Pennsylvania Considers Which Prescriptions to Monitor

April 3, 2014

by Amanda Conschafter, Blog Editor

Proposed legislation to expand Pennsylvania’s prescription drug monitoring program has the state’s patient advocates worried.  Chief among the groups expressing concerns is the Epilepsy Foundation, which argues that expanding the program to include Schedule V drugs could limit care and expose patients to unnecessary risk.  Schedule V includes anti-epilepsy drugs, commonly used to reduce or manage seizures.

Prescription drug monitoring programs (PDMPs), which now exist in 48 states, aim to limit abuse by monitoring and analyzing data on controlled substances.  Physicians and pharmacists input information on prescribing and dispensing, which is then housed in an online state database.

But some states struggle to limit abuse without hindering legitimate use.  Many states’ programs target Schedules II through IV drugs, as these are most prone to abuse and can be dangerous when combined haphazardly.  Advocates point out that Schedule V drugs, however, include low- or no-narcotic substances.  (The United States Drug Enforcement Agency assigns these prescriptions a low potential for abuse as compared to drugs of other schedules.)

These substances do prove useful for the treatment of life-threatening or high-pain conditions, such as fibromyalgia, diabetic peripheral neuropathy and epilepsy.  For that reason, the Epilepsy Foundation wants Schedule V excluded from program expansion.

For healthcare providers, prescribing medications regulated by PDMPs entails an administrative burden that sometimes proves too costly and burdensome for the medical practice, resulting in another barrier to patient access.  For epilepsy patients, limited access could increase the risk of developing breakthrough seizures, resulting in lost productivity and wages, as well as reduced quality of life.

But as prescription drug abuse continues to be “the nation’s fastest-growing drug problem,” Pennsylvania and other states struggle to strike the appropriate balance.  Each state must determine how to curb abuse while preserving access for patients with legitimate medical need.

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