As federal and state governments move to curb opioid abuse, the American Society of Clinical Oncology (ASCO) wants leaders to remember: Cancer patients still need access to pain management medications. In its newly released statement, “Protecting Access to Treatment for Cancer-Related Pain,” ASCO reminds policymakers that cancer patients are a “special population.” Thus, education efforts, monitoring programs and government policies should preserve their access to necessary pain treatment.
ASCO’s statement points out that access challenges for cancer patients exist already, even as state and federal initiatives move to further restrict opioids. The statement describes trends such as:
- Partial fills of opioid prescriptions due to low pharmacy supply, which may require patients to provide a new prescription for the remainder of the fill
- Pharmacies’ refuse to fill prescriptions even when the diagnosis is provided but the ICD10 code is omitted
- Pharmacists’ refuse to honor three-day emergency supplies allowed by state regulations
- Extensive prior authorizations required by insurers
- Insurers limiting the number of pills provided per fill, requiring patients to receive multiple fills (and therefore pay multiple co-payments).
Given these challenges, as well as the individualized nature of both cancer and its treatment, ASCO argues that:
- Cancer patients should be exempt from policies such as opioid dose restrictions
- Opioid prescription limits should not apply to treating cancer patients
- Prescription drug monitoring programs should consider clinicians’ specialty and their patient population when analyzing prescribing patterns.
ASCO’s statement explains that federal and state initiatives may unintentionally disrupt access for cancer patients. “Opioid overdose is a major problem,” the statement concludes, “but what remains to be clarified is to what extent the initiatives to address it should focus on patients who are prescribed these drugs for a legitimate medical condition.”
The organization also emphasizes the importance of fighting opioid abuse. Specifically, ASCO’s statement encourages:
- Greater access to naloxone, the overdose antidote commonly used by first responders
- The value of drug take-back programs
- The importance of access to abuse-deterrent opioid formulations, where appropriate.
The group also notes the need for “rapid access” to addiction treatment, including medication-assisted treatment, for patients with opioid abuse problems.
ASCO’s statement comes on the heels of several state and national efforts to address the opioid abuse epidemic. In March 2016, the Centers for Disease Control and Prevention issued new guidelines urging health care providers to limit opioid prescribing for chronic pain. Some patient advocates criticized the guidelines as overly prescriptive, while cancer advocates noted that the CDC did not acknowledge cancer survivors’ need to manage pain. A month later, the Department of Health and Human Services issued the National Pain Strategy, which endorses integrated and multimodal pain treatment.
For more, read ASCO’s “Protecting Access to Treatment for Cancer-Related Pain.”
