Maine’s Prescription Monitoring Program

Maine Benzodiazepine Study Group Conference

2007 UPDATE

Daniel J. Eccher, MPHProject Coordinator

Outline for Presentation

Program overview Aggregate PMP data PMP data on benzodiazepines How health care providers can use patient-

specific PMP data Time for questions at the end?

PMP Description

Data collection since July 1, 2004 Data submission from over 300 pharmacies

(100%) dispensing controlled substances in Maine (including out-of-state mail order and Internet pharmacies, and the VA-Togus Med. Cnt.)

Schedules II-IV Data stored in centralized, relational

database

OSA’s Goals for PMP

Improve patient care by giving health care providers comprehensive information

Curb prescription drug misuse Get those who are addicted into appropriate

treatment

OSA’s Goals for PMP

Help stop prescription drug overdoses Educate the public on the dangers of

prescription drug abuse Ensure that those who do need prescription

medications still receive them

PMP Database Description

Patient identifiers: Name, DOB, Address(es) Prescriber identifiers: DEA number (from which

we derive name) Drug identifiers: NDC Code, Name, dosage,

days supply Pharmacy identifiers: Pharmacy DEA number,

pharmacy address Possible to derive other info (e.g. patient

county)

Drug Type Proportions (State of Maine, PMP Data, SFY07)

Drug Type as Percent of State Total: 2,106,901

Others1%

Stimulants10%

Tranquilizers35%

Narcotics54%

Drug Types Per Age Group(State of Maine: PMP Data, SFY07)

21,402

69,593

142,296

213,463

368,883

323,979

114,188

24,409 23,495 22,509 28,234

7,721 10,598 23,907

70,750

127,036

246,997 250,027

0

50,000

100,000

150,000

200,000

250,000

300,000

350,000

400,000

Age: 0 - 18 Age: 19 - 25 Age: 26 - 35 Age: 36 - 45 Age: 46 - 60 Age: 61 & Up

AGE GROUP

PR

ES

CR

IPT

ION

CO

UN

T

Narcotics Stimulants Tranquilizers

Maine’s PMP “Top 10” List(SFY 2007)

DRUG COUNT RX % OF TOTAL

HYDROCODONE/ACETAMINOPHEN 448,430 20.73

LORAZEPAM 173,228 8.01

CLONAZEPAM 149,815 6.92

ALPRAZOLAM 136,729 6.32

OXYCODONE HCL 127,541 5.89

OXYCODONE/ACETAMINOPHEN 124,483 5.75

PROPOXYPHENE-N/ACETAMINOP 100,546 4.65

AMBIEN 73,966 3.42

DIAZEPAM 73,945 3.42

CONCERTA 63,411 2.93

TOTAL (for “Top 10”) 1,472,094 68.04

Prescriptions per Person by County (Maine PMP Data, SFY07)

1.40

1.79

1.63

1.67

1.591.70

1.56

1.81

1.60

1.40

1.56

1.621.51

1.54 1.701.83

State Average:State Average:1.60 Scripts/Person

Benzodiazepines

PMP Data

Benzodiazepines (PMP SFY 2006)Drug Name Rx Count % Total Benzos

Alprazolam 132,612 24.09%

Chlordiazepoxide HCl 4,198 0.76%

Clonazepam 139,009 25.25%

Clorazepate Dipotassium 4,428 0.80%

Diazepam 70,855 12.87%

Diazepam (Anticonvulsant) 608 0.11%

Estazolam 383 0.07%

Flurazepam HCl 1,663 0.30%

Lorazepam 162,999 29.61%

Midazolam HCl 52 0.01%

Oxazepam 6,197 1.13%

Quazepam 39 0.01%

Temazepam 22,649 4.11%

Triazolam 4,882 0.89%

Total Benzo's 550,574 100%

Benzodiazepines (PMP SFY 2006)

39

52

383

608

1663

4198

4428

4882

6197

22649

70855

132612

139009

162999

0 20000 40000 60000 80000 100000 120000 140000 160000 180000

Quazepam

Midazolam HCl

Estazolam

Diazepam (Anticonvulsant)

Flurazepam HCl

Chlordiazepoxide HCl

Clorazepate Dipotassium

Triazolam

Oxazepam

Temazepam

Diazepam

Alprazolam

Clonazepam

Lorazepam

Rx Count

Benzodiazepines - Percent of Total (PMP SFY 2006)

