Painkillers: Regulations and Recommendations

By Nisha Chandra

Last month, the FDA made a recommendation to change the way doctors prescribe hydrocodone
painkillers. These painkillers are the highest prescribed medications in the US and include narcotics like
Vicodin, which are legal but highly addictive. These types of painkillers have long been a problem in
America because of the potential for drug abuse. In fact, in the last ten years, more than 100 thousand
have died from overdoses of hydrocodone medication.

Drug companies claim that they have reduced the risk of addiction by adding a drug called
acetaminophen, which is found in Tylenol, to hydrocodone painkillers. However, very little evidence
exists to prove whether acetaminophen actually lowered the risk of abuse.

Efforts in the past to rectify the problem have been met by opposition from lobbyists. Drug companies,
patients-rights groups, and the AMA all oppose restrictions on hydrocodone drugs. The stated reason
for this opposition is that additional regulations will decrease access to those who truly need it. And
these lobbyists have been persuasive. A bill in the House of Representatives to restrict prescriptions
of hydrocodone medication was shut down by a representative from Michigan who had received 300
thousand dollars in campaign contributions from drug companies.

Still, public health advocates pushed for more restrictions. The FDA previously looked into the problem
in 2008, but at that time concluded that there was no need to tighten restrictions on hydrocodone
drugs. But they reversed that decision last week. Now, the FDA recommends that the pain pills should
be moved from Schedule III to Schedule II. Schedule II drugs are ones that are deemed more dangerous
and are more strictly regulated. The FDA also recommended that patients should only be able to get
refills for hydrocodone painkillers for 90 days before having to see a doctor. Previously, the limit was 6
months. Doctors are trained to see the symptoms of addition, and more frequent visits to the doctor are
hoped to cut down on prescription abuse. Additionally, patients will have to take a prescription to the pharmacy for a refill, instead of having their doctors call it in. This may have negative effects for those who live in rural areas and those without access to transportation.

Still, this is just a recommendation from the FDA, not actually law. It will become law when the
department of health and human services approve these recommendations and when the DEA adopts them. These approvals are expected to take place and will result in changes happening early next year.

References:
http://www.nytimes.com/2013/10/25/business/fda-seeks-tighter-control-on-prescriptions-for-class-of-
painkillers.html

http://www.bloomberg.com/news/2013-10-24/u-s-recommends-tighter-control-on-hydrocodone-pain-
pills.html

What does Covered California mean for Californians?

By Penelope Chuah

Tremendous strides towards developing more affordable, accessible, and higher quality healthcare has taken place within the past three years; this year California is about to kick-off its new health market under Covered California.

These changes to the healthcare market all began with the momentous occasion in 2010 when “President Obama with the stroke of a pen, made health care for all Americans a right not a privilege” (Nancy Pelosi, Covered California Town Hall Forum). This monumental legislation called the Patient Protection and Affordable Care Act was designed to restructure the fractured American healthcare system that has consequently ranked the nation 37th in worldwide health performance. Changes to individual premiums as well as other state insurance policies will vary from state to state. In California, Covered California will offer people an online platform to appropriately choose an affordable and high quality health plan.

So what else exactly does this legislation mean for Californians? It means ensuring that both the insured and uninsured find plans well suited to their needs; it means allowing people to choose from 13 health plans presented by the Health Benefit Exchange; it means providing premium assistance targeted by income; and it means decreasing health disparities. 5.3 million represents the number of currently uninsured Californians or those who purchase health insurance on his or her own; this number, however, will decrease tremendously this October 1, 2013 when the California health insurance marketplace opens for enrollment. In the Covered California forum hosted at UCSF, Peter Lee, Executive Director of the California Health Benefit Exchange and Berkley graduate, stated Covered California’s mission: 1. Increase the number of insured Californians and decrease health disparities, 2. Increase healthcare quality, 3. Decrease healthcare costs. The new system will provide standard benefits designed to ensure that money does not become a deterrent of access to care. Rates will be determined by age, zip code, income, and household size. How can you access this new exchange? Covered California has created an easily navigable website to facilitate new users to the options available. This online marketplace offers people a clear layout of the various health plans offered and to which ones they may qualify. For those who already have health insurance, they will be able to keep their insurance and receive the new benefits and security provided by the Affordable Care Act.

The remaining few months of 2013 and the forthcoming months of 2014 provide a bright future for the ongoing health reform process. For more information and details about Covered California and how to enroll, please follow this link: http://www.coveredca.com/