Innovations-Magazine-April-2023 - 13

FEATURE NEWS
The list of legislative and regulatory actions around mobile
pharmacies continues to grow, as states seek to expand
medication therapy to vulnerable populations, particularly
individuals suffering from OUD.
of those deaths involving opioids. The vast majority of people
living with OUD - one study put the number at more than
86% - are not receiving medication to help treat it. Since
regularly traveling to an approved site to receive medication
and other services can be a serious impediment to patients
receiving treatment, mobile units could be an important piece
of improving treatment access for underserved populations,
including in rural areas and among prison populations.
Drug Enforcement Administration (DEA) reopened the door to
allowing mobile OUD treatment in June 2021, when it finalized
rules allowing registered opioid treatment programs (OTPs) to
add a " mobile component " to their existing registration. While
" methadone vans " had originally been permitted, starting in the
late 1980s, DEA stopped approving new vans in 2007, citing
diversion concerns. By 2021, only 10 remained in existence.
The rising number of opioid-involved overdoses over the past
decade caused the agency to reverse course, citing, in particular,
the need to improve treatment access in rural areas. Following
DEA's actions, the Substance Abuse and Mental Health Services
Administration, which likewise regulates OTPs, issued guidance
on the services that can be provided in mobile units. Further, the
Centers for Medicare & Medicaid Services, in a 2023 final rule,
clarified that Medicare-enrolled OTPs could bill " for medically
reasonable and necessary services provided via mobile units. "
Since DEA's final rule, several states have taken actions
A record-breaking 107,622
individuals are estimated
to have died from a drug
overdose in 2021, with
nearly 81,000 of those
deaths involving opioids.
to promote the use of mobile units that perform pharmacy
services. Not all are specifically targeted at the treatment of
OUD - the California Legislature, for example, passed a bill
authorizing primarily public agencies to operate mobile units
to provide a broad array of pharmacy services to homeless
persons and others - but most are. The Washington State
Department of Health, for example, adopted an emergency rule
allowing OTPs to add a mobile unit as an extension of their
license. The Kansas State Board of Pharmacy issued formal
guidance addressing the deployment of a mobile unit in order
to increase access to medication-assisted treatment for substance
use disorder. Similarly, the Pennsylvania Department of Drug
and Alcohol Programs issued a licensing alert addressing the
process for establishing mobile narcotic treatment programs.
States are also taking advantage of new funding options to
make mobile programs possible. Oregon moved quickly to utilize
a new Medicaid plan amendment option, receiving approval for
a community-based mobile crisis intervention service. New York
State put out a request for applications, seeking to grant up to $3.3
million to eligible OTPs, to assist them in developing mobile units.
Philadelphia announced its intention to use some of its anticipated
opioid lawsuit settlement money for a mobile methadone program.
The list of legislative and regulatory actions around mobile
pharmacies continues to grow, as states seek to expand medication
therapy to vulnerable populations, particularly individuals suffering
from OUD. Regulating these efforts to ensure patient safety and
supply chain security while tackling the OUD crisis will involve
many boards of pharmacy in the years ahead.
In line with NABP Past President Timothy D. Fensky, RPh, DPh,
FACA, and his presidential initiative to increase access to medications
for OUD treatment, NABP will continue to work with its members
in their efforts to curb the OUD crisis.
APRIL 2023 | 11
https://nabp.pharmacy/members/medication-treatment/
Innovations-Magazine-April-2023

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