Bill Would Prevent Over-Prescribing

A California bill would require doctors to check California’s prescription drug database before prescribing opiates. The Controlled Substance Utilization Review and Evaluation System (CURES) is the nation’s most advanced prescription drug monitoring program, but just 35% of California providers and dispensers use it. Carmen Balber, executive director of Consumer Watchdogs said, “California loses 4,500 people a year to preventable drug overdoses–more than any other state….The legislature can help…by requiring doctors to check the prescription database before recommending patients take the most dangerous and addictive drugs. It’s clear that making use of the database voluntary does not work.”

SB 482, by California state Senator Ricardo Lara, would require doctors to check California’s CURES database when prescribing Schedule II or III drugs like Oxycontin to a patient for the first time, and annually thereafter if the treatment continues. The Centers for Disease Control and Prevention issued new prescribing guidelines that recommend doctors use prescription drug databases every time they prescribe an opioid. Last month, president Obama proposed $1.2 billion in new federal funding to fight opioid abuse, including funds to expand the use of state prescription drug databases.

Twenty-two states mandate use of a state prescription database. States that track results have seen reduced doctor-shopping and lower opioid prescription rates. Also doctors say that the databases are useful to them in prescribing the right medications. The following states have seen improvements after mandating the use of a database:

  • New York saw a 75% drop in patients seeing multiple prescribers for the same drugs.
  • Kentucky found that opioid prescriptions to doctor-shopping individuals fell 54%. Also, overdose-related deaths declined for the first time in six years in 2013.
  • Tennessee saw a 36% drop in patients who were seeing multiple prescribers to get the same drugs. Tennessee prescribers say they are 41% less likely to prescribe controlled substances after checking the database, and 34% more likely to refer a patient for substance abuse treatment. Also, 86% of prescribers say the database is useful for decreasing doctor shopping.

Having Medicaid Dental Coverage Does Not Prevent ER Visits

In urban areas, expanded Medicaid dental coverage has not reduced dental emergency visits despite an adequate supply of dentists. In fact, 90% of dental emergency visits occurred in urban counties. Even though dental coverage has been expanded under Medicaid, more than 2% of emergency room visits are for non-traumatic dental conditions, according to a study inHealth Affairs. Patients may have difficulty locating dentists who accept Medicaid. The rate of dentists who accept Medicaid is as low as 11% in Missouri, 15% in Florida and 20% in New York.

Group Calls on Senate to Prevent Secret Pharma Money

Section 3041 of the 21st Century Cures Act would remove reporting requirements over pharmaceutical industry payments to doctors and associations that take place in the context of Continuing Medical Education (CME). The UNITE HERE union sent letters to the Senate Committee on Health opposing the legislation. They say it would allow millions of dollars’ worth of pharmacy industry gifts to doctors’ conferences to happen behind closed doors. The bill just passed the House and is expected to be introduced in the Senate soon.

Aside from healthcare providers and pharmaceutical reps, hospitality workers are among the only people who witness the pharmaceutical industry’s presence at CME events. If Section 3041 becomes law, the rest of the public will never see what UNITE HERE members see. In the past two months, UNITE HERE has collected over 9,000 signatures on a petition to the Accreditation Council for Continuing Medical Education (ACCME) to eliminate pharmaceutical money from CME.

UNITE HERE says it is concerned about ballooning costs for its members’ healthcare plans. Prescription drugs, devices, and biologicals are a major factor in rising healthcare costs and the union is concerned doctors may be unduly influenced by contributions from the pharmaceutical industry to prescribe more expensive drugs when more affordable, generic alternatives are available. The letter was also signed by the director and the program manager of PharmedOut, a Georgetown University Medical Center Project that promotes rational prescribing. UNITE HERE represents 270,000 workers in North America who work in the hotel, gaming, food service, manufacturing, textile, distribution, laundry, transportation, and airport industries. For more information, visit NoMoreDrugMoney.org/Senate.

Medicare Legislation Would Prevent Drastic Payment Cuts

President Barack Obama signed into law the Protecting Access to Medicare Act (H.R. 4302). The bill will halt a 24% reimbursement cut to Medicare providers. It will also eliminate the $2,000 deductible cap on small group health plans. Janet Trautwein, CEO of NAHU explains that many carriers have pulled out of Medicare, leaving thousands of beneficiaries in limbo. Addressing the physician payment will avert a similar crisis by ensuring continued access to physician services. The bill also includes bipartisan legislation to repeal the Affordable Care Act’s statutory cap on deductibles for health plans in the small group market; a provision that Trautwein says the ACA’s inflexible deductible caps would force a majority of small group plans to put employees through significant and often higher premium plan re-design, including raising premiums, increasing copays, or stripping benefits to comply with the cap. She said that H.R. 4302 ensures stable and affordable private insurance coverage options and generates significant taxpayer savings.

USPSTF says women shouldn’t use HRT to prevent chronic disease

Postmenopausal women should not be prescribed hormone replacement therapy to prevent chronic diseases such as heart disease and osteoporosis, the U.S. Preventive Services Task Force said. Although recent studies revealed that estrogen alone and estrogen plus progestin lower risk of fractures, these treatments increase the likelihood of stroke, blood clots, gallbladder disease and incontinence. The findings were published in the Annals of Internal Medicine. Reuters (10/22)

Daily low-dose aspirin linked to slower cognitive decline

A study that included almost 700 older women found those who took a daily low-dose aspirin demonstrated less cognitive decline than those who did not follow the regimen, often used to help prevent heart attacks. University of Gothenburg researchers wrote in the journal BMJ Open that the effects were more pronounced the longer the aspirin regimen was followed but that taking the drug did not affect the risk of developing full-blown dementia. A researcher cautioned that the study did not prove a causal link and said more research is needed before any recommendations can be made to women regarding aspirin use for cognitive function. HealthDay News (10/4)

Last Updated 01/13/2021

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