October 30, 2014
(Washington, D.C.)—As policymakers examine ways to curb the prescription drug abuse epidemic, a new report by the National Center for Policy Analysis (NCPA), “Medicare Drug Plans Need the Tools to Fight Prescription Drug Fraud,” recommends allowing drug plans and beneficiaries to choose pharmacies to obtain prescriptions for commonly abused drugs, a policy referred to as a “lock-in” or “safe pharmacy” program.
“The key is stop ‘drugstore shopping’ and prevent improper prescriptions from being filled in the first place,” said Pharmaceutical Care Management Association (PCMA) President and CEO Mark Merritt. “The best way to do this is to allow plans and patients to pick a select number of pharmacies where certain prescriptions can be filled.”
Mr. Merritt and other health policy experts discussed the issue in more detail at a recent Capitol Hill briefing, “Prescription Opioid Abuse: Fighting Back on Many Fronts,” sponsored by the Alliance for Health Reform and PCMA.
Currently, 46 state Medicaid agencies operate “lock-in” programs, and 49 states have enacted prescription drug monitoring legislation. The NCPA report notes that prescription drug fraud, waste and abuse could soon be found in high-priced specialty medicines through over prescribing and filling multiple prescriptions at different pharmacies.
A recent report by the Health and Human Services Office of Inspector General, “Part D Beneficiaries with Questionable Utilization Patterns for HIV Drugs,” calls for a pharmacy “lock-in” program in Part D. The Centers for Disease Control and Prevention, the Centers for Medicare & Medicaid Services, the Government Accountability Office and the Office of National Drug Control Policy also have called for a “lock-in” program in Medicare, in one form or another.
In addition, legislation offered by Ways and Means Subcommittee on Health Chairman Kevin Brady (R-Texas) and Representatives Gus Bilirakis (R-Fla), Ben Ray Luján (D-N.M.) and Frank Pallone (D-N.J.) have all introduced legislation this Congress that includes adding a “lock-in” program in Medicare to stop inappropriate prescriptions from crossing the pharmacy counter.