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Some experts argue that prescription drug monitoring programs can be a game changer when it comes to curbing prescription abuse and misuse. Here are 11 states that stand out for their PDMPs (or lack thereof).
Approximately 44 people die every day as a result of prescription opioid overdoses, according to the Centers for Disease Control and Prevention (CDC). Nearly 2 million Americans abuse or are dependent on opioids, and abuse of these drugs costs the U.S. almost $56 billion each year in lost productivity, healthcare costs, and criminal justice costs, according to the CDC.
As the nation’s opioid epidemic continues to intensify, consider joining trailblazers from health plans, pharmacies and healthcare companies at CBI’s inaugural Prescription Drug Monitoring Programs. This summit will focus on the crucial elements of managing how drugs are prescribed, dispensed and reimbursed.
One way to fight the epidemic (according to some industry experts), is through state-based prescription drug monitoring programs (PDMPs or PMPs). PDMPs are electronic databases used to track the prescribing and dispensing of controlled prescription drugs to patients. PDMPs are primarily used by physicians and pharmacists to ensure that their patients are not receiving duplicate prescriptions or showing any other signs of abuse or misuse.
Heather Gray, legislative director of the National Alliance for Model State Drug Laws, says these programs can help identify potential doctor shoppers, and they can also help healthcare providers identify patients who may be at risk of developing a substance use disorder or even overdose.
But PDMPs vary greatly across state lines, and not all states have a PDMP in place. To help you keep track, here are 11 states that stand out for their PDMP programs (or lack thereof).
California has tracked prescription information for more than seven decades, since the creation of the California Triplicate Prescription Program (TPP) in 1939. In the late 1990s, the current CURES system was created to replace TPP’s Automated Triplicate Prescription System, which tracked Schedule II prescription information. In 2005, CURES was adopted permanently, and in 2009, the PDMP was added as a searchable, client-facing component of CURES.
The latest change occurred in January, when California overhauled the system to overcome a number of glitches and allow prescribers and pharmacists the ability to more effectively flag risky patients. All California physicians and pharmacies are required to report every schedule II, III, IV prescription written to the Department of Justice within seven days. More than 7,500 pharmacies and 155,000 prescribers report to the system annually.
Illinois requires daily reporting from retail pharmacies on schedule II, III, IV, and V drugs. Prescribers and dispensers have typically been able to obtain user login and password information to run searches for prospective patients, but a new system allows integration with electronic health records (EHRs). These pilot projects allow healthcare providers to access the PDMP from within their EHR systems. A number of institutions already are automating their PDMP inquiries so that requests are now sent to EHRs without the provider having to log on to the state’s database.
These states have what many others wish they have-a partnership in fighting prescription drug abuse. In 2014, the three states linked their PDMPs, and roughly 10,000 requests are processed between them each month.
New Jersey now has about 90% of its physicians registered to use its PDMP, and pharmacists even have access to a mobile app that grants authorized users access to the state database from their smartphones.
There are similar partnerships between a number of other states, and there is a national program operated by the National Association of Boards of Pharmacy with 31 member states.
New York has been aggressively tackling prescription drug abuse, with measures to increase the availability of naloxone, and requiring that all prescribers check the state PDMP before prescribing opioid pain relievers-which resulted in a 75% drop in the number of patients who obtain prescriptions from multiple prescriptions.
New York recently joined the National Association of Boards of Pharmacy PMP InterConnect program. The program allows authorized users to transfer data across state lines, linking a number of state PDMPs.
Tennessee requires mandatory participation in its PDMP. Measuring its success from its long-running program, Tennessee’s latest progress report revealed that there was a 12.6% increase in the number of patient reports in 2014 over the previous year, and that the average search took less than 10 seconds.
Additionally, the number of painkillers dispensed decreased by 4.6%, and the number of patients visiting multiple doctors for their prescriptions dropped for the last three years-with a 13.3% decrease in 2014 alone. In terms of prescriber usage, the report notes that 41% of prescribers were less likely to prescribe medications after checking the state database, and one-third of physicians were more likely to refer a patient to a substance abuse treatment program after checking the database.
Kentucky is another state with a long-standing prescription drug monitoring program. Since its initiation in 2012, officials report a decrease in controlled substances by 8.5%. Additionally, the state reports that treatment admissions at hospitals for prescription drug abuses decreased-but at the same time admissions for heroin use increased.
South Carolina began its PDMP in 2008 but is launching a new program that will require physicians who want to bill Medicaid or the state employee health plan to use the database prior to writing a prescription. Dozens of other states have similar requirements. Pharmacists have been required to report the amount of controlled substances sold daily since 2014, but physicians and pharmacists weren’t actually required to look at the information in the database.
While Nebraska already has a PDMP in place, the current system allows physicians and pharmacies to opt out, and doesn’t record the prescriptions of Medicare patients that pay in cash.
The current system allows people to opt out and doesn’t record Medicare patients and those who pay cash, as drug seekers and traffickers typically do. A new bill, in the final stages of passage, would enhance the current system to further prevent prescription drug abuses by requiring participation and making the system free and accessible to all users.
Missouri is the lone state without any form of PDMP. Although many attempts have been made to create a program, strong opposition has held back passage due to concerns about privacy of the medical records and public support. Several proposals are being debated now in the legislature, but it’s unclear when or if Missourians will have access to a PDMP.