States Showing ‘Renewed Interest’ in Rx Drug Monitoring

Although public health officials insist that systematically monitoring prescription drug patterns "saves lives," just 15 states currently employ such programs, the New York Times reports. But particularly because of the recent trend of abuse surrounding the prescription painkiller OxyContin, "at least" eight more states, including Connecticut, Florida and New Jersey, "are considering" implementing new drug tracking programs, which monitor "who gets potentially addictive drugs and who prescribes and fills those prescriptions." According to the Times, "decades of lobbying" by drug companies, doctors, pharmacies and, most recently, groups who favor more use of narcotics to control pain, has precluded many states from employing the programs. Opponents of drug monitoring say that it "violates patient privacy," is too expensive and hinders patients "who really need" certain medications by causing physicians to prescribe fewer or "less potent" prescriptions. A 1992 report completed by the General Accounting Office, along with "a more recent survey" by the Department of Justice, could not substantiate "several of those claims," the Times reports. According to the Times, there is evidence that prescription drug monitoring "works." For instance, when New York state began tracking prescriptions for certain tranquilizers in the late 1980s, emergency rooms in New York City and Buffalo reported 47% fewer hospital admissions for overdoses involving those drugs. In addition, law enforcement officials say that drug monitoring programs would help them "crack down" on prescription drug abuse.

Drug monitoring proponents could clash with "some powerful opponents," the Times reports. "Physicians do not want their activities monitored. Drug companies are also a powerful lobby. Once a drug is monitored, sales decrease, and the drug companies don't like that," Carmen Catizone, executive director of the National Association of Boards of Pharmacy, said. Dr. Russel Portenoy, chair of pain medicine and palliative care at Beth Israel Medical Center, said there can be a "downside" to drug monitoring. According to Portenoy, doctors in New York in the late 1980s avoided monitoring programs by prescribing tranquilizers that the state did not track and that had "greater potential side effects" than the ones the state did monitor. In addition, some states have delayed initiation of monitoring programs because of the cost, "which can reach hundreds of thousands of dollars a year," the Times reports. However, proponents say that monitoring prescription drugs "will save taxpayers money in the long run," because it will cut down on "fraudulent" Medicaid claims and the cost of prosecuting drug offenders (Petersen/Meier, New York Times, 12/21).