A Missouri state Auditor's report released Thursday may help push a prescription drug monitoring program through the General Assembly.
State Auditor Nicole Galloway released a report on Missouri's oversight procedures for prescription drug benefits through Medicaid, the Children's Health Insurance Program (providing health insurance for children whose families' incomes are too high to qualify for Medicaid) and the Missouri Rx program (providing assistance for prescription drug costs to those in need), which are all administered by the Missouri Department of Social Services.
Although prescription drug costs increased from 2010-15, the state was able to offset those increases by encouraging the use of generic drugs and requiring cheaper drugs be prescribed before more expensive drugs. Overall, prescription drug costs then declined in 2016 and 2017, according to the report.
While Missouri has been able to control the costs of prescription drugs for patients, it has not done enough to combat fraud or abuse, such as implementing a prescription drug monitoring program (PDMP), according to the report. A PDMP may be used to help health care professionals identity drug-seeking behaviors in patients who may be addicted to prescription drugs or selling them illegally.
The need for the program became more pronounced as the opioid epidemic took hold.
The opioid epidemic refers to a rapid growth in use of prescription and non-prescription opioids, beginning in the late 1990s and continuing today. The use of opioids led to "epidemic levels of opioid overdose deaths," according to the U.S. Drug Enforcement Agency. In the past few years, there have been more than 50,000 overdose deaths in the United States annually.
Poor drug monitoring has contributed to the U.S. opioid epidemic, authorities say.
The system would allow physicians to see patients' prescription drug history. That would allow them to identify potential opioid abusers.
A PDMP collects data from pharmacies dispensing controlled substances and make the information available to authorized users through databases. The PDMP has been effective in addressing prescription opioid overdoses, according to the U.S. Department of Health and Human Services.
Missouri remains the only state without a statewide PDMP. However, St. Louis County's Department of Public Health established a regional monitoring program in 2016. That program has evolved to take in data from 10 cities (including Jefferson City) and 48 Missouri counties (including Cole County), according to the auditor's report. The PDMP was implemented by Apriss, a prescription drug database, which began the program in dozens of other states.
Former Gov. Eric Greitens attempted to create a statewide PDMP through use of an executive order. But, that order did not address fraud or abuse, according to Galloway's report.
The report recommends the General Assembly "take action to improve the state's PDMP and create a comprehensive PDMP that meets the needs of the Medicaid and CHIP programs."
The General Assembly has over the past several sessions considered implementing a PDMP. Early in December, Rep. Holly Rehder, R-Sikeston, pre-filed a prescription drug monitoring bill for the 2019 session. It is the same bill she filed last year, which passed the House, but not the Senate.