Prescription drugs: Feds seek to limit telemedicine prescriptions for some drugs

WASHINGTON — On Friday, the Biden administration suggested that patients see a doctor in person before receiving attention-deficit disorder medication or addictive painkillers, tightening access to medication amid a deepening opioid crisis.

The proposal could change how millions of Americans get some prescriptions after three years of using telemedicine to see a doctor via computer or phone during the pandemic.

NOTE. The video in the media player is taken from the previous report.

The Drug Enforcement Administration said late Friday that it plans to restore the once-long-standing federal requirements for hard drugs that were phased out in the wake of COVID-19, allowing doctors to write millions of prescriptions for drugs like OxyContin or Adderall without ever having to. meeting with patients in person.

Patients will need to see a doctor in person at least once to get an initial prescription for drugs the federal government says have the greatest potential for abuse, such as Vicodin, OxyContin, Adderall and Ritalin. Refills may be prescribed by telemedicine appointment.

The agency will also restrict how doctors can prescribe other, less addictive drugs to patients they have never met physically. Substances such as codeine, taken to relieve pain or cough, Xanax, used to treat anxiety, Ambien, a sleeping pill, and buprenorphine, a drug used to treat opioid dependence, may be prescribed instead of telemedicine for the initial 30-day dose. Patients would have to see a doctor at least once in person in order to receive a refill.

MORE: Panel urges FDA to move opioid antidote Narcan without a prescription

Patients will still be able to receive conventional prescriptions such as antibiotics, skin creams, contraceptives and insulin prescribed through telemedicine visits.

The new rule aims to maintain expanded access to telemedicine, which is important for patients in rural areas, for example, while also balancing security. DEA administrator Ann Milgram called the approach “an extension of telemedicine with fencing.”

The ease of every American’s access to certain medicines during the pandemic has helped many get the treatment they need, but also raised concerns that some companies could take advantage of lax regulations and prescribe medicines to people who don’t need them, David Herzberg said. , a drug historian at the University at Buffalo.

“There are really good sides to both sides of this tension,” Herzberg said. “You don’t need barriers to people getting the prescriptions they need. But any time you remove those barriers, it’s also an opportunity for profit seekers to exploit weak rules and sell drugs to people who may not need them.”

Overdose deaths in the US hit a record in 2021, about three-quarters from opioids during a crisis that was first launched by drug makers, pharmacies and doctors who offered drugs to patients decades ago. But the grim toll from synthetic opioids like fentanyl far exceeded the deaths associated with prescription drugs, according to the Centers for Disease Control. Fentanyl is increasingly found on the illegal market, being added to counterfeit prescription pills or mixed with other drugs.

The proposed rules deal a major blow to the burgeoning telemedicine industry, with startups launching technology in recent years to treat and prescribe drugs for mental or attention disorders. The industry has largely benefited from the pandemic-induced postponement of in-person drug visits, although some national retailers have stopped fulfilling drug orders created by some telemedicine apps over the past year.

Over the past two years, the DEA has become increasingly concerned that some of these start-up telemedicine companies are improperly prescribing addictive substances such as opioids or ADHD drugs, putting patients at risk, a DEA official said Friday. with Associated Press drugs.

The official said the agency plans to put the new rule into effect before the COVID-19 public health emergency expires on May 11, effectively ending the relaxed rules. That could mean people who can seek care from a doctor hundreds of miles away need to start making plans for in-person visits with their doctors now, said Boston-based attorney Jeremy Scherer, who represents telemedicine companies. When the law goes into effect, patients will have six months to visit their doctor in person.

“Providers and their patients need to know what this treatment will look like in the future and whether they need to figure out how to visit in person after the end of the public health emergency in May before continuing. treatment, and that could be a real problem,” he said.

Many states have already taken steps to reinstate restrictions on out-of-state telemedicine. By October, nearly 40 states and Washington, D.C., had lifted emergency declarations, making it easier for doctors to see patients in other states.

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