Rx monitoring effect on minorities questioned

A new study says prescription monitoring programs can have unforeseen consequences.

By Kevin B. O'Reilly, AMNews staff. April 24, 2006.

As New York state moves this month to monitor all prescription drugs, researchers warn that efforts to combat drug abuse and diversion can have an unintended fallout on minorities' access to appropriate treatment.

A March 13 Archives of Internal Medicine study found that Medicaid patients living in predominantly black neighborhoods were 1.8 times more likely than those living in predominantly white areas to have appropriate benzodiazepine prescriptions discontinued. The study examined the seven years after New York in 1989 added the drug to its list of those monitored under its triplicate prescription program. Patients in majority Hispanic neighborhoods were 1.6 times more likely than patients in white areas to have their prescriptions discontinued.

Patients should have had prescriptions rejected only if they fell into a "problematic use" category defined, with the help of a clinical advisory panel, as a patient filling a prescription at two different pharmacies within seven days, using the drug for more than 120 days or using the drug at a dose more than twice the recommended maximum. Adding benzodiazepine, a potentially addictive anti-anxiety drug, to the list of monitored drugs nearly ended pharmacy hopping, but it also had a racially disparate effect on prescribing, the study said.

"I don't think physicians are saying, 'Here's a black person; I'm not going to give them what they want,' " said Sallie-Anne Pearson, PhD, the study's lead author. "It's probably not that overt, but there does seem to be the perception that black folks and Hispanic folks tend to be the ones abusing this drug."