The Excise Narcotics Distribution in (END) the Epidemic Act of 2019 (HR 4631) would impose an excise tax on manufacturers, producers, and importers of prescription opioids in the US by amending the Internal Revenue Code to expand its application to medical products.
Specifically, manufacturers, producers, and importers of opioids would be taxed at a rate of 1 cent per milligram of active opioid as determined by their production and manufacturing quotas specified under the Controlled Substances Act and authorized by the Drug Enforcement Agency (DEA). If a particular medicine contains secondary and tertiary ingredients in addition to opioids, the medicine would only be taxed with respect to the amount of active opioid it contains. Furthermore, the tax would not be imposed on opioids used in medication-assisted addiction treatment (e.g., buprenorphine) if providers must obtain additional authorization from the DEA to dispense them.
The END the Epidemic Act of 2019 would provide for all revenues generated by this excise tax to be transferred to the Department of Health and Human Services without further need for appropriations, and to be used for the prevention of opioid abuse and treatment of opioid addiction. As such, the bill would amend a section of the Public Health Service Act to direct the US Treasury to issue grants to states to fund:
- Scientific research on opioids;
- Treatment programs for opioid addiction, sober living facilities, and residential treatment services;
- The recruitment of more medical providers who are trained to offer treatment for opioid addiction with a particular focus on communities that have low access to such services or a high rate of opioid addiction;
- Opioid “take-back” programs, which offer safe and controlled means to dispose of excess opioids;
- Social support programs that connect individuals experiencing addiction to relevant resources, such as housing and employment services; and
- Housing programs for the children of individuals participating in residential treatment programs, and facilities to care for children with neonatal abstinence syndrome.
A similar excise tax was implemented in Representative Max Rose’s (D-NY-11) home state in July 2019. However, the measure has raised concerns regarding its potential downstream burden on patients through increased drug prices or reduced access to opioids for pain management patients.