Risk of chronic opioid use in elderly impacted by prescribing doctor

A recent study has found a link between chronic opioid use in Medicare beneficiaries and “high-intensity” prescribers, doctors that prescribe opioids for one in four patients they treat.  Beneficiaries with a high-intensity prescriber were 30% more likely to become a long-time opioid user.  Study authors conclude that their results are indicate that a single opioid prescription can affect the chances of long-term use and additional adverse health outcomes among elderly patients though additional research is needed.

The New England Journal of Medicine

New York Times

 

Tom Price confirmed as HHS secretary

Tom Price was confirmed overnight by the US Senate to become the next secretary of health of human services.  The vote along party lines was largely expected and one of Mr. Price’s first responsibilities will be to head President Trump’s push to dismantle the Affordable Care Act.  Mr. Price is expected to work to limit the growth of Medicare and Medicaid.  Details regarding possible changes to the programs, which insure more than 100 million Americans remain unclear, but Democrats are worried about what they see as the secretary’s desire to dismantle Medicare.  A 2009 op-ed article penned by Mr. Price included the following, “Nothing has had a greater negative effect on the delivery of health care than the federal government’s intrusion into medicine through Medicare.”

New York Times

Tom Price op-ed

Medicare may be permitted to negotiate prescription drug prices under Trump administration

There has been much confusion about the Trump administration’s vision for heath care in America.  Repeated calls to replace the Affordable Care Act and promises to not dismantle Medicare on the campaign trail are still fresh in American’s minds though Trump has provided few details or proposals. President Trump proposed often that Medicare should be able to leverage its buying power to negotiate better drug prices.  Trump presented this idea often on the campaign trail and recently said the following during a January 11 news conference:

I think a lot of industries are going to be coming back. We have to get our drug industry coming back. Our drug industry has been disastrous. They’re leaving left and right. They supply our drugs, but they don’t make them here. To a large extent. And the other thing we have to do is create new bidding procedures for the drug industry because they’re getting away with murder.

Pharma, pharma has a lot of lobbies, a lot of lobbyists and a lot of power. And there’s very little bidding on drugs. We’re the largest buyer of drugs in the world, and yet we don’t bid properly. And were going to start bidding and were going to save billions of dollars over a period of time.

Medicare is currently not permitted to participate in the negotiation of drug prices between pharmaceutical companies and insurance companies that provide Part D prescription drug plans.  Many experts believe negotiating the prices of prescription drugs could save Medicare billions though the only government report on the subject, completed in 2007 by the Congressional Budget Office, found the effects would be insignificant.

Trump has seemed to walk back some of his previous campaign rhetoric on this subject and recently told a group of pharmaceutical executives that he would “…oppose anything that makes it harder for smaller, younger companies to take the risk of bringing a product to a vibrantly competitive market.  That includes price fixing by the biggest dog in the market – Medicare – which is what’s happening.”  White House spokesman Sean Spicer has since clarified that Trump does support Medicare negotiating prescription drug prices.

NPR story by Allison Kodjak