{ "id": "R42593", "type": "CRS Report", "typeId": "REPORTS", "number": "R42593", "active": true, "source": "EveryCRSReport.com, University of North Texas Libraries Government Documents Department", "versions": [ { "source": "EveryCRSReport.com", "id": 584974, "date": "2018-05-24", "retrieved": "2018-09-12T22:52:40.634047", "title": "Prescription Drug Monitoring Programs", "summary": "In the midst of national concern over the opioid epidemic, federal and state officials are paying greater attention to the manner in which opioids are prescribed. Nearly all prescription drugs involved in overdoses are originally prescribed by a physician (rather than, for example, being stolen from pharmacies). Thus, attention has been directed toward better understanding how opioids are being prescribed and preventing the diversion of prescription drugs after the prescriptions are dispensed.\nPrescription drug monitoring programs (PDMPs) maintain statewide electronic databases of prescriptions dispensed for controlled substances (i.e., prescription drugs with a potential for abuse that are subject to stricter government regulation). Information collected by PDMPs may be used to educate and inform prescribers, pharmacists, and the public; identify or prevent drug abuse and diversion; facilitate the identification of prescription drug-addicted individuals and enable intervention and treatment; outline drug use and abuse trends to inform public health initiatives; or educate individuals about prescription drug use, abuse, diversion, and PDMPs themselves.\nAs of February 2018, 50 states, the District of Columbia, and two territories (Guam and Puerto Rico) had operational PDMPs within their borders.\nHow PDMPs are organized and operated varies among states. Each state determines which agency houses the PDMP; which controlled substances must be reported; which types of dispensers (e.g., pharmacies) are required to submit data; how often data are collected; who may access information in the PDMP database (e.g., prescribers, dispensers, or law enforcement); the circumstances under which the information may (or must) be accessed; and what enforcement mechanisms are in place for noncompliance. \nPDMP costs may vary widely, with startup costs that can range as high as $450,000 to over $1.5 million and annual operating costs ranging from $125,000 to nearly $1.0 million. States finance PDMPs using monies from a variety of sources including the state general fund, prescriber and pharmacy licensing fees, state controlled substance registration fees, health insurers\u2019 fees, direct-support organizations, state grants, and/or federal grants. \nThe federal government supports state PDMPs through programs at the Departments of Justice (DOJ) and Health and Human Services (HHS). Since FY2002, DOJ has administered the Harold Rogers Prescription Drug Monitoring Program, and in FY2017, DOJ incorporated this grant program into the new Comprehensive Opioid Abuse Program. HHS programs include National All Schedules Prescription Electronic Reporting (NASPER), State Demonstration Grants for Comprehensive Opioid Abuse Response, Opioid Prevention in States grants, State Targeted Response to the Opioid Crisis Grants, and various pilots and initiatives under the Office of the National Coordinator for Health Information Technology (ONC). Of note, NASPER last received appropriations (of $2.0 million) in FY2010.\nState PDMPs vary with respect to whether or how information contained in the database is shared with other states. Federal policymakers have repeatedly emphasized the importance of enhancing interstate information sharing and the interoperability of state PDMPs. In 2011, the Obama Administration included efforts to increase interstate data sharing in its action plan to counter prescription drug abuse. In 2017, a presidential commission recommended, among other things, that the Trump Administration support legislation to require DOJ to fund a \u201cdata-sharing hub\u201d and require states receiving federal grant funds to share PDMP data.\nThe available evidence suggests that PDMPs can be effective in reducing the time required for drug diversion investigations, changing prescribing behavior, reducing \u201cdoctor shopping,\u201d and reducing prescription drug abuse. Assessments of effectiveness should also take into consideration potential unintended consequences of PDMPs, such as limiting access to medications for legitimate use or pushing drug diversion activities over the border into a neighboring state. Experts suggest that PDMP effectiveness might be improved by increasing the timeliness, completeness, consistency, and accessibility of the data.