related company under
common ownership and control of a corporate entity, or any transaction or transfer
between co-licensees of a co-licensed product;
(2) The sale, purchase, distribution, trade, or transfer of a prescription drug or offer to
sell, purchase, distribute, trade, or transfer a prescription drug for emergency medical
reasons;
(3) The distribution of prescription drug samples by manufacturers' representatives;
(4) Drug returns, when conducted by a hospital, health care entity, or charitable
institution in accordance with 21 C.F.R.
§
203.23;
(5) The sale of minimal quantities of prescription drugs by retail pharmacies to licensed
practitioners for office use;
(6) The sale, purchase, or trade of a drug, an offer to sell, purchase, or trade a drug, or
the dispensing of a drug pursuant to a prescription;
(7) The sale, transfer, merger, or consolidation of all or part of the business of a
pharmacy or pharmacies from or with another pharmacy or pharmacies, whether
accomplished as a purchase and sale of stock or business assets;
(8) The sale, purchase, distribution, trade, or transfer of a prescription drug from one
authorized distributor of record to one additional authorized distributor of record
when the manufacturer has stated in writing to the receiving authorized distributor
of record that the manufacturer is unable to supply such prescription drug and the
supplying authorized distributor of record states in writing that the prescription drug
being supplied had until that time been exclusively in the normal distribution
channel;
(9) The delivery of, or offer to deliver, a prescription drug by a common carrier solely
in the common carrier's usual course of business of transporting prescription drugs,
and such common carrier does not store, warehouse, or take legal ownership of the
prescription drug;
(10) The sale or transfer from a retail pharmacy or chain pharmacy warehouse of expired,
damaged, returned, or recalled prescription drugs to the original manufacturer or to
a third party returns processor.
Section
9.
That chapter
36-11A
be amended by adding thereto a NEW SECTION to read
as follows:
Any wholesale distributor who engages in the wholesale distribution of prescription drugs
in this state must be licensed by the board, in accordance with this Act, before engaging in
wholesale distributions of wholesale prescription drugs. The board shall exempt manufacturers
distributing their own FDA-approved drugs and devices from any licensing, to the extent not
required by federal law or regulation.
Section
10.
That chapter
36-11A
be amended by adding thereto a NEW SECTION to read
as follows:
The board shall require the following minimum information from each wholesale distributor
applying to obtain a license under section 9 of this Act:
(1) The name, full business address, and telephone number of the licensee;
(2) Any trade or business name used by the licensee;
(3) The address, telephone number, and the name of any contact person for any facilities
used by the licensee for the storage, handling, and distribution of prescription drugs;
(4) The type of ownership or operation;
(5) The name of the owner and the operator of the licensee, including:
(a) If a person, the name of the person;
(b) If a partnership, the name of each partner, and the name of the partnership;
(c) If a corporation, the name and title of each corporate officer and director, the
corporate names, and the name of the state of incorporation; and
(d) If a sole proprietorship, the full name of the sole proprietor and the name of
the business entity;
(6) A list of all licenses and permits issued to the applicant by any other state that
authorizes the applicant to purchase or possess prescription drugs;
(7) The name of the applicant's designated representative for the facility, together with
the personal information statement and fingerprints, required pursuant to subdivision
(8) for such person;
(8) Each person required by subdivision (7) to provide a personal information statement
and fingerprints, if required, shall provide the following information to the board:
(a) The person's places of residence for the past seven years;
(b) The person's date and place of birth;
(c) The person's occupations, positions of employment, and offices held during
the past seven years;
(d) The principal business and address of any business, corporation, or other
organization in which each such office of the person was held or in which each
such occupation or position of employment was carried on;
(e) Whether the person has been, during the past seven years, the subject of any
proceeding for the revocation of any license or any criminal violation and, if
so, the nature of the proceeding and the disposition of the proceeding;
(f) Whether, during the past seven years, the person has been enjoined, either
temporarily or permanently, by a court of competent jurisdiction from
violating any federal or state law regulating the possession, control, or
distribution of prescription drugs or had any criminal violations of such laws,
together with details concerning any such event;
(g) A description of any involvement by the person with any business, including
any investments, other than the ownership of stock in a publicly traded
company or mutual fund, during the past seven years, which manufactured,
administered, prescribed, distributed, or stored pharmaceutical products and
any lawsuits in which such businesses were named as a party;
(h) A description of any misdemeanor or felony criminal offense of which the
person, as an adult, was found guilty, regardless of whether adjudication of
guilt was withheld or whether the person pled guilty or nolo contendere. If the
person indicates that a criminal conviction is under appeal and submits a copy
of the notice of appeal of that criminal offense, the applicant shall, within
fifteen days after the disposition of the appeal, submit to the board a copy of
the final written order of disposition; and
(i) A photograph of the person taken in the previous thirty days.
