< Maine Bill Aims To Make Abuse-Deterrent Painkillers More Affordable

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Sales of prescription opioid pain relievers have quadrupled since 1999. That's according to the Centers for Disease Control and Prevention. So, too, have overdose deaths. More than a dozen states are considering bills aimed at this problem. The bills would require insurance companies to cover opioids that deter abuse at the same level as regular opioids. Maine Public Radio's Patty Wight reports that some physicians are skeptical that these proposed laws would make a difference.

PATTY WIGHT, BYLINE: Maine has one of the highest rates of opiate addiction in the nation. It's a problem that Maine Democratic Representative Barry Hobbins is all too familiar with.

BARRY HOBBINS: One of my family members has been struggling with this dreaded addiction of opiates for six years.

WIGHT: Abuse-deterrent opioids are harder to crush, cut or dissolve. Some form into a gel, so they're harder to inject. Hobbins doesn't know exactly how his family member ingested opioids.

HOBBINS: He did use substances for nonmedical purposes that were someone else's prescription or stolen somehow.

WIGHT: So when pharmaceutical company Pfizer, which makes abuse-deterrent opioids, asked Hobbins to sponsor a bill that would require insurance companies to cover those drugs at the same level as regular opioids, he gladly agreed. Massachusetts was first to pass such a law last year. It will take effect this October. But some insurance company officials say limiting the amount policyholders have to pay for these medications could result in overall higher premiums.

KATHERINE PELLETREAU: We have concerns about requiring that a name brand drug, which can be significantly more expensive, be subject to the same cost shares as a generic.

WIGHT: Katherine Pelletreau is executor director of the Maine Association of Health Plans, which represents four insurance carriers. She says there are only three prescription opioids approved as abuse-deterrent by the FDA, and they're all name brand. They're also, she says, relatively new.

PELLETREAU: Insurers really value medical necessity, and the full story on these abuse-deterrent formulations is still evolving.

WIGHT: While insurance companies aren't enthusiastic about the bill, neither are some doctors. Dr. Mark Publicker, the president of the Northern New England Society of Addiction Medicine, says the bill is...

MARK PUBLICKER: ...Well-meaning. I'm not sure it's going to have the desired impact.

WIGHT: Publicker says these opioids are not abuse-proof. He points out the current HIV outbreak in Indiana is linked to the opioid drug Opana.

PUBLICKER: Which is alleged to be tamper-resistant. And people with opiate addiction fairly quickly figured out how to extract the drug.

WIGHT: Publicker says if lawmakers really want to put a dent in the addiction problem, they should increase access to treatment. Dr. Noah Nesin, chief medical officer at Penobscot Community Health Center in Bangor says the current opioid problem has largely been driven by misguided prescribing practices. Making abuse-deterrent opioids more available, he says, could lead to more lax prescribing.

NOAH NESIN: Creating a dynamic in which we think, oh, here's a safer alternative is an extremely relative comparison.

WIGHT: The FDA announced in April that the development of opioids that deter abuse is a high public health priority. The agency has not yet issued guidance on generic opioids that are less susceptible to abuse, but says it's committed to supporting their development. For NPR News, I'm Patty Wight.

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