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Feb. 26, 2013
TOPEKA Kansas is one of at least two states set to receive free software needed to run its prescription drug monitoring program as part of a pilot project by the National Association of Boards of Pharmacy.
According to state officials, that will translate to annual savings of about $120,000 in license and connectivity fees currently paid to run the Kansas Tracking and Reporting of Controlled Substances system (K-TRACS), which doctors and pharmacists use to check on possible prescription drug abuse by their patients.
The pharmacy association's software — which will be free for at least three years — comes at a critical time for K-TRACS. Since it was launched in 2011, the monitoring system's $275,000 annual budget has been covered by a federal grant. The original grant expired in October but was temporarily extended.
K-TRACS Director Christina Morris said she has been scrambling to identify other ways to pay for the system and that the free software will be a major boost.
“Being selected as a recipient of NABP’s free software is monumental in keeping K-TRACS sustainable as it cuts our (costs) by roughly 40 percent,” she said. "Extending the life of (K-TRACS) will continue to enhance patient care in our state, reduce the diversion of controlled substances, as well as reduce Medicaid spending on controlled substances that may be misused, abused and diverted."
Morris said it's not yet known whether the national pharmacy board will charge licensing or connectivity fees for the software after the three-year period.
"They continue to say they think they will be able to provide it for free but just can’t commit to it yet," she said.
Kansas — along with Mississippi and three other states yet to be named — will receive the new software as part of a pilot by the pharmacy board to test the system it is developing. The software is scheduled to be ready in July.
Like the current system software, the new system will allow doctors and pharmacists to log on to a secure website to review the prescription histories of patients. The monitoring system can prompt the sending of letters to providers and pharmacists when it indicates potential prescription abuse. The state mails alerts on about 200 patients per quarter who get controlled substances from multiple providers and pharmacists.
Morris said the new software also would have a few new features but many details still aren't available "because the product is still being created."
Nationwide, 42 states have active monitoring programs and seven states have passed legislation necessary to start one. Only Missouri has not taken that step.
Other states pay for their systems in a variety of ways, including:
• Eleven assess fees to doctors who prescribe and pharmacists who dispense painkillers and other controlled drugs designated by the Drug Enforcement Administration.
• Eight assess registry fees for doctors and pharmacists who prescribe and dispense drugs. For example, Idaho charges $60 a year for their controlled substance fee and 100 percent goes to fund the monitoring program. Kansas does not currently operate its own controlled substance registry or charge such fees.
• Two states draw from a mix of fees and state general funds.
• Two states use only state general funds.
• Two states, including Mississippi, use funding from their pharmacy boards.
K-TRACS officials still need a way to pay for $130,000 in salaries and $25,000 in other annual overhead, Morris said.
"K-TRACS isn’t in the clear sustainability wise," she said. "We are relying on grant funding right now for salaries and overhead that we may be able to extend until next session, but it’s not a sure thing. Something is going to have to change for a long-term solution but nobody can agree yet as to what that will be."
House Bill 2237, which is before the House Committee on General Government Budget, would authorize "an annual portal fee for use of the prescription monitoring program."
The fees would be assessed to third-party networks that offer access to K-TRACS, perhaps including the Kansas Health Information Network and LACIE, two organizations that comprise the statewide digital health information exchange.
Morris said she would like the monitoring system to connect to LACIE and KHIN regardless of whether a financial agreement could be reached. She said patients' electronic medical records would be more valuable, if they include the prescription dispensing data from K-TRACS.
"There is a definite need to get providers the dispensing records of their patients at the point of care, in addition to the rest of the patient's medical records. It would create a more complete medical record for the patient and therefore allow providers to have a more comprehensive view of the patient’s history and hopefully provide them with the best care possible," Morris said. "We are pursuing integration possibilities with both (KHIN and LACIE) at this time and would like to see these integration efforts happen by the end of the year. I am not sure if there will be any financial agreement between K-TRACS and either LACIE or KHIN at this time."
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