SD13 - Report on the Collection of Data and Information about Utilization of the Prescription Monitoring Program pursuant to SJR 73 and SJR 75 (2010)


Executive Summary:
The Virginia Prescription Monitoring Program (VPMP) was created due to grave concerns related to a prescription drug abuse epidemic primarily located in Southwest Virginia. The program is primarily a tool to assist prescribers and dispensers in making more informed treatment and dispensing decisions. It is also designed to be a tool for authorized law enforcement and regulatory personnel to assist them in investigations related to prescription drug abuse and diversion.

The VPMP started operations in September 2003 as a fax-based system covering Schedule II prescriptions dispensed by pharmacies located in southwest Virginia. Information was available only to prescribers licensed in Virginia and to authorized agents of the State Police as well as limited access to Department of Health Professions personnel. In June 2006, the VPMP went statewide covering Schedule II-IV controlled substances prescriptions dispensed by resident and non-resident pharmacies as well as dispensing physicians. At this time, the program began using web-based software to facilitate the submission of requests and the provision of requests and access was expanded to all prescribers and to pharmacists with a current active license regardless of licensing state, as were other categories of users such as authorized personnel of the Office of the Chief Medical Examiner. This generated further growth of the program but did not meet the needs of those healthcare professionals who needed quick access to prescription information during evenings, nights and weekends.

On October 1, 2009 the VPMP turned on 24/7 access, automated response software in response to requests to make the program more accessible, timely, and efficient. The response to this improvement to the program has been astounding with the number of registered users doubling over the past year and the program processing more than 4 times the number of requests from January through September as were processed in all of 2009. Healthcare professionals comment frequently that the speed of response is amazing as approximately 95% of all requests are processed and sent back to the requestor within one minute. Emergency room providers and other healthcare professionals who did not register for the program previously are now using the program with almost one-third of all requests made during evening, nights, and weekend hours.

The VPMP recognizes that providing education about the program and the issues impacting prescription drug abuse and diversion is critical to making an impact on this public health and safety issue. The program has been very involved in co-sponsoring educational conferences such as one held at the University of Virginia in May 2010. Program staff frequently gives presentations at other educational events and have been exhibitors at various state healthcare professional association meetings. In February of 2010 a mass mailing to approximately 39,000 prescribers and pharmacists licensed in Virginia, providing information specific to the program and other resources, resulted in a surge in registrations and use of the program. The VPMP continues to support, in collaboration with the Virginia Commonwealth University School of Medicine, an online chronic pain management course that licensees of the Department of Health Professions may take at no cost and receive continuing education credit through their respective licensing board.

The VPMP is making several recommendations for the enhancement of the program. While some of the recommendations will ensure the program meets certain minimum eligibility requirements for federal grants, the greater overall impact of the recommendations will allow for more meaningful information being provided to users and ensure compatibility for interoperability with other state prescription monitoring programs.

RECOMMENDATIONS

Add tramadol and carisoprodol to Schedule IV in the Drug Control Act

Add authority to add additional drugs of concern as covered substances utilizing the regulatory process of the Virginia Board of Pharmacy

Expand access to include additional federal law enforcement to include authorized agents of FBI, FDA, and HHS with the requirement of having an open investigation. (Based on NASPER)

Expand access to include authority for medical reviewers for workman’s compensation programs (Reviewer would be a prescriber)

Add authority to provide unsolicited reports to law enforcement and regulatory agencies.

Change reporting requirement to “within 7 days of dispensing”

Change reporting format to ASAP version 2007, provide mechanism for Director to change reporting format by providing timeframe to come into compliance.

Add requirement of notarized application for prescribers, dispensers, and delegates

Add requirement of notarized application for Law Enforcement and Regulatory personnel

Add method of payment to reporting requirements (Cash, Medicaid, other)

Require dispensers to report the DEA registration of the dispenser (Note: change from NCPDP#, cost savings for program, align with other state programs)

Require dispensers to report the number of refills ordered

Require dispensers to report whether the prescription was a new or refill

Require the dispenser to report the date the prescription was written

Require estimated number of days for which prescription should last (Days Supply)