Prescription monitoring on tap in Florida

Legislation supported by the Florida Medical Assn. and the governor would be implemented with financial support from Purdue Pharma.

By Andis Robeznieks, amednews staff. April 7, 2003.

Florida physicians knew a prescription-monitoring bill would be introduced in the state Legislature again this year, so they have worked to get one they could live with.

"The bill last year had problems from the start, and we worked hard to get rid of some of the more onerous provisions," said Florida Medical Assn. Director of Governmental Affairs Francesca Plendl.

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Last year's bill, which required sending a copy of all narcotic prescriptions to the state attorney general, would have been a "logistical nightmare," Plendl said. In contrast, this year's bill calls on pharmacies to enter the information into the prescription database.

"I think that, quite frankly, a lot of the physical work will be done by the pharmacists," Plendl said. "The work does not increase for the doctor."

The Florida Legislature convened in early March, but Gov. Jeb Bush has been lobbying for a law to track prescribing patterns of controlled substances since January when he hosted a statewide summit on drug abuse.

Drug Enforcement Administration spokesman Rusty Payne said about half of the nation's doctors operate under monitoring laws, although only 19 states have prescription-monitoring programs.

19 states have programs to monitor prescriptions.

The medical community has mixed feelings about prescription monitoring. Some physicians fear it hampers the treatment of pain, while others believe that doctors who have nothing to hide have nothing to fear from such a program. Despite strong support from high-ranking officials, there are plenty of open seats on the prescription-monitoring bandwagon.

Last year, DEA Administrator Asa Hutchinson called on all 50 states to adopt prescription monitoring, but of those states without programs already in place, Florida is the only one that, to date, seems to have taken the request to heart.

The National Conference of State Legislatures reports that only three other states (Indiana, Massachusetts and Virginia) have active prescription-monitoring bills in their legislatures, but those bills would modify existing programs -- not create new ones.

Plendl said that although she supports the new bill in Florida, she does have concerns that it may have a chilling effect on pain treatment.

But Zachariah P. Zachariah, MD, a Fort Lauderdale cardiologist and former chair of the Florida Board of Medicine, doesn't think prescription monitoring will have that effect.

"I think it will be good for good physicians practicing good medicine," he said. "There is no reason to prescribe narcotics in a secretive manner. I think it will be good for the patient and good for the doctor."

That said, Dr. Zachariah did add that a monitoring program might make doctors "more careful about writing prescriptions" and more likely to make sure there is "medical justification" for writing them.

A spokeswoman for Bush said the "prescription-validation" bill is focused on stopping patients from "doctor jumping" to fraudulently acquire duplicate prescriptions for the same drug.

Financing provided and available

Purdue Pharma, the Stamford, Conn., manufacturer of OxyContin (oxycodone), will provide up to $2 million to finance the development of the software needed to operate the database. Once the computer programs are completed, Florida state officials said the software will be available for free to any other state that asks for it.

Purdue Pharma is also paying $150,000 to fund five training seminars to teach law enforcement staff about prescription-drug diversion.

50% of U.S. physicians operate under programs to monitor prescriptions.

The drug manufacturer is providing the $2.15 million as part of a settlement reached between the company and the state, which began investigating the company's marketing practices after it was reported that 140 people had died from oxycodone-related overdoses in the second half of 2001.

Purdue Pharma spokesman Robin Hogan said that, since the software will be available for other states to use, he doesn't anticipate the company providing funding to other states. It will, however, he said, lobby state legislatures to help pass bills creating prescription-monitoring programs, as it recently did in West Virginia.

Federal money is also available. In February, Congress passed an appropriations bill that included a $7.5 million grant program to help fund state prescription-monitoring systems.

The program was sponsored by Rep. Hal Rogers, (R, Ky.) who sponsored a program in 2001 that awarded $2 million in grants.

From that first pool of money, the DEA's Payne said, Ohio, Pennsylvania, Virginia and West Virginia received funds to get programs started, while California, Kentucky, Massachusetts, Nevada and Utah received grants designed to bolster existing programs.

Hogan noted that 80% of the inquiries made to Kentucky's program are made by health care professionals, not law enforcement.

"A lot of people look at this as a law enforcement tool," he said. "We see it as more of a health care tool."

ADDITIONAL INFORMATION:

Weblink

DEA FAQ on state prescription-monitoring programs (http://www.deadiversion.usdoj.gov/faq/rx_monitor.htm)

Florida attorney general's one-day training conferences on prescription drug diversion for law-enforcement personnel, in pdf (http://www.myflorida.com/myflorida/government/governorinitiatives/drugcontrol/pharm_drug.pdf)