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What is PDMP (Prescription Drug Monitoring Program)?

According to the Centers for Disease Control and Prevention, a Prescription Drug Monitoring Program (PDMP) is an electronic database that keeps track of and records controlled substance prescriptions. PDMPs allow healthcare providers to check their state’s database for a patient’s prescription records prior to prescribing a controlled substance to the patient. When a pharmacist dispenses a controlled substance to a patient they must input the patient’s prescription information into the state’s PDMP. This mitigates the potential for a patient to secure multiple opioid or controlled substance prescriptions.

Who operates the PDMPs?

PDMPs are operated at the state level. Each PDMP is run by a governing body within the state health department. With the exception of Missouri, each state currently has legislation concerning the development and operation of PDMPs. While the laws of each state vary, most state PDMPs require the collection of information on Schedule II-IV controlled substances.

Who has access to PDMPs?

Access to a PDMP is dependent on the laws of the state. While most states give PDMP access to pharmacists and practitioners for the purpose of collecting patient PDMP reports, some states also allow regulatory boards, law enforcement, state Medicaid programs, and medical examiners to access state PDMPs. Each additional entity has access to the PDMP for a specific purpose relevant to the requirements of their work.

How does PDMP relate to the Merit Based Incentive Payment System (MIPS) of the Quality Payment Program?

In 2019, the Centers for Medicare and Medicaid Services (CMS) added the measure, Query of Prescription Drug Monitoring Program as a bonus measure under the e-Prescribing objective for both Medicaid Stage 3 and Medicare Merit-Based Incentive Payment System (MIPS). This bonus measure requires that for at least one Schedule II opioid electronically prescribed using Certified Electronic Health Record Technology during the performance period, the MIPS eligible clinician uses data from CEHRT to conduct a query of a PDMP for prescription drug history, except where prohibited and in accordance with applicable law.

Why the interest in PDMPs?

Prescription drug monitoring programs (PDMPs) continue to be among the most promising state-level interventions to improve opioid prescribing, inform clinical practice, and protect patients at risk. The collection of data within each state’s PDMP allows government officials to study trends, and better understand the practice and frequency of drug prescribing among providers and drug consumption among patients. Evaluations of PDMPs have illustrated changes in prescribing behaviors, use of multiple providers by patients, and decreased substance abuse treatment admissions. States have implemented a range of ways to make PDMPs easier to use and access. Many states have begun sharing their PDMP data with other state’s PDMPs as part of a concentrated effort toward greater data sharing, and to prevent patients from getting prescriptions by crossing state lines. These changes have significant potential for ensuring that the utility and promise of PDMPs are realized.