Medicare’s cost disparity between opioids, other drugs needs to be reviewed

Encouraging people in pain to use opioids for relief if there are effective alternatives is, in a word, insane. Yet the federal government does just that, according to two U.S. senators from states hit hard by the drug abuse epidemic.

Sens. Shelley Moore Capito, R-W.Va., and Sen. Jeanne Shaheen, D-N.H., are familiar with the risks of opioid painkillers.

Both of their states have been hit hard by the drug abuse epidemic. West Virginia has the highest drug overdose death rate in the nation. New Hampshire is No. 4.

Pennsylvania is No. 3.

The Centers for Disease Control (CDC) reports Pennsylvania experienced 44.3 deaths per 100,000 persons in 2017, following West Virginia at 57.8 and Ohio at 46.3 deaths. New Hampshire had 37 per 100,000 persons. Pennsylvania’s numbers rose from 2016, when the rate was 37.9 per 100,000 persons.

Moore and Shaheen are urging federal Medicare officials to scrap a policy that provides health care providers with financial incentives to use opioid-based pain management treatments, rather than those based on other drugs and/or techniques.

“Under Medicare’s current reimbursement policy, the cost disparity between opiod-based pain medication and non-opioid drugs used to treat post-surgical pain creates a disincentive for providers to use the less addictive, non-opioid alternative,” Capito explained in a news release.

A critical aspect of the battle against drug abuse “is ensuring that the Medicare program does not create a perverse incentive for doctors to continue to prescribe opioids to patients,” the senator added.

The CDC also tracks prescribing rates. In the top three states, the 2017 numbers are as follows: West Virginia, 81.3 per 100 persons; Ohio, 63.5 per 100 persons; Pennsylvania, 57.7 per 100 persons. The average U.S. rate was 58.7 prescriptions per 100 persons.

While those numbers sound high, Pennsylvania peaked at 83.3 opioid prescriptions per 100 persons in 2012, according to the CDC. That shows the dent that Pennsylania has made in its battle against this public health crisis in recent years, but more needs to be done.

We will be quite interested in seeing how those steps will affect the numbers — and people’s lives — for 2018 and beyond.

In the meantime, federal officials should look into the complaint by Capito and Shaheen. Uncle Sam should not be promoting use of opioids if viable alternatives exist.


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