NCPA Controlled Substances Access Survey Results January Key Highlights

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1 NCPA Controlled Substances Access Survey Results January 214 NCPA surveyed our members in December 213 regarding pharmacy access to controlled substances and received over 1, responses. These survey results provide important information about access to controlled substances in the independent community pharmacy setting, which dispenses nearly 4% of all retail prescriptions. Many pharmacies are increasingly unable to procure controlled substances, which is a great concern for patients who need these medications. NCPA is working to better understand the prevalence of this situation and its impact on patient access. Key Highlights Approximately 75% of respondents experienced three or more delays or issues caused by stopped shipments with their controlled substance orders, over the past 18 months. On average, 55 patients-per-pharmacy were impacted by these delays. 89% of impacted pharmacies received no advanced notice of the delay; they only found out when their order arrived and included just non-controlled substances. 6% said the delays in receiving these requested medications lasted at least one week. 67.9% were unable to procure controlled substances from an alternate source, such as a secondary wholesaler. Most reported having to turning patients away and referring them to a local competitor.

2 What schedules of controlled substances do you dispense? Controlled Substances Dispensed Schedule 2-5 Schedule 3-5 only Schedule 2 only Have you ever experienced delays or issues with stopped shipments with your controlled substance orders? In the past 18 months how often have you experienced delays or issues with stopped shipments with your controlled substance orders? Delays or Issues with Stopped Shipments Yes No How often Experienced Delays or Issues Three or more times Once Twice 2

3 Approximately how long were shipments stopped each time? Length of Stopped Shipments Several days One week Two weeks Three to four weeks Over a month What types of products were involved in stopped shipments? Products of Stopped Shipments 48 Finished product Both Bulk active pharmaceutical ingredients 6 What schedules of controlled substances were involved in stopped shipments? Controlled Substance Schedules involved in Stopped Shipments Schedule II -V Schedule II only Schedule III -V only

4 How much advanced notice were you given before shipments were stopped? Advanced Notice Provided Were you given reasons for why shipments were stopped? None 1-3 days 3-5 days Over 1 week 5-7 days Were Reasons Given for Stopped Shipments Yes No Were you able to procure controlled substances from an alternate source of supply? Procure Controlled Substances from Alternate Source of Supply No Yes 4

5 Overall, how many of your patients have been impacted by the fact you were unable to procure controlled substances? Which of the following situations have you encountered when there are barriers to procurement of a controlled substance product? Which of the following potential mitigating factors apply to your practice area and the patients you serve? Procure Controlled Substances from Alternate Source of Supply Fewer than or more Situations you Encountered when Procurement was not Possible 613 Turn a patient away and refer to a local competitor Contact a prescriber to A local competitor was notify them and request unable to procure as well an alternate therapy Mitigating Factors that Apply to your Practice Area and Patients Higher number of pain management specialists 36 Located near hospital Large number of Hospice, palliative care patients Large number of Cancer patients 5

6 Which of the following categories describes the majority of services you provide? Majority of Services you Provide 4 2 Community/Retail Pharmacy 172 Compounding Pharmacy Services 1 Home Infusion Services 96 Long-term Care Pharmacy The survey included an open-ended section in which community pharmacists shared hundreds of observations, including the following: It is a shame to watch an arthritic 85-year-old do without. This situation has literally brought customers to tears in our store. I fully understand the diversion and abuse of these powerful chemicals. I agree that something must be done, but to deny pain management to deserving individuals is inhumane at best. We have to find a way to curb the abuse and still provide relief from pain for those truly suffering. We turn away patients on a daily basis that I am sure are legitimate patients with legitimate prescriptions with legitimate issues requiring pain management. I am one in a long line of pharmacies that turns these patients away because of the limits on what I can dispense monthly. A few cancer and pain patients who really need their meds went without it for a few days. Has happened too many times. We try to scrutinize all controlled substance prescriptions, but are made to feel like criminals when trying to service our patients. 6

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