Flurry of opiate bills
are passed by House
The U.S. House of Representatives recently passed 18 bills over two days that respond to the country’s opioid crisis. Earlier in the spring, the Senate passed a measure on the opiate problem, meaning a merger of elements from the two proposals will be required.
One of the House bills would authorize the creation of an interagency task force to review, modify and update best practices for prescribing opioids. Members of the task force would include representatives of federal agencies, pain advocacy groups and mental and behavioral health providers.
Another bill would require states that receive federal grants for child protective services to have laws or programs to ensure babies born to mothers addicted to opioids will be cared for safely when they leave the hospital.
Democrats offered an amendment to provide $600 million in emergency funding for the opioid bills. Republicans blocked the bill, saying funding will come when Congress passes its 2017 spending bills for federal agencies.
A recent statement from the White House noted that four in five new heroin users started out by misusing prescription opioid pain medications. “These trends will not change by simply authorizing new grant programs, studies and reports. Congressional action is needed to fund the tools communities need to confront this epidemic and accelerate important policies like training health care providers on appropriate opioid prescribing, an essential component of this effort.”
The statement from the Administration noted that without allocating the necessary resources to fund the proposals, the measures will not address the proliferating deaths and cases of addiction. The statement said,
While the Administration welcomes Congressional efforts to elevate the importance of combating the epidemic, the Administration is greatly concerned that, without the resources necessary to prevent opioid addiction and increase access to treatment and recovery services, H.R. 4641, H.R. 5046, and related bills that may be considered simultaneously would do little to help the thousands of Americans struggling with addiction.
Every day that passes without Congressional action to support the treatment needs of those suffering from opioid use disorder is a missed opportunity to help the many communities facing the prescription opioid and heroin epidemic. Data from the Centers for Disease Control and Prevention show that opioids – a class of drugs that includes prescription opioid pain medications and heroin – were involved in 28,647 deaths in 2014. In addition to high rates of prescription opioid deaths, there have also been alarming increases in deaths from heroin and synthetic opioids such as fentanyl.
The House’s package of bills will need to be reconciled with the Senate’s Comprehensive Addiction and Recovery Act, which passed in March. The Senate measure authorizes funds for various drug treatment and prevention programs for a wide range of people, including those in jail.
CARA expands prescription drug take-back programs and establishes monitoring to prevent over-prescribing of opioid painkillers. It would expand the availability of medication-assisted treatment, including in criminal justice settings, and would support treatment as an alternative to incarceration. The measure also calls for training and equipping first responders on the use of the opioid overdose-reversal drug naloxone.
Bill requiring health insurers
to cover abuse-deterrent meds advances
Legislation sponsored by Assemblyman Dr. Herb Conaway Conaway (D-Burlington), Assemblyman Daniel Benson (D-Mercer, Middlesex), Assemblywoman Nancy Pinkin (D-Middlesex) and Assemblyman Benjie Wimberly Wimberly (D-Bergen, Passaic) requiring health insurers to cover prescription pain relief medications designed to decrease abuse and addiction gained approval from an Assembly panel on June 2.
Specifically, the bill (A1833) would require health insurers to provide health benefits coverage for prescribed abuse-deterrent opioid analgesic drugs.
"As it stands now, deaths from opioid addiction are at epidemic proportions," said, a practicing physician. "Pain treatment, similar to other courses of treatment, can have side effects - including the risk of addiction. As a doctor, my goal is to reduce those risks and make the patient well. Removing the cost barrier to abuse-deterrent opiates will increase the prescribing and use of these high-tech drugs, which have significant potential to reduce dependency and overdoses. We as policymakers should be encouraging the widespread use of abuse-deterrent formulations to protect consumers and lower costs to the health care system. That's exactly what this bill achieves."
Abuse-deterrent opioid analgesic drugs are pain medications approved by the U.S. Food and Drug Administration to significantly reduce abuse by making them resistant to crushing, breaking or dissolution so that they cannot be snorted or injected for a quick high—reinforcing the extended-release deterrent mechanism.
The sponsors noted that following the introduction of abuse-deterrent extended-release oxycodone in 2010, dispensing of prescription opioid pain medication and prescription opioid overdoses both dropped by nearly 20 percent two years after this change according to an April study published in the Journal of the American Medical Association.
"Prescription painkiller abuse continues to be a major problem in our communities," said Pinkin. "Anything that can possible be done to slow the rampant abuse of prescription narcotics should be done. This bill is a good start."
Under the bill, the following insurers – health, hospital and medical service corporations; commercial individual and group health insurers; health maintenance organizations; health benefits plans issued pursuant to the New Jersey Individual Health Coverage and Small Employer Health Benefits Programs; the State Health Benefits Program; and the School Employees' Health Benefits Program) – would be required to provide coverage subject to the following requirements:
1) require health insurers to provide coverage on the insurer's formulary, drug list, or other lists of similar construct, for at least one prescribed abuse-deterrent opioid analgesic drug product per opioid analgesic active ingredient;
2) Cost-sharing for brand name abuse-deterrent opioid analgesic drugs shall not exceed the lowest cost-sharing level applied to brand name non-abuse deterrent opioid drugs covered under the applicable contract; and
3) Cost sharing for generic abuse deterrent opioid analgesic drug products shall not exceed the lowest cost sharing level applied to generic non-abuse deterrent opioid drugs covered under the applicable contract;
4) An increase in patient cost sharing or disincentives for a prescriber or dispenser shall not be allowed to achieve compliance with the bill's provisions; and
5) Any prior authorization requirements or other utilization review measures for opioid analgesic drugs shall not require first use of non-abuse-deterrent opioid analgesic drugs in order to access opioid analgesic drugs with abuse-deterrent properties.
The bill was approved by the Assembly Health and Senior Services Committee, which is chaired by Conaway.
