Pharmacy Board Overseeing Prescription Monitoring Program as Required; Some Changes Needed

An evaluation of the Louisiana Board of Pharmacy’s oversight of the Prescription Monitoring Program (PMP) found that the Board cannot ensure information in the PMP database is complete and accurate.

In Louisiana, nearly 1,000 people died of drug overdoses in 2016, an increase of 14.7 percent over 2015, according to the Centers for Disease Control and Prevention. Auditors examined whether the Board provided effective oversight of the PMP as required by the state’s Prescription Monitoring Program Act. Among other things, the act requires the Board to establish and maintain an electronic system to monitor controlled substances and drugs of concern dispensed in Louisiana (e.g., opioids and ADHD medications).

Overall, auditors found the Board maintains and reviews the PMP database as required and has implemented many recommended best practices. However, the Board cannot ensure the database is complete and accurate because 1) it needs a more comprehensive process to ensure the PMP database contains complete prescription information, and 2) it does not have a way to identify pharmacies that fail to correct their database submission errors in a timely manner.

In the first instance, auditors found that 161 (5.0 percent) of 3,222 Workers Compensation prescriptions and 14,467 (3.0 percent) of 484,173 Medicaid prescriptions for hydrocodone and oxycodone dispensed during 2016 were missing from the database. While the percentages are not high, they represent 14,628 missing hydrocodone and oxycodone prescriptions in a one-year period.

In the second instance, auditors identified more than 25,500 prescriptions dispensed during 2016 with outstanding errors that were not corrected and therefore not entered into the PMP database as of November 2017.

Auditors also recommended that the Board expand its review of PMP data to proactively identify doctors, pharmacists, and patients with questionable activity related to controlled substances. During their audit, auditors identified potential instances of “doctor shopping,” prescriptions for excessive quantities of controlled substances, and use of forged and expired prescriptions.