DAR File No. 42283

Health, Disease Control and Prevention, Health Promotion

Rule R384-210

Co-prescription Guidelines -- Reporting

Notice of Proposed Rule

(New Rule)

DAR File No.: 42283
Filed: 11/01/2017 01:17:22 PM

RULE ANALYSIS

Purpose of the rule or reason for the change:

The purpose of this rule is to establish scientifically-based guidelines for controlled substance prescribers to co-prescribe an opiate antagonist to a patient pursuant to Section 26-55-108 which was changed during the 2017 General Session with S.B. 258.

Summary of the rule or change:

This rule establishes scientifically-based guidelines for controlled substance prescribers to co-prescribe an opiate antagonist to a patient pursuant to Title 26, Chapter 55.

Statutory or constitutional authorization for this rule:

• Title 26, Chapter 55

Anticipated cost or savings to:

the state budget:

This rule contains scientifically-based guidelines for controlled substance prescribers to co-prescribe an opiate antagonist to a patient and provide education on overdose prevention to patients and/or the patient's household members when factors that increase risk for opioid overdose are present. There may be savings in preventing individuals from requiring treatment in an emergency department or in hospitalization but those costs are hard to measure.

local governments:

There may be savings in preventing individuals from requiring treatment in an emergency department or in hospitalization but those costs are hard to measure.

small businesses:

Some small pharmacies may see an increase in sales of naloxone kits due to the co-prescribing guidelines.

persons other than small businesses, businesses, or local governmental entities:

There may be savings in preventing individuals from requiring treatment in an emergency department or in hospitalization costs but those costs are difficult to measure. Some pharmacies may see an increase in sales of naloxone kits due to the co-prescribing guidelines.

Compliance costs for affected persons:

This rule provides scientifically-based guidelines on co-prescribing an opiate antagonist to a patient established by Title 26, Chapter 55, which will not result in any compliance costs for affected persons.

Comments by the department head on the fiscal impact the rule may have on businesses:

This new rule provides guidelines when a provider who prescribes a controlled substance should also co-prescribe an opiate antagonist. This is pursuant to S.B. 258 (2017). The guidelines are scientifically based. This new rule will have a fiscal impact due to increase in sales for pharmacies and for the payors of the prescriptions which is outweighed by the benefit to the patients.

Joseph K. Miner, MD, Executive Director

The full text of this rule may be inspected, during regular business hours, at the Office of Administrative Rules, or at:

Health
Disease Control and Prevention, Health Promotion
CANNON HEALTH BLDG
288 N 1460 W
SALT LAKE CITY, UT 84116-3231

Direct questions regarding this rule to:

• Trisha Keller at the above address, by phone at 801-538-6865, by FAX at 801-538-9134, or by Internet E-mail at trishakeller@utah.gov

Interested persons may present their views on this rule by submitting written comments to the address above no later than 5:00 p.m. on:

12/15/2017

This rule may become effective on:

12/22/2017

Authorized by:

Joseph Miner, Executive Director

R384. Health, Disease Control and Prevention; Health Promotion.

R384-210. Co-prescription Guidelines -- Reporting.

R384-210-1. Authority and Purpose.

This rule establishes scientifically based guidelines for controlled substance prescribers to co-prescribe an opiate antagonist to a patient pursuant to Section 26-55-108.

 

R384-210-2. Guidelines for the Issuance of a Prescription for an Opiate Antagonist Along with a Prescription for an Opiate .

(1) Co-prescribing guidelines are applicable when prescribing opioids.

(2) Clinicians shall consider offering a co-prescription for an opiate antagonist, such as naloxone, and education on overdose prevention to patients and the patient's household members and/or close contacts, especially when factors that increase risk for opioid overdose are present. These risk factors include:

(a) history of overdose;

(b) history of substance use disorder;

(c) underlying mental health condition that make a patient susceptible to overdose;

(d) risk for returning to a high dose to which they are no longer tolerant (e.g., patients recently released from prison);

(e) medical conditions, such as respiratory disease, sleep apnea, or other comorbidities that make a patient susceptible to opioid toxicity, respiratory distress or overdose;

(f) higher opioid dosages (greater than or equal to 50 MME/day); and

(g) concurrent benzodiazepine use.

(3) Clinicians shall consider offering a co-prescription for an opiate antagonist, such as naloxone, and education on overdose to persons in a position to aid someone who is at risk of overdose.

 

KEY: naloxone, opioid antagonist, co-prescribing

Date of Enactment or Last Substantive Amendment: 2017

Authorizing, and Implemented or Interpreted Law: 26-55