Maines Prescription Monitoring Program Maine Benzodiazepine Study Group

Maine’s Prescription Monitoring Program Maine Benzodiazepine Study Group Conference 2007 UPDATE Daniel J. Eccher, MPH Project Coordinator

Outline for Presentation l l l Program overview Aggregate PMP data on benzodiazepines How health care providers can use patientspecific PMP data Time for questions at the end?

PMP Description l l Data collection since July 1, 2004 Data submission from over 300 pharmacies (100%) dispensing controlled substances in Maine (including out-of-state mail order and Internet pharmacies, and the VA-Togus Med. Cnt. ) Schedules II-IV Data stored in centralized, relational database

OSA’s Goals for PMP l l l Improve patient care by giving health care providers comprehensive information Curb prescription drug misuse Get those who are addicted into appropriate treatment

OSA’s Goals for PMP l l l Help stop prescription drug overdoses Educate the public on the dangers of prescription drug abuse Ensure that those who do need prescription medications still receive them

PMP Database Description l l l Patient identifiers: Name, DOB, Address(es) Prescriber identifiers: DEA number (from which we derive name) Drug identifiers: NDC Code, Name, dosage, days supply Pharmacy identifiers: Pharmacy DEA number, pharmacy address Possible to derive other info (e. g. patient county)

Drug Type Proportions (State of Maine, PMP Data, SFY 07)

Drug Types Per Age Group (State of Maine: PMP Data, SFY 07)

Maine’s PMP “Top 10” List (SFY 2007) DRUG COUNT RX % OF TOTAL HYDROCODONE/ACETAMINOPHEN 448, 430 20. 73 LORAZEPAM 173, 228 8. 01 CLONAZEPAM 149, 815 6. 92 ALPRAZOLAM 136, 729 6. 32 OXYCODONE HCL 127, 541 5. 89 OXYCODONE/ACETAMINOPHEN 124, 483 5. 75 PROPOXYPHENE-N/ACETAMINOP 100, 546 4. 65 AMBIEN 73, 966 3. 42 DIAZEPAM 73, 945 3. 42 CONCERTA 63, 411 2. 93 1, 472, 094 68. 04 TOTAL (for “Top 10”)

Prescriptions per Person by County (Maine PMP Data, SFY 07) State Average: 1. 60 Scripts/Person 1. 67 1. 70 1. 59 1. 40 1. 81 1. 79 1. 56 1. 51 1. 62 1. 56 1. 40 1. 63 1. 54 1. 70 1. 83 1. 60

Benzodiazepines PMP Data

Benzodiazepines (PMP SFY 2006) Drug Name Rx Count % Total Benzos 132, 612 24. 09% 4, 198 0. 76% 139, 009 25. 25% 4, 428 0. 80% 70, 855 12. 87% Diazepam (Anticonvulsant) 608 0. 11% Estazolam 383 0. 07% 1, 663 0. 30% 162, 999 29. 61% 52 0. 01% Oxazepam 6, 197 1. 13% Quazepam 39 0. 01% 22, 649 4. 11% 4, 882 0. 89% 550, 574 100% Alprazolam Chlordiazepoxide HCl Clonazepam Clorazepate Dipotassium Diazepam Flurazepam HCl Lorazepam Midazolam HCl Temazepam Triazolam Total Benzo's

Benzodiazepines (PMP SFY 2006)

Benzodiazepines - Percent of Total (PMP SFY 2006)

Benzodiazepines (PMP SFY 2007) Drug Name Rx Count % Total Benzos 136193 23. 76% 4026 0. 70% 148082 25. 84% 4047 0. 71% 73085 12. 75% Diazepam (Anticonvulsant) 787 0. 14% Estazolam 353 0. 06% 1541 0. 27% 171290 29. 89% 49 0. 01% Oxazepam 6089 1. 06% Quazepam 14 0. 00% 22895 3. 99% 4675 0. 82% 573126 100. 00% Alprazolam Chlordiazepoxide HCl Clonazepam Clorazepate Dipotassium Diazepam Flurazepam HCl Lorazepam Midazolam HCl Temazepam Triazolam Total Benzo's

Benzodiazepines (PMP SFY 2007)

Benzodiazepines - Percent of Total (PMP SFY 2007)

Trend in Counts of Top 4 Benzos (SFY’s 2005 – 2007)

Please analyze our data … and then, publish the results.

Patient-specific PMP Data Using PMP data in the healthcare setting

Patient History Reports l “Unsolicited” reports (automatically sent to prescribers) – – – l Quarterly Patient Threshold Reports Monthly Buprenorphine/Narcotics Reports (new) Quarterly APAP Threshold Reports (in devlpmt. ) “Solicited” reports – registration for anyone with a DEA number, including pharmacists; data available online, through secure portal

Registraton as a “Requestor” l l l Go to: http: //www. maine. gov/pmp Follow the “GHS Web Site” link. Scroll to the bottom and click the “Sign Up” button in the “New Users” section. Fill in the required information on the sequential forms. (Select “Requestor” in the User Type section; last step: entering DEA #. ) Wait for confirmation by fax. (The approval process takes about two business days. )

Prescription Data Portal

Patient History Report

Registration as Requestors l l l Free service Easy to use Immediate access to reports “Sub-accounts” allowed under prescriber accounts Of 6200+ eligible prescribers, only 1557 registered (about 25%)

OSA’s Focus: Treatment l l l Addiction = disease (non-judgemental approach) Helping people find treatment Office of Substance Abuse - questions about PMP or how to find treatment options for a patient

OSA’s Treatment Resources OSA’s Web Site: http: //www. maine. gov/dhhs/osa Treatment Directory: “Find Help” link l Information and Resource Center: Plethora of substance abuse literature l Treatment team l Treatment Data System l

For more information about PMP, … … log on to our web site: http: //www. maine. gov/dhhs/osa/data/pmp Or contact me: Phone: (207) 287 -3363 Email: daniel. eccher@maine. gov Any questions now?