CEPOP Weekly Opioid Policy Report (Week of December 2, 2019)

CEPOP’s All-Participants Teleconference This Afternoon!

On Monday, CEPOP will host its December All-Participants teleconference. As we look to wrap up the remainder of 2019, we encourage all CEPOP participants to join us for this call and end the year with a robust and productive discussion. We’re pleased this month to have some very thought-provoking Focus Topic speakers, including:

Legal Action Center Report Highlights Benefits in Striking MAT Prior Authorization Requirement in New York

On Friday, the Legal Action Center (in partnership with RTI International) announced the release of a study which modeled estimated reductions in costs and mortality for Medicaid beneficiaries due to opioid-related issues should the state, New York, remove prior authorization for all FDA-approved medication-assisted treatment. The researchers from RTI found removal of prior authorization would result in increased MAT utilization and  decreased healthcare costs associated with opioid use disorder. Along with a 20% increase in MAT use, a 42% reduction in both inpatient admissions and emergency department visits would result in greater than $50 million cost savings. Researchers further estimate that removal of prior authorization would result in an 80% decrease in mortality for those seeking treatment – saving nearly 600 lives.

The bills of interest within the New York State Legislature are A.7426B/S.5935A and S.4808/A.2904.

Articles & Resources

Report Link – Economic and Health Effects of Removing Prior Authorization from Medications to Treat Opioid Use Disorders Under New York State Medicaid

Legal Action Center – Removing Prior Authorization for All Addiction Medication Will Save Lives and Reduce Healthcare Costs to New York

The Times Union – Study: Lifting Addiction Meds Rule Would Save N.Y. Lives, Costs

HHS, IHS and Pediatricians Partner to Improve OUD Response in Pregnant, Post-Partum Women and Children

The Indian Health Service and American Academy of Pediatrics Committee on Native American Child Health announced on Thursday the release of clinical recommendations aimed at combatting the prevalence of neonatal opioid withdrawal syndrome within their constituencies. The comprehensive document, linked below, provides consensus standards around coordinated care to include screening, diagnosis and treatment. Recommendations target both pregnant mothers and infants exposed to opioids.

In response to the announcement, Dr. Shaquita Bell, chair of the AAP Committee on Native American Child Health noted, “American Indian and Alaska Native women face significant barriers in obtaining appropriate care for substance use disorders while pregnant, which may delay early intervention efforts that are best for the newborn’s health.” These remarks were further supported by remarks from HHS Secretary Azar: “The new clinical recommendations will help elevate the quality of care offered to mothers and infants affected by the opioid crisis, and this cooperative project reflects the priority that the Trump Administration has put on addressing substance abuse and increasing the quality of care provided through the Indian Health Service.”

Articles & Resources

HHS Newsroom – HIS and AAP Release Clinical Recommendations to Improve Care of American Indian, Alaska Native Women and Infants Impacted By Prenatal Opioid Exposure

Data Indicates Rise in Rural Buprenorphine Since 2017, Led by PAs and NPs

Recurring CEPOP Focus Topic Speaker Dr. Michael Barnett and colleagues – including former HHS Assistant Secretary for Planning and Education Richard Frank – published a research article in Health Affairs this week recognizing the number of DATA 2020-waivered physicians in rural America since the passage of the Comprehensive Addiction and Recovery Act (CARA) in 2017. Between 2016 and 2019, Dr. Barnett and Colleagues found an increase of waivered clinicians rose 111% per 100,000 individuals. More than half of this precipitous rise is due to nurse practitioners and physician assistants, both of whom granted the ability to receive a DATA 2000 waiver under CARA. More than 12,000 NPs and PAs received waivers through March 2019, including a significant proportion of those found in rural areas without another waivered provider.

Articles & Resources

Health Affairs – In Rural Areas, Buprenorphine Waiver Adoption Since 2017 Driven By Nurse Practitioners And Physician Assistants

Tufts Removes Sackler Name from Campus

In response to push back from faculty, students, alumni and others, on Thursday, Tufts University said that it would immediately remove the Sackler name from all campus facilities and programs. The family, who owns OxyContin manufacturer Purdue Pharma, found their name on buildings and programs including: Sackler School of Graduate Biomedical Sciences; the Arthur M. Sackler Center for Medical Education; the Sackler Laboratory for the Convergence of Biomedical, Physical and Engineering Sciences; the Sackler Families Fund for Collaborative Cancer Biology Research; and the Richard S. Sackler, M.D. Endowed Research Fund. Tufts also announced the creation of a $3 million endowment focused on education, research and civic engagement for SUD prevention and addiction programs.

