Understanding EPCS
Prescription drug abuse and misuse has contributed to significant issues, including deaths from overdoses, in the US in recent years. In fact, in 2020, almost 92,000 individuals died from drug-involved overdoses, including prescription opioids. To help combat this issue, steps have been taken by the US Drug Enforcement Administration (DEA) and Congress to better regulate prescriptions. Electronic Prescriptions for Controlled Substances, or EPCS, is designed to help reduce fraud and error.
The opioid epidemic continues to impact the number of drug overdoses and deaths in the US. Drug overdose deaths involving prescription opioids rose from 3,442 in 1999 to 17,029 in 2017. From 2017 to 2019, the number of deaths declined to 14,139, followed by an increase to 16,416 in 2020.
Electronic prescribing, or e-prescribing, is preferred for the safety and security of controlled substances in particular. With e-prescribing, healthcare providers enter the prescription information electronics and securely transmit the prescription to the pharmacy using special software and connectivity to a transmission network.
The benefits of e-prescribing include:
- Improved health care quality and patient safety, by reducing medication errors and checking for drug interactions
- More convenient care, by allowing providers to electronically request prescription refills
- More convenient, cheaper, and safer prescriptions for doctors, pharmacies, and patients.
EPCS was introduced and became effective in 2010. What does EPCS stand for? It comes from the DEA Interim Final Rule titled “Electronic Prescriptions for Controlled Substances,” published in the Federal Register. The rule became effective on June 1, 2010.
The rule revised DEA regulations, providing practitioners with the option of writing prescriptions for controlled substances electronically. The regulations also permitted pharmacies to receive, dispense, and archive these electronic prescriptions. These regulations were an addition to, not a replacement of, the existing rules. The regulations provided pharmacies, hospitals, and practitioners with the ability to use modern technology for controlled substance prescriptions while maintaining the closed system of controls on controlled substances.
In 2018, Congress passed the Substance Use Disorder Prevention that Promotes Opioid Recovery and Treatment (SUPPORT) for Patients and Communities Act in an effort to address the growing opioid epidemic. As part of the legislation, all Medicare Part D providers were mandated to employ EPCS by 2021. What does EPCS stand for in this case? It is a way to help providers integrate prescription drug information into electronic health records (EHRs) more directly, improving patient safety and reducing diversion and fraud.
National estimates of physicians’ use of EPCS technology in 2019 from the National Electronic Health Record Survey revealed that:
- Among physicians that prescribe controlled substances, the proportion that use EPCS increased by 12 percentage points between 2017 and 2019.
- Physicians that prescribe controlled substances more frequently use EPCS at higher rates compared to physicians that prescribe controlled substances less frequently.
- Solo practitioners and providers in physician-owned practices used EPCS at lower rates compared to practices with multiple physicians and those owned by corporations or hospitals.
- The proportion of physicians in community health centers using EPCS increased from 26 percent to 61 percent between 2017 and 2019.