\nPolicy issues that might come before Congress include the role of state PDMPs in federal efforts to combat prescription drug abuse, the role of the federal government in interstate data-sharing and interoperability, and the possible link between the crackdown on prescription drug abuse and the uptick in illicit opioid (e.g., heroin and illicit fentanyl) abuse. While establishment and enhancement of PDMPs enjoy relatively broad support, stakeholders express concerns about health care versus law enforcement uses of PDMP data (particularly with regard to protection of personally identifiable health information).", "type": "CRS Report", "typeId": "REPORTS", "active": true, "formats": [ { "format": "HTML", "encoding": "utf-8", "url": "http://www.crs.gov/Reports/R42593", "sha1": "4dde772662ce1b020eb9d1ed0bec995a047249bc", "filename": "files/20180524_R42593_4dde772662ce1b020eb9d1ed0bec995a047249bc.html", "images": {} }, { "format": "PDF", "encoding": null, "url": "http://www.crs.gov/Reports/pdf/R42593", "sha1": "8a7d590fd83e6f657e82de3c1fcc909eef930355", "filename": "files/20180524_R42593_8a7d590fd83e6f657e82de3c1fcc909eef930355.pdf", "images": {} } ], "topics": [ { "source": "IBCList", "id": 4793, "name": "Drug Control" }, { "source": "IBCList", "id": 4932, "name": "Public Health Services & Special Populations" } ] }, { "source": "EveryCRSReport.com", "id": 454052, "date": "2016-06-27", "retrieved": "2016-10-17T19:48:49.841931", "title": "Prescription Drug Monitoring Programs", "summary": "In the midst of national concern over illicit drug use and abuse, prescription drug abuse has been described by the Centers for Disease Control and Prevention as an epidemic in the United States. Nearly all prescription drugs involved in overdoses are originally prescribed by a physician (rather than, for example, being stolen from pharmacies). Thus, attention has been directed toward preventing the diversion of prescription drugs after the prescriptions are dispensed.\nPrescription drug monitoring programs (PDMPs) maintain statewide electronic databases of prescriptions dispensed for controlled substances (i.e., prescription drugs of abuse that are subject to stricter government regulation). Information collected by PDMPs may be used to support access to and legitimate medical use of controlled substances; identify or prevent drug abuse and diversion; facilitate the identification of prescription drug-addicted individuals and enable intervention and treatment; outline drug use and abuse trends to inform public health initiatives; or educate individuals about prescription drug use, abuse, and diversion as well as about PDMPs.\nHow PDMPs are organized and operated varies among states. Each state determines which agency houses the PDMP; which controlled substances must be reported; which types of dispensers are required to submit data (e.g., pharmacies); how often data are collected; who may access information in the PDMP database (e.g., prescribers, dispensers, or law enforcement); the circumstances under which the information may (or must) be accessed; and what enforcement mechanisms are in place for noncompliance. \nPDMP costs may vary widely, with startup costs ranging from $450,000 to over $1.5 million and annual operating costs ranging from $125,000 to nearly $1.0 million. States finance PDMPs using monies from a variety of sources including the state general fund, prescriber and pharmacy licensing fees, state controlled substance registration fees, health insurers\u2019 fees, direct-support organizations, state grants, and/or federal grants. The federal government has established two grant programs aimed at supporting state PDMPs: The Harold Rogers PDMP grant, administered by the Department of Justice, and the National All Schedules Prescription Electronic Reporting Act of 2005 (NASPER) grant, administered by the Department of Health and Human Services (HHS). The Harold Rogers PDMP received $13.0 million in appropriations for FY2016; NASPER last received appropriations (of $2.0 million) in FY2010.\nState PDMPs vary widely with respect to whether or how information contained in the database is shared with other states. While some states do not have measures in place allowing interstate sharing of information, others have specific practices for sharing. An effort is ongoing to facilitate information sharing using prescription monitoring information exchange (PMIX) architecture. Congress authorized the Secretary of HHS (Section 1141 of the Food and Drug Administration Safety and Innovation Act; P.L. 112-144), consulting with the Attorney General as appropriate, to facilitate the development of recommendations on interoperability standards for interstate exchange of PDMP information by states receiving federal grants to support their PDMPs. In September 2013, HHS submitted its report to Congress on PDMP interoperability standards.