Senators Casey and Alexander Urge Administration to Protect Infants from Harm of Prescription Drug Abuse

Senators: Harm of Abuse During Pregnancy Costs Medicaid Half a Billion Dollars in Excess Expenses

WASHINGTON, DC – Today, U.S. Senators Bob Casey (D-PA) and Lamar Alexander (R-TN) sent a letter to the Acting Administrator of the Centers for Medicare and Medicaid Services (CMS) urging the agency to use all available resources and provide as much information as possible to combat rising rates of prescription drug abuse among pregnant women.

“The prescription drug abuse epidemic is one of the most serious public health problems facing our nation,” the Senators wrote. “New data illustrate the devastating toll that this abuse is taking on the youngest and most vulnerable Americans… We cannot afford to let this trend continue, from a public health or economic standpoint.”

The letter is in response to a recent Journal of the American Medical Association (JAMA) article, which found that the number of newborns being born in drug withdrawal has increased nearly threefold in the past 10 years. The study estimated that every hour a baby is born in the United States with symptoms of withdrawal from opiates — roughly 13,500 babies a year. And the average hospital stay for a newborn in withdrawal topped $50,000 in 2009, compared to approximately $10,000 for a healthy baby.

The Senators argue that preventing neonatal abstinence syndrome (NAS), which can cause seizures, breathing problems, dehydration, difficulty feeding, tremors and irritability, is an economic priority because babies born to mothers addicted to opioids, such as painkillers, necessitate longer and more expensive hospital stays than healthy infants. The study found that eighty percent of the healthcare costs for affected newborns was paid by Medicaid last year.

“We must utilize our validated and available resources to reduce the harmful risks of prescription drug abuse in pregnancy, as the outcomes truly affect us all,” the Senators wrote.

The full letter to CMS Acting Administrator Tavenner is below:

The Honorable Marilyn Tavenner

Acting Administrator

Centers for Medicare and Medicaid Services

Dear Ms. Tavenner:

The prescription drug abuse epidemic is one of the most serious public health problems facing our nation. According to the annual survey sponsored by the Substance Abuse and Mental Health Services Administration (SAMHSA), more than 12 million Americans reported using opioid analgesics, or prescription painkillers, non-medically in 2010. Given this devastating trend, we write to inquire what data and information the Centers for Medicare and Medicaid Services (CMS) have about the incidence of neonatal abstinence syndrome (NAS) and what actions CMS is taking to identify and prevent NAS.

New data illustrate the devastating toll that this abuse is taking on the youngest and most vulnerable Americans. An article published in the Journal of the American Medical Association (JAMA) on April 30 reports that the numbers of newborns being born in drug withdrawal has increased nearly threefold in the past 10 years. The babies affected by NAS, on average, stay in the hospital more than five-times as long and at greater than five-times the cost as healthy newborns and suffer serious health risks, such as respiratory complications. This study found that nearly 80 percent of the healthcare costs for the affected newborns was paid by Medicaid. 

We urge CMS to reach out to state Medicaid directors about this issue and begin to formulate a plan to stop NAS. Effective drug prevention tools, such as Screening, Brief Intervention, and Referral to Treatment (SBIRT) services, are reimbursed by Medicaid; we hope that these and other promising evidence-based interventions, such as maintenance opioid therapy in pregnancy, will be considered by CMS in a strategy to curb the incidence of NAS and its attendant costs.

We cannot afford to let this trend continue, from a public health or economic standpoint. We must utilize our validated and available resources to reduce the harmful risks of prescription drug abuse in pregnancy, as the outcomes truly affect us all.

Thank you for your consideration of this request.

Sincerely,

Robert P. Casey, Jr.                                    

United States Senator                                           

Lamar Alexander

United States Senator

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