Alexandria, VA - August 31, 2010
The National Community Pharmacists Association (NCPA) has proposed that the U.S. Drug Enforcement Administration (DEA) create a new DEA registration sub-category within the "Institutional Practitioner" category in order to break a regulatory logjam that is delaying many seniors who reside in long-term care (LTC) facilities from getting timely access to medication to alleviate severe pain.
"The current system related to the lawful and prompt dispensing of controlled substances in long-term care facilities is broken," NCPA said yesterday in comments submitted to the DEA in response to the agency's request. "Recent changes in interpretation and enforcement of the Controlled Substances Act have made it more difficult to provide needed prescription drugs to LTC patients in a timely manner."
At issue is the DEA's revised interpretation of the Controlled Substances Acts (CSA), which has upended what for years had been accepted practice in long-term care facilities: utilizing nurses to relay information between the physicians and pharmacists, when a direct physician-pharmacist communication was impractical, to ensure the timely administration of critical medications used to treat residents' pain. DEA's current enforcement approach allows such "nurse as agent" exchanges in a hospital setting, but not in long-term care facilities.
In its comments to DEA, NCPA proposed that the agency promulgate a proposed rule to create a new sub-category of DEA registrant known as an "institutional facilitator" that would allow nurses to resume communicating valid prescriptions to the pharmacist so that the appropriate medicine is administered to the patient on a timely basis. NCPA suggested defining an "institutional facilitator" as "a long-term care facility licensed, registered, or otherwise permitted, by the United States or the jurisdiction in which it practices, to facilitate the administration of controlled substances to the end user in the course of professional practice."
"This solution provides for the common goal of ensuring timely medication access to patients in pain while recognizing the DEA's mission to enforce the controlled substances laws and regulations of the United States," NCPA said.
NCPA also told the agency:
The National Community Pharmacists Association (NCPA®) represents America's community pharmacists, including the owners of more than 22,700 independent community pharmacies, pharmacy franchises, and chains. Together they represent an $88 billion health-care marketplace, employ over 65,000 pharmacists, and dispense over 40% of all retail prescriptions. To learn more go to www.ncpanet.org or read NCPA's blog, The Dose, at http://ncpanet.wordpress.com.
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