Docs don't want to treat 'them'

The ideas and innovators shaping health care

Apr 02, 2024 View in browser   By Carmen Paun, Ruth Reader and Erin Schumaker POLICY PUZZLE It may take more than loosened regulations to expand treatment for opioid use disorder. | Joe Raedle/Getty Images Turns out that lifting restrictions on doctors prescribing buprenorphine, a controlled drug used to treat opioid use disorder, is only the first step to expanding access to addiction treatment. A 2022 law removed a requirement that practitioners undergo special training to prescribe the drug. But the measure hasn’t been the game-changer lawmakers and federal agencies had hoped it would be, according to Thomas Prevoznik, deputy assistant administrator for the Drug Enforcement Administration. Speaking Monday at the Rx and Illicit Drug Summit in Atlanta, Georgia, Prevoznik said the total volume of buprenorphine prescriptions dispensed since the law entered into force has remained around 1.4 million and hasn’t spiked up as expected, Carmen reports. Here are the reasons he attributes to the low uptick: — Stigma “The biggest thing I heard and continue to hear from prescribers and pharmacists … is they continue to call those who suffer from opioid use disorder ‘them,’ like they don't want ‘them,’ they don’t want to treat ‘them’ in their practice,” Prevoznik said. That attitude was an eye-opener for the DEA, he said, noting that people with opioid use disorder are “our family members, our neighbors, our friends. … They’re dying. This has to become part of mainstream health care,” he said. — Low drug-reimbursement rates Prevoznik said pharmacists have complained about losing money when they prescribe buprenorphine because of low reimbursement rates. “That has to change,” he said. — Fear of the DEA The DEA controls access to buprenorphine because it’s an opioid. The drug helps people wean off more dangerous and usually illicit drugs, such as fentanyl and heroin. But drug distributors and pharmacists fear running afoul of DEA thresholds on the amount of buprenorphine that can be bought. Prevoznik said he’s made it clear that the federal agency does not have such thresholds; however, states imposed levels as the prescription opioid crisis persisted. The DEA and HHS and its Substance Abuse and Mental Health Services Administration sent a letter last month to health care practitioners and distributors clarifying some of those issues, he said.   YOUR GUIDE TO EMPIRE STATE POLITICS: From the newsroom that doesn’t sleep, POLITICO's New York Playbook is the ultimate guide for power players navigating the intricate landscape of Empire State politics. Stay ahead of the curve with the latest and most important stories from Albany, New York City and around the state, with in-depth, original reporting to stay ahead of policy trends and political developments. Subscribe now to keep up with the daily hustle and bustle of NY politics.      WELCOME TO FUTURE PULSE Skógafoss, Iceland | Daniel Payne This is where we explore the ideas and innovators shaping health care. Three-quarters of healthcare workers think AI could help solve the nursing shortage, according to a 2024 survey from Carta Healthcare—a health AI company. Consider the source! Do you think AI could solve staffing issues in health care? Reach out! Share any thoughts, news, tips and feedback with Carmen Paun at cpaun@politico.com, Daniel Payne at dpayne@politico.com, Ruth Reader at rreader@politico.com or Erin Schumaker at eschumaker@politico.com. Send tips securely through SecureDrop, Signal, Telegram or WhatsApp.   SAFETY CHECK Cyber threats could pose a significant risk to one HHS division, according to a new report. | AFP via Getty Images HHS’ Administration for Children and Families is at risk of being hacked, according to a new report from the Office of the Inspector General. The agency supports the wellbeing of families and children. OIG audited ACF’s data cloud to ensure it was secure and compliant with federal standards. It wasn’t. The inspector general found that while ACF had some cybersecurity protections in place, it didn’t follow all requirements and guidelines. In particular, ACF didn’t create an inventory or monitoring system for its cloud. It also didn’t proactively test its systems’ security. Three ACF websites weren’t included on its inventory list, leaving them potentially unmonitored or appropriately updated and vulnerable to an attack. OIG, with cybersecurity assessment firm Breakpoint Labs, simulated real-world attacks on the agency’s infrastructure and found it could access sensitive data and gain authorized control over parts of its cloud network. Why it matters: Overall, more than 30 percent of Health and Human Services’ systems were cloud-based in 2022, per the audit.  Cyberattacks on federal agencies have become more damaging and disruptive, according to a December report from the Government Accountability Office.  President Biden has bolstered federal cybersecurity efforts through executive orders. He had budgeted $3 billion for the Cybersecurity and Infrastructure Security Agency in 2024, but Congress came in nearly $200 million short of that figure in its final spending package. What’s next: OIG has asked ACF to track its cloud inventory, outline a strategy for implementing additional security and use penetration testing services that HHS already offers to ensure the safety of its infrastructure.   Easily connect with the right N.Y. State influencers and foster the right relationships to champion your policy priorities. POLITICO Pro. Inside New York. Learn more.     FORWARD THINKING Congressional action could make organ transplant innovations more lucrative. | Getty Images Organ transplant tech could soon be a lucrative market, thanks to Congress. That’s according to a new report from industry analyst PitchBook, which estimates the market opportunity for innovations like transplant diagnostics, organ transport and artificial intelligence-based transplant matching to be at least $7 billion globally. Bird’s-eye view: The opportunity is fueled partly by legislation President Joe Biden signed into law in September. The Securing the U.S. Organ Procurement and Transplantation Network Act is meant to bolster the nation’s organ donation system by putting the system’s management out for bid. The United Network for Organ Sharing, which ran the system for 40 years, came under fire for poor performance, culminating in a two-year Senate Finance Committee investigation, which concluded in 2022 that “from the top down, the U.S. transplant network is not working, putting Americans’ lives at risk.” The Senate report recommended removing barriers to competition and breaking up the existing contract. An upcoming review of that contract, “may lead to additional disruption with opportunity for transplant startups to gain a foothold as technology partners,” according to PitchBook. Why it matters: More than 100,000 people are on the national waitlist for an organ transplant, and federal officials say 6,000 people die each year waiting for a transplant. Current preservation methods, including what essentially amounts to storing organs in a cooler, can freeze or damage organs. What's next: Bipartisan Energy and Commerce Committee leaders announced an investigation into UNOS last month and sent a letter to Carole Johnson, administrator of the Health Resources and Services Administration, requesting information on how HRSA “will support fair and competitive practices during the contracting process, promote data transparency and patient safety, and ensure system security and operability.” UNOS told FP it received the request for information and is cooperating with the committee. The committee requested Johnson's answers by April 3.   Follow us on Twitter Carmen Paun @carmenpaun Daniel Payne @_daniel_payne Ruth Reader @RuthReader Erin Schumaker @erinlschumaker   Follow us

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