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Once again, a bill has been introduced that would require companies to pay a tax on the amount of opioids they make or import, and the funds would be used by the federal government to establish abuse prevention and treatment centers.

The latest bid is from Rep. Michelle Lujan Grisham (D-N.M.), who first introduced such a bill last December, and follows similar moves by Sen. Joe Manchin (D-W. Va.), whose most recent bill arrived in March. Their initial efforts went nowhere and it is unclear if these latest attempts will fare any better.

Nonetheless, the idea is provocative, and comes as a growing number of city, county, and state governments sue drug makers to recover money spent on pills and treatment.

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The tax is estimated to raise about $2 billion, which one expert says would be a good start. Dr. Andrew Kolodny, who heads the Opioid Policy Research Collaborative at Brandeis University, estimates $6 billion is needed to “clean up the mess” made by drug makers and to ensure adequate treatment.

“Given the profits made from selling these products, despite the known risks, having the companies cover a portion of the harm is sensible,” added Dr. Lewis Nelson, who chairs the Department of Emergency Medicine at Rutgers New Jersey Medical School.

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Not everyone is so sure. Dr. Jonathan Gavras, chief medical officer, at Prime Therapeutics, a pharmacy benefits manager, warned that a tax “adds more cost to the system, and [the companies] will pass that on [to payers and consumers] at some point.”

What do you think?

  • Taxing prescription pain relievers to POSSIBLY apply the funds to combat the illegal drug market is just a money grab by the people who are already harming chronic pain patients because of misguided attacks based on personal emotional biases and direct personal financial interests.

    It would make far more sense to apply the proposed tax to substances that have no legitimate medical use such as tobacco and alcohol.

  • Ignorant liberals! Prescription meds that people need is not the major player in abuse. It is heroine and fentanil coming into the US from the southern border primarily. This tax will solve nothing!! It will just make my meds more expensive.

  • The best thing I can say about Andrew Kolodny is that he has not reached the depths of depravity relegated to the likes of Joseph Mengele…yet. However, if tax money should become available for revolving-door medical facilities which citizens would be forced to enter, which would be of no long-term benefit to patients, and which would cause Andrew Kolodny to feel important and pocket a return on his entrepreneurial investment, then move over Joseph Mengele and make room for Andrew Kolodny. Kolodny’s unsubstantiated stand against opioid drugs, which are used responsibly by chronic pain patients, has been refuted regularly and thoroughly by many well qualified researchers and by chronic pain patients who use opioids to relieve life-altering pain and achieve some semblance of normality. Kolodny’s involvement in financial ventures for addiction treatment invalidate any claim he makes to being an unbiased consultant on addiction. Kolodny is a textbook example of conflict of interest.

    • M.J.

      Thank you for pointing out the obvious, but with a bit of homework Lewis S. Nelson, MD shows he may know Kolodny more than he claims.

      http://njms.rutgers.edu/departments/emergency_medicine/fac_adult.cfm

      Kolodny and all government agencies are very comparable to Josef Mengele, MD. Josef Mengele was a physician who was infamous for his inhumane treatment in Nazi concentration camps.

      https://www.ushmm.org/wlc/mobile/en/article.php?ModuleId=10007060

      It’s sad that we’ve an American Holocaust page to track all who died from pain. It includes suicides and many who died without opioid medication, including cancer patients after years of compliant without increases.

      What about our veterans who protected our country? The VA adopted the genocidal policies of the CDC before in 2011 and have a worse plan for 2017. They took 90% of vets off pain medication, but didn’t do all VA facilities at once. Hmm ? I’d say the VA didn’t want all vets up in arms at once? Many compliant for 15-20 years or more, but stripped of opioids without warning or nothing in 2 – 3 months. Some were told over the phone the day before they were to get their next RX they’d get NONE.

      I’ll let one vet I know who’s fighting with and for all of us about this article. Then all can sit back and enjoy ? the comments.

  • This article and most of the nonsense being spouted by Andrew Kolodny derives from a fraudulent notion: that the pharmaceutical companies have facilitated a spreading wave addiction by making pain relief available to hundreds of thousands of people in agony. In my opinion, besides being dead wrong on facts, Kolodny is financially self-interested in reallocating funds from pain relief research to addiction treatment in the chain of 28 day detox centers of which he has long been a serving corporate officer. He is one of the most universally hated figures in pain medicine and for good reason.

