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Wednesday, July 18, 2012

Move to Restrict Painkillers Founders in Congress - NYTimes.com

June 18, 2012
Lobbying Effort Is Said to Sink New Controls on Painkillers
By ROBERT PEAR


WASHINGTON — Efforts to impose stricter controls on prescription drugs that are subject to rampant abuse have apparently failed after a groundswell of lobbying by pharmacists and drugstores, members of Congress said on Monday.

The proposed controls, sought by senators and law enforcement officials, would apply to products like hydrocodone that are used for the treatment of moderate to severe pain.

The Senate approved the new restrictions last month as part of a bill reauthorizing user fees for the Food and Drug Administration. The House version of the legislation does not address the issue. House and Senate negotiators announced Monday night that they had reached a bipartisan agreement on the overall bill, and said they hoped Congress would approve it by the end of the month.

Abuse of prescription medications has risen sharply in the last decade, with hydrocodone products among those most often misused, according to the Drug Enforcement Administration.

A recent report by the federal Centers for Disease Control and Prevention says, “Overdoses involving prescription painkillers are at epidemic levels and now kill more Americans than heroin and cocaine combined,” adding, “The death toll from overdoses of prescription painkillers has more than tripled in the past decade.”

Senator Joe Manchin III, a West Virginia Democrat who led the push for new controls, said it appeared that his proposal was falling victim to the financial interests of drugstores and related businesses.

“We don’t want to put anybody out of business,” Mr. Manchin said in an interview. “But perhaps the chain pharmacies and druggists need to change their business model a bit. These are legal drugs needed by some people. But they can also be addictive. They are so readily accessible, so easy to obtain, that they are ravaging society and ending many young lives.”

Mr. Manchin’s proposal would require patients to seek new prescriptions for refills of hydrocodone-combination products like Vicodin, require a higher level of security for the storage and transportation of the drugs, and increase penalties for misuse.

Chuck Canterbury, national president of the Fraternal Order of Police, urged Congress to adopt the restrictions, saying they would help reduce illicit trafficking in prescription drugs.

Pharmacists and drugstores raised two major objections. The new restrictions, they said, would make it more difficult for some people in pain to obtain treatment, and pharmacies would be saddled with costly administrative burdens.

In a letter to Congress, five groups of pharmacists and drugstores said that under Mr. Manchin’s proposal, “prescribers will no longer be able to phone in prescriptions to pharmacies for their patients.” In addition, the groups said, “there is a greater chance that patients with a legitimate clinical need would be unnecessarily forced to endure symptoms of pain for a longer period of time.”

The groups, including the National Association of Chain Drug Stores and the National Community Pharmacists Association, said the additional requirements would increase overhead costs for pharmacies. Almost every pharmacy, they said in the letter, would have to buy and install larger safes for the storage of these widely used products.

Separately, the lobbying arm of the American Cancer Society expressed concern that the proposed policy change would cause hardship for some patients, requiring them to visit doctors more often to renew prescriptions. Patients might then owe more in co-payments for doctor’s office visits, the group said.

“Somebody in extreme pain should not have to go back to the doctor’s office every time they need more of their drug,” said Christopher W. Hansen, president of the society’s Cancer Action Network.

However, Dr. Andrew Kolodny, chairman of the psychiatry department at Maimonides Medical Center in Brooklyn, said the suggestion that patients would suffer as a result of the additional controls was “totally bogus.”

Instead, he said, patients might benefit from closer monitoring, as they would have to visit their doctors every three months, rather than every six months.

Dr. Kolodny said he had treated many patients who became addicted to hydrocodone products in their late teens and early 20s and were now taking 20 to 30 tablets a day.




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Move to Restrict Painkillers Founders in Congress - NYTimes.com
 
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