Prescription Drug Monitoring Programs (PDMPs) and Official Prescription Programs
Prescription drug monitoring programs (PDMPs) are being used to deter and identify illegal activity such as prescription forgery, indiscriminate prescribing and "doctor shopping." Most programs provide patient-specific drug information upon request of the patient’s physician or pharmacist. Some state programs proactively notify physicians when their patients are seeing multiple prescribers for the same class of drugs. These programs assist healthcare professionals in managing patient care and have been extremely successful in thwarting drug diversion in a number of states.
The National Survey on Drug Use and Health reports that in 2000, 3.8 million people aged 12 and older reported the current nonmedical use of a prescription drug. In 2006, that figure increased more than 84 percent to seven million Americans, with the misuse of pain relievers representing three quarters of the overall problem. The same report also found that prescription drug abuse among young adults aged 18-25 increased 20 percent from 2002 to 2006, driven by the non-medical use of prescription pain relievers.
The U.S. Department of Justice Office of Justice Programs contracted with Simeone Associates, Inc. to evaluate PDMPs’ impact on the supply and abuse of controlled substances. At the time of the study, 20 states had implemented systems to monitor the prescription and sale of drugs identified as controlled substances by the DEA. The results of the study indicate that the per capita supply of prescription pain relievers and stimulants increased substantially over the 1993 to 2003 period and that this growth was much more pronounced in states that did not have PDMPs than in states that did.
An Official Prescription Program can be established as its own program or as an enhancement to an already established PDMP. Official Prescription Programs require the use of a single prescription format per state, allowing only authorized prescribers to order such products, and by establishing an automated prescription validation process.
After implementing an official prescription program, New York Medicaid reported savings of $18 million in January 2007 alone and $68 million through May 2007. New York is not the only state that would benefit financially by reducing Medicaid fraud. According to a recent report by the Government Accountability Office, an audit of government programs in five large states found about 65,000 instances of beneficiaries improperly obtaining potentially addictive drugs at the cost of $65 million during 2006 and 2007. The report concludes that when bills from doctor visits and the potential for Medicaid fraud in the states not surveyed is taken into account, hundreds of millions of dollars are at stake.
Prescription drug fraud hurts the nation in loss of lives, increased crime, addiction, increased health care costs, medical expenses and Medicaid fraud, a price which all Americans ultimately pay.
