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Congress urged not to make pseudoephedrine medicine Rx-only

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ALEXANDRIA, Va. — As lawmakers amplified their call to crack down on methamphetamine production and abuse, the National Association of Chain Drug Stores highlighted pharmacy’s proactive efforts to tackle the problem and urged against requiring patients to get prescriptions for medicines with pseudoephedrine.

NACDS commented on the issue Tuesday in conjunction with a hearing held the same day by the U.S. Senate Caucus on International Narcotics Control, which is chaired by Sen. Diane Feinstein (D., Calif.).

The association noted that any congressional action should not focus on prescription-only approach to pseudoephedrine, the key ingredient in methamphetamine. A nationwide electronic system to track sales of these products would be more effective at crime-fighting and more patient-friendly than a move to prescription-only status for these products, according to NACDS.

"Our membership remains committed to working with law enforcement to address this ongoing problem in a manner that stops criminal activity while ensuring that legitimate consumers continue to have access to medications for treatment of colds, flu and allergies," NACDS said in a statement.

Pharmacies’ voluntary actions to help prevent illegal pseudoephedrine production and use include placing these medicines in areas of the store where access can be controlled; initiating sales limits; participating in theft-deterrent programs; participating in youth anti-methamphetamine education efforts; educating employees to help them identify instances in which these products may be purchased for illicit purposes; and working with law enforcement to report suspicious activities in stores.

NACDS also cited members’ cooperation with the Drug Enforcement Administration and state and local law enforcement officials since 1995 to stem the tide of methamphetamine production nationwide, as well as the association’s engagement with Congress to advance legislation.

As Congress mulls its course of action, NACDS stressed that moving over-the-counter pseudoephedrine products to prescription-only status "ultimately harms consumers, imposes unjustified burdens on the health care system, and creates additional cost burdens for public and private healthcare payers."

NACDS said a national electronic system for tracking pseudoephedrine sales would be preferable to a prescription-only solution but noted that "it is imperative that such a program be designed to include provisions that minimize safety risks and compliance burdens for retailers and consumers."

The National Community Pharmacists Association also urged lawmakers against mandating prescription status for all pseudoephedrine medicines. "Making pseudoephedrine a prescription product will have the detrimental effect of unreasonably burdening patients who rely on their local community pharmacists to provide timely access to beneficial OTC medications, including the counseling services that allow patients to make the right decision on which therapy will best suit their symptoms," the association stated Tuesday.

NCPA, too, pointed to an electronic tracking system as a potential alternative but said that solution would raise a number of concerns for independent pharmacists.

"When considering expansion of electronic tracking systems, it is imperative to realize the fact that approximately 35% of independent pharmacies do not have point-of-sale capabilities to log sales transactions and would have to utilize the Internet instead," NCPA noted. "This approach is oftentimes not conducive to pharmacy workflow and OTC sales."

Independent pharmacists also might be hard-pressed to shoulder the financial burden of deploying and maintaining the necessary technology. "Consideration must be given to the cost of implementation of an electronic tracking system on pharmacy operations," NCPA pointed out. "We expect the manufacturers would bear the full short- and long-term cost of developing, maintaining, updating and installing the systems in pharmacies. This has to be a long-term commitment and cannot be an unfunded mandate on community pharmacies."

Late last month, the Consumer Healthcare Products Association (CHPA) reported that Kansas plans to become the fifth state to implement the National Precursor Log Exchange (NPLEx), an electronic tracking system to prevent the illegal purchase of medications containing pseudoephedrine. Missouri earlier in March became the fourth state to adopt NPLEx, joining Kentucky, Illinois and Louisiana.

On Tuesday, CHPA urged Congress to amend and strengthen the federal Combat Methamphetamine Epidemic Act (CMEA) by requiring electronic tracking for all over-the-counter sales of cold and allergy medicines containing pseudoephedrine. The group stated that "e-tracking is the only solution that will immediately block illegal sales and prevent criminals from buying illegal amounts of pseudoephedrine to manufacture methamphetamine."

At a hearing before the U.S. Senate Caucus on International Narcotics Control, CHPA president Linda Suydam made a commitment on behalf of the industry to fund a national system and work with the retail community to expand the NPLEx system, which the association said is now being implemented in eight states that have passed e-tracking legislation.

"We are asking Congress to significantly improve the Combat Methamphetamine Epidemic Act by leveraging cutting-edge technology to block illegal pseudoephedrine sales nationwide," Suydam said in a statement. "Electronic tracking offers the best solution to reducing methamphetamine labs without imposing a costly and unnecessary prescription mandate. Our goal is to stop illegal pseudoephedrine sales while maintaining important over-the-counter access to the 15 million consumers who rely on these medicines each year."

According to CHPA, 10 states have enacted laws requiring retailers to use e-tracking for pseudoephedrine product sales, including Alabama, Arkansas, Illinois, Iowa, Kansas, Kentucky, Louisiana, Missouri, Oklahoma and Washington. In addition, attorneys general from Alabama, Kansas and Washington submitted letters to the caucus noting their support for e-tracking and urged consideration of e-tracking at the federal level, the association said, adding that it’s funding NPLEx in eight of these states to help retailers to comply with the new laws.

CHPA said two states, Oregon and Mississippi, make pseudoephedrine medicines available by prescription only.

*Editor’s Note: Article updated April 14 to include NCPA comment.


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