The Delaware Division of Public Health (DPH), a division of the Delaware Department of Health and Social Services, is a nationally accredited public health agency recognized by the Public Health Accreditation Board for its outstanding dedication to driving change through innovation. DPH is committed to improving the quality of the lives of Delaware’s citizens by promoting health and well-being, fostering self-sufficiency, and protecting vulnerable populations. 

A person who is deaf, hard-of-hearing, deaf-blind or speech-disabled can call the DPH phone number above by using TTY services. Dial 7-1-1 or 800-232-5460 to type your conversation to a relay operator, who reads your conversation to a hearing person at DPH. The relay operator types the hearing person’s spoken words back to the TTY user. To learn more about TTY availability in Delaware, visit http://delawarerelay.com.

Department of Insurance will lead effort to rein in monopolistic behavior and excessive pharmaceutical costs

Insurance Commissioner Trinidad Navarro announced today that the Delaware Department of Insurance will begin the process of building and enforcing regulations regarding Pharmacy Benefit Managers (PBMs) as a new law goes into effect. The new authorities of the department will ensure consumer access to affordable medications and protect local pharmacies from the predatory behaviors exhibited by the PBM industry through measures of transparency and corporate accountability.

“Alongside members of the General Assembly, advocates, pharmacy representatives, and industry stakeholders, we have been working towards this goal for years. We have heard the voices of those who have had to travel hundreds of miles for their children’s medications. We have heard the plight of the local pharmacies, the way they have been financially devastated by PBM’s preference of their own chains. We have watched as other states were taken advantage of by these companies and cheered those states on as they took action to stop predatory practices. We have seen partners in this fight retaliated against by these companies, and we mourned as more and more neighborhood pharmacies had to close their doors,” said Insurance Commissioner Trinidad Navarro, referencing the work of the Pharmacy Reimbursement Task Force and other legislative initiatives and discussions. “Now, with these new powers, we say ‘No more.’”

HB 219, sponsored by Rep. Andria Bennett, Sen. Spiros Mantzavinos, Senate President Pro Tempore David Sokola, and Rep. Mike Smith, was passed by the General Assembly unanimously and recently became law, bringing Delaware’s oversight of the multi-billion-dollar industry on par with leading states.

PBMs act as intermediaries for prescription drug plans, influencing what medications will be covered and the costs of those drugs for both consumers and pharmacies. These companies bring in billions through manufacturer rebates, limiting generic drug offerings, and retaining negotiated savings, while costs for consumers continue to rise. The largest PBMs operate their own pharmacy chains, and their consolidated market power has, prior to this law, allowed them to pay unaffiliated pharmacies unsustainably low reimbursement rates – rates lower than it costs the pharmacy to dispense the drug to a consumer. PBMs’ move toward monopolization has contributed to waves of independent pharmacy closures across the nation, especially in rural, inner city, and under-served areas that already crave equity and access.

“I have worked on this issue for years and have seen firsthand how pharmacy benefit managers’ predatory practices have increased consumer costs while decreasing consumer access and driving out small, unaffiliated pharmacies. With healthcare cost emphasized throughout the pandemic, it is more important than ever to have these protections in place,” said Rep. Andria Bennett, the prime sponsor of HB 219 and chair of the Pharmacy Reimbursement Task Force. “This new law passed the General Assembly unanimously, and it did so because there are two things we all agree on: that the cost of prescription drugs is far too high, and that billionaire corporations should not be above the law.”

The new law aims to solve many issues of access and inequal treatment through use of the National Average Drug Acquisition Cost for pharmacy reimbursement, prohibiting inequal payments to unaffiliated pharmacies, and providing the Department of Insurance the ability to investigate PBMs, enforce consumer protection measures, and incentivize corrections through increased regulatory authority. In order to better understand PBM’s existing processes, the department recently began introductory Market Conduct exams on registered PBMs, known to be the first investigations of this kind in the nation. These initial examinations will not result in fines or enforcement actions, but will highlight areas for improvement, including those that are not compliant with the new law, and will require corrective action plans.

Rep. Mike Smith – a prime sponsor of HB 219 – stated, “This is an exciting moment for Delaware. This was a collaborative effort to support Delaware’s small, independent pharmacies and all Delawareans. At the end of the day, consumer protection won, and I’m proud of the work we did to bring accountability to PBMs.”

