New York Residents with Chronic Pain Deserve Affordable Treatments While Curbing Abuse

New York Residents with Chronic Pain Deserve Affordable Treatments While Curbing Abuse

by Shaina Smith

shaina-smith

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.

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Authored by: Shaina Smith

There are 14 comments for this article
  1. BL at 9:40 am

    Joy, the DEA reduced the Schedule II active ingredients they gave manufacturers for 2017. ADHD medications and opiates are both Schedule II.

    It is a good idea for those that take Schedule II medications regularly to put some back every month so they won’t be without any medications when they aren’t able to get them towards the end of the year, if not sooner.

    https://s3.amazonaws.com/public-inspection.federalregister.gov/2016-23988.pdf?utm_campaign=pi%20subscription%20mailing%20list&utm_source=federalregister.gov&utm_medium=email

  2. Joy at 7:39 pm

    My nightmare began with the “shortages” after Obama’s “healthcare” Reform Act. I have co-occurring diagnoses of both ADHD and Chronic pain. After 12 years of being on the best generic ADHD med, it suddenly disappeared, [I had the script, but no pharmacy had it] After months of chaos, I found my script in a town 2 hours away, received it for a month and it “disappeared” again. Then, my opiate pain meds “disappeared w/o warning or notice. The ADHD med is so misrepresented and unrecognizable to be only toxic enough-to incur 4 doctor visits, where I am loaded with heavy metals like Cadmium.
    One “version of Oxycodone almost gave me an aneurysm, the other headaches, a sleep-deprivition component added to it.
    I am not the only one. I have written letters, contacted N.Y. Human Rights Watch, called disability advocates, and never received a call back. This is a “Holocaustic” TORTURE CAMPAIGN, nothing else can describe this experience for so many of us. I am grateful for the protests, [first time in American History]. The Government will not give me “The Last Option”, I will do this myself if need be. I feel like I live in NAZI GERMANY, only with the dark abuse of technology.

  3. Robert at 6:39 am

    I do not see legislation limiting out of pocket costs as a solution (at the cash register, in other words). Where do we think the insurance company gets the money to cover a prescription that costs 100s (or 1000s even) a month? Do they have money trees? Not mine – my employer was self-insured – meaning my employer cut a check to the insurance company every week to cover the claims the insurance company had paid out. I am not interested in my employer and I having to spend $500+ a month on a patented ADF when inexpensive, generic morphine cost a pittance and works just as well. I did not get a pay raise for the last 8 years of my employment with my last employer – largely because expenditures on health care went from ~4-5k per employee to more than $14k per employee. And addiction is a red herring. Don’t forget . . most people who use even illicit drugs do not have a problem. They vast majority never become addicted. They work, pay taxes, mow the lawn, volunteer. Some of them even become President of the United States.

    I am sick of hearing chicken little run around hysterically proclaiming that we are in the midst of the worst epidemic, public health emergency, etc. in the history of our nation. It is absurd. Again, where do we think the money is going to come from? Insurance companies have to make a profit to remain in business. They do not have money trees. Nearly 1 of every 5 dollars spent in this country is spent on health care. And there is no free lunch – that money is coming out of our pockets whether it be in the form of higher copays/deductibles, or reduced income/lower standard of living.

  4. Christina at 12:53 pm

    There is not one size fits all solution. These deterrent meds have not had enough of a study on how they metabolize and break down threw the body. Couple good trials is all they need to put this crap on the market and every politician thinks it solves everything without true scientific backing. Whom also do not know anything about pain that make these decisions. The people should votes on laws being it effects their treatment and future treatment. Pain medication has been around and because the DEA didn’t do their job of checking into Doctor office opening up to me has failed the people. We should hold them accountable for their hand in doing nothing untill it was so far gone that government getting involved was only way to stop the financial gain doctors were getting. Now there just turning rehabilitation in big profit.

  5. Mark Ibsen MD at 11:09 am

    Often, the abuse deterrent formulas don’t work as well.

    So, abuse is deterred.
    But
    Pain is still terrorizing.
    And
    Ultra rapid metabolizers need extended release meds more frequently than others, yet are not approved for taking them more frequently.
    Dilemma

  6. Sandrag at 8:36 am

    The only thing that will work from bottom up is preventive . Educate the young youth continue this education . People are working from top down …it’s not working.
    The DEA is looking at making money off this. Everything they touch they see money can be made for them and others. This is not for the people. Educate the young that where you make changes.

  7. Elizabeth Simonetti at 2:38 am

    this bill sounds reasonable- I pray it is passed

  8. PP at 7:38 pm

    What about the patients who cannot digest/absorb these abuse deterrent medications? I had HA MRSA, and half my stomach and intestines had to be removed. I have been in pain, compliantly on meds and on Medicare since 1994, and I’m not near 65 yet. This year the formulary puts my pain meds on tier 4, 94.00 each! They also now have limits per month. When I asked BC/BS of Florida about that, they told me that it was the DEA that did it to them! When I looked it up online, I found out that ALL the Medicare plans in Florida had put limits on THEMSELVES. That’s a deterrent alright, but then again, they never had to worry about me….

  9. Tim Mason at 6:52 pm

    I am with MichaelL on this one. The single largest risk to addiction is youth. With that being said, these deaths come from theft of drugs or diversion of prescriptions sold by scamming patients. These patients are fading fast as doctors catch them.
    Many of the opioid deaths are from first generation drugs. i.e. heroin, codeine
    If your city has a Right 2 Know website check it out and you will see what I am talking about.
    Also, many quickie markets sell a “busted” paper. They are in there as well.

  10. HJ at 6:12 pm

    Brand name copays are out of reach. I have been begging my asthma Doctor for asthma inhaler samples and can’t afford to take them as prescribed. I ration their use.

    And that’s only breathing. Big deal, right? Yeah.

    Most of us have comorbid health conditions.

  11. BL at 1:18 pm

    A drug being abuse-deterrent does not mean it cannot be abused. The Physician and Pharmacist Insert is clear about that. If abuse if a concern that does not mean that an abuse-deterrent will be prescribed.

  12. Kevin Starr at 9:44 am

    And how effective will this new ADF pill be? With break out pain? I say no to this. They already have Extended Release medication.

  13. MichaelL at 8:42 am

    The majority of overdose deaths are still due to illegally obtained drugs. The other side of the problem is the number of intentional overdoses, by people tired of the pain, of life or otherwise, is unknown.

  14. SandraG at 7:38 am

    This is a start. Big Pharma will try an stop this one.
    SandraG