Fragmented Opiod Debate Impacts Variety of Healthcare Sub-Sectors
It’s an election year. Congress has to appear to be “doing something” about the opioid epidemic engulfing communities across the U.S.
The good news, it is: Senator Rob Portman (R-OH) introduced a bipartisan bill this week, the “CARA 2.0 Act of 2018,” to reauthorize and expand the Comprehensive Addiction and Recovery Act (CARA) of 2016, passed that year in response to opioid addiction, and concomitant social and crime challenges.
As with so many other healthcare-oriented bills that work their way through the legislative and regulatory process, it never ceases to amaze the degree to which so many healthcare sub-sectors, with billions of dollars at stake, are impacted by the bill.
In this case, it’s the relatively small but growing long term care (LTC) pharmacy sector — which, unlike more common retail pharmacies, delivers drugs to LTC facilities like nursing homes, assisted living facilities and other congregate settings.
Section Three of the new Portman bill, for example, limits opioid dispensing to three-day doses. Of course, this ‘one size fits all’ three day provision will require discussion, and likely alteration as the bill proceeds. While there is an exception for seniors’ hospice care in this new CARA 2.0 bill, there is no similar exception for long term care (LTC) facilities — as was the case in the 2016 bill.
Seniors in long-term care (LTC) settings prescribed opioids are suffering intense and severe pain (obviously similar to hospice patients) — which means arbitrary three-day dispensing limits inadvertently threaten effective pain management. in the 2016 final bill, It simply made sense to add an exemption for patients in LTC facilities.
The industry says it will, as it did in 2016, work to ensure the new 2018 bill, CARA 2.0, includes a common sense LTC facility exemption “that strikes the right balance between protecting our citizens and communities on the one hand, and protecting the ability of LTC pharmacies to meet and manage the medication needs of LTC residents on the other,” said Alan G. Rosenbloom, President and CEO of the Senior Care Pharmacy Coalition (SCPC), based in Washington, D.C.
The effort to ensure the ‘exemption’ for LTC facilities is again in the final 2018 bill requires lobbyists, consultants and a sound policy rationale. The case will again be made to Capitol Hill, Rosenbloom says, that LTC pharmacies “already provide stringent oversight of prescription drug dispensing and usage — including even greater oversight of Schedule II drugs like opioids dispensed to LTC patients.”
With precedent and policy logic working in its favor, odds are the LTC Pharmacy sector will again be successful in its efforts.
While the issue is esoteric, efforts such as this — which fly far under the radar due to obscure and complex regulatory and policy detail — are the bread and butter of Washington lobbying activity.