Panel Explores Compact to Monitor Prescription Drugs
By Mary Branham, CSG Managing Editor
Kentucky has a pretty good program for monitoring the dispensation of prescription drugs.
The Kentucky All Schedule Prescription Electronic Reporting system—or KASPER for short—requires anyone who writes a prescription in the state to report it to the system within seven days, said Dave Hopkins, KASPER program manager.
The problem, he said, is that people who might be doctor shopping to get multiple prescriptions for a particular medication and other drug seekers can easily go to other states to access the drug. Kentucky has developed a memorandum of understanding with Ohio to link their prescription reporting systems, but that doesn’t completely solve the problem. Kentucky borders seven other states, and because it is a small state, anyone seeking a prescription drug wouldn’t have to travel far to access a state without such an agreement.
“For every state pair that wants to be able to share this data, to have to draft an (agreement) for every state that they would want to share data with, that would be a monumental undertaking,” said Hopkins.
Enter The Council of State Governments’ National Center for Interstate Compacts. The center is exploring the possible use of an interstate compact to connect the prescription drug monitoring programs of the 33 states that have them.
A national advisory panel has met twice, and Hopkins, who represents Kentucky on the panel, said members are optimistic about the benefits a compact could bring to the efforts to share information.
“Everybody came away thinking this could be a much better approach, an interstate compact, to allowing the states to enter into agreements to share this data as opposed to everybody trying to create their own (memorandum of understanding) with every other state they want to share data with,” he said.
Kansas Sen. Vicki Schmidt, who chairs the advisory panel, said the group decided in December to appoint a committee to develop compact language. That language will then go back to the full committee for review, and then on to states for legislative consideration.
“We have to address the security concerns (of information) and individual state concerns about access and security,” Schmidt said.
Kansas adopted prescription drug monitoring legislation in 2008. Schmidt acknowledged there are differences in the various state laws regarding drug monitoring. Kansas, for instance, requires a subpoena for law enforcement to access information; other states do not.
“We have some obstacles to overcome in terms of uniformity and who will guide the rules of each individual state,” she said.
Crady deGolian, a policy analyst with CSG’s National Center for Interstate Compacts, said the recommendations from the group will be used to develop compact language during the drafting phase of the project. DeGolian said the compact could develop as a national compact or a series of regional agreements depending on the drafting team’s recommendation.
Kansas is still in the implementation phase of prescription drug monitoring, but other states, such as Kentucky, have had operational monitoring programs for some time.
How Prescription Monitoring Programs Work
Here’s how KASPER and other prescription drug monitoring programs work, according to Hopkins: Dispensers of medication report to the program when a drug is dispensed and information is stored in a database. Only authorized users can access the information in that database, Hopkins said. Among the authorized users: prescribers of medical treatment for a current patient; a pharmacist for pharmaceutical treatment of a current patient; and law enforcement officers with an open investigation that specifies an individual.
“They are not allowed to go on fishing expeditions,” Hopkins said of law enforcement in Kentucky seeking to use the database.
The state Medicaid program can access the program for recipient review and drug courts can gather information on individuals appearing before them.
According to Hopkins, the goals of prescription drug monitoring programs are:
To help health care providers provide better care for their patients;
To help stop doctor shopping and drug-seeking behaviors, and to help those patients with a drug problem; and
To help stop the diversion of prescription drugs into the illegal market.
Achieving those goals can alleviate several problems, and could possibly save states money, according to Schmidt. Having better tools to address substance abuse, she said, can eliminate some drug crimes, save money for the courts, and reduce expenses to the state Medicaid program by eliminating unnecessary prescriptions.