“Reducing prescription drug prices will directly improve the health and welfare of our neighbors,” said Sen. Spiros Mantzavinos, Senate prime sponsor of HB 219. “This new law will provide for greater oversight of the pharmacy benefit manager industry, allowing for more consistent prescription drug prices and ensuring expanded access to the medications Delawareans rely on. I am proud to have helped champion HB 219 alongside Rep. Bennett and look forward to Delawareans reaping the benefits of this expanded oversight.”

While independent pharmacies faced retaliation from the multi-billion-dollar giants, including through costly audits, they continued to advocate for change. Now, they are celebrating the new law and the protections it holds for their customers.

“The true beneficiaries of this new PBM oversight will be the patients. They have always deserved health care that is accessible, affordable and transparent – not barriers to care, higher costs and excuses while PBMs lined their pockets. Having the Delaware Insurance Commissioner’s office oversee PBMs will greatly assist underserved and vulnerable populations who struggle to afford their medications, and who have experienced barriers to patient care,” explained Kevin Musto, R.Ph., FAPhA, an independent pharmacist.

The Delaware Pharmacy Society also shared their enthusiasm for the new law. “We are tremendously delighted with enactment of HB 219, which increases transparency and equity in pharmacy benefit management. It is our belief that this law will result in increased access to health benefits for Delawareans, provided at the most accessible health care providers – pharmacies. This law makes Delaware a pioneer in controlling health care costs,” they stated.

In the coming months, the Department of Insurance will draft relevant regulations, receiving input from stakeholders during that process. After draft regulations are developed, they will be published, and the public will have 30 days to comment.

Delaware will hold its 20th Prescription Drug Take-Back Day on Saturday, April 24, 2021. Delawareans can discard their expired or unused medications at 26 locations statewide between 10:00 a.m. and 2:00 p.m.

Organized nationally by the Drug Enforcement Administration (DEA), National Prescription Drug Take-Back Day is operated locally by the Division of Public Health (DPH). The twice-a-year event is aimed at reducing the risk of prescription medications being diverted for misuse, and has resulted in nearly 100,000 pounds of medication being collected in Delaware since 2010. Properly discarding unused medications is an important part of the ongoing effort to address the nationwide opioid epidemic. Doing so, reduces the risk of addiction by keeping prescription medications out of the hands of people who may misuse, abuse, or sell them, and helps reduce the risk of drug overdoses.

“The prescribing of opioids for pain and the abundance of drugs in our medicine cabinets and communities, have been a strong force behind the opioid epidemic,” said DPH Director Dr. Karyl Rattay. “By turning in your prescription medications safely on Drug Take-Back Day, you can help fight the epidemic in Delaware while also making your home safer.”

According to the 2019 National Survey on Drug Use and Health, 9.7 million people in the U.S. misused prescription pain relievers, 4.9 million people misused prescription stimulants, and 5.9 million people misused prescription tranquilizers or sedatives in 2019. The survey also showed that a majority of misused prescription drugs were obtained from family and friends, often from the home medicine cabinet.

Since January 1, 2021, there have been 102 suspected overdose deaths in the state. Preliminary estimates for 2020 indicate 446 overdose deaths across Delaware, an increase of 3.5 percent from the 2019 total of 431 deaths, according to the Delaware Division of Forensic Science.

In addition to the sites participating in April’s Drug Take-Back Day activities, there are 28 permanent medicine drop-off locations across the state available year-round. Six of Delaware’s permanent drop-off sites are in Walgreens pharmacies and the other 22 are located in local law enforcement agencies. For a list of permanent collection sites, visit https://www.helpisherede.com/Get-Help/Prescription-Drug-Drop-Box.

On Drug Take-Back Day, medications for disposal must be in a container such as a pill bottle, box, blister pack, or zipped plastic bag, with personal information removed. Liquid medications must be in their original containers. Needles, aerosols, biohazard materials, medical equipment and batteries will not be accepted.

Delaware’s Drug Take-Back Day sites for April 24, 2021, from 10:00 a.m. to 2:00 p.m. are:

New Castle County:

• Christiana Surgicenter, Christiana Hospital, 4755 Ogletown-Stanton Road, Newark
• Wilmington VA Medical Center, Main Entrance Circle, 1601 Kirkwood Hwy., Wilmington
• New Castle County Airport, 151 N DuPont Hwy., New Castle
• Delaware City Police, 407 Clinton St., Delaware City
• Newark Police Department, 220 S Main St., Newark
• Delaware State Police, Troop 2, La Grange Parkway, Glasgow
• Middletown Police Department, 130 Hampden Road, Middletown
• Delaware Department of Justice MFCU/Cadia Healthcare Silverside, 3322 Silverside Road, Wilmington

