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Prescription Drug Database Fight Continues in Missouri

Lawmakers want to create an electronic system to monitor who is being prescribed potentially addictive drugs, but critics are concerned with privacy risks.

by / February 18, 2014

Actor Heath Ledger’s high-profile death in January 2008 from an overdose on a lethal cocktail of medications sparked national outcry on the dangers of prescription drug abuse. But the problem reaches far beyond Hollywood’s elite. Pill-popping has become a widespread addiction for people of all ages, from pre-teens to retirees, all in search of a “legal” high.

States have spent the last few years looking at more effective ways to control the misuse of medications such as OxyContin and Xanax. Forty-nine states have – or plan to – put databases online that enable physicians and pharmacists easily spot “doctor shoppers” – people who go from doctor to doctor getting multiple prescriptions for the same drug.

The one holdout? Missouri.

The Prescription Drug Monitoring Program Act was introduced earlier this year to create a prescription drug database in the Show-Me State. But trepidation over the potential of data breaches may derail the bill, just as they did when a similar proposal was filibustered by Sen. Rob Schaaf, R-St. Joseph, in 2012.

This year’s effort, House Bill 1133, was authored by Missouri Rep. Kevin Engler, R-Farmington. The bill gives the Missouri Department of Health and Senior Services management over the database, which would be funded through a series of grants and donations. Pharmacies would then share data about prescriptions, patients and the doctors authorizing certain types of medications. Law enforcement could have access to the information through a court order.

Missouri’s problem is that people pay cash to see a doctor at a local clinic, get a prescription, pay cash for that and then repeat the process in other cities to score the same drugs. Without a shared database, there’s no way for pharmacies to cross-check and see if a person is abusing the system.

Schaaf, however, told the St. Louis Post-Dispatch he still has the same privacy concerns with a database as he did two years ago. He also noted that no studies have shown that prescription drug databases lower the death rate caused by overdoses.

Florida’s experience with its prescription drug database hasn’t been good and supports some of Schaaf’s beliefs. The Sunshine State’s database was breached last year, leaking the names and prescription information of approximately 3,300 Floridians. In addition, The Tampa Bay Times reported in 2012 that many doctors and pharmacists in Florida don’t bother to use the database.

Despite the criticisms, Engler remains adamant that Missouri needs to address the problem of “doctor shopping.” In an interview with Government Technology, he said any effort the state can make to potentially save lives is worth more than risks that a database may be hacked.

“Everyone who produces these drugs are in agreement that something needs to be done,” Engler said. “The other states have been proactive … and Missouri has done nothing except [say] it’s OK to cleanse the gene pool.”

While he remains passionate about the issue, Engler admitted he wasn’t confident HB 1133 would survive deliberations in the Missouri Senate. He doesn’t expect Sen. Schaaf to change his view regarding privacy, but he’d like to see some senators take a stand and push to take a vote on the legislation.

Engler was, however, open to discussing further cybersecurity measures for the database to beef up protection of the information, including a mandatory purging of records over time. But felt the issue shouldn’t be a roadblock.

“To just use the excuse that there could be cyberattacks, therefore we don’t want to keep track of drugs, is flimsy at-best,” he said.

HB 1133 was read for a third time and passed by the Missouri House of Representatives on Feb. 13. On Feb. 17, the bill was reported to the Senate and read for the first time. At press time, further action was not scheduled on the Act.

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Brian Heaton

Brian Heaton was a writer for Government Technology magazine from 2011 to mid-2015.

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