Good news for New Yorkers who want freedom of choice to fill their prescriptions at pharmacies located where they are more affordable: in other countries. There is now an explicit exception to the electronic prescription (e-prescribing) law in New York that permits paper prescriptions to be filled in other countries. I’m sorry we didn’t catch this earlier, but here it is now. As of January 2017, according to the NY State Department of Health, one exception to e-prescribing, which allows a provider to write a paper prescription, is when the medicine is: 

“…dispensed by a pharmacy located outside the state, outside the country, or on federal property, including and not limited to the following examples; Veterans Administration, West Point, Fort Drum, and Indian Reservations;”

When e-prescribing became mandatory in NY, people had a hard time obtaining paper prescriptions. This was not just an inconvenience. It was a threat to their access to affordable medicine. In our country, it’s sometimes imperative to shop around and find the pharmacy that charges the lowest price in our neighborhood – or in another country. This development should be very helpful to people looking to shop around.

NY Won’t Interfere in a Patient’s Decision to Order Meds from Abroad

I have to admit, I’m surprised that NY unambiguously mentions foreign pharmacies. It’s very cool. The old exceptions list noted out-of-state but not foreign pharmacies. No, this doesn’t make personal drug importation lawful in NY. It’s the federal government, not states, that creates regulations for interstate commerce and international trade, and— while the law is highly complicated – personal drug importation is prohibited under most circumstances.

It does mean that New York State healthcare providers will not interfere in a patient’s personal decision to import lower-cost medicine from pharmacies outside the U.S. that require a valid prescription.

So, if you live in NY, go to this page on the state’s website, and print it out before visiting your provider to show that they can write you a prescription.

History of Misuse of Paper Prescriptions

Paper prescriptions were often misused by people addicted to prescription narcotics and other controlled substances.

As a part of numerous steps by New York to curb illegal and/or dangerous prescribing of prescription narcotics, such as the I-STOP provisions, the state mandated the strictest e-prescribing law in the country, which became effective on March 27, 2016. A headline in the NY Times from 2016 says it all: “The End of Prescriptions as We Know Them in New York.” The article stated:

“New York is the first state to require that all prescriptions be created electronically and to back up that mandate with penalties, including fines and imprisonment, for physicians who fail to comply.”

After e-prescribing became mandatory in New York State, PharmacyChecker began hearing from New Yorkers that weren’t able to get paper prescriptions from their doctors so they could order from foreign pharmacies. So, we did some research and found that there were exceptions permitted for writing paper prescriptions. Unfortunately, those were not clear, and prescribers were telling patients “no” – wrongly informing them that paper prescriptions were illegal. This was especially frustrating for people not seeking addictive prescription drugs, but ones to treat conditions such as asthma, diabetes and heart disease.

We blogged about and tried to communicate just before the law went into effect that as long as providers reported it to the Department of Health, they could write paper prescriptions. Basically, the old policy required a prescriber to notify the NY Department of Health if he or she made an exception. The new policy just requires the prescriber to make a note of it in the patient’s record.

New York can still do better. This FAQ, which was updated after the new policy of January 2017, says there are exceptions to e-prescribing but doesn’t state what they are or even link to them.

We will try and ask NYS to update that information.

E-prescribing has helped maintain better recordkeeping and certainly has minimized misuse of prescriptions to obtain addictive drugs. Not to mention the fact that e-prescriptions are easier to read than doctors’ handwriting! On the other hand, e-prescribing has limited patient choice, which makes it harder for consumers to find a pharmacy with affordable drug prices.