Expect a bill that will require doctors to have KASPER accounts, state drug policy director says

By Tara Kaprowy

Kentucky Health News

A bill is likely to be filed in the General Assembly that will require drug prescribers to have an account with the state’s drug monitoring system known as KASPER, news that was met with applause at the Different Faces of Substance Abuse conference yesterday.

“We’ve got to get KASPER out of the dark,” said Van Ingram, executive director of the Kentucky Office of Drug Control Policy. “Let’s take the guesswork out of this, and let’s use the data proactively.”

The bill would also propose using the Kentucky All-Schedule Prescription Electronic Reporting system to “mine data toward patients,” Ingram said, meaning analysts would look for people who have gone to an unusually high number of physicians or other providers within a short period of time, presumably to doctor shop for drugs.

Ingram said the KASPER Advisory Council, charged by Gov. Steve Beshear to identify prescribing thresholds in various medical disciplines, is discussing targeting providers who write 6,000 to 8,000 prescriptions a year — or the top 5 percent of prescribers. Kentucky’s Office of the Inspector General, which is in charge of maintaining KASPER, would find the information and refer it to the various licensing boards, which would then take appropriate action. The move is “quite a paradigm shift,” since it would be using data proactively, rather than reactively, Ingram said.

Since some providers aren’t in the same location for a year at a time, Ingram said the counsel will likely advise KASPER to be analyzed on a per-day basis, since many "problem prescribers are here for a day."

Dave Hopkins, KASPER program manager in the Office of Inspector General, said 6.6 percent of Kentuckians have used prescription drugs for non-medical purposes, second highest in the nation behind Oklahoma. He said 15,000 Americans die annually of overdoses involved in prescription drugs.

KASPER monitors all Schedule II, III, IV and V controlled substances that are dispensed in Kentucky, data that is required by law to be inputted by pharmacists and other dispensers. That translates to more than 11 million controlled substance prescriptions each year, Hopkins said.

To use KASPER, doctors and providers can request reports about specific patients and see their prescription history over the Internet. In 2004, 122,469 such reports were requested by providers. In 2011, that number jumped to more than 800,000. “When we started this in 1999, the Cabinet for Health and Family Services estimated there would be a maximum of 200,000 reports a year,” Hopkins said.

Still, while 95 percent of the reports were requested by prescribers, just 32 percent of them have KASPER accounts. And though pharmacies are required to input the information, just 26 percent of them have accounts.

Ingram would not say who would file a bill that would change those numbers, but he feels hopeful about changes to come. “I’m really excited for the first time in a long time that we’re going to get some things done,” he said.

Kentucky Health News is a service of the Institute for Rural Journalism and Community Issues, based in the School of Journalism and Telecommunications at the University of Kentucky, with support from the Foundation for a Healthy Kentucky.