\nThe available evidence suggests that PDMPs may be effective in reducing the time required for drug diversion investigations, changing prescribing behavior, reducing \u201cdoctor shopping,\u201d and reducing prescription drug abuse. Assessments of effectiveness may also take into consideration potential unintended consequences of PDMPs, such as limiting access to medications for legitimate use or pushing drug diversion activities over the border into a neighboring state. Experts suggest that PDMP effectiveness might be improved by increasing the timeliness, completeness, consistency, and accessibility of the data.\nPolicy issues that might come before Congress include the role of state PDMPs in federal efforts to combat prescription drug abuse, the role of the federal government in interstate data-sharing and interoperability, and the possible link between the crackdown on prescription drug abuse and the uptick in heroin abuse. While establishment and enhancement of PDMPs enjoy relatively broad support, stakeholders express concerns about health care versus law enforcement uses of PDMP data (particularly with regard to protection of personally identifiable health information) and maintaining access to medication for patients with legitimate medical needs.", "type": "CRS Report", "typeId": "REPORTS", "active": true, "formats": [ { "format": "HTML", "encoding": "utf-8", "url": "http://www.crs.gov/Reports/R42593", "sha1": "5fc83fdc07883fdc31228211b4db7f05488cf9fd", "filename": "files/20160627_R42593_5fc83fdc07883fdc31228211b4db7f05488cf9fd.html", "images": null }, { "format": "PDF", "encoding": null, "url": "http://www.crs.gov/Reports/pdf/R42593", "sha1": "16840ef1637f4db9dd148f3882b71ae93b1838c8", "filename": "files/20160627_R42593_16840ef1637f4db9dd148f3882b71ae93b1838c8.pdf", "images": null } ], "topics": [ { "source": "IBCList", "id": 4793, "name": "Drug Control" }, { "source": "IBCList", "id": 4932, "name": "Public Health Services & Special Populations" } ] }, { "source": "EveryCRSReport.com", "id": 451147, "date": "2016-03-23", "retrieved": "2016-04-06T16:56:19.753524", "title": "Prescription Drug Monitoring Programs", "summary": "In the midst of national concern over illicit drug use and abuse, prescription drug abuse has been described by the Centers for Disease Control and Prevention as an epidemic in the United States. Nearly all prescription drugs involved in overdoses are originally prescribed by a physician (rather than, for example, being stolen from pharmacies). Thus, attention has been directed toward preventing the diversion of prescription drugs after the prescriptions are dispensed.\nPrescription drug monitoring programs (PDMPs) maintain statewide electronic databases of prescriptions dispensed for controlled substances (i.e., prescription drugs of abuse that are subject to stricter government regulation). Information collected by PDMPs may be used to support access to and legitimate medical use of controlled substances; identify or prevent drug abuse and diversion; facilitate the identification of prescription drug-addicted individuals and enable intervention and treatment; outline drug use and abuse trends to inform public health initiatives; or educate individuals about prescription drug use, abuse, and diversion as well as about PDMPs.\nHow PDMPs are organized and operated varies among states. Each state determines which agency houses the PDMP; which controlled substances must be reported; which types of dispensers are required to submit data (e.g., pharmacies); how often data are collected; who may access information in the PDMP database (e.g., prescribers, dispensers, or law enforcement); the circumstances under which the information may (or must) be accessed; and what enforcement mechanisms are in place for noncompliance. \nPDMP costs may vary widely, with startup costs ranging from $450,000 to over $1.5 million and annual operating costs ranging from $125,000 to nearly $1.0 million. States finance PDMPs using monies from a variety of sources including the state general fund, prescriber and pharmacy licensing fees, state controlled substance registration fees, health insurers\u2019 fees, direct-support organizations, state grants, and/or federal grants. The federal government has established two grant programs aimed at supporting state PDMPs: The Harold Rogers PDMP grant, administered by the Department of Justice, and the National All Schedules Prescription Electronic Reporting Act of 2005 (NASPER) grant, administered by the Department of Health and Human Services (HHS). The Harold Rogers PDMP received $13.0 million in appropriations for FY2016; NASPER last received appropriations (of $2.0 million) in FY2010.