Price of Addiction: Oregon explores new painkiller abuse-deterrent rules

Portland Business Journal, Jan. 26, 2015

1404229962000-AP-PAINKILLERS-FDA-59377298Legislation is being prepared in Oregon to encourage safer opioid prescribing practices.

Officials could do so by removing any disincentives to prescribing abuse-deterrent painkillers.

“The concept addresses the idea of patient safety and consumer protection around the use of opioid analgesics and abuse deterrents,” said Dr. David Russo, a pain management specialist with Columbia Pain Management in Hood River. “At least a portion of the problem can be attributed to the drug itself.”

Oregon has the highest rate of nonmedical use of prescription opioids in the U.S.

The legislation, supported by a loose coalition of pain and addiction specialists including Russo, would:

  • require insurance carriers to provide coverage for abuse-deterrent opioids as preferred drugs on their formulary.
  • require that the cost-sharing for abuse-deterrent opioids not exceed the lowest cost-sharing applied to prescription drugs.
  • prohibit an increase in patient cost-sharing.

Massachusetts passed a similar law last year.

“Payers and insurance companies shouldn’t prioritize cost over patient safety,” Russo said. Doctors should also take the abuse-deterrent drugs into consideration as they figure out the best treatment for a patient, he said.

The pharmaceutical industry’s two largest trade groups are calling on the Food and Drug Administration not to approve generic equivalents of older, non-abuse-resistant painkillers if a drug maker has since made improvements to a drug that make it harder to abuse, according to Regulatory Affairs Professional Society.

The FDA last year approved a painkiller called Hysingla, which is difficult to crush, break or dissolve, and, thus, abuse. But the agency didn’t revoke approval of Zohydro, which isn’t abuse-deterrent.


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