Industry Supports New Federal Law Aimed at Curbing Opioid Epidemic

New federal legislation aimed at curbing the opioid crisis has received an outpouring of support from the pharmacy industry, including drug manufacturers, patient advocates, and professional organizations.^1-5

President Donald J. Trump signed the bipartisan legislative package into law Wednesday¹ during National Pharmacy Week.²

The law aims to reduce access to and the supply of opioids and expands access to prevention, treatment, and recovery services.¹

In attendance at the White House signing, Paul W. Abramowitz, PharmD, ScD (Hon.), FASHP, and chief executive officer (CEO) of the American Society of Health-System Pharmacists (ASHP), said that the legislation’s provisions aimed at treatment, recovery, training, and education for opioid use disorder (OUD) help fulfill a public health effort to address the opioid crisis.²

“Pharmacists can play a major role in solving the epidemic of opioid abuse and misuse, and ASHP looks forward to continuing to work with the White House, Congress, federal agencies, and states to pursue policies that further support the vital roles pharmacists play as patient care providers and as leaders in addressing the opioid crisis and ensuring that patients receive effective pain management,” he said in a statement.²

The SUPPORT for Patients and Communities Act (HR 6) was created to lead Medicaid changes, such as drug management programs for at-risk beneficiaries, additional drug review and utilization requirements, and coverage for medication-assisted treatment (MAT). The changes to Medicare will include stricter electronic prescribing and postsurgical pain management, as well as a required initial opioid use disorder screen for new enrollees. In addition, Medicare will include requirements for Part D Plans to establish drug management programs for at-risk beneficiaries’ coverage for certified opioid treatment programs.²

The legislation is expanding access to buprenorphine medication-assisted treatment by:³

• Allowing for administration of OUD-injectable treatments by non-waivered health care practitioners;
• Allowing waivered practitioners to immediately treat 100 patients at a time if the practitioner is board certified in addiction medicine or addiction psychiatry, or in a qualified practice setting;
• Authorizing additional funding for State Targeted Response Grants to support programs that help reduce opioid-related overdoses and addiction;
• Making the buprenorphine prescribing authority permanent for nurse practitioners and physician assistants;
• Putting into law the regulation expanding the patient limit to 275 for certain qualified physicians;
• Specifically allowing for specialty pharmacy distribution of injectable medications to treat OUD; and
• Embedding substance-use-disorder training into medical school curricula with a goal of expanding the number of physicians able to treat OUD.

In a statement, executives for international pharmaceutical company Indivior commended Congress and the Trump administration for passing the bipartisan legislation and declaring the opioid epidemic a public health emergency.³

"This bipartisan effort will improve the ability of patients with OUD to access treatment and begin their path to recovery. This is critical in the fight against the increasing number of human lives lost to opioid overdose in the United States every year," Indivior CEO Shaun Thaxter, said in the statement.³

"We know from our decades-long commitment to helping patients with this complex and stigmatized disease that there is a small window of time when a person is emotionally and physically able to pursue treatment," he said. "HR 6 will make treatment more immediately accessible and allow health care professionals to care for more patients when they decide to seek help."

Indivior's Chief Medical Officer Ponni Subbiah, MD, said that company officials were pleased to support the newly signed legislation.

"The SUPPORT for Patients and Communities Act expands treatment authorization and ensures increased access to new, innovative FDA-approved buprenorphine formulations for OUD treatment. This, in addition to allowing certain qualified waivered practitioners to immediately treat up to 100 patients at a time, is imperative in combatting the current opioid crisis," Subbia said in a statement.³

The legislation also was publicly recognized by the Pharmaceutical Care Management Association (PCMA), a national organization representing pharmacy benefit managers (PBMs). The PCMA called the law’s enactment a significant step in the fight against the United States’ opioid epidemic.⁴

“We applaud the president for enacting this important legislation that will save lives and reduce fraud,” PCMA CEO and President JC Scott, said in a prepared statement.⁴ “PBMs have led the effort in using e-prescribing and other cutting-edge technology to combat opioid abuse an improve patient safety.”

In response to the signing, DisposeRx officials said that they are donating a quantity of the company’s at-home drug disposal packets to destroy more than 10 million opioid pills.

According to DisposeRx President William Simpson, who also attended the signing in Washington, DC, 10 million opioid pills equal to the source of more than 70% of new addictions in the United States.⁵

"We are committed to stop the opioid epidemic by eradicating the misuse of unused medications,” he said in a statement.⁵ “We will continue to work alongside government and industry leaders, including HR-6 co-sponsor Congressman Richard Hudson [R-North Carolina], and will join our pharmacy partners, such as Walmart, Rite Aid and Kroger, in donating our abuse-deterrent drug disposal packets."

In a separate statement, Walgreens said that it is expanding its drug disposal kiosk program and will be stocking at-home safe medication disposal kits that will be available in stores at no cost to customers.⁶

The OUD epidemic in the United States has affected more than 11 million individuals across the country, with an average of 5 people dying from opioid overdose every hour. The majority of the more than 2.5 million patients living with OUD do not receive MAT.³

Each patient's journey toward recovery is different, making it essential that those individuals with OUD have access to all evidence-based treatment options, Subbiah said.

The implementation of the new legislation’s provisions is critical to that end, she said.³

References

• President Donald J. Trump signed H.R. 6 into law [news release]. Washington, DC; October 24, 2018. White House press office. whitehouse.gov/briefings-statements/president-donald-j-trump-signed-h-r-6-law/. Accessed October 25, 2018.
• ASHP CEO Paul Abramowitz attends White House signing of comprehensive opioid bill [news release]. Bethesda, MD; October 24, 2018: ASHP website. ashp.org/news/2018/10/24/ashp-ceo-paul-abramowitz-attends-white-house-signing-of-comprehensive-opioid-bill. Accessed October 25, 2018.
• Indivior applauds enactment of the SUPPORT for Patients and Communities Act of 2018 [news release]. Slough, England and Richmond, VA; October 24, 2018: Indivior. prnmedia.prnewswire.com/news-releases/indivior-applauds-enactment-of-the-support-for-patients-and-communities-act-of-2018-300737277.html. Accessed October 25, 2018.
• PCMA applauds the administration for enacting legislation to curb America's opioid crisis [news release]. Washington, DC; October 24, 2018: PCMA. prnmedia.prnewswire.com/news-releases/pcma-applauds-the-administration-for-enacting-legislation-to-curb-americas-opioid-crisis-300737237.html. Accessed October 25, 2018.
• DisposeRx executives join President Trump at the White House as historic opioid legislation is signed into law [news release]. Southern Pines, NC; October 24, 2018: DisposeRx. prnmedia.prnewswire.com/news-releases/disposerx-executives-join-president-trump-at-the-white-house-as-historic-opioid-legislation-is-signed-into-law-300737256.html?c=n. Accessed October 25, 2018.
• Walgreens to provide free safe medication disposal option in all drugstores in 2019 [news release]. Deerfield, IL; October 24, 2018: Walgreens News. news.walgreens.com/press-releases/general-news/walgreens-to-provide-free-safe-medication-disposal-option-in-all-drugstores-in-2019.htm?view_id=8541. Accessed October 24, 2018.