Pharmacies consider prescription drug program impacts

Wednesday, February 4, 2015

Missouri is only state that does not monitor prescriptions

Barring a few trepidations, local pharmacies are lining up in support of the possible first ever prescription drug monitoring program in Missouri, saying it would be beneficial for slowing the illegal sales of prescription drugs.

"I'm pretty sure we're the only state that doesn't have one," said Rebecca Becker, pharmacist at Sater Pharmacy in Cassville. "Being down here in the south, we've got a lot of people who come up from Arkansas that want us to fill their prescriptions without insurance. There is no way to track anything. If a patient doesn't have insurance, there is no way to track if they're doctor shopping and getting multiple prescriptions."

After buying the prescription drugs, the person usually sells them, Becker said. The program might deter doctors who conduct cash prescribing practices or doctors who prescribe medication without a current license. It could also decrease diversion.

"Once you decrease diversion, then you would decrease the illegal use of it and and keep [the drugs] out of the hands of children," she said.

Blake Whitley, pharmacist and owner of Whitley Pharmacy in Cassville, said there is room for a prescription drug monitoring program.

"If it's going to add burden, regulations, record keeping or whatever on the pharmacy, I probably would not be much in favor of it because right now with most pharmacies, we can't hardly keep up with what we've got to do now," he said. "But, if this is going to be something that is going to run in the background or just collecting information on prescribing habits of the narcotics, I think it could be a beneficial thing."

State Sen. David Sater, R-Cassville, and State Rep. Holly Rehder, R-Sikeston, have sponsored prescription drug monitoring program bills in this year's legislative session, which started Jan. 7.

"I would really like to be able to talk to Dave Sater personally and get a description from him exactly -- with him being a pharmacist -- because he could put it in my language," Whitley said. "I could understand what this actually would entail. Just knowing him and his background, I would say it would probably be a program that would be worthwhile."

Senate Bill 63, which Sater first read in the Senate on Jan. 7, states that the Department of Health and Senior Services would establish and maintain the program to monitor the prescribing and dispensing of all Schedule II through Schedule IV controlled substances in Missouri. All submitted prescription information would be kept confidential, but the act authorizes the release of non-personal, general information for statistical, educational and research purposes.

If the bill becomes law this year, it would become effective Aug. 28. Starting Aug. 28, 2017, the Health and Senior Services should discard the data obtained by the program every two years.

People have concerns about privacy and how the government would handle the personal data, said Whitley, who thinks the program needs safeguards and to penalize anyone from leaking the collected information.

Under Sater's bill, people authorized to have the dispensation information could face a Class A misdemeanor for purposefully disclosing personal information.

The program will create a database that is easily accessible, said Ron Fitzwater, executive director of the Missouri Pharmacy Association, who confirmed Missouri is the last state to not have a prescription drug monitoring program.

"Anybody who has an insurance card today, their information is already in a database," Fitzwater said. "[The program] is not going to track any additional information that's not already in a consolidated healthcare plan or a private insurer's database. It's frustrating trying to get that message out."

He understands the opposition in the Senate, but the personal data is already out there, he said.

"Law enforcement cannot use the database to mine the information to try and find criminal activity, but they would be entitled to use the database if they have a problem area where they know they've got an issue," Fitzwater said. "They could use the database and verify that there is a problem with a prescriber or with a dispenser."

The program would help shut down the trade of the prescription drugs that are out in the marketplace, he said.

The Missouri Pharmacy Association is one of more than 30 state organizations that are part of the Missouri Prescription Drug Monitoring Program NOW Coalition.

Everyone is concerned about privacy, said Heidi Frederickson, the coalition coordinator.

"We've got the benefit at looking at the 49 states in the country that have passed PDMPs and figuring out how we can craft Missouri legislation, so that we've got the most tightly worded privacy protection," Frederickson said. "If we were to pass a PDMP, it would actually allow for more privacy protection.

"Basic law enforcement would require a subpoena to get access to some of these records where that is not the case today. A PDMP would only contain information on specific drugs, like opiates, that have the most potential for abuse or overdose. It wouldn't be every prescription."

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