The information required pursuant to this section shall be provided under oath.
Section
11.
That chapter
36-11A
be amended by adding thereto a NEW SECTION to read
as follows:
The board may not issue a wholesale distributor license to an applicant, unless the board or
a nationally recognized accreditation program approved by the board:
(1) Conducts a physical inspection of the facility at the address provided by the applicant
as required in subdivision (1) of section 10 of this Act; and
(2) Determines that the designated representative meets the following qualifications:
(a) Is at least twenty-one years of age;
(b) Has been employed full time for at least three years in a pharmacy or with a
wholesale distributor in a capacity related to the dispensing and distribution
of, and recordkeeping relating to, prescription drugs;
(c) Is employed by the applicant full time in a managerial level position;
(d) Is actively involved in and aware of the actual daily operation of the wholesale
distributor;
(e) Is physically present at the facility of the applicant during regular business
hours, except when the absence of the designated representative is authorized,
including sick leave and vacation leave;
(f) Is serving in the capacity of a designated representative for only one applicant
at a time, except where more than one licensed wholesale distributor is co-
located in the same facility and such wholesale distributors are members of an
affiliated group, as defined in Section 1504 of the Internal Revenue Code;
(g) Does not have any convictions under any federal, state, or local laws relating
to wholesale or retail prescription drug distribution or distribution of
controlled substances; and
(h) Does not have any felony convictions under federal or state laws.
Section
12.
That chapter
36-11A
be amended by adding thereto a NEW SECTION to read
as follows:
The board may require the applicant to submit the fingerprints provided by a person with
a license application for a statewide criminal record check and for forwarding to the Federal
Bureau of Investigation for a national criminal record check of the person.
Section
13.
That chapter
36-11A
be amended by adding thereto a NEW SECTION to read
as follows:
The board shall require every wholesale distributor applying for a license to submit a bond
of at least one hundred thousand dollars, or other equivalent means of security acceptable to the
board, such as an irrevocable letter of credit or a deposit in a trust account or financial
institution, payable to a fund established by the board. The board shall establish a fund, separate
from its other accounts, in which to deposit the wholesale distributor bonds. Any chain
pharmacy warehouse that is engaged only in intracompany transfers is exempt from the bond
requirement. The purpose of the bond is to secure payment of any fines or penalties imposed by
the board and any fees and costs incurred by the board regarding that license, which are
authorized pursuant to statute and which the licensee fails to pay thirty days after the fines,
penalties, or costs become final. The board may make a claim against such bond or security until
one year after the licensee's license ceases to be valid. A single bond may suffice to cover all
facilities operated by the applicant in the state.
If a wholesale distributor distributes prescription drugs from more than one facility, the
wholesale distributor shall obtain a license for each facility.
Section
14.
That chapter
36-11A
be amended by adding thereto a NEW SECTION to read
as follows:
In accordance with each licensure renewal, the board shall send to each wholesale distributor
licensed under section 9 of this Act a form setting forth the information that the wholesale
distributor provided pursuant to section 10 of this Act. Within thirty days of receiving such
form, the wholesale distributor shall identify and state under oath to the board any changes or
corrections to the information that was provided pursuant to section 10 of this Act. Changes in,
or corrections to, any information in section 10 of this Act shall be submitted to the board as
required by such authority. The board may suspend or revoke the license of a wholesale
distributor if such authority determines that the wholesale distributor no longer qualifies for the
license issued under section 10 of this Act.
Section
15.
That chapter
36-11A
be amended by adding thereto a NEW SECTION to read
as follows:
The designated representative identified pursuant to subdivision (7) of section 10 of this Act
shall receive and complete continuing training in applicable federal and state laws governing
wholesale distribution of prescription drugs.
The information provided under section 10 of this Act may not be disclosed to any person
or entity other than a state board or agency, government board, or government agency,
determined to be comparable by the board, provided such licensing authority, government
board, or agency needs such information for licensing or monitoring purposes.
Section
16.
