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Wed June 5, 2013
Pharmacists, Doctors Ignore Database
Only one-third of pharmacists and 10 percent of doctors are using Florida's prescription drug database, and that's a serious problem, federal officials told the state Board of Pharmacy on Tuesday.
A consumer member of the board has been working hard to get the board to require such a check, but he didn't get anywhere on Tuesday at the board's meeting in Miami.
Medical regulators have shown no enthusiasm for the requirement, either; during this year's session, Florida legislators squelched a bill that would have required both professions to use the database.
Florida set up the database in 2010 to track how many narcotic pain pills patients obtain, so that doctors and pharmacists could check their patients and refuse to give more drugs to those who already received them. The database was created to be a weapon against dealers and abusers who obtain excessive quantities of prescription narcotics, such as oxycodone.
But use of the database remains voluntary. Federal officials said Florida still has a serious problem with pill mills in Tampa Bay, Orlando, the southwest coast and parts of northern Florida.
That set off board member Gavin Meshad, who chairs a subcommittee on prescription drug abuse. He said he was “disappointed” by pharmacists ignoring the database and called for the board to make database checks mandatory, at least for certain prescriptions. His panel is looking into mandatory requirements.
“I’m very upset,” Meshad said. “They’re not using [the database] to the level they could be using it. Unless we as a board put in some rules, it’s not going to be checked as aggressively as it could be… That’s human nature.”
Board member DeAnn Mullins, a Lynn Haven pharmacist, replied that the board needs to slow down and wait for a list of suggestions on how to improve prescription drug databases used by states across the country. Some board members and pharmacists are not satisfied with the mechanics of the database, she said, but would be more receptive if it worked better.
The suggested database improvements are being developed nationally by the National Community Pharmacist Association. Board members agreed to discuss them during future meetings.
“We want to get things right before we start imposing requirements on anyone,” Mullins said.
Meshad, a Sarasota consumer member on a board led by pharmacists, went along with the decision but was unhappy that the board was backing off what he saw as a past consensus to require some database checks.
“It’s more like excuses,” Meshad said. “It’s like, ‘Let’s not put more mandates on the pharmacists.’ I get it… But we’re absolutely ignoring that we have a database that could go to the heart of [the problem]. There’s no good reason not to put this in our rules.”
During the state Legislature’s session this year, a bill was filed in the state House (HB 831) that would have required pharmacists and doctors to consult the database before writing or filling a prescription for addictive medications. The bill died on the House floor when legislators adjourned on May 3. The Senate passed a bill (SB 1192) that would have forced doctors to check the database, but it, too, died in the House.
The Legislature did approve $500,000 to keep the database running for another year.
The database has helped officials crack down on pill mills and oxycodone abusers in South Florida, but the problem is far from solved elsewhere in the state, said Susan Langston, manager of the anti-diversion program of the U.S. Drug Enforcement Administration office covering South Florida.
Langston told the board she has spoken to many pharmacists who routinely dispense narcotic medications after making only basic checks to verify the customer’s identity and to confirm the doctor wrote the script. That’s not enough, she said. Judges have punished pharmacists for not making stronger checks in cases that were obviously suspicious, she said.
“The database has been working well,” Langston said. “Everyone should use it.”
Pharmacists strongly support the database, but they don’t feel they should be forced to use it in every case, said Michael Jackson, executive vice president of the Florida Pharmacy Association. “It’s best to let pharmacists use their professional judgment,” he said.