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California bills zero in on risky painkiller prescribers

Legislation follows outcry over Purdue Pharma's internal list of high-prescribing docs
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California is pushing some new legislation that drugmakers and physicians were none too happy with in its original form. But after some amendments, a slate of reforms to increase authorities' powers to crack down on risky narcotics prescribers has made its way to the desk of Gov. Jerry Brown. The three bills now await his signature to make them law.

As the LA Times reports, the bills propose actions that would require coroners to report prescription drug OD deaths to the medical board, beef up California's drug monitoring program and sanction doctors who do not cooperate with authorities investigating their patients' deaths. Lawmakers hope to accomplish some of those goals by passing an upgrade of a database known as CURES, which contains detailed information about the narcotics California pharmacies dispense--including the names of prescribers and patients.

Recently, Purdue Pharma came under fire for flagging too few suspect cases from its own risky prescriber database. Last month, the maker of opioid painkiller OxyContin acknowledged it had compiled a list of 1,800 doctors, most of whom were suspected of recklessly prescribing its highly addictive drug. Lawmakers called for Purdue to hand over the list, claiming the decision to further probe a physician for violations belonged in the hands of state medical boards and law enforcement, rather than to a corporation that benefits from over-prescribing.

State Sen. Mark DeSaulnier (D-Concord) said CURES would transform the way authorities root out reckless prescribers. "Before this, it was like looking for a needle in a haystack--just searching blindly," he said, as quoted by the LAT. With the improvements, he said, it would be "more like a surgical strike."

But not everyone was on board with the CURES bill initially. The California Medical Association lobbied hard to remove a mandate that doctors check the database before prescribing narcotics, the LAT reports. And while lawmakers have amended the bills to make them "fairer," consumer advocates have said they'd seek restorations of some of the provisions left on the cutting-room floor during the legislative process.

In some cases, pharmacies have taken up the matter themselves. A few weeks ago, CVS Caremark stopped filling prescriptions for doctors who prescribe opioids at alarmingly high rates. It hinted other pharmacies should follow suit.

Opioid makers like Purdue continue to face civil litigation over their safety disclosures. As the AP reports, Kentucky's attorney general sued Purdue, claiming the company misled healthcare providers, consumers and government officials regarding OxyContin's addiction risks. A state judge is weighing whether to move the lawsuit to a different court; Purdue's attorneys say seating an impartial jury there would be impossible.

- read the LA Times story
- get more from the AP

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