FDA Calls Out Juul; Opioid Crackdown; States Tackle Drug Pricing

September 16, 2019 by Chris Pirschel ONS Staff Writer/Producer, and Alec Stone MA, MPA, Former ONS Director of Government Affairs and Advocacy

FDA Issues Stark Warning to Juul

With more deaths reported from vaping and a forceful U.S. Senate declaration to the U.S. Food and Drug Administration (FDA) acting commissioner (https://voice.ons.org/advocacy/durbin-calls-out-fda-medicare-for-all-support-cancer-mortality-drops) to either enact stronger federal provisions restricting e-cigarettes, flavored tobacco, and inhalants or resign, the Trump administration moved quickly to demonstrate a recognition that cessation is a national, bipartisan concern. FDA sent a warning letter to Juul (https://www.fda.gov/news-events/press-announcements/fda-warns-juul-labs-marketing-unauthorized-modified-risk-tobacco-products-including-outreach-youth) about its marketing and labeling, and the president, Health and Human Services secretary, and FDA commissioner issued very public statements on the matter, making it clear that federal oversight (https://voice.ons.org/advocacy/fda-takes-stronger-oversight-role-of-tobacco-products) will be enforced on youth tobacco issues.

Several public figures verbalized their commitment to stopping the growing impact of youth tobacco use (https://voice.ons.org/advocacy/house-committee-examines-juuls-role-in-the-youth-smoking-epidemic) through alternative mechanisms this week, and two states have passed restrictive laws against vaping. Juul has been the case study, but the new industry has many moving parts, including small businesses. Courts will be the likely next step. ONS is working with the broader health community on ensuring nurses’ voices (https://voice.ons.org/stories/providing-expert-testimony-in-the-virginia-state-senate) are part of the important public health discussion.

Opioid Crackdown Forces Patients Off Drugs They Need

Although the 21st Century Cures Act and legislation specifically dedicated to the prescription drug overdose and abuse epidemic had an impact, it also had what is known in policy as the unintended consequences clause, leading to some patients tapering off drugs they need (https://www.washingtonpost.com/health/opioid-crackdown-forces-pain-patients-to-taper-off-drugs-they-say-they-need/2019/09/10/3920f220-c8da-11e9-a4f3-c081a126de70_story.html). Restricting access to medications can reduce abuse of prescription drugs (https://voice.ons.org/advocacy/hhs-awards-nearly-400-million-to-combat-opioid-crisis), but it also limits pain medications for patients who are taking them as prescribed (https://voice.ons.org/advocacy/pain-management-task-force-issues-first-report-on-pain-control-best-practices).

Patient-centered care requires nursing conversations about symptom management. Legislation can overreach in an attempt to solve a problem, negatively affecting patient outcomes. Nurses can help policymakers understand the process. Learn how you can share your thoughts (https://voice.ons.org/advocacy/get-involved) with legislators and ensure that patients have access to quality cancer care (https://www.ons.org/make-difference/ons-center-advocacy-and-health-policy/position-statements/access-quality-cancer), including medications for cancer-related pain.

States Aim to Reel in Drug Prices With New Laws

State legislatures are the incubators for federal lawmaking policy. But more than that, with state leaders seeing public health affect their financial bottom line, some are eager to erase their debt and make a statement about policy priorities. Drug pricing (https://voice.ons.org/advocacy/the-battle-against-drug-pricing-wages-on) is popular, and according to 33 states (https://khn.org/news/states-pass-record-number-of-laws-to-reel-in-drug-prices/), necessary to assist their own citizens in gaining access to life-saving prescription medications.

Often the first example is insulin for diabetics, but next on the list are cancer drugs. The legality of regulating free-market industry supplies is not new, and public health through state economics may not be enough. And it doesn’t hurt that public support and priority for lower drug pricing (https://voice.ons.org/advocacy/hhs-announces-safe-importation-action-plan-for-high-medication-costs) is increasing. This could be the beginning of a new paradigm.


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