Forcing doctors to electronically prescribe all controlled drugs, as in Oklahoma proposed bill Req. No. 8141, is a “flawed and misguided” idea that will not reduce opioid abuse, writes Albert L. Fisher, M.D., president of the Association of American Physicians and Surgeons (AAPS), in a letter to Representative Charles McCall, Speaker of the Oklahoma House of Representatives. Dr. Fisher is a family physician in Oshkosh, Wisconsin.
The main effect it will have on patients is to make it impossible to shop for the best price for their prescriptions, Dr. Fisher notes. Prices vary widely, but an e-prescription can be used at only one pharmacy. One pharmacy may offer a better price for one prescription but not another.
The Oklahoma bill would cover all controlled substances, of which there are hundreds, not just potent pain remedies like OxyContin that are widely diverted or abused. That includes cough syrup, sedatives, anti-anxiety medications, and testosterone.
New York’s I-STOP law requires e-prescribing for all drugs, with very narrow exceptions. The opioid overdose rate continues to rise in New York, writes Lawrence Huntoon, M.D., Ph.D., a neurologist practicing in upstate New York. Pharmacists strongly supported the law as it locks in their customers. Dr. Huntoon points out that electronic health records generally only allow a single pharmacy to be listed for the patient.
“The differences in medication prices vary shockingly from pharmacy to pharmacy,” he writes. “A 90-day supply of a generic medication (that has been around for decades) costs $9.99 at one pharmacy and $1,500.00 at another local pharmacy.” For a patient who has a high-deductible plan or who is paying out of pocket, “the financial consequences can be devastating,” he adds.
E-prescribing increases busy work for doctors, Dr. Fisher states, taking time from patient care. And some physicians in small practices are not at present capable of doing it but would have to buy computer equipment. Yet the majority of abusers don’t even obtain a prescription, he writes.
An AAPS action alert to Oklahoma physicians states that “Interfering with the patient-physician relationship with more rules and regulations is the wrong solution.” In fact, “policies that impede physicians’ ability to appropriately prescribe end up exacerbating the opioid abuse epidemic.”
The Association of American Physicians and Surgeons (AAPS) represents physicians in virtually all specialties and every state. Founded in 1943, AAPS has the motto “omnia pro aegroto,” which means “all for the patient.”