By Michael Whiteley, Eastern Bureau Chief
Florida’s crackdown on “pill mills” cut physicians’ purchases of the opioid painkiller oxycodone by 97% during 2011 and appears to have driven the business to Georgia, Kentucky and Tennessee, according to a report issued last week by the U.S. Drug Enforcement Administration (DEA).
Leaders of the Florida House on Monday credited the passage of House Bill 7095 with drastically reducing the purchase of the painkiller by physicians last year and reducing its overall purchase by pharmacies by 14%. The law took effect on July 1.
Oxycodone is marketed under the brand name OxyContin.
House leaders posted a link to the DEA’s findings on the House website on Monday. The agency said HB 7095, signed into law by Gov. Rick Scott on June 3, appears to be working.
HB 7095 banned physicians from dispensing drugs on Schedules II and III of the DEA’s controlled substances list except in very limited circumstances and mandated creation of a state prescription drug-monitoring program (PDMP).
“Florida was previously the nation’s capital for prescription drug abuse, but thanks to critical reform measures spearheaded by the Florida Legislature, prescription drug abuse continues to fall,” House Health and Human Services Committee Chairman Robert Schenck, R-Spring Hill, said in the House news release.
The DEA said the number of doctors appearing on its national list of the top 100 U.S. physicians ranked by the volume of oxycodone they purchase dropped from 90 in 2010 to only 13 in 2011.
The 2011 list of oxycodone-purchasing doctors, published through the agency’s Automation of Reports and Consolidated Orders System (ARCOS), showed 21 doctors listed in the top 100 now practice in Georgia, and another 11 practice in Tennessee.
The DEA reported “notable increases” in doctors purchasing oxycodone in Georgia, Kentucky and Tennessee.
The DEA said monthly purchases of oxycodone by Florida pharmacies increased slightly during January, February and March of 2011, while HB 7095 was being debated, and then began to drop significantly.
The DEA said the statistics contradict predictions that the crackdown on Florida doctors and pain clinics would drive more business to pharmacies.
Pharmacy purchases of oxycodone declined by 14% in July 2011 â€“ the month the ban took effect â€“ when compared to purchases for the same month in 2010, according to the DEA.
Comparing monthly purchases between the two years, the DEA said purchases declined by 13% in August 2011, 22% in September 2011, 25% in October 2011 and by 29% in both November and December.
In addition to banning doctors from dispensing drugs on Schedules II and III of the DEA’s controlled substances list, except as samples and during periods following surgeries, HB 7095 required doctors to resell their remaining inventories to wholesalers or turn them over to the Florida Department of Law Enforcement.
The law also required the Florida Department of Health to launch the PDMP last fall.
Pharmacies are required to supply the PDMP database with the names and other information of all persons receiving controlled substances, the dates the drugs were purchased, the quantities purchased, and information on prescribing physicians.
In addition, the bill toughened licensing standards for Florida pain clinics and required drug wholesalers to assess monthly orders from individual pharmacies for more than 5,000 unit doses of any one controlled substance to determine whether the purchase is reasonable based on the pharmacy’s location and the population it serves.
Drug wholesalers are required to report pharmacies receiving unusual quantities of controlled substances to the state Health Department.
Michael Jackson, executive director of the Florida Pharmacy Association, could not be reached for comment on Monday but said in a previous interview wholesalers are limiting their shipments of oxycodone and other painkillers to Florida pharmacies.
He said some pharmacies, in turn, are refusing to fill prescriptions when they don’t know the patient or prescribing physician.
Schenck’s committee played a pivotal role in drafting HB 7095.
It also is the next stop this session for House Bill 511, which could cap the price of repackaged drugs â€“ those primarily dispensed by physicians â€“ at the average wholesale price (AWP) established by the original manufacturer, plus a $4.18 dispensing fee.
The price-cap bill passed the Florida House and Senate unanimously in 2010 but was vetoed by former Gov. Charlie Crist. A similar bill cleared the Florida Senate in 2011 but died in a House-Senate budget conference committee, which approved HB 7095 in its place.