Numerous provider and insurer groups say proposed policy changes for opioid quotas could worsen current drug shortages.
A proposed rule, released last month by the Drug Enforcement Administration, would limit drug makers' annual production of opioids in some circumstances and require manufacturers to identify a need for controlled substances to justify their production.
Additionally, the agency is seeking to take greater control of production quotas and will consider how often a drug is diverted for misuse when setting production limits. The proposal is part of an effort by the Trump administration to "strengthen controls over diversion of controlled substances" during a time when the country is facing an opioid epidemic.
In a letter (PDF) to the agency, six major provider, service and payer groups, including America's Health Insurance Plans, said the proposal could exacerbate drug shortages for vital opioid medications.
"Injectable opioids dispensed in clinical settings pose a far lower risk of diversion than other dosage forms dispensed directly to patients," the groups said. "Having diminished supply of these critical drugs, or no supply at all, can cause suboptimal pain control or sedation for patients in addition to creating burdensome workarounds for healthcare staff."
Intravenous opioids are used in hospitals and ambulatory surgical centers for the treatment of acute and chronic pain that cannot be managed because the patient has an addiction or contraindication for oral opioids, making the drugs vital for some patients.
The groups asked the agency to add drug shortages as a factor when determining quotas and added that shortages are unlikely to be resolved in the near future.
Individual insurers have made strides on in reducing prescriptions of opioids. Cigna announced in March that it had reduced opioid use among its customers by 25%.