    That said, let’s please correct our understanding of cause and effects in addiction. During the first meeting of the President’s Commission on Combating Addiction and the Opioid Epidemic, one of the medically qualified participants from NIH quoted an absolutely vital statistic that Kolodny and others in his camp are working to suppress because it’s inconvenient to their finances: 90% of all addicts first begin abusing drugs and intoxicants in their teens — long before the great majority are ever seen by a licensed physician for a pain condition of sufficient severity to warrant prescription of an opioid pain reliever.

    It is often shouted by anti-opioid zealots that 75% of addicts begin with prescription drugs. This statistic is actually a distortion of what is really going on. Kids very often steal prescription opioid analgesic pills from family medicine closets or buy them from street dealers. But pain patients only rarely become addicts. And those under appropriate doctor oversight almost never do.

    Big Pharma did contribute in the 1990s to the opioid crisis by over-promoting their products and under-reporting the risks of addiction in those who choose to abuse them. But this is NOT NOT NOT the same thing as claiming that prescription drugs “caused” the crisis. Drugs left over in medicine closets joined the millions of doses stolen from pharmacies and hospitals, to circulate in the street.

    Taxing opioids manufactured for people in pain is not even remotely a “solution” to fund the level of investment needed in addiction prevention and treatment in the US. $2 Billion dollars will only add to the expenses faced by pain patients without making even a dent in the problem. As I wrote in a letter to the President’s Commission…

    … effective programs to reduce the death and destruction wrought by illicit drugs must be multi-dimensional. Five aspects must be addressed. None is adequate to stand alone, or will be effective standing alone. There are no simple solutions here.

    a. Prevention in kids, beginning in Middle School, continuing through High School and beyond.

    b. Prevention in adults, focusing on employment development and the creation of hope. Addiction in adults is not primarily a disorder created by drug exposure. It is created by social disintegration and hopelessness that leave people vulnerable.

    c. Initial recognition of addiction by properly trained community medical professionals.

    d. Ongoing community engagement and support for recovering addicts over periods of at least 3-5 years and possibly longer. Relapse is an ongoing issue for which there are no simple, one-size-fits-all solutions.

    e. Diversion of addicted kids and adults out of the prison system and into community treatment and re-integration programs.

    One additional thing we can say with confidence: there is absolutely no reason beyond corporate greed for charging more than $10 dollars per prescription for medications like Oxycontin, Percocet, or Methadone. These medications are no longer under patent. There is also no economic reason in the world for charging hundreds of dollars per dose of intervention meds used in stopping opiod overdose.

    There are plenty of reasons for regulation of pharmaceutical companies. But blaming them for an opioid epidemic isn’t among those reasons. We do nobody any constructive good by misunderstanding the causes of addiction or misallocating public funds in more law enforcement that has never worked and never will. The war on drugs is bogus. And it has turned into a war on chronic pain patients.

    It is time to STOP THE WAR ON PAIN PATIENTS!

    • Well said, Mr. Lawhern! This is not a war on drugs – it’s a war on abusing and neglecting pain patients. It’s inhumane; it’s cruel.

    • Mr. Lawhern, I do declare! Each time I read a comment written by you in response to an errant piece of so-called journalism, your composition becomes more comprehensive and your arguments more compelling than the response your wrote before. Keep up the good work! Your contributions are vital to the basic rights denied chronic pain sufferers, who are vastly under-represented. Thank-you, Sir.

    • I’d like to know where they think all this tax money is going to come from,They’ve managed to take the ability of thousands of people who suffer in pain jobs away by taking their medicines that kept them working and supporting their Families ,This is Genocide, not only of the person’s suffering from pain but the whole family unit as well,We have no money for Medicaid or Medicare as it is,and now the ability to work even a part time job has been taken away as well,I would like to know how this Government is going to handle all those who can no longer work and function in their homes and feeding their Families,they will no longer have insurance due to not being able to work,Where is all this money coming from?? there will be no incomes for these families they will be homeless and uninsured so good luck getting extra tax money from all the Homelessness this Government has caused

  • What will stop pharmaceutical companies from passing the cost on to patients? This is basically taxing people who live with severe pain and legitimately need these medications, to pay for the treatment of people with addiction who (as studies have shown) largely obtain prescription medications illegally. This does not stand up to any ethical test. Do we tax people with any other disease to pay for addiction treatment?

  • Everybody knows that they will just increase prices on consumers! Don’t people think that those of us with painful chronic conditions have taken the brunt of what others do when they abuse their medications enough? If a society is going to punish one man for the actions of another, it is no longer a Country based in individual responsibility and individual liberty! It is slowly becoming a totalitarian state! This is not the type of Country I was willing to put my life on the line for, when I served in the United States Army! I was and am still willing to give up my life for this Country, but only if we don’t fall deeper into the type of Country based on socialism, where my or any ones amount of physical suffering is based on the abuses of another!