Alprazolam24.09%

Chlordiazepoxide HCl0.76%

Clonazepam25.25%

Clorazepate Dipotassium0.80%

Diazepam12.87%Diazepam (Anticonvulsant)

0.11%

Estazolam0.07%

Flurazepam HCl0.30%

Lorazepam29.61%

Oxazepam1.13%

Temazepam4.11%

Triazolam0.89%

Quazepam0.01%

Midazolam HCl0.01%

Benzodiazepines (PMP SFY 2007)Drug Name Rx Count % Total Benzos

Alprazolam 136193 23.76%

Chlordiazepoxide HCl 4026 0.70%

Clonazepam 148082 25.84%

Clorazepate Dipotassium 4047 0.71%

Diazepam 73085 12.75%

Diazepam (Anticonvulsant) 787 0.14%

Estazolam 353 0.06%

Flurazepam HCl 1541 0.27%

Lorazepam 171290 29.89%

Midazolam HCl 49 0.01%

Oxazepam 6089 1.06%

Quazepam 14 0.00%

Temazepam 22895 3.99%

Triazolam 4675 0.82%

Total Benzo's 573126 100.00%

Benzodiazepines (PMP SFY 2007)

14

49

353

787

1541

4026

4047

4675

6089

22895

73085

136193

148082

171290

0 20000 40000 60000 80000 100000 120000 140000 160000 180000

Quazepam

Midazolam HCl

Estazolam

Diazepam (Anticonvulsant)

Flurazepam HCl

Chlordiazepoxide HCl

Clorazepate Dipotassium

Triazolam

Oxazepam

Temazepam

Diazepam

Alprazolam

Clonazepam

Lorazepam

Rx Count

Benzodiazepines - Percent of Total (PMP SFY 2007)

Alprazolam, 23.76%

Chlordiazepoxide HCl, 0.70%

Clonazepam, 25.84%

Clorazepate Dipotassium, 0.71%Diazepam, 12.75%

Diazepam (Anticonvulsant), 0.14%

Estazolam, 0.06%

Flurazepam HCl, 0.27%

Lorazepam, 29.89%

Oxazepam, 1.06%

Quazepam, 0.00%

Temazepam, 3.99%

Triazolam, 0.82%

Midazolam HCl, 0.01%

Trend in Counts of Top 4 Benzos(SFY’s 2005 – 2007)

70,855

145960

128403

69288

129586

162,999

132,612 139,009

171290

148082

73085

136193

0

20000

40000

60000

80000

100000

120000

140000

160000

180000

Diazepam Alprazolam Clonazepam Lorazepam

DRUG

CO

UN

T

SFY 05 SFY 06 SFY 07

Please analyze our data …

and then, publish the results.

Patient-specific PMP Data

Using PMP data in the healthcare setting

Patient History Reports

“Unsolicited” reports (automatically sent to prescribers)– Quarterly Patient Threshold Reports– Monthly Buprenorphine/Narcotics Reports (new)– Quarterly APAP Threshold Reports (in devlpmt.)

“Solicited” reports – registration for anyone with a DEA number, including pharmacists; data available online, through secure portal

Registraton as a “Requestor”

Go to: http://www.maine.gov/pmp Follow the “GHS Web Site” link. Scroll to the bottom and click the “Sign Up”

button in the “New Users” section. Fill in the required information on the

sequential forms. (Select “Requestor” in the User Type section; last step: entering DEA #.)

Wait for confirmation by fax. (The approval process takes about two business days.)

Prescription Data Portal

Patient History Report

Registration as Requestors

Free service Easy to use Immediate access to reports “Sub-accounts” allowed under prescriber

accounts Of 6200+ eligible prescribers, only 1557

registered (about 25%)

OSA’s Focus: Treatment

Addiction = disease (non-judgemental approach)

Helping people find treatment Office of Substance Abuse - questions about

PMP or how to find treatment options for a patient

OSA’s Treatment Resources

OSA’s Web Site: http://www.maine.gov/dhhs/osa

Treatment Directory: “Find Help” link Information and Resource Center:

Plethora of substance abuse literatureTreatment teamTreatment Data System

For more information about PMP, …

… log on to our web site:

http://www.maine.gov/dhhs/osa/data/pmp

Or contact me:

Phone: (207) 287-3363

Email: daniel.eccher@maine.gov

Any questions now?