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Why States Might Start Taxing Opioids

Should states tax opioids?

by Axios | 12.6.18

The next wave of state actions against the opioid crisis may focus on taxing them — depending on the outcome of an industry lawsuit against New York, the first state to try it.

Between the lines: Most of the bills that have been proposed would tax opioid painkillers and use the money for addiction treatment and prevention. But the health care industry argues that they're bad policy and, at least in the New York law's case, illegal. That case will be tested when oral arguments in the lawsuit begin Monday.

More than a dozen states saw the introduction of bills to tax opioids last year, but only New York’s made it into law.

  • The New York law will collect $600 million over six years from drugmakers and distributors and use it to fund addiction treatment and prevention. These industry groups have responded with three different lawsuits arguing that the law is unconstitutional. Oral arguments for each lawsuit will be heard on Monday.
  • Some groups are also arguing that the law is bad policy. “The fee itself could force a generic company, which is making a very low margin, to leave the market. And so a potential policy consequence is that patients are only left with the brand-name, high cost opioids when they have medical needs,” said Jeff Francer of the Association for Accessible Medicines, one of the plaintiffs.

Why it matters: If the industry is successful in its attempt to kill the law, that could influence whether other states follow New York’s lead or how they write legislation.

  • “I think that the states see what’s going on in litigation,” Francer said. “No legislator wants to pass a law that a court finds to be unconstitutional.”

One state to watch is Minnesota, where Governor-elect Tim Walz has said he’s supportive of a fee on opioid prescriptions to help pay for treatment and prevention.

  • Legislation that would have created such a fee failed to pass last year, but lawmakers have said they want to try again, per Kaiser Health News.
  • Other states to watch include California, Delaware, Iowa, Kentucky, Maine, Massachusetts, Montana, New Jersey, Tennessee and Vermont, per KHN.
  • Here's a list of state opioid tax legislation that was introduced in 2018, as compiled by the National Conference of State Legislatures.

Proponents of opioid taxes argue that their value goes beyond just raising money. “If the actual price for these products reflected their true costs, I think we'd see a greater emphasis on reducing opioid use and encouraging use of pain treatments that are much safer and more effective,” said Andrew Kolodny of Brandeis University.

The other side: Opponents say these taxes could make it harder for people to get the pain medication they need. "We do not believe levying a tax on prescribed medicines that meet legitimate medical needs is an appropriate funding mechanism for a state's budget," said a spokeswoman for Pharmaceutical Research and Manufacturers of America.

The bottom line: It's a unique new approach to the fight against the opioid crisis — but a ruling against New York could easily shut it down.

Caitlin Owens

Illustration: Aïda Amer/Axios

Axios

Written by Axios

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Leave a comment
(61)
  • Chickie
    Voted No
    12/06/2018
    ···

    This is not the answer. Taxing the opioids will make it financially difficult for the millions of Americans who have, (without abuse), taken opioid medication(s), for years. Why are the legislators eager to tax patients versus penalizing pharmaceutical companies and/or insurance companies? Could it be because many have received election monies from them?

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  • S.
    Voted Yes
    12/06/2018
    ···

    The creators of the opiate crisis are pharmeceutical companies and they should fund the entirety of the harm reduction overhead since they have profited off of devastating addiction and deaths. Tax them out of existence, please.

    Like (8)
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  • Daniel
    Voted Maybe
    12/06/2018
    ···

    Let’s eliminate the Senate and move to full publicly funded campaigns and full democratic elections.

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  • Mark
    12/07/2018
    ···

    I'm an RN and until you see people truely suffering from pain you have no right to limit the use by taxing those that truely need opioids. Are they abuse ?without a doubt. I've seen patients come in and be admitted 90 times in one year so they could get their Dilaudid .however there are those who really need pain relief.tax big pharm !!! Oh I forgot big pharm donates millions to our elected officials so they can live high on the hog .that wouldn't make since .no tax the common man as usual.

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  • Ronald
    Voted No
    12/06/2018
    ···

    Some people need this medication. Do not punish the innocent people in pain for abuse done by other people.

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  • Lauralee
    12/07/2018
    ···

    The doc should pay for there crap in trying to diagnose everyone who has fillings and make them drug zombie and mind controlled also the death toll in witch they cause on giving child drugs that may cause suicidal tendencies. Really dumb people think drugs help. No natural meditation and love ❤️ and respect for others going through hard time. Also some doctors need therapy. What kind of doctor or therapist think Pedo’s are good for children😡Crazy doctor who probably took to many drugs the self.

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  • Sylvia
    Voted Maybe
    12/07/2018
    ···

    The first thing that needs to be done is to prohibit Pharmaceutical companies from providing free opioid samples to doctors. Secondly, doctors need to be held accountable as they are the ones writing the scripts for their patients. Thirdly, pharmacies need to monitor their what their customers are taking and report abuses. Everyone is pointing the finger at each other to blame. Taxing won’t help, making individuals accountable will.