\nState PDMPs vary widely with respect to whether or how information contained in the database is shared with other states. While some states do not have measures in place allowing interstate sharing of information, others have specific practices for sharing. An effort is ongoing to facilitate information sharing using prescription monitoring information exchange (PMIX) architecture. Congress authorized the Secretary of HHS (Section 1141 of the Food and Drug Administration Safety and Innovation Act; P.L. 112-144), consulting with the Attorney General as appropriate, to facilitate the development of recommendations on interoperability standards for interstate exchange of PDMP information by states receiving federal grants to support their PDMPs. In September 2013, HHS submitted its report to Congress on PDMP interoperability standards.\nThe available evidence suggests that PDMPs may be effective in reducing the time required for drug diversion investigations, changing prescribing behavior, reducing \u201cdoctor shopping,\u201d and reducing prescription drug abuse. Assessments of effectiveness may also take into consideration potential unintended consequences of PDMPs, such as limiting access to medications for legitimate use or pushing drug diversion activities over the border into a neighboring state. Experts suggest that PDMP effectiveness might be improved by increasing the timeliness, completeness, consistency, and accessibility of the data.\nPolicy issues that might come before Congress include the role of state PDMPs in federal efforts to combat prescription drug abuse, the role of the federal government in interstate data-sharing and interoperability, and the possible link between the crackdown on prescription drug abuse and the uptick in heroin abuse. While establishment and enhancement of PDMPs enjoy relatively broad support, stakeholders express concerns about health care versus law enforcement uses of PDMP data (particularly with regard to protection of personally identifiable health information) and maintaining access to medication for patients with legitimate medical needs.", "type": "CRS Report", "typeId": "REPORTS", "active": true, "formats": [ { "format": "HTML", "encoding": "utf-8", "url": "http://www.crs.gov/Reports/R42593", "sha1": "f6828212237236c97ab6cd863691f03a147f61d5", "filename": "files/20160323_R42593_f6828212237236c97ab6cd863691f03a147f61d5.html", "images": null }, { "format": "PDF", "encoding": null, "url": "http://www.crs.gov/Reports/pdf/R42593", "sha1": "0848eb9960896f0701fe115793df19e696b23dff", "filename": "files/20160323_R42593_0848eb9960896f0701fe115793df19e696b23dff.pdf", "images": null } ], "topics": [ { "source": "IBCList", "id": 2496, "name": "Crime and Punishment" } ] }, { "source": "University of North Texas Libraries Government Documents Department", "sourceLink": "https://digital.library.unt.edu/ark:/67531/metadc284447/", "id": "R42593_2014Mar24", "date": "2014-03-24", "retrieved": "2014-05-06T21:21:54", "title": "Prescription Drug Monitoring Programs", "summary": "This report looks at ways that prescription drug monitoring programs (PDMPs), which maintain statewide electronic databases of prescriptions dispensed for controlled substances, can help to deter prescription drug misuse.", "type": "CRS Report", "typeId": "REPORT", "active": false, "formats": [ { "format": "PDF", "filename": "files/20140324_R42593_b5e6bc388e7be92c9a1be399db0878fa177c6941.pdf" }, { "format": "HTML", "filename": "files/20140324_R42593_b5e6bc388e7be92c9a1be399db0878fa177c6941.html" } ], "topics": [ { "source": "LIV", "id": "Medication abuse", "name": "Medication abuse" }, { "source": "LIV", "id": "Drug abuse", "name": "Drug abuse" }, { "source": "LIV", "id": "Drugs", "name": "Drugs" }, { "source": "LIV", "id": "Medicine", "name": "Medicine" } ] }, { "source": "University of North Texas Libraries Government Documents Department", "sourceLink": "https://digital.library.unt.edu/ark:/67531/metadc96731/", "id": "R42593_2012Jul10", "date": "2012-07-10", "retrieved": "2012-08-07T13:52:45", "title": "Prescription Drug Monitoring Programs", "summary": "This report looks at ways that prescription drug monitoring programs (PDMPs), which maintain statewide electronic databases of prescriptions dispensed for controlled substances, can help to deter prescription drug misuse.", "type": "CRS Report", "typeId": "REPORT", "active": false, "formats": [ { "format": "PDF", "filename": "files/20120710_R42593_3755fdaa93514c03dfc2361a0fcc57dfeeeea73f.pdf" }, { "format": "HTML", "filename": "files/20120710_R42593_3755fdaa93514c03dfc2361a0fcc57dfeeeea73f.html" } ], "topics": [ { "source": "LIV", "id": "Medication abuse", "name": "Medication abuse" }, { "source": "LIV", "id": "Drug abuse", "name": "Drug abuse" }, { "source": "LIV", "id": "Drugs", "name": "Drugs" }, { "source": "LIV", "id": "Medicine", "name": "Medicine" } ] } ], "topics": [ "Appropriations", "Crime Policy", "Health Policy" ] }