New Mexico’s Prescription Monitoring Program (PMP) · Prescription Monitoring Program (PMP) Peter...
Transcript of New Mexico’s Prescription Monitoring Program (PMP) · Prescription Monitoring Program (PMP) Peter...
1/10/2018
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New Mexico Board of PharmacyPrescription Monitoring Program (PMP)
NMPhA Mid-Winter Meeting – Law Update
January 27, 2018
New Mexico Board of PharmacyPrescription Monitoring Program (PMP)
Peter Ryba, PharmDPMP Director
Maria GonzalesPMP Manager
PRESCRIPTION MONITORING PROGRAM
NEW MEXICO BOARD OF PHARMACY
Agenda
• Prescription Drug Information and Statistics
• What is the PMP?
• PMP Registration Process
• PMP Regulatory Facts
• PMP InterConnect
• PMP AWARxE
• Reports Provided
• Current Projects
• Useful Links
PRESCRIPTION MONITORING PROGRAM
NEW MEXICO BOARD OF PHARMACY
Prescription Drug Information and Statistics
The National Epidemic
• The United States is in the midst
of an epidemic of prescription
opioid overdose deaths, which
killed more than 63,600 people
in 2016 alone.
Source: NCHS Data Brief, Number 294, December 2017 www.cdc.gov/drugoverdose/prescribing/guideline.html
PRESCRIPTION MONITORING PROGRAM
NEW MEXICO BOARD OF PHARMACY
Prescription Drug Information and Statistics
Source: www.cdc.gov/drugoverdose/prescribing/guideline.html
PRESCRIPTION MONITORING PROGRAM
NEW MEXICO BOARD OF PHARMACY
Source: NCHS Data Brief, Number 294, December 2017
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PRESCRIPTION MONITORING PROGRAM
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Source: NCHS Data Brief, Number 294, December 2017
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NEW MEXICO BOARD OF PHARMACY
Prescription Drug Information and Statistics
The State of New Mexico
• In 2014, New Mexico had the second highest drug overdose
death rate.
• In 2015, New Mexico ranked #8 with a rate of 25.3.
• In 2016, New Mexico ranked #12 with a rate of 25.2.
Source: www.cdc.gov/drugoverdose/prescribing/guideline.html
PRESCRIPTION MONITORING PROGRAM
NEW MEXICO BOARD OF PHARMACY
Prescription Drug Information and Statistics
Source: NCHS Data Brief, Number 294, December 2017
PRESCRIPTION MONITORING PROGRAM
NEW MEXICO BOARD OF PHARMACY
Source: NM Department of Health
0
5
10
15
20
25
30
35
40
45
2010 2011 2012 2013 2014 2015
Dea
ths
per
10
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00
peo
ple
West Virginia New Hampshire Kentucky Ohio
Rhode Island Pennsylvania Massachusetts New Mexico
Rates are age adjusted to the US 2000 standard populationSource: National Center for Health Statistics, CDC via CDC Wonder
Drug Overdose Death Rates for the 8 States with the Highest Rates in 2015
PRESCRIPTION MONITORING PROGRAM
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Prescription Drug Information and Statistics
Source: NM Department of Health
Northwest Northeast
San Juan 19 Santa Fe 45
Cibola 10 Rio Arriba 31
Central/Metro
Bernalillo 187
Sandoval 21
Southwest Southeast
Dona Ana 27 Lea 14
Otero 12 Chaves 13
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NEW MEXICO BOARD OF PHARMACY
Prescription Drug Information and Statistics
Source: NM Department of Health
Year Nat’l Rank OD Deaths Rate
2014 2nd 540 27.3
2015 8th 493 25.3
2016 12th 497 25.2
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PRESCRIPTION MONITORING PROGRAM
NEW MEXICO BOARD OF PHARMACY
What is the PMP?
The New Mexico Prescription Monitoring Program is a web-based
electronic database that aids in the collection and reporting of
dispensed controlled substance prescriptions.
PRESCRIPTION MONITORING PROGRAM
NEW MEXICO BOARD OF PHARMACY
What is the PMP?
