Guest AuthorLegislation being debated in Tallahassee — SB 728 — will raise costs for the state’s employers, consumers and public programs, while offering no clinical benefit to patients.
In an effort to lower prescription drug abuse, the bill forces health plans to cover the most expensive brand name opioids even when more affordable generics are available. Such a mandate would undermine the extensive and ongoing efforts of physicians, pharmacists, health insurers and pharmacy benefit managers working together to find clinically-sound, cost-effective treatments for patients dealing with acute and long-term pain management. This legislation assumes all users of opioids are abusers and therefore need expensive pain medicines that provide zero additional clinical benefit.
A better way to lower prescription drug abuse would be to embrace the “safe pharmacies” proposal advocated in Congress by U.S. Rep. Gus Bilirakis from Florida. His plan would assure that highly addictive medicines like opioids would only be dispensed at pharmacies that are equipped to prevent overuse and fraud. This would protect patients’ access to needed medications but prevent “drugstore shopping,” which occurs when abusers go to several different drugstores until they are able to obtain the drug.
We should also allow health plans to coordinate with state drug monitoring databases, which observe drugstore sales to detect patterns of “drugstore shopping” and other forms of fraud and abuse.
Mark Merritt is president and CEO of the Pharmaceutical Care Management Association. Column courtesy of Context Florida.
