Minnesota governor proposes penny-a-pill fee on opioid prescriptions

Minnesota Gov. Mark Dayton is proposing a “penny-a-pill” paid for by drug companies to fund an opioid stewardship program for addiction prevention, treatment and recovery efforts in Minnesota. The governor estimates the program would raise $20 million each year.

Minnesota Department of Health data shows the state had 395 opioid deaths in 2016, an 18 percent increase over 2015. Of those 395 deaths, 194 were linked to prescription opioids.

CHANGING GUIDELINES: Last December, Minnesota announced new guidelines to change how physicians are writing prescriptions for painkillers. These new guidelines were the product of 18 months of planning by a group of physicians on both sides of the aisle. 

Part of the opioid prescribing work group are two state lawmakers, Rep. Baker and Senator Chris Eaton, who both have lost children to opioid overdoses. Their goal is to curb the number of opioids being prescribed across the state. Statistics from the CDC show 47 opioid scripts are written for every 100 Minnesotans. 

The new guidelines include:

1. Prescribing the lowest effective dose and duration of opioids when used for acute pain.  
2. Monitoring the patients closely, including prescribing opioids in multiples of seven days.
3. Avoid initiating chronic opioid therapy, make it so long term prescriptions would include face-to-face visits with the provider at least every three months. 

“To our patients already on these pain medications, we are not abandoning you,” said Dr. Chris Johnson leading the group.

Johnson emphasized the focus will be on educating and guiding physicians, patients and their families. Minnesota is currently the fifth lowest state in the country when it comes to prescribing opioids, but everyone involved in this effort points out doing better is vital. 

“One opioid prescription can start the downward spiral in the right person,” said Dr. Rahul Koranne, Chief Medical Officer for the Minnesota Hospital Association. 

LAWSUITS AGAINST DRUG COMPANIES: Multiple Minnesota counties have filed lawsuits against pharmaceutical companies, accusing the drugmakers of using an aggressive marketing campaign to change the culture of prescribing opioids. A lawsuit filed by Anoka County last month claims pharmaceutical companies convinced doctors that it was safe to prescribe opioids to treat not only severe and short-term pain, but also for less severe and longer-term pain, such as back pain and arthritis. 

“The defendants knew, however, that their opioid products were addictive, subject to abuse and not safe of efficacious for long-term use,” the lawsuit says. 

In 2016, the Food and Drug Administration recognized opioid abuse as a public health crisis. Despite this, the lawsuit says pharmaceutical companies have maintained that prescription opioids are not dangerous and have continued to sell the drugs. 

About 20 other Minnesota county attorneys filed similar lawsuits in November, led by Washington County Attorney Pete Orput.