Mission
To provide practitioners, pharmacists, and other authorized users
the ability to review a patient’s controlled substance prescription
history and assist in the prevention of diversion, abuse, misuse,
and drug overdose deaths of controlled substance prescriptions.
PRESCRIPTION MONITORING PROGRAM
NEW MEXICO BOARD OF PHARMACY
What is the PMP?
• Information in the PMP is only as accurate as the data
submitted by dispensers.
• Disclaimer: “The State of New Mexico does not warrant the
above information to be accurate or complete. This report is
based on the search criteria entered and the data entered
by the dispenser. For more information about any prescription,
please contact the dispenser or the prescriber.”
PRESCRIPTION MONITORING PROGRAM
NEW MEXICO BOARD OF PHARMACY
What is the PMP?
• PMP reports should not be used as evidence or testimony for
any legal proceedings.
• The PMP is a tool for prescribers to use their professional
judgement in prescribing controlled substances.
PRESCRIPTION MONITORING PROGRAM
NEW MEXICO BOARD OF PHARMACY
History of the NM PMP
• July 2004 – NMAC 16.19.29 was adopted which created the
PMP.
• August 2005 – The PMP went live and was operated under the
NM BOP.
• October 2014 – The NM BOP was awarded the 2014 Harold
Rogers grant.
• November 2016 – Appriss began hosting the NM PMP.
• January 2017 – The NM State Legislature enacted new
mandatory PMP use requirements for all practitioners.
PRESCRIPTION MONITORING PROGRAM
NEW MEXICO BOARD OF PHARMACY
PMP Registration Process
Registrants include:
• Healthcare Professionals
• Delegates
• Up to four (4) delegates per practitioner
• A delegate can have an unlimited number of practitioners
• Law Enforcement
• Regulatory Board Agents
• Medicaid Compliance Officers
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PMP Registration Process
• Chiropractor
• Nurse Practitioner/Clinical
Nurse Specialist
• Midwife with Prescriptive
Authority
• Physician Assistant
• Optometrist
• Naturopathic Physician
• Pharmacist with Prescriptive
Authority
• Pharmacist
• Out of State Pharmacist
• Pharmacist in Charge
• Psychologist
• Medical Resident
• Medical Resident with
Prescriptive Authority
• IHS Prescriber
• Pharmacist’s Delegate –
Licensed
• Prescriber Delegate –
Unlicensed
• Prescriber Delegate –
Licensed
• Dispensing Physician
• Dentist
• Out of State Prescriber
• Physician (MD, DO)
• VA Prescriber
PRESCRIPTION MONITORING PROGRAM
NEW MEXICO BOARD OF PHARMACY
PMP Registration Process
1. Create an account at
https://newmexico.pmpaware.net/login.
2. Verify your email by clicking on the link in the auto-generated
email you received when you created an account. The link is
only good for 20 minutes. Contact us to resend if it expires.
3. Upload or email a copy of your driver's license, state issued
photo ID, or a passport. No other forms of identification will be
accepted (for example work badges, Social Security Cards).
4. Complete the required training at
http://nmpmp.org/Training.aspx.
PRESCRIPTION MONITORING PROGRAM
NEW MEXICO BOARD OF PHARMACY
PMP Registration Process
• Only authorized account holder can access the NM PMP.
• Sharing login information is a violation of both federal and
state regulations.
PRESCRIPTION MONITORING PROGRAM
NEW MEXICO BOARD OF PHARMACY
NM BOP PMP Regulatory Facts
Dispensers
• All dispensers (including dispensing practitioners) must report
within one business day if more than 12 doses within a 72 hour
period was dispensed.
• If you do routinely dispense, but do not do so during a specific
reporting period, a “zero report” must be submitted weekly.
PRESCRIPTION MONITORING PROGRAM
NEW MEXICO BOARD OF PHARMACY
NM BOP PMP Regulatory Facts
Practitioner
• Before a practitioner prescribes or dispenses an opioid for the first
time to a patient, the practitioner shall obtain and review a report
from the PMP for the previous 12 months, and obtain and review
the PMP report from an adjacent state if available.
