In the midst of an epidemic of opioid use that caused almost 32,000 deaths last year, the American Medical Association is pushing back against a wave of legislation that sets limits on doctors prescribing the pain med.
Dr. Patrice Harris, the chairwoman of the AMA's opioid task force, says her organizations has grave concerns about limiting a physician's ability to prescribe medication that a patient might need and that decisions on how a doctor treats a patient is best left up to them.
Any specific regulations by Congress or individual states will impact the bottom lines for opioid makers like Purdue Pharma, Allergan plc (AGN) , Janssen Pharmaceuticals, Teva Pharmaceutical Industries Ltd. (TEVA) and Endo International plc (ENDP) . For drug distributors like McKesson Corp. (MCK) , Cardinal Health Inc. (CAH) and AmerisourceBergen Corp. (ABC) , their revenues would be affected as well.
At the same time, if regulations limiting the amount of opioid-based painkillers that could be prescribed by doctors, it stands to reason there could be fewer overdoses as well, so regulations at a federal level could have a bearing on companies like Alkermes (ALKS) plc, which produces the anti-opioid Vivatrol and Indivor plc, which makes Suboxone, Mylan MV (MYL) also is in the group of anti-opioid drugmakers.
While the Trump administration has come under fire for the slow pace at which it moved on the opioid crisis, there were a trio of hearings about opioids on Capitol Hill on April 11. And no less than 28 states have moved since 2016 to either limit doctors or provide strong guidance on how the addictive painkillers can be prescribed.
The AMA argues that treating pain is a complex process and that placing hard and fast regulations on how doctors can treat patients is unwise.
People calling for prescription limits say that by enforcing restrictions on the number of pills patients receive, the danger of addiction is lessened. They also argue that fewer pills going to patients also cuts down on the number that might end up on the street.
Federal regulation has not followed the path of states when it comes to opioid controls. The Centers for Disease Controls did issue guidelines that called for most patients being treated for acute pain to receive no more than three days of the drug and in any event not more than a week's worth.
The Comprehensive Addiction and Recovery Act was introduced in February by a group of bipartisan lawmakers in congress and calls for a three-day limit for first-time patients receiving the drugs for acute pain. The bill is still under discussion.
Pharmacy benefit manager CVS Caremark Corp.has limited prescriptions for new patients to a seven-day supply of the drug, and the American Dental Association also has a seven-day limit for dental patients suffering with acute pain.
PhARMA, the lobbying organization of the pharmaceutical industry came out last September in support of a seven-day limit for first-time acute pain patients, and a month maxium for chronic pain patients.
Last month, the federal budget that passed included almost $4 billion in funding for opioid related issues including $1 billion for distribution to states for grants, $50 million for treatment on Native American reservations and $84 million for medication-assisted addiction treatment. Another $100 million is focused on treatments in rural communities.
The Senate Health Committee has been circulating a draft measure asking the HHS to generate a report examining on a national basis the opioid prescription environment including the quantity of medications being prescribed, the dosages and the length of time on the scripts.
The AMA weighed in last month with an 11-page letter to the House Ways and Means Committee presenting a multifaceted group of ideas addressing the opioid disaster. The letter covered everything from Medicare to medication therapy programs to prescription monitoring platforms.