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Rx database heads to vote

Senate bill could hit the floor this week

Posted: Monday, April 07, 2008

A senate bill that would create a prescription database for controlled substances in the state of Alaska could be headed for a floor vote this week.

Proponents are confident of passage, said Ginger Blaisdell, aide to the bill's prime sponsor, Senate President Lyda Green. So confident in fact that arrangements are already being made for Gov. Sarah Palin to sign Senate Bill 196 into law in a ceremony that may be attended by White House representative Scott Burns and Linda Barefoot from Purdue Pharma, which manufactures OxyContin, a narcotic medicine the control of which is part of the bill's intent.

Blaisdell said Friday she expects the measure to pass the House, and subsequently the Senate for concurrence, sometime this week.

The Alaska Board of Pharmacy would administer the database, which would contain data from every prescription dispensed in the state for all schedule IA, IIA, IIIA, IVA or VA medications controlled under state law, or schedule I, II, III, IV or V controlled under federal law. The law would apply to patients receiving medications through a pharmacy, not inpatients in a licensed health care facility.

The database would include the date prescriptions were written and filled, along with the method of payment, though the law does not permit the board to retain credit card or other numbers in the database.

Also included in the data would be the name, address and date of birth of patients, the drug code of the controlled substance, the name of the pharmacy and pharmacist or practitioner dispensing the drugs.

That kind of information could be used to track prescribing practices and dispensing patterns, and to determine if practitioners are prescribing in an unlawful manner. It would also track individuals obtaining controlled substances with a frequency or in a manner beyond recognized standards for dosage, sponsors said.

While not public, the database information could be made available under the law to personnel of the board, drug dispensers including doctors, nurse practitioners, dentists, veterinarians and pharmacists to the extent the information relates to a specific patient, as well as federal, state and local law enforcement authorities under the power of a search warrant, subpoena, or probable-cause court order.

The bill would also protect those submitting information to the database from civil liability for damages for accessing or failing to access the database.

Data would be purged from the system after two years from the date the prescription was filled.

Finally, the bill includes provisions making it a Class A misdemeanor to access information in the database beyond legal authority, and a Class C felony for knowingly disclosing information from the database to a person not authorized to receive it, or for allowing an unauthorized person to access the database.

The bill is designed to curb misuse of prescription drugs in Alaska and to deter so-called "doctor hopping" by patients. But its provisions have raised concerns about privacy, including among lawmakers, Blaisdell said.

"A lot of people (legislators) are not comfortable with knowing their personal data is being managed by a government agency," she said.

Many of those concerns have been addressed in amendments adopted over the past several weeks, she said.

Proponents insist Board of Pharmacy members and staff who have specific medical knowledge and who could accurately interpret reports and data would manage the Prescription Drug Monitoring Program, not law enforcement. According to information provided by Blaisdell, statistics from other states that have such programs show that between 80 and 85 percent of report requests come from physicians who need to know what medication their patients may be taking in order to avoid dangerous effects of mixing drugs. Between 5 and 10 percent of reports are sought by pharmacists, 5 percent by licensing boards and data managers, and less than 5 percent by law enforcement.

The database would not collect any data that is not already required by the federal Drug Enforcement Agency. There would be no random searches of the database, and subpoenas or warrants would have to be based on information from outside the database itself.

The data itself would cover medicinal narcotics such as painkillers, stimulants, tranquilizers, sedatives and other drugs that the Legislature might add to the scheduled drug statutes, according to information from Sen. Green's office.

Fiscal notes attached to the bill show the Board of Pharmacy receiving $400,000 in federal start-up funding.

"It is expected that in future years, the cost will fall to half," Blaisdell said.

The Medicaid program anticipates a savings of $86,000 based on the expectation that abusers would be found and limited by the database to only one prescribing doctor, thus cutting the number of prescriptions Medicaid would have to fund, Blaisdell said.

Finally, the Department of Corrections would use the data to help control the flow of drugs within the prison system. However, Blaisdell said theirs is a zero fiscal note.

Hal Spence can be reached at hspence@ptialaska.net.



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