Abstract

Beyond REMS & PDMPs: A Proposed Framework for Next-Generation Opioid Regulation

Aysha Rana1 and Kavetha Ram2
(1)Spectra Medical Devices, LLC, Boston, MA, (2)Elevaris Medical Devices, Boston, MA

APHA 2025 Annual Meeting and Expo

This presentation proposes a next-generation regulatory framework for opioid analgesics that integrates real-world data, adaptive licensing and labelling, and community-driven surveillance to overcome the shortcomings of traditional, static regulatory approaches. The framework is built on four pillars: first, an AI-augmented surveillance system that combines clinical data with social determinants of health to dynamically identify high-risk areas; second, adaptive licensing with evolving labels that use continuous real-world data submissions to update risk-benefit profiles in near-real time; third, pharmacist-led surveillance networks employing secure, automated reporting systems to enhance early detection of misuse; and fourth, the incorporation of harm reduction metrics through partnerships with community organizations and non-traditional data sources. This dynamic, process-oriented approach enables timely regulatory adjustments, ensures better alignment with FDA's REMS and post-marketing requirements (PMRs), and addresses ethical concerns related to AI bias and patient privacy. By proposing a framework under the FDA's Opioid Data Initiative, this study aims to provide actionable recommendations for policymakers and stakeholders to mitigate opioid misuse and improve public health outcomes.

Communication and informatics Ethics, professional and legal requirements Public health administration or related administration Public health or related laws, regulations, standards, or guidelines Public health or related public policy Systems thinking models (conceptual and theoretical models), applications related to public health