A Minnesota bill seeking to establish an Opioid Stewardship Fund doesn’t address the root cause of the opioid crisis – the illegal sale of narcotics – and will only increase costs to taxpayers, insurance companies and their customers, critics argue. And while well-intentioned, it potentially could drive pharmaceutical companies out of the state, they say.
The bill, HF 400, passed the state House by a vote of 94-34 and awaits action in the Senate. If passed into law, it would create an opioid stewardship fund, an opiate product registration fee, and modify provisions related to opioid addiction prevention, education, intervention, treatment and recovery.
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Rep. Tony Albright, Assistant Minority Leader, who voted against the bill, has proposed several alternatives over the years, including better access to treatment and prevention resources.
The fund’s revenue would come from fees on manufacturers and wholesalers of opioid medication. Board members of the Opioid Stewardship Fund would determine fees based on its $20 million annual budget.
But imposing arbitrary fees on pharmaceutical distributors will only increase costs for everyone and do nothing to address the opioid crisis, Grover Norquist, president of Americans for Tax Reform, argues.
HF 400 "could even make the opioid crisis worse," Norquist says. "The legislation would impose a harmful new tax that would hurt patients in need of medicine by driving up costs directly and causing supply problems that would further hike costs and create access issues."
Action 4 Liberty, an advocacy group that opposes the bill, argues "government should not get involved in the decision-making of prescribing pain medication from medical professionals."
The bill dictates how much opioid pain medication a doctor can prescribe to patients who’ve had surgery or undergone a major trauma. It states, "when used for the treatment of acute pain associated with a major trauma or surgical procedure, initial prescriptions for opiate or narcotic pain relievers listed in Schedules II through IV of section 152.02 shall not exceed a seven-day supply."
The bill also adds mandated acupuncture coverage to Minnesota health insurance plans: "health plans must cover acupuncture services for the treatment of pain and ongoing pain management."
The new regulations are misplaced and overly burdensome, the Washington, D.C.-based advocacy organization, Citizens Against Government Waste (CAGW), argues.
"Because the opioid crisis is primarily driven by illegal narcotics like fentanyl and heroin, it would be prudent for legislators to focus their efforts on preventing those drugs from being trafficked, instead of placing further regulations and taxes on the legal pharmaceuticals that Americans use every day," Elizabeth Wright, CAGW’s director of health policy, said.
According to a study published this month by economics professors at Union University in New York, any costs to comply will be passed on to taxpayers. When evaluating a similar opioid tax proposed in New York, the researchers found that "the proposed tax will encourage residents suffering from opioid dependence to switch to cheaper illegal opioids, including heroin and fentanyl, with increased rates of accidental overdose."
The opioid tax would drive up prices for consumers and insurers, the researchers found, and not actually address the drug-addiction crisis.
None of these initiatives address the root of the opioid problem, critics argue.
Approximately 26,000 people died nationwide from fentanyl sold on the black market originating from China and Mexican cartels in 2017, according to a Bloomberg News report. According to Centers for Disease Control (CDC) data, the sale of illicit fentanyl poses the greatest risk in the opioid crisis.
Critics point out that because the tax demands an arbitrary amount of fees, once one fee-paying pharmaceutical company leaves the state, the rest will end up paying more, and then also might consider leaving. Suppliers would then leave the state, opponents of the bill fear, creating another crisis altogether – less access to medication.
"Taxpayers should make their voices heard and demand that policies related to the opioid epidemic are focused on the cause of the crisis, not on a political scapegoat," Wright added.