Monday, February 25, 2013

SB 809 is a Rx for CA's CURE

Is $3.7 million enough?

That's the amount of money that Sen. Mark DeSaulnier (D-Walnut Creek) is seeking in sponsoring Senate Bill 809, which would impose a 1.16% tax on providers' and pharmacists' annual licensing fees, to pay for upgrades to the California Controlled Substance Utilization Review and Evaluation System (CURES).

CURES is a computer network intended to give doctors and pharmacists information about a patient's drug prescriptions.

Attorney General Kamala Harris had called for legislators to restore the $3.7 million in funding for the prescription drug monitoring program, which had been slashed amid hefty state Department of Justice budget cuts during the 2011-12 fiscal year.

In 2010, Sen. Mark DeSaulnier, D-Walnut Creek, authored SB 1071, which would have imposed on every manufacturer and importer of a Schedule II, Schedule II or Schedule IV controlled substance a tax of 0.0025 cents per pill sold. The Senate Committee on Health refused to pass the bill, and DeSaulnier withdrew the measure from consideration.

My guess is that legislators in 2010 experienced significant pressure from the pharmaceutical industry that saw the tax as a burdensome intermeddling into their business that would drive up their costs, and interfere with their profits.

SB 809 shifts the taxation/funding burden onto the individuals actually dispensing the medication. This sounds logical, but likely the real reason for this change in funding philosophy is the level of objection that would be received - pharmacists and other medication providers are going to be less organized and less funded than the pharmaceutical companies.

Sam Mahood, communications director for DeSaulnier's office, told WorkCompCentral that there are currently 12,967 registered users of the CURES program.

"This represents only 6% of the 212,631 licensed to prescribe or dispense narcotics," Mahood wrote via email. "To ensure the program is effective, it is important all prescribers and dispensers enroll and consult the CURES (prescription drug monitoring program.) SB 809 mandates that once the CURES/PDMP is capable of accommodating all prescribers and pharmacists, they must enroll and use the program. Resources are needed to upgrade the web-based CURES/PDMP system before all users can be accommodated."

I think that's a good and positive goal because I believe that a PDMP can be beneficial to society at large. As I pointed out in a previous blog post, Oklahoma has a PDMP that is more active in its notification system than CURES, has a more installed, committed, user base, and has seen notable success.

It is unfortunate that California's finances are such a travesty because I also believe that the $3.7 million estimated to bring CURES into popular usage among the intended user-audience is a drop in the bucket for the General Fund, and that this system would benefit the public at large - not just those who use or prescribe narcotics.

I don't know what the cost is going to be to assess and collect the license assessment - ultimately it will drive up the costs of acquiring services from these vendors, who are under unnatural, and rather arbitrary, rules constricting their ability to pass those costs onto the consumer.

But given the extent of the prescription drug issue, which some say has reached epidemic proportions and costs society at large a huge amount in lost time, productivity and lives, not to also say money, I'll take what I can get given California's fiscal limitations.

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