States set differing rules for use of PDMP data in opioid fight

Prescription drug monitoring programs, state-run electronic databases, are on the frontlines of fighting America’s opioid crisis but have different requirements for prescribers to review the PDMP information.

The Department of Health and Human Services’ Office of Inspector General took a close look at of eight states—Nebraska, Nevada, New Hampshire, Tennessee, Texas, Utah, Washington and West Virginia—to assess their oversight of opioid prescribing and their monitoring of opioid use.

What the OIG found was that all eight states have laws, regulations or policies related to opioid prescribing—as well as to using PDMP data—and also perform data analytics.

“The states are using opioid-related data to perform data analytics, as well as performing outreach to providers and patients,” according to the report, which notes that the states are analyzing data to determine the number of opioid prescriptions written by providers to detect high-prescribing providers.

In West Virginia, a Drug Utilization Review committee sends prescriber reports to high-prescribing providers based on data analytics. Nevada uses data analytics to identify the top 10 opioid-prescribing providers to monitor their activities.

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In Washington, the Medicaid program sends prescriber report cards to prescribers based on data analytics for the measures of chronic use, high dose and concurrent opioid and sedative prescribing. In Texas, analystdeveloped an algorithm that looks at outpatient pharmacy claims for opioid prescriptions that are disproportionately prescribed by non-pain providers participating in Medicaid

Also See: Questions swirl on the utility of current PDMP role in opioid crisis

State requirements for reviewing PDMP information also varies. In Nevada, prescribers are required to review the PDMP data before issuing an initial prescription for a controlled substance and at least every 90 days during extended courses of treatment.

In New Hampshire, prescribers are required to check the PDMP data before prescribing an initial opioid prescription and at least twice a year thereafter, while in Utah, prescribers are required to check the database before issuing the first prescription of an opioid to a patient—unless the prescription is for a 3-day supply or less or for a 30-day post-surgery supply.

At the same time, all of the states OIG reviewed have requirements for sharing PDMP data with law enforcement. However, according to auditors, the level of data sharing also varies by state.

“In some states, such as Nebraska and Washington, law enforcement must have a warrant or be engaged in an investigation of a specific person to have access to PDMP data,” finds OIG’s report. “In other states, such as Utah and Tennessee, law enforcement can be provided more open access to PDMP data.”

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