FILE - Missouri Legislature, 2021

A Color Guard enters the Missouri House chamber to open the 2021 legislative session on Wednesday, Jan. 6, 2021, in Jefferson City, Missouri. Only the more senior incumbent lawmakers were present in order to try to reduce the number of guests in the galleries as a COVID-19 precaution. Newer lawmakers were later added to the floor, filling up the chamber. 

(The Center Square) – Prescription drug monitoring programs (PDMPs) have been implemented in every state in the nation but Missouri, where a compromise measure to establish a state-run electronic database to track pharmaceuticals failed in 2020 but has re-emerged this year in Jefferson City.

The Senate late Monday “perfected” a proposed bill that would establish Missouri’s first statewide PDMP after a lengthy debate – an indication that the measure faces uncertain prospects when it is debated for a final time on the floor this week and when, or if, it is transmitted for House endorsement.

Senate Bill 63 would compile information about prescriptions for controlled substances in a centralized database, allowing medical professionals to see what has been dispensed by other providers.

The centralized database would be a PDMP, a state-run electronic database that collects data from pharmacies on substances and prescription drugs that are dispensed to patients.

SB 63 advanced after weathering a series of failed amendments that proponents successfully argued against, claiming the proposed changes would have imposed needless, costly restrictions on vendors and diluted needed support from doctors.

“A PDMP protects patients from lethal combinations,” said sponsor Sen. Holly Rehder, R-Sikeston, noting SB 63 is nearly identical to the compromise reached last year with senators that fell apart as the session adjourned.

SB 63’s PDMP would be a statewide replacement for a St. Louis-based PDMP that covers more than 80 percent of the state, Rehder said, and impose stricter restrictions on sharing data.

“It’s no longer a question if we have a PDMP,” she said. “We have a PDMP. It’s which one we want.”

SB 63 requires the state’s Office of Administration to create the Joint Oversight Task Force of Prescription Drug Monitoring to be comprised of members from the state’s Board of Registration for the Healing Arts, Board of Pharmacy, Board of Nursing and Missouri Dental Board.

Under SB 63, the task force shall enter a contract with a vendor to collect and maintain “patient-controlled substance prescription dispensation information” submitted by pharmacies statewide in the PDMP.

Each time a prescriber writes a prescription, a PDMP is utilized. PDMPs create a record for the patient so that healthcare providers can understand a patient’s full prescription drug history, under SB 63.

The pharmaceutical industry and pharmacy benefit managers (PBMs) are among those lobbying against the bill. Missouri’s conservative Republicans have been leery of establishing PDMPs, citing privacy concerns about patient data landing in the hands of law enforcement and insurers.

Sen. Mike Moon, R-Ash Grove, argued the vendor used by the St. Louis County Department of Public Health’s PDMP allows patient data to be shared widely, according to its user agreements., and has not proven to be effective in preventing over-prescribing or lowering costs.

Rehder said the state will contract with a vendor who agrees with the terms in SB 63, which restricts how information can be shared and disallows using the database to confiscate firearms or as probable cause for an arrest or search warrant.

Sen. Tony Luetkemeyer, R-Parkville, said it would be “impossible” for St. Louis County’s PDMP vendor to secure the state contract if it insisted on the same user agreement.

Sen. Rick Brattin, R-Harrisonville, wondered why there is such urgency in created a PDMP when the state’s opioid addiction statistics don’t vary from the other 49 states with the databases.

“Are we not the last remaining holdout state in the entire union?” he asked, questioning that If PDMP programs work “we should be the only state dealing with this epidemic.”