Mississippi lawmakers' decision to make all pseudoephedrine-containing drugs prescription-only will not prompt other states combating methamphetamine to do the same, the Consumer Healthcare Products Association predicts.

CHPA, which opposes making PSE prescription, says other states likely will not follow Mississippi because it places an added financial burden on the health care system, consumers oppose the measure, and less expensive electronic sales tracking systems are available.

The Mississippi Senate Feb. 2 voted 45 to 4 to require a prescription to obtain PSE-containing drugs, including popular OTC cold and allergy medicines, which are used in illicit methamphetamine production.

The Senate vote came days after the state House passed the same bill, which Republican Gov. Haley Barbour supports and intends to sign (¹ Also see "Wyden's Rx Pseudoephedrine Bill On Doorstep As States Continue Meth Fight" - Pink Sheet, 1 February, 2010.).

The bill "will make it more difficult to obtain ingredients for [meth, which] tears families apart and harms many of our consumers," Barbour said in a same-day release. "Meth labs threaten public safety, and I don't think there is any doubt we will see a drop in the number of labs in our state."

The bill, which will be effective July 1, follows a path Oregon blazed in 2005 to require prescriptions for all drugs with PSE (² Also see "Oregon Pseudoephedrine Law Requires Prescription Status By July 2006" - Pink Sheet, 22 August, 2005.).

CHPA has been in a similar position before, when it and other groups opposed the move of PSE products behind the counter. State-level momentum and pressure from retailers who faced a patchwork of legislation contributed to the passage of the federal Combat Methamphetamine Epidemic Act in 2006 (³ 'The Tan Sheet' May 1, 2006).

Now however, the impetus toward Rx appears to have less support than the behind-the-counter movement, and the trade group has electronic tracking as an alternative to offer.

Rx Switch Of PSE Unpopular With Consumers

Mississippi legislators' decision to move PSE drugs to Rx "flies in the face of consumer sentiment," CHPA spokeswoman Elizabeth Funderburk said in an e-mail. Other states' legislators likely would need to weigh this factor if considering a similar move.

A CHPA-funded survey of 350 Mississippi voters showed 61 percent opposed making all PSE-containing products prescription-only.

In a separate question, 75 percent agreed requiring consumers to go to the doctor before treating a cold or allergies to obtain a prescription for PSE "creates an unnecessary burden for law-abiding citizens who require these medications," according to the survey David Binder Research conducted between Jan. 13 and Jan. 23.

Switch Will Burden Health System, CHPA Says

Moving PSE to Rx status has significant financial consequences that might stop other states from following Mississippi's lead.

"Under this legislation, if only half of those Mississippians who rely on these medicines are now forced to visit a doctor to obtain a prescription for these cold and allergy medicines containing pseudoephedrine, the cost to the health care system would be over $7 million," said CHPA President Linda Suydam in a same-day release.

She added other financial impacts include a loss of $500,000 in sales tax revenue and "notable cost increases" to the state's Medicaid program and state employee and retiree programs.

"In a time of economic scrutiny, this option is counterproductive in addressing the current crisis in health care delivery," Suydam said.

E-Tracking Is A Less Expensive Alternative

An electronic-tracking system for OTC drug sales, including PSE, is "a more effective, less-costly alternative ... to fight domestic methamphetamine production while maintaining consumer access to these medicines," Suydam said.

Recognizing that states are strapped for funds, CHPA offers the National Precursor Log Exchange system for free to states to electronically track purchases of nonprescription ephedrine or PSE products (⁴ Also see "Industry Goes On Offensive Against Prescription Pseudoephedrine Trend" - Pink Sheet, 26 October, 2009.).

Since Oregon's PSE law took effect, eight other states that considered switching PSE to Rx-only opted instead for electronic tracking - a trend Funderburk says demonstrates other states will not likely follow Mississippi.

Most recently, Indiana legislators passed a bill Feb. 2 requiring retailers to electronically submit sales of ephedrine and PSE to a statewide tracking system. The bill also requires retailers that sell ephedrine and PSE to tell consumers they can buy only a maximum of 3.6 grams of ephedrine or PSE in one day or 9 grams in 30 days.

Other states considering electronic tracking requirements include California, Florida, Georgia, Mississippi, New Jersey, Pennsylvania, Tennessee and Washington.

Arkansas, Kentucky and Oklahoma already require e-tracking of PSE purchases statewide. Iowa, Illinois, Kansas, Louisiana and Missouri require tracking but have not implemented it yet.

According to CHPA's poll of Mississippi voters, 66 percent support an electronic tracking system that would require consumers buying decongestants with PSE to sign an electronic log that would instantly update how close consumers are to the legal limit, the trade group said.

CHPA argues that with prescription status, meth labs will still be able to procure PSE via "smurfing," or collecting small quantities from multiple sources - in this case doctors. Without the electronic tracking system, those smurfers might not be caught.

In addition, 81 percent of respondents agree that electronic tracking "will be a huge help to law enforcement, allowing them to find criminals and help shut down illegal meth labs," according to CHPA.

Opposition To E-Tracking PSE Sales

Not everyone agrees that electronic logs are a better option than prescription-only status.

Law enforcement officers in Kentucky, which participates in the NPLEx system, recently urged legislators to make PSE drugs prescription-only.

They say the Combat Meth Act does not work and noted the number of meth labs in Kentucky grew 55 percent in 2008 and 2009 (⁵ 'The Tan Sheet' Dec. 21, 2009, In Brief).

However, CHPA says e-tracking helped Kentucky law enforcement find labs that would have been undetected otherwise. Funderburk added that "some of Kentucky's hardest hit counties report that 70 to 100 percent of the labs they find are as a result of using e-tracking."

Sen. Ron Wyden, D-Ore., plans to introduce legislation that would make PSE drugs prescription-only nationwide. But Wyden has not introduced his bill yet, and the House does not have a similar bill filed.

Wyden originally proposed the bill last year, and claimed such a move would greatly reduce meth lab incidents, as demonstrated in Oregon. The state saw a 90 percent drop in meth lab incidents to 18 in 2007 from 192 in 2005 when the state passed its PSE prescription bill.

- Elizabeth Crawford ( ⁶ e.crawford@elsevier.com )

Mississippi PSE Prescription Switch Will Not Start An Avalanche - CHPA

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