Kent County:

• Dover Airforce Base, Dover Commissary, 268 Galaxy St., Dover
• Rite Aid, 1580 S. Dupont Hwy., Dover
• Dover Police Department, 400 S Queen St., Dover
• Delaware State Police, Troop 3, 3759 S State St., Dover
• Felton Police Department, 24 E Sewell St., Felton
• Milford Police Department, 400 NE Front St., Milford
• Polaris Healthcare and Rehabilitation Center, 21 W. Clarke Ave., Milford

Sussex County:

• Laurel Police Department, 205 Mechanic St., Laurel
• Milton Police Department, 101 Federal St., Milton
• Delaware State Police Troop 4, 23652 Shortly Road, Georgetown
• Lewes Ferry Terminal, 43 Cape Henlopen Drive, Lewes
• Lewes Police Department at Lewes Board of Public Works, 129 Schley Ave., Lewes
• Delaware State Police, Troop 7, 19444 Mulberry Knoll Road, Lewes
• Rehoboth Beach Police Department, 229 Rehoboth Ave., Rehoboth Beach
• Ocean View Police Department, 201 Central Ave., Ocean View
• Selbyville Police Department at CVS, 36252 Lighthouse Road, Selbyville
• Selbyville Police Department, 1 Church St., Selbyville
• Delaware State Police Troop 5, 9265 Public Safety Way, Bridgeville

Find the most complete and up-to-date locations on the DEA’s Drug Take-Back Day website at: takebackday.dea.gov.

For more information about proper disposal of prescription medications, visit https://www.helpisherede.com/Get-Help/Prescription-Drug-Drop-Box#symptoms-of-an-overdose.

If you or a loved one is struggling with addiction in Delaware, call Delaware Hope Line at 833-9-HOPEDE. To search online for treatment and recovery services in Delaware or nearby states, visit HelpisHereDE.com.

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Anyone who is deaf, hard of hearing, Deaf-Blind or speech disabled can contact DPH by dialing 711 first using specialized devices (i.e. TTY, TeleBraille, voice devices). The 711 service is free and to learn more about how it works, please visit delawarerelay.com.

The Delaware Department of Health and Social Services is committed to improving the quality of the lives of Delaware’s citizens by promoting health and well-being, fostering self-sufficiency, and protecting vulnerable populations. DPH, a division of DHSS, urges Delawareans to make healthier choices with the 5-2-1 Almost None campaign: eat 5 or more fruits and vegetables each day, have no more than 2 hours of recreational screen time each day (includes TV, computer, gaming), get 1 or more hours of physical activity each day, and drink almost no sugary beverages.

DOVER, DE – All Delaware prescribers and pharmacists can now integrate their electronic health record and pharmacy management systems with the state’s prescription monitoring program (PMP), the Delaware Division of Professional Regulation has announced.

The integration will be via Appriss Health’s PMP Gateway solution.

Appriss Health has delivered PMP services for the Delaware Division of Professional Regulation since 2017. The system manages more than 16 million controlled substance prescriptions and currently has more than 7,800 users.

The Delaware Division of Professional Regulation is covering all fees associated with the integration service to ensure broad adoption and help providers meet state mandates and policies regarding the prescribing of controlled substances.

“Delaware currently has the second highest drug overdose death rate in the United States, and the ongoing opioid crisis has created a colossal challenge for the state’s behavioral health treatment providers,” Delaware Prescription Monitoring Program Administrator Jason Slavoski said. “This statewide partnership with Appriss Health improves our PMP’s efficacy to help mitigate the opioid epidemic in our communities.

Through PMP Gateway, all providers throughout the state will have easier access to new resources and PMP information within their clinical workflow. This integration helps to enhance timely clinical support decisions and improve patient care and safety for all Delaware residents.

The statewide integration of PMP data into electronic health records (EHR) at the point of care increases the ease of access and use of prescription information to help healthcare providers make critical clinical decisions, including the prescribing and dispensing of controlled substances, as well as patient care and safety.

Prior to this integration initiative, Delaware prescribers had to log in to separate systems to query patient information, which took important time away from patient care. Now, the EHR will automatically initiate a patient query, which will return the patient’s controlled substance prescription records directly within the clinical workflow inside the EHR.

“Wide adoption of prescription monitoring information into clinical workflow can effectively identify, prevent, and manage potential problems with prescription drug addiction,” said Appriss Health President Rob Cohen. “We’re honored to partner with the Delaware Division of Professional Regulation to provide healthcare providers with enhanced tools for early intervention of substance use disorder and improved outcomes.”

