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Research firm works to credit ODs for prescriptions they are writing
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Optometrists across the country are continually broadening their therapeutic and controlled substance prescribing privileges, making the OD market more important to pharmaceutical companies.
ODs in all 50 states have therapeutic prescribing privileges, and ODs in 32 states now have controlled narcotic substance prescribing privileges.
“Keep in mind that none of these numbers are ever static. They change constantly,” said Sherry Cooper, the state legislative analyst in the State Government Relations Center of the American Optometric Association (AOA).
Oregon just promulgated a rule in June, allowing ODs to prescribe controlled narcotic substances, Ms. Cooper told Primary Care Optometry News. It is hoped that the District of Columbia will promulgate a rule soon, bringing the number to 33 jurisdictions in the country, she said.
While ODs have made great strides in gaining these prescribing privileges, problems have surfaced in accurately reporting the number of prescriptions written by ODs to the pharmaceutical companies.
Tracking by DEA number
One major problem Primary Care Optometry News identified in an article that ran in the December 2000 issue (“Prescription tracking: discrepancies are being addressed from all sides") was the use of a Drug Enforcement Administration (DEA) number in reporting methods.
Not all ODs are entitled to apply for a DEA number. Only those who practice in the 32 states that can prescribe controlled narcotic substances and ODs in a 33rd state, Illinois, who can prescribe controlled non-narcotic substances, are entitled to apply for a DEA number. That leaves ODs in 17 states who have therapeutic prescribing privileges not necessarily getting credit for the prescriptions they write.
Even doctors who have a DEA number do not need to write it on the prescription unless they are prescribing a controlled substance.
“The Drug Enforcement Administration does not recommend having the DEA number preprinted on the prescription pad,” said Thomas Hinojosa, DEA spokesman, “due to a potential for abuse by others who may steal or remove papers from the pad without the doctor’s knowledge. The DEA recommends writing it on the pad only for controlled substances.”
Ms. Cooper said she also tells doctors not to put the DEA number on the prescription pad unless they are prescribing a narcotic. “The more times the DEA number is out there in the public, the more chance there is for it to be abused by somebody,” she said. “On the other hand, I realize it’s a reality of life and I know their drug prescription probably will not get tracked unless it’s on there.”
Jeffrey L. Weaver, OD, MBA, MS, director of the Clinical Care Group at the AOA, said prescription tracking companies are working to improve reporting methods. “I think the tracking companies continue to do things to try to make the reporting better, because they are in the business to be as accurate as possible,” Dr. Weaver said.
However, in situations where tracking companies are not actually doing specific counts, and where they are having to make some assumptions, Dr. Weaver said that he still believes there are possibly some shortcomings based on the distribution of optometrists and the way that the statistical analysis is performed by the tracking companies.
U.S. Dispensed Total Scripts by Optometrists | ||
Total U.S. market | Total scripts 2001 2,847,296,000 | % growth from 2000 5% |
Total U.S. market | Total scripts 2000 2,718,924,000 | % growth from 1999 5% |
Total U.S. market | Total scripts 1999 2,595,329,000 | % growth from 1998 9% |
Total U.S. market | Total scripts 1998 2,379,757,000 | % growth from 1997 7% |
Includes prescription drugs only. Includes insulin. | ||
Other information used for tracking
Alternative methods to match prescriptions are being used by IMS Health, a global provider of pharmaceutical information based in Fairfield, Conn.
“We don’t limit our matching for prescriptions to the DEA number,” said Pat Procopio, director of marketing at IMS Health. “We have a very large comprehensive database of all prescribers in the United States for which we have state license information as well as other key demographic information. When retailers provide prescription transaction information, we can track them using the name and other fields that are identifiers to verify the information. Therefore, we don’t need the DEA number. It’s not a necessary part for our matching,” Ms. Procopio told Primary Care Optometry News.
ODs should use their own pads
Some of the problems are not in the hands of the research firms.
ODs are encouraged to write prescriptions on their own pads, not on those of an ophthalmologist in the office.
The prescription pad should also include a state license number. In the cases where a DEA or state license number is not available, the tracking companies try to match the prescriptions geographically.
“One of the key things ODs can do is to write their prescriptions on their own pads,” said Ms. Procopio. “When the retailers are filling them, make sure that the retailers have the correct name as well as the state license number. The state license number is not a DEA number. It’s really important that ODs have all of their information at the retailers’ side so that when that script gets filled, it’s being tracked to that individual.
An AOA study
The AOA continues to study this issue, Dr. Weaver said. It has recently completed a study with ODs from five states: Florida, Illinois, Missouri, North Carolina and Texas. The results will be published in an upcoming issue of the AOA’s journal, Optometry, Dr. Weaver said.
For the study, the AOA asked ODs to track the prescriptions they wrote for a 3-month period and compared the number of prescriptions written to those actually credited by a tracking company.
“Based on those results, it’s not a perfect system yet,” Dr. Weaver said. “Though the tracking companies continue to work on it, we identified some potential flaws.
“Optometrists are encouraged to report any problems that they might encounter with this issue,” Dr. Weaver continued, “including pharmaceutical company representatives being less than willing to provide samples to the practice.”
For Your Information:
- Sherry Cooper is the state legislative analyst in the State Government Relations Center for the American Optometric Association. She can be reached at the AOA, 243 North Lindbergh Blvd., St. Louis, MO 63141; (314) 991-4100; fax: (314) 991-4101; e-mail: slcooper@aoa.org.
- Thomas Hinojosa is spokesman for the Drug Enforcement Administration, Washington, DC 20537.
- Jeffrey L. Weaver, OD, MBA, MS, is director of the AOA Clinical Care Group. He can be reached at the AOA, 243 North Lindbergh Blvd., St. Louis, MO 63141; (314) 991-4100; fax: (314) 991-4101; jlweaver@aoa.org.
- Pat Procopio is the director of marketing at IMS Health. She can be reached at IMS Health’s regional headquarters at 600 W. Germantown Pike, Plymouth Meeting, PA 19462; (610) 834-5000.