Courtesy MIRS News
Physicians wouldn’t be able to prescribe a schedule 2, 3, 4 or 5 drug without running a report on the patient through the Michigan Automated Prescription System, or MAPS, to check for opioid abuse, under SB 0166 and SB 0167, sponsored by Sen. Tonya SCHUITMAKER (R-Lawton).
The Senate Health Policy Committee today heard testimony on the MAPS legislation, which is designed to help stem the prescription drug and opioid addiction epidemic.
“Today, committee members, we start a journey — a journey on this issue of addressing, legislatively at least, the growing problem of pain killers, controlled substances and opioid abuse in our state and in our nation,” said committee chair Sen. Mike SHIRKEY (R-Clarklake). “This is indeed a journey. It starts today but I can’t tell you how long it’s going to last.”
“Ultimately, this is a community-level culture issue not a statutory issue,” Shirkey continued. “But we can do some things to enable these things to take root and make a difference. It could take us through at least the time we go on summer break and I suspect even beyond that.”
According to Schuitmaker, the United States contains 5 percent of the world’s population but 80 percent of all opioids are used here. She also said 44 U.S. residents die every day from opioid overdoses and that Michigan’s opioid prescription rate ranks 10th nationally. Michigan ranks 18th nationally in the number of overdoses.
Schuitmaker told the panel that, as a member of the state’s Prescription Drug and Opioid Abuse Task Force, she discovered there was an “existing tool” that could be utilized to battle the epidemic.
“The Michigan Automated Prescription System recently upgraded to a user-friendly format that allows physicians to see their patients’ history,” Schuitmaker said. “It can easily be integrated into an electronic medical records system.”
She also said that other states, including Ohio, have experienced some success through the use of prescription drug monitoring.
“In Ohio, there were 92 million fewer overdoses and a drop in the number of patients seeking multiple prescriptions,” Schuitmaker said.
Sen. Cutis HERTEL, Jr., (D-East Lansing) asked about objections to SB 166-167 coming from the Epilepsy Foundation, which argues that the legislation would be very burdensome regarding some drugs are typically prescribed for epileptic patients.
Schuitmaker said she realized some (particularly schedule 5) drugs would be covered by the legislation that didn’t necessarily need to be, but that other schedule 5 drugs — particularly cough syrup with codeine — needed to be covered.
“(The legislation) is all encompassing and will probably grab some other things,” Schuitmaker said “But the thought is that we need to include schedule 5.”
Sen. Jim STAMAS (R-Midland) asked Kim GAEDKE, director of the Bureau of Health Care Services at the Department of Licensing and Regulatory Affairs (LARA), what percentage of participation MAPS had, under its newly (one month ago) implemented system.
“Prior to implantation of the new system it had about 38.2 percent,” Gaedke said. “But that was inflated due to multiple accounts. Today, it’s around 18,000, which is about 31 percent.”
“What is your goal?” Stamas asked.
“For states that don’t have a mandate it hovers at about 20 percent,” Gaedke said. “For states that have a mandate it’s between 80 and 90 percent. Ideally, we’d like to say 100 percent, but that’s not realistic. We have just under 63,000 prescribers. Our goal is to be like the other mandated states, at about 80 to 90 percent.”
“One of things I’ve heard from doctors is the amount of time it can take; from 10 to 20 minutes,” Stamas said.
“So far, according to the feedback we’ve gotten on our new system, it’s taking literally seconds,” Gaedke responded. “On average, the first day it took about 2 seconds to get a record.”
“What’s your timeline?” Stamas asked.
“Our hope is that by mid-summer we exceed the original 38 percent,” Gaedke said. “It would be good to say that by end of year we’d be at 80 percent. But minus mandatory use I don’t think it would be realistic to say that.”
“How many states have mandates?” Sen. Jim MARLEAU (R-Lake Orion) asked.
“28 have mandated use,” Gaedke replied
“I understand that methadone clinics are not reporting to MAPS,” Marleau said.
“We’re working with Sen. Dale ZORN (R-Ida) on SB 0047,” Gaedke responded. “I think there might be some opportunities to get through the federal regulations.”
“Federal regulations protect the privacy of individuals in those (substance abuse) programs,” Gaedke explained after a follow up question. “That’s a challenge all states are facing.”
“So, we’re hitting those who may or may not, but excluding the ones we already know do — and not sharing that with the doctors,” Stamas said. “That seems very counterproductive.”
“That’s an issue physicians are running into, too,” Gaedke pointed out. “We may have some creative solutions. We may be able to get around that.”
Blue Cross and the Pharmacy Association support the legislation. The Michigan Association of Health Plans supports SB 0166 but opposes SB 0167. The Epilepsy Foundation opposes the legislation.