Update on CA e-Pedigree from Board of Pharmacy Meeting on Sept 7, 2011

On September 7, 2011 I attended a meeting of the full CA Board of Pharmacy, held in Los Angeles. One of the agenda items was an update on the state's e-Pedigree laws. There's not much new under the sun...and no new laws for the upcoming implementation of this program appear to be imminent. However, there are still some unresolved issues, mostly in the areas of technology, RFID and 2-dimensional bar code standards, the repository of the electronic pedigree database and other issues. So, some updates can be expected in the next couple of years.

CA's e-Pedigree is still going to be implemented on January 1, 2015...by that date manufacturers will be required to have an electronic product code on serialized containers for 50% of their products. The system will be phased in. Wholesalers are required to receive a pedigree starting on July 1, 2016 and on July 1, 2017 pharmacies will be required to receive a pedigree for prescriptions drugs that are received. After delays that have occurred every 2 years starting in 2007 and going to 2011, no further delays after 2015 are expected.

Executive Officer Virginia Herold and Deputy Attorney General Joshua Room gave an excellent overview presentation of the current state of pedigree statutes and requirements. A representative from the FDA also presented a talk on the federal government's support of CA pedigree model. Several reasons and justifications were given for the establishment of e-Pedigree. Among them are: drug diversion (increased in CA by 45% from 2008-2010), drug recalls, and drug counterfeiting.

However, there were some very apparent concerns. First, this board is not very knowledgeable in this area. The questions that were being asked by the members to the various presenters were questions that were asked and answered at the last update meeting on March 25, 2008. I was also at that meeting...it was disheartening to hear that not much progress or knowledge had increased. I believe that a better understanding of the drug distribution industry that they regulate is necessary.

Second, it was obvious to me and to most of the attendees that I talked with after the meeting...one of the primary goals of these laws is that they will be primarily used as an enforcement tool. They are also there to protect the public from counterfeit drugs, which was the primary reason that these laws exploded all over the country in the mid 2000's when counterfeiting became a huge 'business' and showed such dramatic increases. It believe that board members and staff sincerely have that as a goal, but drug counterfeiting was hardly discussed.

Instead, the first 2 reasons cited as benefits of e-Pedigree were diversion and drug recalls. Several cases of drug diversion by pharmacy employees, cargo thefts, and warehouse break-ins were cited. The infamous Chinese sourced Baxter Pharmaceuticals contaminated Heparin from 2008 was also discussed.

There a couple of problems with the logic used here. It is unknown how a bar code or an RFID tag on a bottle of Vicodin will prevent a pharmacy technician from diverting the drug from a pharmacy, it is also unknown how it will prevent a truck from being hijacked, and it certainly is not known how it would prevent a raw materials manufacturer in a foreign country from contaminating an Active Pharmaceutical Ingredient (which does not even require an e-Pedigree).

What will these laws do? When the board finds diverted or stolen dangerous drugs and/or controlled substances...an electronic product code on every bottle will tell them where it came from, who owned it and where it had been. I believe that brings a great deal of value to the industry. But it is not the initial reason that these laws were legislated. Back in 2004 and 2005, it was all about counterfeiting.

And, if these laws, once implemented, help capture criminals who divert, steal, contaminate or counterfeit dangerous drugs then I'm on board. They have my full support. More captures might result in less diversion, contamination and counterfeiting. But, let's call it what it is...it is an enforcement tool. The board is asking the industry to do much of the heavy lifting to assist in those enforcement efforts.

I welcome your comments,
Greg Evans, Pharm.D.