There is no question con- trolled substance abuse— particularly opioids—is a real problem. Pharmacies can play a role in helping to address it,
whether by helping to reduce fraud and
abuse or improving patient safety and
But how can pharmacies easily and
effectively navigate the requirements for
prescription drug monitoring programs
(PDMPs) and e-Prescribing?
It is important to understand exactly
how your state is addressing the issue
and what you must
do to comply. It is also
important to ensure
your pharmacy management system has
the security, documentation and communication tools necessary for
Federal and state
governments are tightening the requirements
for handling controlled
substances and it is only
expected to escalate as New York implements its own requirement that all prescriptions be e-Prescribed.
Also giving the movement traction is
Washington’s proposal that physicians
meet an 80 percent e-Prescribing threshold or face reductions in Medicare payments for noncompliance.
Electronic Prescribing of Controlled
Substances (EPCS) is now permitted in all
50 states and continues to gain momentum as a way to help pharmacies:
• improve patient safety, patient
care and pharmacy efficiency
• Provide secure electronic records
• reduce prescription fraud and
• decrease callbacks between
pharmacies and physicians
• Flag potentially deadly
prescription errors and drug
interactions related to opioid use
• lower costs
However, for pharmacies, this means
even more compliance requirements.
EPCS compliance mandates validating prescriptions and documenting and maintaining information about whoever picks up
the medication. In order to comply fully,
pharmacy software must be able to accept
electronic prescriptions and handle the
A pharmacy’s e-Prescribing software
application must be certified ECPS compliant and be able to validate the digital signature of the prescriber, verify the content
of the prescription to ensure that it has
not been altered and complete the DEA-required checks to ensure the digital certificate is current and valid. The software
should also prompt staff for required information when a controlled substance prescription is entered and picked up.
Despite compliance requirements, EPCS
is an overall time-saver that is here to stay.
In addition, the progress of EPCS is improving. In just the first half of 2015, Surescripts
processed 4 million electronic prescriptions for controlled substances, officials
say, or more than double the 1.6 million
processed in 2014.
Prescription Drug Monitoring Programs
(PDMPs) must be effective in reducing
the abuse of prescription opioids without
restricting access to those with genuine
needs. Unintentional consequences from
excessive regulatory enforcement—such
as the possibility of inadequate prescribing for patients with a true need for these
medications—are a real concern.
PDMPs can help identify patients who
are receiving legitimate prescriptions, but
may be at risk for complications from the
use of multiple medications. There is however, a delicate balance between appropriate therapeutic uses of these medications
and the risk of developing dependence.
Because the population suffering from
chronic pain is significant, the difference
between “pain patients” and “illicit users”
can be complex with overlap between
the two. An estimated 11.2 percent of the
U.S. adult population experiences chronic
pain. Consequently, of those patients with
chronic pain, over one-third are affected
by opioid dependence.
PDMPs are effective in improving quality of care and reducing doctor shopping,
diversion and prescription fraud. Every
program has opposing opinions, but prescription drug monitoring is likely to
remain relevant for a long time.
QS/1’s Pharmacy Management Systems
are customizable and comprehensive,
with EPCS and PDMP tools that increase
pharmacy efficiency, reduce prescription
pad fraud, pharmacy callbacks on illegible
prescriptions and patient “pharmacy shopping.” QS/1 makes it easier for providers to
adhere to treatment guidelines and monitor patient responses to treatment.
What does the controlled substances epidemic mean for grocery store pharmacies?
By Ed Vess
Ed Vess, RPh is senior manager –
market analysts for QS/1. He can
be reached at Ed_Vess@qs1.com.