House bill seeks to create nationwide Prescription Safety Alert System

Bipartisan congressional legislation has been introduced to create a nationwide Prescription Safety Alert System to enable pharmacists to better protect patients from opioid overuse.

The Analyzing and Leveraging Existing Rx Transactions (ALERT) Act, introduced on Thursday by Reps. Tom MacArthur (R-N.J.), Ann Kuster (D-N.H.) and Barbara Comstock (R-Va.), would require the Department of Health and Human Services to work with the private sector to establish a system that analyzes the transaction data that pharmacists and payers—such as health insurers and Medicare— generate when prescriptions are filled.

“We absolutely have to get smarter about how we use technology and data analysis to fight this crisis,” says MacArthur, who is co-chair of the Bipartisan Heroin Task Force. “By giving pharmacists, insurance companies, and programs like Medicare a new tool to understand the data they already have, we can help prevent further harm.”

According to MacArthur, the data analysis would provide real-time feedback to pharmacists at the point of sale and would be included in their normal workflow.

“A pharmacist will receive an alert that someone might be at risk of overuse based on their prescription history, or might be doctor-shopping to feed their addiction,” added MacArthur. “Instead of filling that unnecessary prescription, pharmacists will have an extra tool to detect and prevent these dangers.”

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The ALERT Act is endorsed by Health IT Now, a coalition of patient groups, provider organizations, employers and payers, which launched the Opioid Safety Alliance in January—along with IBM, Intermountain Healthcare, McKesson, Oracle and Walgreens—to advance a health IT-centric policy agenda to combat the problem of opioids.

According to Joel White, executive director of HITN's Opioid Safety Alliance, an alert system would provide a much-needed capability not currently provided by Prescription Drug Monitoring Programs (PDMPs)—electronic databases that track controlled substance prescriptions by flagging suspicious patient prescribing activities.

“Today, clinicians rely on PDMPs to flag fraudulent opioid transactions and, while these systems hold great promise, significant blind spots remain,” says White. “Too often PDMPs are not updated in real-time, do not include prescriptions filled across state lines, and do not include fill attempts—leaving clinicians with only a partial view of a patient's true opioid history. The Prescription Safety Alert System delineated in the ALERT Act will arm clinicians with the proper tools to thwart opioid misuse in real-time and prevent undue delays in access for those with a legitimate medical need.”

The Opioid Safety Alliance has been calling for a nationwide Prescription Safety Alert System, based on a model developed by the National Council for Prescription Drug Programs (NCPDP) that leverages existing ANSI-accredited standards widely adopted by the industry.

“It is gratifying to have NCPDP’s model supported by the HITN Opioid Safety Alliance and Representatives MacArthur, Kuster and Comstock,” says Lee Ann Stember, NCPDP’s president and CEO. “Our members representing diverse stakeholder perspectives developed the model to provide a sustainable solution that conforms to provider workflows and can complement existing PDMPs to prevent diversion, ensure appropriate access to medications for patients with a valid medical need, and protect patients.”

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