April 24, 2018
Committee on Ways and Means Releases Opioid White Paper
On Wednesday, April 11, the House Ways and Means Committee released an opioid white paper with suggested solutions to the opioid epidemic that it received as responses to the committee’s request for information. Last month, ASA submitted formal comments to the Committee in response to the request, proposing a variety of programs that could help address opioid misuse and abuse.
Of the 110 responses to the committee’s request, the majority came from members of the stakeholder community, such as ASA. Themes included better data tracking, treatment reimbursement and increasing access to Medication Assisted Treatment (MAT), increasing utilization and access to non-opioid treatments of pain, limiting prescriptions, and increased education of both providers and patients. Comments regarding treatment reimbursement indicated the importance of evidence-based treatment for opioid addiction and coverage for non-pharmacological pain management. Furthermore, commentators pointed out that Medicare and other payers often cover opioid treatments more than alternatives, thereby incentivizing opioid prescribing.
On the topic of prescribing limits, commenters where split in support of duration of supply and limits on second-fills. Some suggested physician groups work with Congress and CMS to develop guardrails while also ensuring certain populations (e.g., cancer patients and hospice enrollees) have access to needed medications. Many commented on the need for increased interoperability of state-to-state Prescription Drug Monitoring Plans (PDMPs) as well as greater access to data, as they are the "most promising state-level interventions to improve opioid prescribing."
Those commenting on provider education and communication were mostly in favor of increased provider education. Some encouraged wider development and implementation of the Extension for Community Healthcare Outcomes (ECHO) Project which supports peer-to-peer training for managing chronic pain and substance use disorders while also connecting rural providers with experts via telehealth technology. Many discussed a need for improved patient education regarding non-opioid options for pain management, risks of chronic opioid use, and treatment options for addiction and substance use disorders. Finally, other comments encouraged Congress to consider policies that increased proper drug disposal across all areas of patient care.
ASA will continue to work with Congress to find solutions to this epidemic and will support public-private partnerships to address the ongoing opioid abuse epidemic.