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HHS Expands Use of Buprenophine, Eliminates Financial Incentives for Opioid Prescriptions


July 07, 2016

Sylvia M. Burwell, secretary of the Department of Health and Human Services (HHS), recently announced new measures aimed at reducing the epidemic of opioid misuse in the US.

Secretary Burwell stated in a press release, “The opioid epidemic is one of the most pressing public health issues in the United States. More Americans now die from drug overdoses than car crashes, and these overdoses have hit families from every walk of life and across our entire nation.”

Burwell outlined HHS’s newest efforts which include expanding access to buprenorphine, a partial antagonist used to treat opioid use disorder; a proposal intended to eliminate any potential financial incentive for doctors to prescribe opioids based upon a patient survey; and a requirement for Indian Health Service prescribers and pharmacists to check state Prescription Drug Monitoring Programs (PDMP) databases prior to prescribing opioids.

These preventive measures build on the HHS Opioid Initiative launched in March 2015, which focuses on improving opioid treatment practices, expanding access to treatments for opioid misuse, and increasing the use of naloxone to reverse opioid overdoses.

Providers with a waiver allowing them to prescribe buprenorphine to up to 100 patients may now obtain a new waiver to treat up to 275 patients, according to one new measure.

In addition, HHS announced, “Many clinicians report feeling pressure to overprescribe opioids because scores on the [HCAHPS (Hospital Consumer Assessment of Healthcare Providers and Systems)] survey pain management questions are tied to Medicare payments to hospitals.” The Centers for Medicare and Medicaid Services (CMS) proposes to remove the HCAHPS survey pain management questions. HHS officials stated that the connection between opioid-related patient satisfaction and hospital payments is currently very limited.

The final measure requires that clinicians within the Indian Health Service perform a PDMP database check before prescribing or dispensing opioids for more than one week, in order to help identify patients with opioid misuse.

Furthermore, HHS announced the department will launch more than a dozen scientific studies on opioid misuse and pain treatment to help fill the knowledge gaps and help fight the current epidemic.

Burwell said, “At HHS, we are helping to lead the nationwide effort to address the opioid epidemic by taking a targeted approach focused on prevention, treatment, and intervention.”

Notably, the announcement comes after recent research  by Dr Ellen Meara and colleagues, published in the New England Journal of Medicine, found that the adoption of controlled-substance laws was not associated with reductions in potentially dangerous use of opioids or overdose among a population at risk, disabled Medicare beneficiaries.   

 

References:

The Department of Health and Human Services. HHS announces new actions to combat opioid epidemic [press release]. HHS.gov. Published July 6, 2016. Accessed July 7, 2016.

Meara E, Horwitz JR, Powell W, et al. State Legal Restrictions and Prescription-Opioid Use among Disabled Adults [published online June 22, 2016]. N Eng J Med. 2016;375:44-53.

DOI: 10.1056/NEJMsa1514387 

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