Madara says the AMA strongly agrees with the need for combating prescription drug abuse and diversion. But he says the new policy's pitfalls would be compounded when a Part D drug plan is allowed to restrict access to other drugs as well. "This is especially troubling when the population of patients impacted will be elderly, more likely to be medically fragile, and less likely to be equipped to navigate the already bewildering array of Part D sponsor and pharmacy practices, policies, and requirements."
Besides, he wrote, 80% of the drug safety problem under discussion deals with just two types of drugs, oxycodone and hydrocodone.
But the lengthy CMS policy letter explains with an actual case how unsafe drug prescription policies in place today can elude checks in the current system.
"A beneficiary is receiving care from 13 different physicians over the course of one year. Nine of these providers are writing for controlled substances. The patient is receiving methadone 30mg/day from one provider routinely each month, while receiving oxycodone SR 80mg three tablets/day routinely each month from another provider.
"Neither provider prescribes the other prescriber’s medication, so it is conceivable that they are each unaware the patient is on both of these Schedule II controlled substances, which must be rewritten each month.