In a letter sent to the entire Tufts Community, Peter Dolan (Chairman of the Board of Trustees) and Anthony Monaco (President) noted, “Our students, faculty, staff, alumni, and others have shared with us the negative impact the Sackler name has on them each day, noting the human toll of the opioid epidemic in which members of the Sackler family and their company, Purdue Pharma, are associated. We are grateful to those who have shared their thoughts with us. It is clear that the Sackler name, with its link to the current health crisis, runs counter to the school’s mission.”

Articles & Resources

Tufts University – Office of the President: Important Announcement

New York Times – Tufts Removes Sackler Name Over Opioids: ‘Our Students Find It Objectionable’

STAT News – Tufts Will Scour Sackler Name From Its Medical Campus, In Rebuff of Family That Controls Purdue Pharma

What We Read Last Week

Several articles were published last week pertaining to the opioid epidemic, covering a variety of different components of the issue. Links to relevant articles are provided below.

Articles & Resources

Washington Post – Prescription Opioids Destroyed Families. Now, Victims Worry Addiction Stigma May Keep Them From Getting Justice.

Washington Post – Affordable Treatment for Mental Illness and Substance Abuse Gets Harder to Find

Boston Globe – Many Colleges Still in Denial About Need for Recovery Services

STAT News – The History of OxyContin, Told Through Unsealed Purdue Documents

Harvard Medical School – Stopping Pain

Associated Press – Testing, No Suspensions for Opioids Considered Likely in MLB

Associated Press – Tennessee Doctor Pleads Guilty to Overprescribing Opioids

New York Times – The Class of 2000 ‘Could Have Been Anything.’ Until Opioids Hit.

Bloomberg – Ohio’s Top Cop Proposes Opioid Settlement Constitutional Tweak

USA Today – ‘A Distinctly American Phenomenon’: Our Workforce is Dying Faster Than Any Other Wealthy Country, Study Shows

Forbes – Doctor Pleads Guilty to Accepting Bribes to Prescribe Powerful Opioid Fentanyl

LINK – Hassan, Shaheen, Markey and Warren Letter to Attorney General Bar on Bureau of Prison Efforts to Expand MAT Access to Incarcerated Individuals

CDC Division of Unintentional Injury Prevention – Urine Drug Testing Fact Sheet

Department of Justice – Tennessee Emergency Medical Doctor Pleads Guilty to Unlawfully Distributing Controlled Substances

U.S. Attorney for the District of Connecticut – APRN Who Received Kickbacks from Insys Therapeutics for Prescribing Fentanyl Spray is Sentenced

West Philadelphia Pharmacy Employee Convicted in Illegal Oxy Pill Mill Scheme – West Philadelphia Pharmacy Employee Convicted in Illegal Oxy Pill Mill Scheme

U.S. Attorney for the Western District of Florida – Suspended Pharmacist Charged with Health Care Fraud Conspiracy, Fraudulently Obtaining Controlled Substances and Misbranding Drugs

U.S. Attorney for the Southern District of New York – Doctor Pleads Guilty In Manhattan Federal Court To Scheme To Illegally Distribute Massive Quantity Of Oxycodone

U.S. Attorney for the Southern District of New York – Manhattan Doctor Convicted in Manhattan Federal Court of Accepting Bribes And Kickbacks From A Pharmaceutical Company In Exchange For Prescribing Fentanyl Drug

U.S. Attorney for the Northern District of Florida – Physician Pleads Guilty to Acquiring Controlled Substances By Fraud And Using A Means Of Identification Of Another To Acquire Controlled Substances By Fraud

U.S. Attorney for the Southern District of Florida – South Florida Pain Management Doctor Sentenced to 17 ½ Years in Prison for Illegally Dispensing Opioid Drugs and Jumping Bond

U.S. Attorney for the Middle District of Florida – Jacksonville Nurse Pleads Guilty To Tampering With Injectable Painkillers By Substituting Saline For Medication

This Week’s Calendar – Welcome to Thanksgiving Recess!

Good morning all and welcome to the last three weeks of the decade! The House and Senate remain in session this week, with a significant focus placed on issues around the federal budget and impeachment proceedings. Should there be any additions to House or Senate schedules or updates with respect to additional events, this information will be made available. Enjoy your Thanksgiving holiday!

• Senate Commerce Science and Transportation Committee
  Pending Business and Markups
  Wednesday, December 11, 2019, 10:00am, G-50 Dirksen Senate Office Building
• CDC’s National Center for Injury Prevention and Control & Trust for America’s Health
  Fireside Chat: Preventing Adverse Childhood Experiences – The Way Forward
  Thursday, December 12, 2019; 12:00pm; Registration

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