The Drug Enforcement Agency (DEA) is pushing for easier online access to anabolic steroids and other scheduled drugs. Physicians will soon be able to digitally prescribe steroids to patients. While it is generally agreed that this is a good move to reduce medical mistakes, some drug law policy experts feel it will make the DEA’s job more difficult.
Why, then, is the DEA pushing for easier online access to these drugs? And who is lobbying the DEA to do this, when it clearly will only make the DEA’s job harder?
When it comes to policy matters, it is always helpful to follow the money trail to understand the actions of federal agencies and bureacrats. Pharmaceutical companies (Barr Pharmaceuticals), large employers (Wal-mart), prescribing software makers (Allscripts Healthcare Solutions) and electronic prescription networks have lobbied for and/or supported the electronic prescribing of controlled substances.
The Wall Street Journal identifies several companies who will benefit financially from easier online prescription regulations (“Electronic-prescription plan is set,” July 1).
The merger of RxHub and SureScripts unites what are otherwise fierce competitors to a common goal. RxHub is backed by pharmacy benefits managers, or PBMs, which administer prescription drug benefits for employers and health plans, and typically dispense drugs through mail-order pharmacies, the direct competitors of the retail outlets, such as Walgreen Co. and Wal-Mart Stores Inc., represented by SureScripts.
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Sean Wieland, a senior research analyst at Piper Jaffray, says both parties stand to gain financially. Enabling physicians to prescribe based on the drugs covered under a patient’s health plan will help to drive formulary compliance, important to PBMs and insurers, while pharmacies can save time and money through fewer calls to physicians’ offices, he says.
The big question is whether the proposed electronic prescription regulations will be abused and manipulated for unauthorized access to prescription anabolic steroids and other controlled substances.
The DEA claims that the rationale for the new proposed rules have nothing to do with the corporate interests who stand to benefit; while the DEA is concerned the rules could contribute to diversion and further abuse of controlled substances, they argue that the online prescriptions rules will likely help curtail diversion for non-medical purposes.
However, with proper controls, the risk of diversion can actually be reduced through the use of electronic prescriptions. Among the essential elements of such a system are ensuring that only DEA registrants electronically sign and authorize controlled substance prescriptions and that the prescription record cannot be altered without the alteration being detectable. A system that fails to provide verification of the signer’s identity and authority to issue controlled substance prescriptions, and/or fails to ensure that alteration of the record is detectable, would create new routes of diversion that could be even harder to prevent and detect.
About the author
Millard writes about anabolic steroids and performance enhancing drugs and their use and impact in sport and society. He discusses the medical and non-medical uses of anabolic-androgenic steroids while advocating a harm reduction approach to steroid education.
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