That chapter
36-11A
be amended by adding thereto a NEW SECTION to read
as follows:
A wholesale distributor shall receive prescription drug returns or exchanges from a
pharmacy or chain pharmacy warehouse pursuant to the terms and conditions of the agreement
between the wholesale distributor and the pharmacy or chain pharmacy warehouse, including
the returns of expired, damaged, and recalled pharmaceutical product to either the original
manufacturer or a third party returns processor. The returns or exchanges are not subject to the
pedigree requirement of section 21 of this Act, so long as they are exempt from pedigree under
the Federal Food and Drug Administration's currently applicable Prescription Drug Marketing
Act guidance. Wholesale distributors and pharmacies shall be held accountable for
administering their returns process and ensuring that the aspects of this operation are secure and
do not permit the entry of adulterated and counterfeit product.
Section
17.
That chapter
36-11A
be amended by adding thereto a NEW SECTION to read
as follows:
A manufacturer or wholesale distributor shall furnish prescription drugs only to a person or
entity licensed by the appropriate board. Before furnishing prescription drugs to a person or
entity not known to the manufacturer or wholesale distributor, the manufacturer or wholesale
distributor shall affirmatively verify that the person or entity is legally authorized to receive the
prescription drugs by contacting the appropriate board.
Section
18.
That chapter
36-11A
be amended by adding thereto a NEW SECTION to read
as follows:
Prescription drugs furnished by a manufacturer or wholesale distributor shall be delivered
only to the premises listed on the license. However, the manufacturer or wholesale distributor
may furnish prescription drugs to an authorized person or agent of that person at the premises
of the manufacturer or wholesale distributor if:
(1) The identity and authorization of the recipient is properly established; and
(2) This method of receipt is employed only to meet the immediate needs of a particular
patient of the authorized person.
Section
19.
That chapter
36-11A
be amended by adding thereto a NEW SECTION to read
as follows:
Prescription drugs may be furnished to a hospital pharmacy receiving area provided that a
pharmacist or authorized receiving personnel signs, at the time of delivery, a receipt showing
the type and quantity of the prescription drug so received. Any discrepancy between receipt and
the type and quantity of the prescription drug actually received shall be reported to the
delivering manufacturer or wholesale distributor by the next business day after the delivery to
the pharmacy receiving area.
Section
20.
That chapter
36-11A
be amended by adding thereto a NEW SECTION to read
as follows:
A manufacturer or wholesale distributor may not accept payment for, or allow the use of,
a person or entity's credit to establish an account for the purchase of prescription drugs from any
person other than the owner of record, the chief executive officer, or the chief financial officer
listed on the license of a person or entity legally authorized to receive prescription drugs. Any
account established for the purchase of prescription drugs must bear the name of the licensee.
Section
21.
That chapter
36-11A
be amended by adding thereto a NEW SECTION to read
as follows:
Each person who is engaged in wholesale distribution of prescription drugs, including
repackagers, but excluding the original manufacturer of the finished form of the prescription
drug that leave, or have ever left, the normal distribution channel shall, before each wholesale
distribution of such drug, provide a pedigree to the person who receives such drug.
A retail pharmacy or chain pharmacy warehouse shall comply with the requirements of this
section only if the pharmacy or chain pharmacy warehouse engages in wholesale distribution
of prescription drugs, as defined in section 8 of this Act.
Section
22.
That chapter
36-11A
be amended by adding thereto a NEW SECTION to read
as follows:
The board shall determine by July 1, 2009, a targeted implementation date for electronic
track and trace pedigree technology. Such a determination shall be based on consultation with
manufacturers, distributors, and pharmacies responsible for the sale and distribution of
prescription drug products in this state. After consultation with interested stakeholders and prior
to implementation of the electronic pedigree, the board shall determine that the technology is
universally available across the entire prescription pharmaceutical supply chain. The
implementation date for the mandated electronic track and trace pedigree technology shall be
no sooner than July 1, 2010, and may be extended by the board in one year increments if it
appears the technology is not universally available across the entire prescription pharmaceutical
supply chain.
Section
23.
That chapter
36-11A
be amended by adding thereto a NEW SECTION to read
as follows:
Each person who is engaged in the wholesale distribution of a prescription drug including
repackagers, but excluding the original manufacturer of the finished form of the prescription
drug, who is provided a pedigree for a prescription drug and attempts to further distribute that
prescription drug, shall affirmatively verify before any distribution of a prescription drug occurs
that each transaction listed on the pedigree has occurred.
Section
24.
That chapter
36-11A
be amended by adding thereto a NEW SECTION to read
as follows:
The pedigree shall include all necessary identifying information concerning each sale in the
chain of distribution of the product from the manufacturer, or the manufacturer's third party
logistics provider, co-licensed product partner, manufacturer's exclusive distributor, through
acquisition and sale by any wholesale distributor or repackager, until final sale to a pharmacy
or other person dispensing or administering the drug. At minimum, the necessary chain of
distribution information shall include:
(1) Name, address, telephone number, and if available, the e-mail address, of each owner
of the prescription drug, and each wholesale distributor of the prescription drug;
(2) Name and address of each location from which the product was shipped, if different
from the owner's;
(3) Transaction dates; and
(4) Certification that each recipient has authenticated the pedigree.
