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Bill Cecil
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Tennessee has relinquished its No. 1 status in rate of prescription drug use.
Averaging 16.9 prescriptions per person in 2006, Tennessee had the second-highest level of prescription drug use in the country, according to a report released this month by BlueCross BlueShield of Tennessee.
West Virginia was the leader with 17.4 prescriptions per capita, according to the BlueCross report, which used data from drug company Novartis’ most recent Pharmacy Benefit Report.
Tennessee’s rates were down 6.6 percent from the 18.1 prescriptions in 2004, a drop that experts attribute to statewide efforts to curb the rate of drug use here, particularly among the TennCare population.
Tennessee now is on the right track, said Bill Cecil, health policy research director for BlueCross.
“The state has kind of marshaled all the different resources together from all the sectors and ... it’s beginning to pay off,” he said.
In 2005 the TennCare Bureau began limiting prescriptions for most adults to five per month, with exceptions for some medications, including treatments for chemotherapy and immunosuppression therapy, said David Beshara, TennCare chief pharmacy officer.
In 2006 changes in a court settlement between TennCare enrollees’ advocates and state officials, known as the Grier consent decree, allowed TennCare to require prior authorizations for certain drugs, which has cut usage, he said.
Those efforts were intended to promote necessary utilization of drugs for chronic conditions while deterring the discretionary use of medications, he said.
Painkiller hydrocodone is the No. 1 drug by volume that TennCare pays for, officials said. In 2005, TennCare paid for about 1.35 million hydrocodone prescriptions, but in 2006 that figure dropped to less than 610,000. Part of that drop was from the implementation of Medicare’s Part D prescription drug benefit, Mr. Beshara said.
Still “huge lead”
Tennessee’s drug utilization rates remain well above the national average, which was 11.8 prescriptions per capita in 2006, the BlueCross report stated.
Russ Miller, senior vice president for the Tennessee Medical Association, said the physicians’ group has helped develop a program to combat misuse of the more addictive Schedule II drugs.
The Tennessee Prescription Safety program will allow physicians and pharmacists to access a patient’s prescription history with a swipe card that is distributed free of charge to the patient and compliant with privacy laws.
The card will approve or deny the transaction, though pharmacists and doctors will be able to override denials of a prescription if necessary.
The program is slated to launch in Monroe County in May, Mr. Miller said.
Tennessee Board of Pharmacy also recently implemented a controlled substance monitoring database that will allow prescribers, pharmacists and authorized users to access prescription data to be sure that patients are not wrongly seeking drugs.
The study also showed that the growth in per capita spending on prescriptions in Tennessee is slower than the U.S. average. Tennessee’s prescription drug spending in 2006 grew by 7.2 percent to $1,272.94 per person, while national spending grew 18.8 percent to $948.72.
Matt Callihan, regional director of addictive disorders at Parkridge Valley, said he has not seen any changes in the number of admissions to Parkridge Valley for prescription drug addiction.
“I think it might have some impact, but the drugs of abuse, they’re always going to figure out how to get them,” he said.
Health care reporter Emily Bregel has worked at the Chattanooga Times Free Press since July 2006. She previously covered banking and wrote for the Life section. Emily, a native of Baltimore, Md., earned a bachelor’s degree in American Studies from Columbia University. She received a first-place award for feature writing from the East Tennessee Society of Professional Journalists’ Golden Press Card Contest for a 2009 article about a boy with a congenital heart defect. She ...
