1. Short title This Act may be cited as the Analyzing and Leveraging Existing Rx Transactions Act of 2018 or the ALERT Act of 2018 . 2. Prescription Safety Alert System to help prevent abuse and misuse of prescription drugs The Federal Food, Drug, and Cosmetic Act is amended by inserting after section 505–1 of such Act ( 21 U.S.C. 355–1 ) the following new section: 505–2. Prescription Safety Alert System to prevent abuse and misuse (a) In general For the purpose of combating the national prescription drug abuse epidemic, the Secretary shall, with respect to covered drug products, establish and maintain an electronic system, to be known as the Prescription Safety Alert System, that— (1) reviews patient prescription and dispensing history through pharmaceutical claims data transactions described in section 1173(a)(2) of the Social Security Act and developed by a standard setting organization; (2) collects, maintains, and is capable of providing to dispensers, within a dispenser’s ordinary clinical workflow, information about a patient’s prescription and dispensing history; (3) delivers information about a patient’s prescription and dispensing history in summary form, that allows the dispenser to evaluate the risk of misuse, abuse, addiction, overdose, and drug-drug interactions associated with filling the prescription sought by a patient based upon such patient’s prescription and dispensing history for covered drug products; (4) provides to dispensers the information described in paragraphs (2) and (3) in real-time; (5) allows dispensers to obtain access to a patient’s prescription and dispensing history; and (6) requires dispensers as a condition on using such System to have a written use agreement with such System to— (A) allow such System to access required data elements about the dispenser’s patients to ensure that the prescribing and dispensing history of such patients is updated on a real-time basis in such System