Section
25.
That chapter
36-11A
be amended by adding thereto a NEW SECTION to read
as follows:
In addition to the requirements of section 24 of this Act, the pedigree shall also include the
following minimum requirements:
(1) Name of the prescription drug;
(2) Dosage form and strength of the prescription drug;
(3) Size of the container;
(4) Number of containers;
(5) Lot number of the prescription drug; and
(6) Name of the manufacturer of the finished dosage form.
Section
26.
That chapter
36-11A
be amended by adding thereto a NEW SECTION to read
as follows:
Each pedigree or electronic file shall be:
(1) Maintained by the purchaser and the wholesale distributor for three years from the
date of sale or transfer; and
(2) Available for inspection or use within two business days upon a request of an
authorized officer of the law.
Section
27.
That chapter
36-11A
be amended by adding thereto a NEW SECTION to read
as follows:
The board shall issue an order requiring the appropriate person including any distributor or
retailer of the drug to immediately cease distribution of the drug within this state if the board
finds that there is a reasonable probability that:
(1) A wholesale distributor, other than a manufacturer, has:
(a) Violated a provision of this Act; or
(b) Falsified a pedigree, or sold, distributed, transferred, manufactured,
repackaged, handled, or held a counterfeit prescription drug intended for
human use;
(2) The prescription drug at issue as a result of a violation in subdivision (1) could cause
serious, adverse health consequences or death; and
(3) Other procedures would result in unreasonable delay.
An order under this section shall provide the person subject to the order with an opportunity
for an informal hearing, to be held not later than ten days after the date of the issuance of the
order, on the actions required by the order. If, after providing an opportunity for such a hearing,
the board determines that inadequate grounds exist to support the actions required by the order,
the board shall vacate the order.
Section
28.
That chapter
36-11A
be amended by adding thereto a NEW SECTION to read
as follows:
It is unlawful for a person to perform or cause the performance of or aid and abet any of the
following acts in this state:
(1) Failure to obtain a license in accordance with this Act, or operating without a valid
license when a license is required by this Act;
(2) If the requirements of section 16 of this Act are applicable and are not met, the
purchasing or otherwise receiving a prescription drug from a pharmacy;
(3) If a state license is required pursuant to section 17 of this Act, the sale, distribution,
or transfer of a prescription drug to a person that is not authorized under the law of
the jurisdiction in which the person receives the prescription drug to receive the
prescription drug;
(4) Failure to deliver prescription drugs to specified premises, as required by section 18
of this Act;
(5) Accepting payment or credit for the sale of prescription drugs in violation of section
20 of this Act;
(6) Failure to maintain or provide pedigrees as required by this Act;
(7) Failure to obtain, pass, or authenticate a pedigree, as required by this Act;
(8) Providing the state or any of its representatives or any federal official with false or
fraudulent records or making false or fraudulent statements regarding any matter
within the provisions of this Act;
(9) Obtaining or attempting to obtain a prescription drug by fraud, deceit,
misrepresentation or engaging in misrepresentation or fraud in the distribution of a
prescription drug;
(10) Except for the wholesale distribution by manufacturers of a prescription drug that has
been delivered into commerce pursuant to an application approved under federal law
by the Food and Drug Administration, the manufacture, repacking, sale, transfer,
delivery, holding, or offering for sale any prescription drug that is adulterated,
misbranded, counterfeit, suspected of being counterfeit, or has otherwise been
rendered unfit for distribution;
(11) Except for the wholesale distribution by manufacturers of a prescription drug that has
been delivered into commerce pursuant to an application approved under Federal law
by the Food and Drug Administration, the adulteration, misbranding, or
counterfeiting of any prescription drug;
(12) The receipt of any prescription drug that is adulterated, misbranded, stolen, obtained
by fraud or deceit, counterfeit, or suspected of being counterfeit, and the delivery or
proffered delivery of such drug for pay or otherwise; and
(13) The alteration, mutilation, destruction, obliteration, or removal of the whole or any
part of the labeling of a prescription drug or the commission of any other act with
respect to a prescription drug that results in the prescription drug being misbranded.
Any person who violates this section is guilty of a Class 1 misdemeanor for the first
conviction and a Class 6 felony for any subsequent conviction.