IPLEDGE program
Effective 3/1/06, the iPLEDGE web site must be utilized by U.S. dermatologists for isotretinoin ("Accutane") prescribing.
Isotretinoin is the drug of choice for severe cystic acne vulgaris which causes often causes scarring and depression from disfigurement. There is nothing else that works like it! Unfortunately, because of a new government program (“iPLEDGE”), getting the drug has become next to impossible. The doctor prescribes the drug, enters all the patient information on the iPLEDGE website, then the pharmacist interviews the patient about her sexual practices and checks the website before filling the prescription. A major problem is the website; physicians can not edit it to correct misinformation or mistakes like “the patient is inactive.” Problems are universal and take days to correct, if you are lucky!
IPLEDGE is a "risk management" internet program which was designed by the FDA (Food and Drug Administration) to decrease the chance of pregnancy while on this drug. It supposedly keeps the drug available, but the requirements to get it are so intrusive, bewildering, and byzantine, that no one can get pregnant while on it because no one will be able to get it! Obviously, a website has nothing to do with pregnancy prevention anyway.
It will be easier to get a firearm, an abortion or thalidomide, than to obtain this safe and important medication. This program requires the pharmacist, the physician, and the patient to get online, answer personal and sensitive questions about the patients' sexual practices, urine tests, and menstrual cycles to a faceless governmental confessor, all according to a very tight schedule, just so that a patient may have the privilege of having their acne treated. If anything does not completely comply with this morass of requirements, the initiation of the prescription not only fails but is locked out for another 30 days. That thirty days is a lot a of time to an acne sufferer. Doctors are faced with choosing to help their patients and suffer financially by this time-consuming quest, or simply not prescribing the drug. Also, pharmacists have all they can do right now trying to comply with Medicare part D. Patients have to choose between privacy or treatment, and it is becoming harder to find doctors to prescribe this drug because of difficulty with the web site.
On the iPLEDGE website, physicians lack the ability to “edit” information about their patients in order to allow the pharmacist to dispense the drug. Help is a phone call away, with waits “on hold” of easily 2 hours or more.