Prescription monitoring requirements aren’t going away after being left out of opioid bill

The final version of legislation to combat opioid abuse and addiction didn’t include a requirement for prescribers to check their state’s prescription drug monitoring program (PDMP), but a new bill in the U.S. Senate would change that.

Introduced by Sens. Amy Klobuchar, D-Minnesota, Joe Manchin, D-West Virginia, and Angus King, I-Maine, the Prescription Drug Monitoring Act of 2016 would require physicians to use the database before prescribing opioids in order for those state to receive federal funding for addiction treatment and prevention programs.

“In some states, yeah, they have a program, but that just means a doctor has to sign up. It doesn’t mean they actually record information,” Klobuchar said on the Senate floor July 13. “It doesn’t mean that they share it with other doctors. It doesn’t even mean that they share it between states.”

If enacted, the bill would create an interstate “data-sharing platform” for prescription information, along with requiring all states to make their PDMP data available to other states.

Physicians would have to check the database before writing prescriptions, pharmacists would report each new opioid prescription within 24 hours of being filled, and state regulators would alert physicians when a patient appears to be receiving multiple prescriptions from multiple doctors.

The goal is to prevent that kind of doctor-shopping. Klobuchar mentioned one extreme example in her speech, saying she heard from a patient in Minnesota who had received 108 prescriptions for opioid painkillers from 85 different prescribers.

The anti-opioid abuse package passed by the Senate, the Comprehensive Addiction and Recovery Act, had similar PDMP requirements removed. While that legislation didn’t include emergency funding for treatment and prevention programs, it did authorize several new grant programs. Under Klobuchar’s bill, states would have to follow the new PDMP standards before receiving any money through those new grants.

Forty-nine states have PDMPs, with Missouri being the lone exception, but only eight have state laws requiring physicians to use them. Research has shown that when healthcare systems implement PDMPs, prescribing habits do change, with a Health Affairs study published in June finding the rate of prescriptions for Schedule II opioids at an office visit dropped by 30 percent