• A practitioner shall obtain and review a report from the state’s PMP
and adjacent states, no less than once every three months for each
established patient for whom opioids are prescribed or dispensed.
PRESCRIPTION MONITORING PROGRAM
NEW MEXICO BOARD OF PHARMACY
NM BOP PMP Regulatory Facts
Exceptions for Practitioners
• A practitioner does not have to consult the PMP report before
prescribing, ordering, or dispensing a controlled substance II-V:
• If the dispensed quantity is for a period of 4 days or less,
• To a patient in a nursing facility,
• To a patient in hospice care,
• Or when prescribing, dispensing or administering
testosterone, pregabalin, lacosamine, ezogabine or
stimulant therapy for pediatric patients less than age 14.
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NM BOP PMP Regulatory Facts
Pharmacists
• Review PMP reports covering at least one year and another
states’ report if applicable and available.
• PMP reports shall be reviewed a minimum of once every three
months during the continuous use of opioids.
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NM BOP PMP Regulatory Facts
Exception for Pharmacists
• A prescription for an opioid written for a patient in a long term
care facility (LTCF) or for a patient with a medical diagnosis
documenting a terminal illness is exempt from Subsection E of
16.19.4.16 NMAC. If there is any question whether a patient
may be classified as having a terminal illness, the pharmacist
shall contact the practitioner. The pharmacist shall document
whether the patient is “terminally ill” or an “LTCF patient”.
PRESCRIPTION MONITORING PROGRAM
NEW MEXICO BOARD OF PHARMACY
NM BOP PMP Regulatory Facts
DENTISTRY (DENTISTS, DENTAL HYGIENISTS, ETC.)
16.5.57 NMAC - MANAGEMENT OF PAIN WITH CONTROLLED SUBSTANCES
MEDICINE AND SURGERY PRACTITIONERS
16.10.14 - NMAC MANAGEMENT OF PAIN WITH CONTROLLED SUBSTANCES
MIDWIVES
16.11.2 NMAC - CERTIFIED NURSE MIDWIVES
NURSING AND HEALTH CARE RELATED PROVIDERS
16.12.9 NMAC - MANAGEMENT OF CHRONIC PAIN WITH CONTROLLED
SUBSTANCES
PRESCRIPTION MONITORING PROGRAM
NEW MEXICO BOARD OF PHARMACY
NM BOP PMP Regulatory Facts
OPTOMETRIC PRACTITIONERS
16.16.15 NMAC - MANAGEMENT OF PAIN WITH CONTROLLED SUBSTANCES
OSTEOPATHIC MEDICINE AND SURGERY PRACTITIONERS
16.17.5 NMAC - PRESCRIBING AND DISTRIBUTION OF CONTROLLED SUBSTANCES
PHARMACISTS
16.19.4 NMAC - PHARMACIST
16.19.20 NMAC - CONTROLLED SUBSTANCES
16.19.29 NMAC - CONTROLLED SUBSTANCE PRESCRIPTION MONITORING PROGRAM
PODIATRISTS
16.21.9 NMAC - MANAGEMENT OF PAIN WITH CONTROLLED SUBSTANCES
PRESCRIPTION MONITORING PROGRAM
NEW MEXICO BOARD OF PHARMACY
PMP InterConnect
• The PMP InterConnect (PMPi) facilitates the transfer of PMP
data across state lines.
• PMPi allows participating states across the United States to be
linked, providing a more effective means of combating drug
diversion and drug abuse nationwide.
• Currently, 45 states and jurisdictions have agreed to securely
share PMP data through PMPi.
• There were 15 million interstate transactions a month in 2017.
