Pharmaceutical executives bring concerns and recommendations to Christie-led opioid panel
Pharmaceutical companies around the country have begun developing a range of non-addictive treatments in response to the country’s deadly heroin and opiate crisis, but executives told the panel led by Gov. Chris Christie that they face financial, regulatory and insurance obstacles that could delay meaningful progress toward curbing the abuse.
In a two-hour hearing Wednesday in Washington, D.C., leaders in the pharmaceutical and health care industries registered their concerns and laid out a series of recommendations to the President’s Commission on Combating Drug Addiction and the Opioid Crisis. Christie, who mostly listened and took notes during the meeting, said the day’s focus was “to talk to leaders in science across the country about the issues that are confronting us regarding the opioid epidemic and attempting to get input and information from those experts regarding their ideas on how to deal with this epidemic.”
While many of the interim report’s recommendations to stem the abuse remain under evaluation by the White House, including the president’s declaration of a national public health emergency, the panel is moving toward long-term proposals intended to save lives and reduce addiction rates. Many companies have already begun that work by developing treatments that do not contain opioids and are not addictive.
And in one significant development, the lobbying group PhRMA, which represents major pharmaceutical companies, said it supports limiting opioid prescriptions to seven days for acute pain treatment. Some states, including New Jersey, have already adopted prescription limits because overprescribing of painkillers has been at least partly responsible for the opioid addiction epidemic. PhRMA chief executive Steve Ubl described the group’s backing of the limits as “unprecedented.”
More than half a dozen pharmaceutical executives presented the panel with drugs they have either developed or plan to produce that appear to be promising alternatives to the commonly prescribed opioid painkillers used after surgery or to treat chronic pain. One treatment characterized as a “digital medicine,” for example, uses sensors on prescriptions that sync to a smartphone app, allowing doctors to monitor the patient’s use. Opiant Pharmaceuticals, the company that created Narcan, the opioid reversal drug that states like New Jersey use regularly to revive overdose victims, is working with Titan Pharmaceuticals on an implant that acts as an opioid antagonist, said chief executive Dr. Roger Crystal.
But there was wide agreement among those who testified Wednesday that Food and Drug Administration regulations make the approval process long and difficult. There were suggestions that the FDA should allow exceptions or give priority to drugs designed to deter abuse.
Health insurance is another hurdle, because insurers don’t cover certain treatments, executives said. Or as Richard Pops, chief of executive of Alkermes, which developed the injection drug Vivitrol, said, insurers make reimbursement “difficult, cumbersome and uneconomic for providers.”
Affordability and lack of coverage for treatments, as well as limits on dosages and restrictions on drugs, lead to “suboptimal disease management” for patients, said Dr. Ponni Subbiah, chief medical officer of Indivior. The company is developing a once-monthly buprenorphine injection. She urged the panel to recommend compliance and enforcement of the Mental Health Parity and Addiction Equity Act, which was designed to prevent insurers from limiting health benefits to patients.
White House counselor Kellyanne Conway said Trump “has from Day One really put his full presidential will and platform behind” combating the crisis. But the president has not declared the opioid use a public health emergency, two months after Christie recommended that Trump do so swiftly to provide money and resources to support the interim report’s recommendations. And there is no “special appropriation for the things we’re talking about” at the National Institutes of Health, said its director, Dr. Francis Collins.
“We will figure out how to redirect funds from other areas to this very high-priority effort, but they will not be sufficient to go at the pace that we would like to go,” Collins said. “The funds that have so far gone toward the management of the opioid crisis have been, and appropriately so, for management of patients and grants out to the states. If we are seriously going to make this go as fast as it needs to, there’s a lot of things to do to stimulate this partnership.”