Some things aren’t always what they seem. Such is the case in the state legislature with many well-meaning bill titles, for example, LD 793 “An Act to Improve Accountability of Opioid Manufacturers” As with so many things in Augusta, the details will surprise you.
Everyone in Maine is aware of the devastating effect the opioid epidemic has had on our state. With this in mind, there are two areas that must be addressed in order to move the needle on the crisis. First we must help the people that have already become addicted and second, we need to put standards in place to reduce the chance of opioid use or abuse among the rest of the population.
The goal of LD 793 is to punish not just opioid manufacturers, but also distributors. Some contend these parties should be punished for marketing a drug by saying it has little or even no abuse liability in comparison to other drug regimens, or for distributing quantities that don’t seem medically reasonable. But many health care professionals and legislators have spent significant time and effort looking at all the ways to reduce over-prescribing and overutilization. There are stacks of reports with suggestions from dispensing thresholds to prescription thresholds and everything in between.
Drug manufacturers provide literature regarding the indications, prescribing, and marketing of their drug. As manufacturers of drugs, it is their responsibility to provide this information. But LD 793 goes after distributors as well, yet their involvement is much more passive. Distributors can only distribute what the scripts are requiring to be dispensed, but this measure would similarly penalize distributors.
LD 793 conjures up penalties based on guidelines that are very difficult to design. In my pharmacy, when I get low on opiates, I reorder based on what my clients’ needs are. My distributor doesn’t know why I ordered what I did, just that they had an order from a licensed pharmacist to fulfill. That is their job and the service that they provide to me.
Ultimately, the wholesale distributors are at the will of what I need to purchase. Distributors and wholesalers cannot ship me drugs that I don’t order and I don’t order drugs that are not prescribed, or in excess of what will be dispensed.
It is unfair to put distributors on the hook for determining what prescriptions are “medically reasonable.” Distributors work hard to ensure the security of the health care supply chain, but their shipments are strictly based on orders from DEA-licensed medical professionals and pharmacies like mine. A distributor is not in a position to know what a patients’ needed dosage of a medication is, or whether their prescription is a daily, weekly, or monthly frequency. That is up to licensed medical professionals.
Everyone is doing what they can to stop the opioid epidemic in Maine and across the country. LD 793, however, will not be helpful in the fight. It will only cause prescriptions drug prices to increase across the board, further impeding access for those who need prescription medications. I encourage the legislature to oppose this bill before it negatively impacts patient care.
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