Updated Clinical Practice Guideline for Prescribing Opioids is Available for Public Comment.
The updated, proposed, 229-page guidance document reiterates that “opioids should not be considered first-line or routine therapy for subacute or chronic pain”. It also provides guidance and recommendations for alternative therapies and non-drug interventions for pain.
What’s not in the updated guidance is significant. There is no language that states prescribers should “avoid increasing dosage” to 90 morphine milligram equivalents or more per day or, to “carefully justify” a higher dose. Additionally, the updated guidelines have removed any time limits for opioid prescriptions for acute pain. The 2016 version stated “three days or less will often be sufficient; more than seven days will rarely be needed.” States, payers and pharmacies adopted the 2016 guidelines as “limits”.
Opioid prescription prescribing has been falling since 2012. Additional declines increased after the CDC’s publication of the 2016 guidelines.
Commenting on the new guidance, Christopher Jones, acting director of the CDC’s National Center for Injury Prevention and Control stated, “We’ve built in flexibility so that there’s not a one-size-fits-all approach.”
The CDC is accepting comments on the draft through April 11. A finalized update is expected this year.
CMS Proposes Rule That May End DIR Fees, Comment Period Open
On January 12, 2022, the Centers for Medicare and Medicaid Services (“CMS”) issued a proposed new rule which may fundamentally change Direct and Indirect Remuneration (“DIR”) fees.
The new Rule will redefine “negotiated prices” removing the exception for contingent fees. The rule appears to be an improvement for beneficiaries that pay a coinsurance based on the negotiated price. However, CMS made it clear that the new Rule does not eliminate all contingent fees. Plans and PBMs may continue to have DIR Programs and charge fees to pharmacies retroactively. The one caveat is that they will not be able to profit from DIR fees as they do today.
But CMS was silent when it came to preventing a PBM from setting reimbursement below the drug cost and it does not comment on price transparency.
The comment period for the new rule ends March 7, 2022. See the link below to comment.
Senate Confirms Dr. Robert Califf as FDA Commissioner
The Senate has confirmed Dr. Robert Califf as Food and Drug Administration (FDA) commissioner. Dr Califf is a cardiologist by profession. He previously served as FDA commissioner under President Obama.
MarkeTouch was founded with the goal of being a premier provider for pharmacy patient engagement services. MarkeTouch started with outbound notifications and while that is still the core of our service suite, over the past 20 years MarkeTouch has added multiple communication technologies, numerous patient engagement campaigns and services for retail pharmacy, specialty pharmacy, health system pharmacy, and managed care pharmacy. All services are focused on improving clinical outcomes, generating incremental revenue, streamlining operations and creating a world class patient experience.
If you are looking to implement any of the following services, call 1-800-235-7244 to set a convenient meeting time during HIMSS22.