New state law requires electronic prescriptions for controlled drugs

New Hampshire has joined nearly 40 other states in addressing its opioid epidemic by requiring electronic prescriptions for controlled drugs with a few exceptions. Pharmacists, however, are not required to prove a requested exception is valid, and there are no penalties for violating the new law – at least not now. 

Instead, licensing boards will be able to track and investigate how many exceptions prescribers are requesting.

House Bill 143 was one of three pharmacy-related bills sponsored by Rep. Gary Merchant, a Claremont Democrat, signed into law this week. “It’s a lot easier to modify a written prescription than an electronic one,” he said. “We were trying to find one of the last few loopholes that people can use to fraudulently deceive a pharmacist. “

The other two new laws permit a licensed advanced pharmacy technician to administer a vaccine under a pharmacist’s supervision (House Bill 572) and allow pharmacists to provide nicotine cessation therapy (House Bill 479).

The Centers for Disease Control and Prevention reported in 2019 that New Hampshire had among the highest number of opioid overdose-related deaths in the country that year with 407. It also reported that in 2018, the most recent numbers available, prescription opioids were tied to 43 of New Hampshire’s 412 overdose deaths that year. 

States have been allowed to require electronic prescriptions for controlled drugs since 2010, and all New England states do, except for Vermont. The New Hampshire law takes effect in January. 

Prescribers are exempted when technology makes electronic prescriptions impossible; they are located out of state; and when the medication is a compound prescription for a hospice patient because the prescribing software does not work well with a mixed medication prescription. Veterinarians prescribing medication for a pet are also exempted, again because of software limits. 

Pharmacists are not required to verify that the prescription properly falls under one of the exceptions. Some states have attached penalties for those who violate the law. New Hampshire does not. 

Merchant said the law takes a “carrot versus stick” approach by giving prescribers and pharmacists time to adjust to the new requirement while allowing the licensing board to track exceptions. “If we see a lot of exceptions, hopefully the board will tackle it,” he said. “And if the board does (see abuse of exceptions), obviously we’ll go back and put the stick in.”