  • Do we really want the government to levy and manage this tax? Most of this opiod discussion involves those in addiction treatment, not pain management. Follow the money.

  • Andrew kolodny is not a real doctor; Your article loses all credibility when you quote him. He doesn’t see any actual patients and he lives on the lunatic fringe of the public health community. So PLEASE stop giving this crazy man a platform to spew garbge

    • Hello ‘D,’

      Thanks for stopping by. Let’s put Kolodny aside, since Nelson expressed the same sentiment. In fact, I could have quoted him alone to offer the same point of view as Kolodny. So do you disagree with their views or is this simply another issue concerning Kolodny?

      Regards,
      ed at pharmalot

    • Mr. Silverman, in your response to “D’s” comment, perhaps you could clarify whether you are using the word, “issue,” in its trendy context, which is vague in a hackneyed “politically correct” way and which obfuscates its meaning. If you meant to assert that “D” has a problem with Andrew Kolodny’s behavior, it’s pretty well known among the chronic pain population why “D” would have such a problem. Possibly “D” was leaving abbreviated comments due to time limitations, much like the author of the poorly researched article above.

  • I was surprised that I am in the minority. I can’t see why an absolutely legal essential medication should pay for rehab because either it was prescribed inappropriately, or diverted to illegal use. When it costs more the people will bitch. Do we tax high cholesterol foods, sugar drinks, fast cars, motorcycles or anything else that can contribute to heart disease or obesity. Maybe we should tax the prescribers who incorrectly monitored or selected patients who used opiates long term, kidding so why the manufacturer? How about taxing the industries that abandoned the small towns that so many people without jobs and without hope. They contributed to the opioid epidemic as well. I guess what I am saying choosing one part of a complicated problem and taxing them makes no sense to me.

    • Hi Victor,

      Thanks for the notes and those are good points. I will not pretend to speak for the lawmakers, but I believe their point is that the companies allegedly downplayed risks and inappropriately encouraged prescribing.

      Of course, those points will be adjudicated in the growing number of lawsuits filed by city, county and state officials. So perhaps a settlement can be used for the same purpose. Although as the Prime cmo and another reader point out, rising expenses may simply prompt one or more companies to raise prices.

      Regards,
      ed at pharmalot

    • This comment is for Ed. Couldn’t see a reply button for your comment regarding settlement money being used for rehab etc.
      Just a bit of information on that subject. The law firm Cohen Milstein has been coaxing state attorneys general to file suits against the pharmaceutical companies that manufacture opioids in exchange for campaign funds. In most cases the cities or states had not even considered pursuing a lawsuit. Jane Ballantyne, the President of PROP, has served as a paid consultant to Cohen Milstein. Andrew Kolodny is the founder of PROP. PROP was instrumental in drafting the CDC guidelines for opioid prescribing. Andrew Kolodny and Tom Frieden, former head of the CDC, worked together years ago at the NYC Heath Department. At that time Frieden and Kolodny made it their mission to put 60k New Yorkers on Suboxone (a drug used to treat those who are dependent on opioids).
      Who knows where these settlement funds are going but my guess is it’s making a lot of individuals a whole lot of money. In the meantime a lot of the sick and elderly in this country are being abandoned by their doctors and left with no treatment for their painful conditions.
      This entire campaign against opioids smells bad to me.

    • Hi Jojordan,

      Thanks for the note. I’m familiar with the issues you’ve raised. I’m aware of the litigation, having written about this on and off for the past few years. I’ve also written in the past about the CDC guidelines and noted Ballantyne’s role as a litigation consultant. I’ve no idea where the litigation is headed, but if enough lawsuits are filed, a settlement is more likely. Where the money goes from there will be interesting to follow.

      Regards,
      ed at pharmalot

  • Ed, somebody didnt do their homework. There is oxycodone made annually to give the entire US population 200 mg of percs per year. Tax it at a penny/mg comes to a tax of $60 billion. Lets knock that down to 0.1 cent/mg and the law of unintended consequences kicks in. Drug companies are not in the business of losing money and they will pass the taxes on to the patient, which will make more unaffordable and expedite the transition to dangerous street drugs.

    • Hi Pharmvet1,

      I tend to agree that costs will be passed along, yes. For that matter, I would imagine prices might rise, for some pills anyway, if and when these companies reach a settlement over the lawsuits filed by city, county and state officials.

      Cheers
      ed at pharmalot

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