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Prescription Drug Monitoring Compact Nears Completion

By Mary Branham, CSG Managing Editor
Kentucky pharmacies filled nearly 700,000 prescriptions written by prescribers in its seven border states last year.
That doesn’t even count the prescriptions written in nonborder states, including more than 9,000 written in Michigan, according to Dave Hopkins, project manager for the state’s prescription drug database, the Kentucky All-Schedule Prescription Electronic Reporting, or KASPER.
“Prescriptions dispensed in Kentucky have been prescribed all over the country,” said Hopkins. “You know there is some drug-seeking traffic going across state lines.”
Hopkins is a member of a national advisory panel exploring the need for an interstate compact that would allow prescription drug monitoring programs from different states to share data.
The Council of State Governments served as a neutral convener for the exploration of establishing the interstate compact among states with prescription drug monitoring programs. The committee drafting legislation is putting the final touches on the proposal, and hopes to have it ready for consideration in state legislatures beginning in the 2011 sessions, said Kansas Senate Assistant Majority Leader Vickie Schmidt, the advisory panel chair.
Once the language is finalized, the drafting team will share it with stakeholder groups, test states and the full advisory panel, Schmidt said, “to ensure everyone is comfortable with the legislation and that state legislators ultimately will be willing to introduce that legislation in respective states.”
The next phase, said Schmidt, will be an education phase. “This is the most important piece of this project,” she said.
The panel will develop electronic and written materials detailing the specifics of the compact, along with a legislative resource kit. Schmidt said plans also include convening a legislative briefing for state legislatures.
“I think it’s a great example of how we can all work together to come up with a solution to a very complex problem,” Schmidt, a registered pharmacist, said.
Forty states have some sort of prescription drug monitoring program; 33 of them are operational, according to the National Alliance for Model State Drug Laws. But individual state programs do not address the ability to monitor the movement of prescription drugs across state lines, according to Schmidt. That’s a key problem when it comes to people who doctor shop to feed an addiction to prescription drugs like pain killers.
That’s where the interstate compact would play a role. “I believe the development of a monitoring compact will improve interstate cooperation on the issue and dramatically reduce the epidemic of prescription drug abuse,” Schmidt said.
She said misuse of prescription drugs is an epidemic more lethal than crack cocaine or heroin abuse.
“In no way are these programs trying to inhibit prescribers from prescribing drugs for patients who need them,” Hopkins said.
Instead, the programs targeted those people who don’t need the drugs medically, but are obtaining them for illicit use. Hopkins said prescribers can now share information in other states, but it would entail each physician setting up separate accounts with each state program.
“We need to come up with a more efficient way to do this,” he said.
While the compact would provide a secure and authorized way to exchange prescription drug monitoring program data among member states, it would not mandate how member states operate their individual programs. The compact would establish consistent policies among member states to minimize cost of nationwide data sharing and establish security requirements for the shared use and exchange of data.
“This project has been another example of how states can work cooperatively to address difficult policy challenges by creating meaningful and long-lasting change,” said Crady deGolian, a senior policy analyst who works with interstate compacts at CSG.

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