Health IT, Pharma

Vermont becomes final state to legalize e-prescribing of controlled substances

After a long battle, proponents of e-prescribing have achieved their goal of electronic prescribing of controlled substances becoming legal nationwide, as Vermont has become the last holdout to change its rules.


After a long battle, proponents of e-prescribing have achieved their goal of electronic prescribing of controlled substances becoming legal nationwide, as Vermont has become the last holdout to change its rules.

Following years of protests from law enforcement over concerns that drug diversion would increase, the federal Drug Enforcement Agency in 2010 legalized e-prescribing of Schedule II-V drugs, with several conditions. It took five more years for every state to change prescribing regulations and for technology vendors to develop systems that complied with the DEA rules, which require, among other things, two-factor authentication.

E-prescribing proponents have long said that electronic means were more secure than paper prescription pads, particularly in stopping illegal dispensing of narcotics. With its rules, the DEA “wanted to raise the bar from paper prescriptions,” said Paul Uhrig, chief administrative and legal officer and chief privacy officer of Arlington, Va.-based e-prescribing connectivity network Surescripts.

Uhrig told MedCity News that 3 to 9 percent of drug diversion is the result of forged paper scripts.

Bans on e-prescribing of controlled substances had hindered wider adoption of e-prescribing technology in general because physicians who prescribe scheduled drugs were reluctant to have dual systems.

Uhrig said that only about 4 percent of prescribers nationwide are writing e-prescriptions for controlled drugs, even though 80 percent of pharmacies have technology that meets DEA standards. However, the volume is growing; Uhrig said that Surescripts processed more orders for controlled substances in the first quarter of 2015 than in did in all of 2014.

Some states are more active than others. Because of a New York mandate for all prescriptions be electronic by March 2016, that state rocketed from No. 19 in EPCS last year to No. 1 so far this year, according to Surescripts, with the network processing 5 million orders for scheduled drugs from January through July. New York was responsible for just 1.6 EPCS in all of 2014.

In July alone, New York prescribers sent 420,000 such prescriptions, up from 8,100 a month last November, Surescripts said. Texas saw its EPCS volume shoot up by 45 percent between June and July.

“We have patients who have come to expect it,” Uhrig said.

Photo: Flickr user Thomas Hawk