Source: https://nabp.pharmacy/initiatives/pmp-interconnect/
PRESCRIPTION MONITORING PROGRAM
NEW MEXICO BOARD OF PHARMACY
PMP InterConnect
Source: https://nabp.pharmacy/initiatives/pmp-interconnect/
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NEW MEXICO BOARD OF PHARMACY
PMP AWARxE
https://newmexico.pmpaware.net/login
PRESCRIPTION MONITORING PROGRAM
NEW MEXICO BOARD OF PHARMACY
PRESCRIPTION MONITORING PROGRAM
NEW MEXICO BOARD OF PHARMACY
PRESCRIPTION MONITORING PROGRAM
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PRESCRIPTION MONITORING PROGRAM
NEW MEXICO BOARD OF PHARMACY
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PRESCRIPTION MONITORING PROGRAM
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PRESCRIPTION MONITORING PROGRAM
NEW MEXICO BOARD OF PHARMACY
PRESCRIPTION MONITORING PROGRAM
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PRESCRIPTION MONITORING PROGRAM
NEW MEXICO BOARD OF PHARMACY
PRESCRIPTION MONITORING PROGRAM
NEW MEXICO BOARD OF PHARMACY
MyRx
• MyRx gives users that have a DEA number associated with their
account to run a self-report to see what prescriptions have
been filled where they were listed as the prescriber.
• Proactive measure for prescribers to help curb forgeries and
diversion.
Source: https://nabp.pharmacy/initiatives/pmp-interconnect/
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PRESCRIPTION MONITORING PROGRAM
NEW MEXICO BOARD OF PHARMACY
PRESCRIPTION MONITORING PROGRAM
NEW MEXICO BOARD OF PHARMACY
Reports Available
• Quarterly Reports to Licensing Boards
• Prescriber Feedback Report
PRESCRIPTION MONITORING PROGRAM
NEW MEXICO BOARD OF PHARMACY
Quarterly Reports to Licensing Boards
• Total number of patients
• Total number of opioid patients
• Total opioid Morphine Milligram Equivalents (MME) filled
• Total number of benzodiazepine (BZD) patients
• Total BZD Diazepam Milligram Equivalents (DME) filled
• Percent of opioid patients with ≥90 MME/day
• Percent of opioid patients with ≥90 days of opioids in 6 months
• Percent of BZD patients with prescriptions ≥30 DME/day
• Percent of BZD patients with ≥90 days of BZDs in 6 months
• Percent of opioid patients with concurrent BZDs ≥30 days
PRESCRIPTION MONITORING PROGRAM
NEW MEXICO BOARD OF PHARMACY
Quarterly Reports to Licensing Boards
• Controlled substance prescriptions per prescribing day, 3 months
• Percent of estimated required reports requested
• PMP reports required under Board rules (estimated)
• PMP reports requested on patients
• Percent of patients with a total of 5 or more practitioners or
pharmacies in 6 months
PRESCRIPTION MONITORING PROGRAM
NEW MEXICO BOARD OF PHARMACY
Prescriber Feedback Report
Reports reflect top 1% of prescribers with 20 or more patients
receiving controlled substances within 6 month period
• High opioid doses
• Long term opioid patients
• High benzodiazepine (BZD) doses
• Long term BZD patients
• High volume of opioids and BZDs
• High volume prescribing
• Concurrent therapy
• Multiple provider episodes
• No PMP use
PRESCRIPTION MONITORING PROGRAM
NEW MEXICO BOARD OF PHARMACY
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PRESCRIPTION MONITORING PROGRAM
NEW MEXICO BOARD OF PHARMACY
Current Projects
PMP Integration within Workflow
• EDIE
NarxCare
• The Narx Report includes a patient’s NarxScores, Predictive
Risk Scores, Red Flags, Rx Graph and PDMP Data, as well as
access to Resources and Care Team Communications all in a
single, easy-to-use interface.
PRESCRIPTION MONITORING PROGRAM
NEW MEXICO BOARD OF PHARMACY
Useful Links
NM Board of Pharmacy http://www.rld.state.nm.us/boards/Pharmacy.aspx
PMP Registration and FAQs http://www.nmpmp.org/
PMP AWARxE https://newmexico.pmpaware.net/login
Support
Technical Customer Service (24/7/365) 1-844-366-4767
Local Non-Technical (M-F 8a-5p) 505-222-9847
NM BOP PMP Support [email protected]
PRESCRIPTION MONITORING PROGRAM
NEW MEXICO BOARD OF PHARMACY
Questions?