House Health and Aging Committee
November 18, 2015
HB 248 Proponent Testimony
Ohio Society of Anesthesiologists
Chair Gonzalez and members of the Committee, I am Dr. Jim Bruns MD. I am dually board certified in
physician anesthesiology and pain medicine. I am here today on behalf of the Ohio Society of
Anesthesiologists (OSA) which represents over 1200 practicing physician anesthesiologists and physician
anesthesiologist pain management specialists. We are here today to convey our support for HB 248 that
protects access to abuse deterrent opiate analgesic drugs. (ADO)
First of all, we want to thank Representative Robert Sprague for his tireless efforts to fight Ohio’s
prescription drug abuse epidemic. This bill is another important step in that battle. As physician pain
specialists, we treat patients suffering from chronic pain. We are very careful and thorough when
determining a patient’s course of treatment. Not every patient, not even a majority of patients that I
see need an ADO or any opiate necessarily. When we see a patient, make a diagnosis based on
medical and environmental factors, and determine that they need the ADO then the patient needs to
be able to actually get the prescription. This is not usually the case.
Insurers have different requirements for coverage of ADO medicines: different requirements among the
various carriers and different requirements within the various benefits packages within each carrier. All
carriers will tell you they provide “access” to ADO medicines. However, “access” may mean the patient
must fail on a crushable opiate first. (fail first on a less expensive drug that can be easily abused).
“Access” may also mean the prescriber must gain prior authorization from the carrier. Prior
authorization may require a variety of chart notations that are different depending on the carrier and
even the benefit plan within the same carrier. All of these “utilization review mechanisms” delay access
and often deny access for our patients to the ADO medicines.
In order to ensure true access without hoops for prescribers and patients to jump through in order to
prove to the insurer the medicine is needed, HB 248 Lines 57-71 are essential. Make no mistake, ADO
medicines are simply a tool that we can use with patients that we, physicans, determine need the ADO
medicine immediately and are at risk for abuse or diversion given medical and/or environmental
reasons.
HB 248 would allow patients access to medicines they need and will limit additional costs to the medical
system. Additional costs may include: administrative costs to convince the insurer of the patient’s
needs, unnecessary hospital and other costs to the treatment system and our society and finally costs to
the patient both financially and emotionally.
Thank you and I am happy to answer any questions you may have.