Legislature(2003 - 2004)
04/27/2004 03:11 PM House HES
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* first hearing in first committee of referral
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+ teleconferenced
= bill was previously heard/scheduled
HB 239-ID SYSTEM FOR PRESCRIPTIONS Number 1764 CHAIR WILSON announced that the next order of business would be HOUSE BILL NO. 239, "An Act directing the Department of Public Safety to establish an Internet-based identification and tracking system relating to controlled substances that are prescribed for human use; and relating to the manner in which prescriptions for controlled substances may be filled by a pharmacist." Number 2131 SUE WRIGHT, Staff to Representative Mike Chenault, Alaska State Legislature, presented HB 239 on behalf of Representative Chenault, sponsor of HB 239. She told the members that Alaska has a drug problem of epidemic proportions. In the Kenai Peninsula area there have been 27 near fatal or fatal overdoses of OxyContin. This number includes accidental deaths or suicides. She told the members that there is a licensed physician in Anchorage who prescribed 16,000 milligrams in one 30-day period in July of 2001. Ms. Wright said it is not possible to ingest that much. The person who that was prescribed to is dead, she added. CHAIR WILSON asked if that prescription was for one person. MS. WRIGHT replied yes, it was prescribed to one person who is now dead. She explained that the patient died in July of 2001, but the prescriptions were not filled until September or October of that year. It is assumed that these drugs were being sold on the street. Ms. Wright added that Medicaid dollars paid for these prescriptions. One person on the Kenai Peninsula has been present at seven different deaths and is a known [drug] dealer. She told the members that Representative Chenault's office has worked with a police chief whose wife had been on OxyContin and who had obtained it illegally. Ms. Wright pointed out that Representative Wolf has sponsored two bills that either outlaws or restricts OxyContin use. She told the member that HB 239 allows for the Board of Pharmacy to design and implement a system to track controlled substances in schedule IA in AS 11.71.140. The board was chosen because the pharmacy is the origination of a filled prescription. It is the best place to control the use of a drug, she added. Number 2262 MS. WRIGHT said this bill gives the Board of Pharmacy the authority to manage the tracking system once it is designed. This shall be done through regulation, she added. The bill also requires the revamping of the delivery of schedule IA drugs via the U.S. Postal Service or other delivery services. She said there have been concerns raised by out-of-state providers such as Medco Health Solutions, Inc. [letter dated April 6,2004] of increased costs to providers of $16.76. Ms. Wright told the members that she researched this question by visiting the UPS web site and found that it would increase cost by $1.75 per prescription. Ms. Wright pointed out that there are in-state pharmacies that already implement controlled substance deliveries out into the bush communities by registered mail. There is an additional $5.00 charge per prescription, she said. Ms. Wright told the members that while this bill is not perfect, it is a start. Number 2314 MS. WRIGHT shared that there are concerns that the additional requirements would "red flag" drug packages. She said she learned that outside pharmaceutical companies often have its name printed on the outside of delivery packages. When companies use its company's logo on the outside of packages, she said she believes it is a moot point to say the package is red flagged by requiring a signature for delivery at a home. She noted that Medco uses its logo on the outside of packages. MS. WRIGHT said in conclusion, Medicaid alone paid over $2 million in 2001 for OxyContin. Between 10 percent and 27 percent of Medicaid costs for OxyContin were for drugs that were sold on the streets. If these statistics are shown to be true for one drug and if tracking can be shown to keep OxyContin off the streets, it may be possible to save several million dollars by implementing this tracking system, she said. Ms. Wright emphasized that this is not meant to be an invasion of privacy, but a reaction to the drug problems that face Alaska. TAPE 04-38, SIDE B Number 2361 REPRESENTATIVE SEATON referred to the Department of Community and Economic Development's November 17, 2003 letter which says: We feel, however, that for any monitoring program to work, the prescribers must be included along with pharmacists and law enforcement agencies. REPRESENTATIVE SEATON asked Ms. Wright if this provision was incorporated into the legislation. MS. WRIGHT replied that the letter Representative Seaton referred to is addressing a different version of the bill. She explained that the new version of HB 239 provides for a state of the art tracking system that would run over the same secure Internet lines that are currently being used by pharmacies when billing or prequalifying insurance payments on prescriptions. Ms. Wright told the members that there is a software company that designs this type of system and has successfully implemented it nationwide. Number 2241 CHAIR WILSON moved to adopt CSHB 239, 23-LS0897\S, as the working document. There being no objection, Version S was before committee. Number 2221 MARGARET SODEN, Chair, Alaska Board of Pharmacy, Division of Occupational Licensing, Department of Community and Economic Development, testified on HB 239. She told the members that her testimony is only on behalf of herself, as the board has not had an opportunity to look at the latest version of the bill. Ms. Soden said that the board and pharmacists in general are in favor of this concept of an Internet tracking system for controlled substances. She explained that the board of pharmacy's budget is quite slim so in order to do this right there would have to be adequate funding to implement it and keep it running. Number 2157 CHAIR WILSON commented that she has had calls from pharmacists who believe they will be in the position of being the policemen in this system. MS. SODEN replied that is true. She pointed to Section 1, page 1, lines 7 through 11, which says: ... secure networked server-based data base and procedures under which each pharmacist in the state will be required to determine, by consulting the secure data base, whether a prescription for a controlled substance that is being dispensed by the pharmacist to cover a certain time period for a human patient duplicates a prescription already dispensed for the same patient that was intended to cover a substantial portion of the same time period. MS. SODEN commented that it will be very difficult for a pharmacists to make that kind of determination and it will make it difficult for a patient to get a prescription filled. She said she has a problem with this portion of the bill because of the burden it places on the pharmacists. CHAIR WILSON asked if pharmacists across the state would have to purchase new software to accomplish this requirement. MS. SODEN replied that there are some pharmacists in the state that only bill Medicaid over the Internet. In those cases, the pharmacist does not do any insurance billing electronically, she said. She acknowledged that it would be necessary for those pharmacists to purchase software. Ms. Soden said she has seen studies that say it costs anywhere from $150,000 to $1,000,000 to setup these programs. She commented that she does not know who would pay for it. There are probably some grants from the U.S. Department of Justice, she commented. CHAIR WILSON said that Commissioner Gilbertson has expressed the desire to track prescription drugs. She suggested that Ms. Wright and the Board of Pharmacy meet with the commissioner to work on a compromise to bring to the legislature next session. MS. WRIGHT replied that avenue has been explored and there was an outburst of concern that the Department Public Safety or the Department of Health and Social Services would control the tracking system. The concern was that the departments are too big and too many people would have access to the information. It was for that reason Representative Chenault chose the Board of Pharmacy. Number 1950 [CSHB 239, Version S, was held in committee.]
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