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Missouri's version of long-awaited prescription monitoring program is up and running

Missouri's version of long-awaited prescription monitoring program is up and running

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JEFFERSON CITY • Gov. Eric Greitens’ version of a statewide prescription drug monitoring program is now in use.

The state recently began receiving data on dispensing records of controlled substances by doctors and pharmacists throughout the state. It’s an attempt to identify prescribers who help fuel the abuse of prescription painkillers.

State officials said they have already used the data “to immediately open investigations” although they would not comment on the investigations.

Frustrated by the Legislature’s failure to pass a statewide prescription drug monitoring program, the only state to lack one, Greitens signed an executive order this summer to form his own.

On Nov. 20, the state signed a deal with Express Scripts to obtain prescribing data voluntarily and free, according to a copy of the contract obtained by the Post-Dispatch.

“This program is a big step in addressing this crisis — allowing us to monitor prescribers and dispensers, eliminate bad actors and keep more Missourians safe,” Greitens spokesman Parker Briden said in a statement to the Post-Dispatch.

Express Scripts is one of the nation’s largest pharmacy benefit management firms, serving as a middleman between drug makers and employers.

Under the contract, the state is to receive a batch of records from Jan. 1 through the end of October and every month after that.

Express Scripts is supposed to provide monthly data reports to the Department of Health and Senior Services, according to the contract. The information does not include patient names or information.

That data sent to the state includes: the prescriber’s name, pharmacy name, drug name and strength, quantity, days’ supply, date drug was dispensed, information on the pharmacy and prescriber and how many refills are available.

“Express Scripts stands by our efforts to help modernize the state’s opioid monitoring system. Rather than continuing to let unscrupulous pharmacists and doctors profit from opioid addiction, we are voluntarily sharing our expertise to help end this crisis. Maintaining the status quo is not an option,” Express Scripts said in a statement to the Post-Dispatch.

Initially, the contract between the state and Express Scripts was expected to cost $250,000. Lawmakers criticized the governor for awarding Express Scripts — a Greitens donor — a no-bid contract.

Language in the executive order and the Nov. 20 contract makes it appear there is nothing preventing the state from entering into data-sharing agreements with other providers and competitors of Express Scripts.

Greitens’ prescription drug monitoring program differs significantly from what has been debated in the Legislature and what is in place in other states and in more than 26 counties and jurisdictions across Missouri.

While most monitoring programs track when patients are prescribed an opioid painkiller, this effort focuses on those who prescribe and distribute addictive drugs such as Vicodin, OxyContin and Percocet.

Greitens said he wants the program to target “pill mills” that pump out prescription drugs at “dangerous and unlawful levels.”

It’s unclear what criteria the state will use to determine what pharmacy qualifies as a “pill mill” or whether a doctor is overprescribing.

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