PARTIAL FILLING OF SCHEDULE II PRESCRIPTIONS

To advocate that state legislatures and boards of pharmacy create consistent laws and rules to allow partial filling of Schedule II drugs; further,

To advocate that public and private entities construct criteria for partial filling to minimize the additional burden on patients, pharmacists, and healthcare organizations; further,

To advocate that pharmacists educate prescribers and patients about options for filling prescriptions for Schedule II drugs, including the risks of overprescribing, while recognizing the patient or caregiver's rights to make their own care and management decisions.

Rationale

The issue of opioid abuse and addiction has been at the forefront of federal and state activity. Increasing addiction rates of patients taking powerful opioids have spurred calls for action to help address this growing problem. The issue has become national in scope and has generated discussion among policymakers and healthcare practitioners alike. In mid-2016, Congress passed the Comprehensive Addiction and Recovery Act of 2016, legislation aimed at curbing opioid abuse and enhancing access to addiction treatment. States have been considering their own legislative initiatives to address what is increasingly described as an epidemic.

One solution proposed by policymakers is to allow pharmacists to dispense only a portion of the quantity of a Schedule II drug prescribed (e.g., 7 days of the prescribed quantity of the drug rather than an entire 30-day supply). Such “partial filling” of Schedule II drug prescriptions reduces the potential of opioid addiction for the patient and the risk of diversion for others. Federal law has been changed to permit partial filling of Schedule II drugs, and Massachusetts and Maine have passed laws to allow for partial filling of Schedule II drugs. ASHP advocates that other state legislatures and boards of pharmacy amend pharmacy practice acts and rules to allow for partial filling of Schedule II drugs, and that such laws and rules be made consistent across states. However, ASHP has concerns about quantity and duration limits applied across the board and not on an as-needed basis. ASHP believes that each patient must be evaluated individually and that polices that allow for partial filling are not indiscriminately applied as an across-the-board mandatory rule. ASHP encourages public and private payers to recognize the additional burden placed on patients and pharmacies by partial filling and to minimize these burdens when possible, including providing appropriate reimbursement for pharmacist activities. ASHP encourages pharmacists to serve as patient advocates by educating prescribers and patients about options for filling prescriptions for Schedule II drugs.