Summary of Responses
The table below summarizes the responses to prescription fraud, the mechanism by which they are intended to work, the conditions under which they ought to work best, and some factors you should consider before implementing a particular response. It is critical that you tailor responses to local circumstances, and that you can justify each response based on reliable analysis. In most cases, an effective strategy will involve implementing several different responses. Law enforcement responses alone are seldom effective in reducing or solving the problem.
| Increasing the Risk of Detection | ||||
| ## | Response | How It Works | Works Best If... | Considerations |
| 1 | Informing doctors and pharmacists of fraudulent activity | Sharing information on offenders and scams through bulletins and mass communication increases the risk of apprehension, thereby deterring potential offenders | …the information is shared throughout the jurisdiction, and quickly | A means of networking/communication that reaches the most people possible (e.g., faxes or the Internet) should be used |
| 2 | Improving pharmacists’ screening of prescriptions and patients | Pharmacists act as “gatekeepers” by checking ID, verifying doctor information, and detecting suspicious behavior | …pharmacists are consistent in screening and report fraudulent activity to police | Takes time, effort, and experience, both for pharmacists and police |
| 3 | Educating the public about prescription abuse and fraud | Increasing the awareness of prescription abuse and fraud through local and national efforts allows more people to identify friends and family members engaged in fraudulent activity | …informational campaigns are multidisciplinary and target specific populations | Initiatives should provide statistics and other specific information (e.g., if the target group is youth, use youth-related data); can be resource-intensive |
| Increasing the Effort Required to Commit Prescription Fraud | ||||
| ## | Response | How It Works | Works Best If... | Considerations |
| 4 | Verifying prescriptions | Pharmacists do callbacks on phoned-in prescriptions and check doctors’ information, maintain a file of doctors, and dispense only a limited dosage until they can verify prescriptions | …pharmacists are consistent in the verification process, refuse to fill unverifiable prescriptions, and report suspicious activity to police | Takes time, effort, and resources |
| 5 | Employing security measures | Strategies include using tamper-resistant prescription pads, increasing the precautions the practitioner’s receptionist and answering service take, checking photo ID, and keeping prescription pads in a secure place, all increasing the difficulty for would-be offenders | …all security measures are consistently used, and fraud is not being committed internally (by employees of the doctor’s office) | Tamper-resistant pads can be costly; checking ID can be time-consuming; measures are ineffective against internal fraud |
| 6 | Prescribing drugs electronically | Direct transmission of prescriptions (via computer) from prescribers to pharmacists eliminates the problems of false phoned-in prescriptions, forged and altered prescriptions, and stolen prescription pads | …all pharmacists and prescribers in the jurisdiction are doing so | Cost of setting up systems and maintaining system security; getting buy-in from doctors and pharmacists; once implemented, very cost-effective and time-efficient |
| 7 | Creating or changing laws regarding prescription fraud | Specific, targeted laws make it easier to prosecute and convict offenders | …used in conjunction with other prevention and education efforts | Can be time- and resource-intensive; does not address the underlying problem |
| 8 | Maintaining a Prescription Monitoring Program | Tracking and monitoring prescription drugs aids in identifying patterns of problem behavior | …the program covers the drugs most often abused, and data are used proactively | Patient confidentiality; limited to only the drugs covered (which varies by state); cost of administering the program |
| Reducing Rewards to Offenders | ||||
| ## | Response | How It Works | Works Best If... | Considerations |
| 9 | Curbing distribution | Limiting the dosage or distribution of a drug reduces the opportunity for offenders to easily obtain large quantities of it | …focused on a particular problem drug or target group/region | There will always be exceptions: patients who need higher dosages or more frequent refills. |
| Removing Excuses | ||||
| ## | Response | How It Works | Works Best If... | Considerations |
| 10 | Facilitating compliance with the law | Programs such as drug treatment/ rehabilitation, Narcotics Anonymous, and Drug Court help to prevent repeat offenses | …used in conjunction with one another, there are consequences for nonparticipation, and offenders want to change | Resources are needed to ensure attendance and compliance with program rules |
| Removing Excuses | ||||
| ## | Response | How It Works | Works Best If... | Considerations |
| 11 | Using crackdowns | Police and/or medical boards target specific doctors or pharmacies to identify and curtail illegal activity | …the effort can be sustained for multiple people or pharmacies over an extended period | Extensive resources are required (and not generally available); without prevention measures in place, illegal activity will resume in the long term |
| 12 | Creating a prescription database | Pharmacies are able to verify patient information and monitor the number of prescriptions previously issued | …multiple—or all—pharmacies in the jurisdiction share the database | Cost of, and cooperation required for, implementing a networked system; patient confidentiality |