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Senate rejects bill on prescription monitoring program

California lawmakers fail to pass a measure calling for higher fees for pharmacists and doctors and a tax on drug makers to improve CURES' narcotics-tracking database.

May 28, 2013|By Lisa Girion and Scott Glover, Los Angeles Times

Amid opposition from the pharmaceutical industry, state senators Tuesday failed to pass a bill that would have significantly enhanced a prescription monitoring program aimed at curbing drug abuse and overdose deaths.

Under the proposed legislation, the program — known as CURES — would have received a steady stream of funding from an increase in licensing fees on pharmacists, physicians and other prescribers. The bill also called for a tax on drug makers to allow the attorney general to hire teams of investigators to crack down on drug-seeking patients and doctors who recklessly prescribe to them.

The bill was part of a package of measures introduced in response to a Times analysis of 3,733 accidental fatal overdoses in Southern California in which prescription drugs caused or contributed to the deaths. Nearly half of those cases involved drugs prescribed by physicians to their patients.

State Sen. Mark DeSaulnier (D-Concord), who introduced the bill with Senate President Pro Tem Darrell Steinberg (D-Sacramento), said he would seek another vote on the proposal later this week, but conceded that they would have to drop the tax on drug makers in an effort to pass the measure, which enjoyed the support of a broad coalition of interest groups and industries, including the California Medical Assn., which represents physicians.

"You couldn't get a wider group supporting it," DeSaulnier said. "We've got the CMA. We've got public safety. We've got business groups.… We've got the insurers. The only people who were opposed to this bill were from the pharmaceutical industry."

The tax would have raised $5 million from pharmaceutical companies that sell nearly $1 billion worth of OxyContin, Vicodin and other narcotics every year in California, according to estimates from DeSaulnier's office.

Industry representatives say they support prescription drug monitoring programs like CURES to ensure that their drugs are safely prescribed. But trade groups for drug makers have successfully opposed efforts to upgrade California's program for years.

Lobbyists for drug makers could not be reached for comment.

CURES — which is essentially a program that uses a computer database to track narcotics prescription transactions throughout the state — was developed to allow doctors to see what drugs a patient has received from others before prescribing potentially dangerous narcotics. But the database is so outdated and difficult to use that few doctors bother to check it.

Public health authorities and medical experts are urging states to also use such databases as an investigative tool to identify physicians who are prescribing recklessly. Atty. Gen. Kamala Harris, a co-sponsor of the bill, said in an interview earlier this year that she wants to use the database that way but lacks the investigative staff to do so

Funding for the CURES program was cut to $400,000 a year amid the state's budget crisis. The entire program is overseen by a single employee. Doctors who have contacted the office with questions about CURES, or have sought help gaining access to the database to check on patients, have received email responses stating: "Unfortunately, due to budget restrictions, there is no staff to accept or respond to your communication."

Because the bill called for a new tax, it required approval of two-thirds of senators. Democrats hold 28 seats in the chamber, one more than is needed to pass the bill. But the measure fell 4 votes short, with five Democrats and nine Republicans voting against it; two Republicans abstained.

In the weeks prior to the vote, DeSaulnier said he believed the bill had a better chance than previous attempts to upgrade CURES because of heightened awareness of the prescription drug epidemic and because it has the support of Harris, the state's top law enforcement official.

Bob Pack, a technology entrepreneur who has championed improvements to CURES since a woman driving under the influence of painkillers struck and killed his two children in 2003, said he was disappointed by the Senate vote.

"I'm appalled that those senators who voted against it are not putting citizen safety first," he said.

Nonetheless, he said, he believed an amended version of the bill would pass later this week. He also said he was considering going to voters with a ballot initiative that would seek additional funding and improvements for CURES.

Pack was critical of drug companies who he said lobbied against the bill, even though they profit handsomely from the sales of drugs that fuel an epidemic of overdoses.

"They are the single biggest beneficiaries, yet they don't want to contribute one dime," he said.

The California Medical Assn., which initially opposed the bill, endorsed it after DeSaulnier agreed to drop a provision that would have required doctors to check CURES before prescribing painkillers and other narcotics.

Last week, Senate and Assembly committees voted to include nearly $4 million in the state budget to upgrade CURES and keep it running for two years until the proposed new funding stream takes effect. The money would come from existing funds held by the medical and other healthcare professional oversight boards.

"We're talking about lives — people are dying and a big part of the problem is we have this outdated database," said Assemblyman Robert Blumenfield (D-Woodland Hills), a co-sponsor of the bill. "This is going to make it much more effective."

Times staff writer Patrick McGreevy contributed to this report.

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