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Sen. Brown joins physician to urge health insurers to step up opioid-fight efforts

By Norwalk Reflector Staff • Updated Mar 9, 2018 at 3:41 PM

WASHINGTON — U.S. Sen. Sherrod Brown (D) has joined Cincinnati physician and president of the Ohio Society of Addiction Medicine, Dr. Shawn Ryan, on a news conference call to urge the health insurance industry to step up their response to the opioid epidemic.

In 2016, the opioid crisis accounted for more than 63,000 deaths nationwide.

“We need to change the status quo, and that starts with insurers taking a hard look at their coverage policies,”  Brown said. “We need them to be a partner in this fight; it should be as easy for an Ohioan to get access to treatment as it is for them to get an opioid in the first place.”

This month, Brown and Sen. Ed Markey (D-Mass.) led a group of senators in asking the nation’s top health insurers to both review their existing policies in light of the epidemic and to take additional steps to make sure they are doing their part to help curb addiction.

“Many insurance companies have been taking steps to improve access to non-narcotic pain management strategies, but there is still room for significant improvement,” Ryan said. “Until it is just as easy to access other proven modalities — such as physical therapy — as it is opioids, we will continue to see overutilization of these pain medications which can lead to misuse and addiction.”

The letter asks the insurance companies to review old policies that could unintentionally be contributing to the drug addiction crisis and asks the companies what policies they have in place to make sure patients can access less addictive or non-addictive pain treatments.

For example, policies like prior authorization – where a patient’s doctor must get prior approval from an insurer before prescribing a more expensive or non-formulary medication – have been in place long before today’s opioid epidemic and are well intentioned to keep costs down. But when thousands are dying each day, insurance algorithms that default to the cheapest opioid alternative could miss opportunities to turn the tide against addiction.

The senators pressed the companies to disclose whether they use internal controls to fight addiction, and how they identify a patient who might be struggling with addiction. The letter also asks for industry input on other factors Congress should be aware of as it considers additional legislation to address the nation’s addiction epidemic. The senators wrote to Aetna, AHIP, Anthem, BCBS, CareSource, Centene, Cigna, Humana, Kaiser, Molina and UnitedHealth.

U.S. Sens. Pat Leahy (D-Vt.), Dianne Feinstein (D-Calif.), Sheldon Whitehouse (D-R.I.), Jeanne Shaheen (D-N.H.), Richard Blumenthal (D-Conn.), Tammy Baldwin (D-Wis.), Chris Murphy (D-Conn.), Angus King (I-Maine), Tim Kaine (D-Va.), Elizabeth Warren (D-Mass.), Chris Van Hollen (D-Md.), Cory Booker (D-N.J.) and Maggie Hassan (D-N.H.) also signed the letter.

In other opioid-related news, the Senate Homeland Security & Governmental Affairs Committee has approved two amendments offered by U.S. Sen. Rob Portman (R) to the Department of Homeland Security (DHS) Authorization Act to combat the influx of synthetic opioids in our country.

Portman authored the amendments with Sen. Tom Carper (D-Del.). The amendments build on the shocking report from the Permanent Subcommittee on Investigations (PSI) detailing how drug traffickers exploit vulnerabilities in our international mail system to easily ship synthetic drugs like fentanyl from China into the United States.

“Synthetic opioids like fentanyl are killing Ohioans and people across America, and they’re coming into the country through our own postal service,” Portman said.

“These two amendments build on recommendations we made in our groundbreaking PSI report and require DHS to follow through and ensure we make progress in our efforts to stop drug traffickers in China from shipping these poisons into our communities. This epidemic is devastating our communities, and I’m pleased the committee is taking an active role in ensuring we have effective oversight of DHS. I’d like to thank Senator Carper for his leadership on this issue and will continue to work with him and the rest of my colleagues to address this important issue.”

On Jan. 24, the PSI released a stunning report detailing how drug traffickers exploit vulnerabilities in the international mail system to easily ship synthetic drugs like fentanyl from China into the United States.

Last year alone, 318 million international packages entered the U.S. with no advanced electronic data such as a shipper and recipient’s names, address, or contents — which is used by federal law enforcement agencies to target packages containing illegal items, like fentanyl. Portman has introduced bipartisan legislation – the Synthetics Trafficking & Overdose Prevention (STOP) Act – designed to help prevent these synthetic drugs like fentanyl from being shipped from China into the United States through the postal service.

The Portman/Carper amendments that passed the committee  would:

• Require DHS to develop a strategy to fulfill one of the recommendations in the PSI report to increase counter-narcotics information sharing between Customs & Border Protection, the U.S. Postal Service, and the express consignment carriers on these drug shipments, known drug traffickers, and best practices.

• Require DHS to report on another recommendation in the PSI report for DHS to engage the Chinese government on synthetic opioid production and mail shipments through the U.S.-China Law Enforcement and Cybersecurity Dialogue.

Also, opioids prescribed to Ohio patients declined for the fifth consecutive year in 2017, according to a newly released report from the State Board of Pharmacy’s Ohio Automated Rx Reporting System (OARRS).

Between 2012 and 2017, the total number of opioids dispensed to Ohio patients decreased by 225 million doses or 28.4 percent. The report finds an 88-percent decrease in the amount of people engaged in the practice of doctor shopping since 2012. Additionally, the use of OARRS continues to break records, with more than 88 million patient reports requested last year; or an increase of 4,900 percent since 2011.

“Ohio has one of the most comprehensive and aggressive approaches in the country to tackling the opioid epidemic,” said Steven Schierholt, State of Ohio Board of Pharmacy executive director.

“Through improvements to OARRS, new prescribing rules and guidelines, shuttering pill mills and aggressive regulatory action against unscrupulous prescribers, the state is making considerable progress in reducing the supply of prescription opioids and other controlled substances that can be abused or diverted.”

Established in 2006, OARRS collects information on all outpatient prescriptions for controlled substances and one non-controlled substance (gabapentin) dispensed by Ohio-licensed pharmacies and personally furnished by Ohio prescribers. OARRS data is available to prescribers when they treat patients, pharmacists when presented with prescriptions from patients and law enforcement officers during active drug-related investigations.

“It is widely accepted that prescription opioid abuse often progresses to the use of heroin and other illicit drugs. That is why Ohio’s efforts to reduce exposure to prescription opioids are essential to combatting this public health crisis,” said Tracy Plouck, director of the Ohio Department of Mental Health and Addiction Services.

An executive summary of the report can be accessed at www.pharmacy.ohio.gov/Summary2017.

The complete 2017 OARRS annual report can be accessed by visiting www.pharmacy.ohio.gov/OARRS2017.

Updated county level data for 2017 can be accessed by visiting www.pharmacy.ohio.gov/county.

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