PSE is the active ingredient in many FDA-approved nasal decongestant products, intended to relieve cold and allergy symptoms, but also can be used illegally in the manufacture of methamphetamine. For decades, policy makers and other stakeholders have restricted illegitimate access to non-prescription medicines containing PSE; this paper examines the implications of two different types of restrictions:

Real-time statewide electronic tracking systems to monitor purchasing patterns of PSE in an effort to effectively enforce federal retail limits and deny illegal transactions. As of January 2014, 30 states have adopted this approach.
Prescription requirement to obtain products containing PSE. As of January 2014, two states have adopted this approach.

This paper aims to identify the potential economic impacts of both approaches to controlling consumer access to PSE-containing drugs on major stakeholders, such as federal and state governments, healthcare providers, commercial health insurance plans and consumers, and where possible, to quantify those effects at a national level.

Avalere found that a prescription-only requirement, one such solution, would likely reduce PSE purchase for illicit use but also yield unintended burdens for a variety of stakeholders, including legitimate users of PSE products. Conversely, they found that real-time stop sale technology will minimize illicit PSE purchases and also avoid additional burdens on such stakeholders.

Successfully addressing the methamphetamine problem requires a multifaceted strategy that balances the need for consumers to have appropriate access to PSE-containing medication with concerns of law enforcement officials regarding the production and use of methamphetamine.

View Avalere’s full paper attached.