Media Contact:
Michael Chesney
Delaware Department of State
302-577-8472
michael.chesney@delaware.gov

DOVER, Del. – The number of prescriptions for opioid medications in Delaware, as well as the total quantity of opioids dispensed, have dropped significantly in the 12 months since the Department of State enacted stricter prescribing regulations to help combat the opioid crisis statewide.

Statistics from the Division of Professional Regulation (DPR), which licenses controlled substance prescribers, show 14 percent fewer prescriptions for opioids were written by Delaware practitioners in the first quarter of 2018 compared to the first quarter of 2017. The Division also reports an 18-percent decline in the total quantity of opioids dispensed to patients over the same period.

“The opioid epidemic continues to ravage families across our state and our nation, but numbers like these show that the public policies we have put in place are having a positive impact,” said Gov. John Carney. “Health care practitioners in Delaware are partners in the shared effort to overcome this crisis, and we are seeing the results of changes in prescribing practices that will, without question, save lives across our state.”

The regulations, which took effect April 1, 2017, were designed to help prescribers more closely monitor and control the use of opioids by their patients. Six months after the regulations were implemented, statistics showed a 12-percent drop in opioid prescriptions and an 8-percent drop in the number of Delawareans receiving prescriptions.

“Fewer prescriptions written and fewer pills dispensed mean fewer chances for Delawareans to become addicted to opioids, or for these dangerous drugs to be diverted for illegal use,” said Secretary of State Jeff Bullock. “The regulations we enacted last year to put limits on opioid prescriptions seem to be working. We hope that in the long term these trends will mean a reduction in opioid addiction and deaths.”

Key elements of the regulations were aimed at controlling the amount of opioids given to new patients and aggressively monitoring their treatment. Except in special circumstances, first-time opioid prescriptions may not exceed a one-week supply under these rules. If further opioid prescriptions are deemed necessary, further action is required, including a physical exam with discussion of relevant patient history and the risks of opioids, and a check of the statewide Prescription Monitoring Program (PMP) database.

Data collected through the PMP is being used to track prescribing trends, document the impact of state efforts to address the opioid crisis, and identify practitioners whose prescribing histories send up red flags so that further outreach may be conducted.

“This is very good news. We hoped when we saw the first drop in opioid prescriptions after the new, more stringent regulations went into effect that those numbers would hold. This new report shows that they have not only held but improved,” said Attorney General Matt Denn. “This is further evidence that the Delaware regulations strike a good balance between making opioid drugs available to those who need them, and ensuring that they are prescribed in a responsible way and with appropriate monitoring and follow-up. Secretary Bullock deserves a lot of credit for investing the time to implement these new regulations, which will save lives.”

The regulatory reforms complement efforts organized across state government and in cooperation with Delaware’s community of public health organizations and anti-addiction advocates.

“There is no silver bullet for solving the addiction epidemic, but these new regulations give us one more tool to fight with,” said Lt. Governor Bethany Hall-Long. “Smarter prescribing practices undoubtedly save lives. As chair of Delaware’s Behavioral Health Consortium, I can promise we will continue to seek out approaches and use every tool we can to fight this epidemic and create stronger, healthier communities.”

The Behavioral Health Consortium, created last year by the General Assembly, is working to develop an action plan to prevent and treat substance use disorder, expand and improve mental health treatment and recovery and provide support for family members of loved ones who are battling addiction or coping with mental health issues.

The state’s Addiction Action Committee, also created by the General Assembly last year, is actively considering two other initiatives related to the prescription of opioid drugs: possible legislation requiring health insurance coverage of alternatives to opioids for pain management, and possible state responses to the co-prescription of opioids and benzodiazapenes.

“The regulations are an important component of the state’s overall plan to address the prescription opioid epidemic, and we are pleased to see the regulations are having the intended effect of reducing the number of prescriptions written,” said Division of Public Health (DPH) Director Dr. Karyl Rattay. “DPH and the Safe Prescribing Subcommittee of the Addiction Action Committee continue to partner with DPR to increase awareness among prescribers regarding the regulations, safe prescribing practices and alternatives to pain management.”

The Department of Health and Social Services also has boosted resources to help individuals struggling with addiction. Educational materials about identifying and fighting addiction can be found at HelpIsHereDE.com. Individuals who are suffering from addiction can also call DHSS’ 24/7 Crisis Hotline to be connected to treatment options. In New Castle County, call 800-652-2929; in Kent and Sussex counties, call 800-345-6785.