President Trump made improving Americans’ health a centerpiece of his 2024 campaign. Perhaps no issue has devastated our public health more over the last 25 years than the opioid crisis. Thankfully, there are now modern alternatives to highly addictive opioids, with even more about to enter the market.
Unfortunately, outdated Medicare rules still steer doctors toward prescribing cheap, generic opioids to seniors instead of these effective alternatives. This is why Congress needs to pass legislation like the Alternatives to Prevent Addiction in the Nation (Alternatives to PAIN) Act, which would remedy this situation by expanding access to non-opioid pain management options for Medicare recipients.
The opioid crisis has touched nearly every demographic in our society. One area that doesn’t get enough attention is the toll it has taken on seniors. In 2021, for example, 1.1 million seniors were diagnosed with an opioid-use disorder. Between 2012 and 2020, deaths from opioid overdoses among those 65 and older increased by 63 percent. Often, opioid addiction begins in the doctor’s office when a senior receives a prescription for pain medication.
While doctors know there are better, alternative pain medicines available, Medicare rules often require them to try a lower-priced, generic opioid medicine before “stepping up” to something more expensive, like a non-opioid alternative. Lawmakers have been working to change the rules around alternative pain medicines in recent years, but more must be done.
The first major legislative win for this issue came in 2022 when the NO PAIN Act was signed into law. By providing separate Medicare reimbursement for non-opioid therapies, this bill expanded patient and provider access to FDA-approved non-opioids in all outpatient surgical settings.
Then, last year, a follow-up bill called the Alternatives to PAIN Act was introduced. This bill builds on the progress of the NO PAIN Act in three key ways. First, it limits patient cost-sharing for those receiving non-opioid pain treatment under Medicare Part D, making these opioid alternatives more affordable. Second, it prohibits “step therapy” and prior authorization for these drugs, allowing doctors to prescribe them without first having to try treating the pain with cheaper, generic opioids. Third, the bill would encourage dialogue between patients and providers about the available pain management choices.
Last year, the Alternatives to PAIN Act garnered an impressive show of bipartisan support in the House and Senate. Unfortunately, lawmakers failed to get the bill across the finish line. It must be reintroduced in Congress before representatives can vote on it.
During his first term in office, Donald Trump declared the opioid crisis a public health emergency. Sadly, the crisis is far from over, and the economic costs are nearly as astounding as the human toll. Some estimates peg the cost of the opioid crisis to American taxpayers at $1.5 trillion annually, while Medicare Part D accounts for an increasing portion of opioid prescriptions, up 75 percent since 2011.
Passing the Alternatives to PAIN Act would be an excellent way for Trump to uphold his promise to “Make America Healthy Again.” Let’s reintroduce this bill in Congress and encourage our elected officials to get it onto Trump’s desk as soon as possible. Doing so could save lives, and our seniors can’t afford to wait longer.
