by Shaina Smith
During the 2016 legislative session, there were several lawmakers across the nation looking at a quick fix to stop the disheartening number of deaths and misuse taking place as the result of abusing medications. While some sought out to generate bills that restricted opioid prescribing, others were turning to a new wave of technology to deter addiction rates.
This new promising technology, known as abuse-deterrent formularies (ADF’s), are a promising treatment option in that the pills cannot be crushed, melted or otherwise altered to achieve the powerful high that those with addiction disease desire. This makes opioid painkillers unattractive to those who may, unfortunately, abuse them without interfering with the pain management of compliant patients who take their medications as prescribed.
In New York, Senate Bill 6962 has recently been delivered to New York Governor Andrew Cuomo. Introduced by Senator Kemp Hannon, the bill has received support from his peers. The bill’s title, An Act to amend the insurance law, in relation to the use of abuse-deterrent technology for opioids as a mechanism for reducing abuse and diversion of opioid drugs is certainly a mouthful. Yet, the title captures the basics of the legislation’s intent.
If turned into law, SB 6962 would require an insurance carrier or health plan to provide coverage on its formulary for at least one abuse-deterrent opioid analgesic drug product per opioid analgesic active ingredient. It would also allow chronic pain patients the chance to afford their treatment, as the cost sharing for brand name ADF’s would not be allowed to exceed the lowest cost-sharing level applied to regular, brand name opioid medications.
Another financial protection within SB 6962 includes the exclusion of increasing patient cost-sharing or disincentives for prescribers. When it comes to delaying treatments for pain patients, the bill has that covered too. It clearly notes that a patient is not required to use a non-ADF product before being granted coverage for an ADF treatment option.
With several states in pre-filing mode and other states patiently waiting for the start of the 2017 legislative session, it is safe to say that ADF technology and legislation will not be going away. This year, some states such as Oklahoma and Virginia opted to pass a study bill. Others mulled over the concept of utilizing this form of treatment to curb abuse and a few, such as Florida and West Virginia, passed ADF legislation.
To date, only a handful of ADF medications have been approved by the U.S. Food and Drug Administration (FDA), which includes seven extended-release medications. Meetings, hearings, documents and studies have surrounded ADF’s since they were first introduced into the market a few years ago. Within the patient-advocacy arena, there are a few groups which have focused its activism on abuse-deterrent formularies.
U.S. Pain Foundation has requested that Governor Cuomo sign SB 6962 so that New York may become the next state to offer affordable access to abuse-deterrent opioids. Such legislation would help reduce the potential for opioid abuse without penalizing compliant patients who legitimately require opioid therapy. In addition to the organization submitting its letter to the Governor, U.S. Pain has crafted a petition New York residents can sign. If passed, the state would be ensuring patients with chronic pain have access to effective relief while reducing misuse by non-compliant patients.
Shaina Smith is Director of State Advocacy & Alliance Development for U.S. Pain Foundation. Diagnosed with various pain conditions, including Ehlers-Danlos Syndrome Hypermobility Type, Shaina utilizes her Journalism background to mobilize pain patient advocates and engage volunteers to participate in awareness programs.