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  • Joel
    Voted Yes
    12/07/2018
    ···

    Yes, yes, yes. Tax Opiates because the conscious-less Pharmaceutical Companies are making money killing Americans with these addictive drugs. There will be a special place in hell for big Pharma executives.

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  • Miles
    Voted No
    12/06/2018
    ···

    This is stupid. Most people that pay for them legally, who will be taxed, genuinely need them. It will only further drive up the price of street pills, which leads to people using heroin instead because it’s cheaper, which is far more dangerous. This is beyond dumb.

    Like (7)
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  • burrkitty
    Voted No
    12/06/2018
    ···

    Not the answer.

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  • Robert
    Voted No
    12/06/2018
    ···

    Our representatives need to hold the pharmaceutical companies and the physicians who, over manufacture and over prescribe opioids responsible. These are the main reasons for the increase in heroin and fentanyl use. On another note maybe if pharmaceutical companies were prohibited from donating to campaigns and buying off our politicians the cost of prescription medicine would go down.

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  • Leon
    Voted No
    12/06/2018
    ···

    Wow. Just wow. Taxes aren’t the answer. Spending within limits is the answer. Prioritize treatment over incarceration. Prioritize education over incarceration.

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  • Amber
    Voted No
    12/07/2018
    ···

    While I understand the need for funding addiction treatment, taxing a prescription medication? What's next? Taxing chemotherapy, birth control, insulin? Whether you realize it or not, opiate medication is just as vital and life saving for some people as insulin is for diabetics and chemotherapy is for cancer patients. And it's already becoming next to impossible for legitimate chronic pain patients to get and keep adequate care. I know because I am a chronic pain patient myself. I have Ehlers Danlos Syndrome, which causes all of my joints to dislocate often. Trust me when I say that it takes more than an aspirin to cope with your shoulder or hip popping out of socket, even if it happens regularly. I would be bedridden without the opiate medication that I have prescribed to me by my pain management specialist. Yet even though he follows the law to the letter (even though it already hinders his ability to really treat his patients properly), he has told me that he may be arrested any time, and I would have to try to find another pain specialist who is still risking going to jail in order to do their job.

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  • TadhgNV
    Voted No
    12/06/2018
    ···

    If we tax opioids it’ll limit the supply of them because of costs, putting those who need opioids in danger.

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  • ChristianNelson
    Voted No
    12/07/2018
    ···

    Honestly it’s pretty messed up to further penalize the people who desperately need these medications. Their life is already living hell, this only makes it worse.

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  • JDMA
    Voted No
    12/07/2018
    ···

    No, this is classical failure of not finding a root cause. Taxing opioids is not going to fix people who are addicted to it. It’s only going to become a barrier for people who need it. I’m in no ways an advocate for opioids. I think that they are over prescribed and I think that is why we have an epidemic. When people can’t get their drugs illegally they go to a black market to find them and people die because they overdose. Taxing opioids would only make the epidemic worse, because more people will be forced out of the legal market to buy them illegally. We see this with marijuana. Making it illegal didn’t rid the USA of it, people found other means of buying it. Even saw it with alcohol. Taxing does not work this way. I think opioids need to have more supervision from physicians when they are administered to prevent addiction. Where ever possible Opioids should be avoided and not prescribed.

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  • Mary
    Voted No
    12/07/2018
    ···

    Taxing opioids would be harmful to people who actually need these medications: the chronically ill in pain management programs, the terminally ill, our wounded veterans, those recovering from major surgery or accidents, and so on. How about taxing the companies that produce opioids? They are making massive profits and enjoying tax cuts they did not need.

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  • Sean
    Voted No
    12/07/2018
    ···

    Instead fine companies and doctors that violate our drug control laws.

    Like (2)
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  • Marylynn
    Voted No
    12/07/2018
    ···

    What they need to do is start taxing the manufacturers of opioids, not people that are being prescribed them. It's the drug companies that are making money, billions on these toxic drugs and created the opioid crisis in our country. Perhaps if these companies are held accountable and made to pay maybe we wouldn't have this problem.

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  • John
    Voted No
    12/06/2018
    ···

    The burden of the tax will fall on people who need the drug and will have absolutely no effect on illegal use of opioids. Another measure misdirected to the the real problem because it’s an quick and easy idea that says “I’m doing something.”

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  • Langho
    Voted No
    12/06/2018
    ···

    That’s the most ridiculous thing of ever heard of

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  • Tina
    Voted No
    12/06/2018
    ···

    Government should only work to reduce prescription drug price. Addicts will always find a way to get their drugs. The only the poor will be affected!!

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  • Lesia
    Voted No
    12/07/2018
    ···

    Why would this be helpful. U think addicts are paying taxes. No. It’ll just drive up the street value and won’t solve anything. If u want changes big pharmaceutical is the place to start. Their the world’s drug dealers.

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