Prescription Monitoring Programs (PMPs)

What are prescription monitoring programs?

Preventing diversion and abuse of prescription controlled substances while ensuring their availability for legitimate medical use is an important public health goal.  To be balanced, efforts to prevent diversion of controlled substances should not interfere with their use in the treatment of pain.  There are a number of types of information that can be used to identify sources of diversion, including law enforcement intelligence, pharmacy theft data, retail distribution of controlled substances, Medicaid, and PMPs.  
Forty-three states have operational PMPs to monitor the prescribing of certain controlled substances and detect illicit prescribing and dispensing; all but one state (Missouri) have adopted laws establishing a PMP and identify patients who are obtaining prescriptions from multiple sources.  Typically, PMPs collect prescribing and dispensing data from pharmacies, conduct review and analysis of the data, and make it available under certain circumstances to regulatory and law enforcement agencies, as well as practitioners and patients.  Further information about the status and trends of PMPs, as well as Model PMP legistlation from a variety of sources, is available below.

Forty-three (43) states (Alabama, Alaska, Arizona, California, Colorado, Connecticut, Delaware, Florida, Hawaii, Idaho, Illinois, Indiana, Iowa, Kansas, Kentucky, Louisiana, Maine, Massachusetts, Michigan, Minnesota, Mississippi, Nevada, New Jersey, New Mexico, New York, North Carolina, North Dakota, Ohio, Oklahoma, Oregon, Pennsylvania, Rhode Island, South Carolina, South Dakota, Tennessee, Texas, Utah, Vermont, Virginia, Washington, West Virginia, Wisconsin, and Wyoming) have operational PMPs.  All PMPs rely on electronic transmission of data from pharmacies, although California, New York, and Texas require practitioners to obtain and use serialized security forms in addition to the electronic component.

The PPSG encourages research on current PMPs to evaluate their effectiveness in

  1. curtailing the abuse and diversion of controlled substances,
  2. ensuring legitimate use of controlled substances in healthcare, and 
  3. making prescription information accessible.

Through these efforts, an accurate assessment of the success of PMPs in achieving a balanced approach can be made.

Model Prescription Monitoring Program Legislation

  1. Alliance of States with Prescription Monitoring Programs (includes Explanation for 2010 Amendments and Responses to Comments received)
  2. American Cancer Society Cancer Action Network/Pain & Policy Studies Group
  3. National Alliance for Model State Drug Laws

Using Medicaid data to identify prescription drug diversion

  1. Office of Inspector General.  Intiative to improve states' internal controls over prescription drugs purchased under the Medicaid program (A-03-90-000204). Washington, DC: U.S. Department of Health and Human Services; 1990.
  2. United States General Accounting Office. Controlled substances: Medicaid data may be useful for monitoring diversion. Washington, DC: United States General Accounting Office, GAO/HRD-88-111; 1988.
  3. United States General Accounting Office.  Medicaid prescription drug diversion: A major problem, but state approaches offer some promise.  Washington, DC: United States General Accounting Office, GAO/T-HRD-92-48; 1992.
  4. United States General Accounting Office.  Prescription drugs and Medicaid: Automated review systems can help promote safety, save money. Washington, DC: United States General Accounting Office, GAO/AIMD-96-72; 1996.