Dive Brief:
- Opioid supply levels decreased by 11% from 2016-17, according to Avalere, a healthcare consulting firm.
- Supplies tanked most in states that passed laws limiting opioid sales. Maine had the largest dip of nearly 25%.
- Government-mandated fill limits aren't the only solutions to limiting opioid supply, and can sometimes lead to unintended consequences.
Dive Insight:
As the nation battles the opioid crisis, a decrease in the opioid supply has mixed implications for actors along the supply chain, requiring a multi-faceted solution.
By spring of 2018, 28 states provided some sort of limit or guidance for opioid prescriptions, according to the National Conference of State Legislatures. These limits come in the form of dosage limits or caps on prescription time periods, usually three, five, or 14 days. The Drug Enforcement Administration (DEA), meanwhile, had ordered a 25% reduction in supply in 2017 and an additional 20% in 2018.
The government isn't the only one advocating such policies to hamper supply, though; some actors in the supply chain are on board as well.
Pharmaceutical distributor McKesson, for example, said in a recent policy paper that it supports "regulatory policies that encourage policymakers to look 'upstream' in the supply chain to prevent abuse, misuse and diversion: (1) Enact nationwide opioid prescription limits (seven-day supply limit for acute pain), (2) Permit partial fills, and (3) Require DEA to revisit annual production quotas."
But top-down crackdowns on prescription quotas aren't the only solutions to reducing supply. McKesson's report advocates training for pharmacists, technological tracking and drug return programs as well. It also recommends education for patients on proper use of the drugs.
Earlier this year, a shortage of opioids emphasized the need for a nuanced approach to supply policies. Pfizer, which manufactures about 60% of injectable opioids, couldn't produce enough opioids because of upgrades to a plant in Kansas. The resulting shortage left nurses resorting to alternative drugs or administering drugs in different, potentially harmful, doses, CNN reported. Eventually, the DEA eased the quotas in April.
McKesson noted that any policy approach must weigh restrictions on supply with assurance that needed opioids are available: "We remain steadfast in our commitment to work with all stakeholders to protect the supply chain and prevent diversion while ensuring that patients who need their medicines get them in a timely manner."