108th Congress

Pain Research

H.R. 1863 and H.R. 2507/S. 1278

Background

Chronic pain is said to affect untold numbers of Americans, causing both physical and mental anguish. In addition, many people experience unremitting, intractable pain associated with cancer and other life-threatening diseases and disorders. Consequently, there is growing attention to the need for more effective treatments, access to information, and palliative care for affected individuals. Although much is being done in the area of pain research, Members of the 108th Congress indicated their belief that more needs to be done and that legislation may be needed. Issues related to pain research were raised most recently at an October 2, 2003, joint hearing before the House Committee on Energy and Commerce and the Senate Committee on Health, Education, Labor and Pensions on National Institutes of Health (NIH) authorization issues.

Thus far in the 108th Congress, three bills have been introduced to encourage further research, education, and treatment in response to what is considered a public health crisis.

Provisions of the Legislation/Impact on NIH

H.R. 1863—National Pain Care Policy Act of 2003

H.R. 1863 would amend the Public Health Service Act to require the Secretary of Health and Human Services (HHS) to establish within NIH a National Center for Pain and Palliative Care Research. The Center would have a director appointed by the Director of NIH, be treated as a national research institute for the purposes of Section 405, Public Health Service Act, and have an advisory board. The purpose of the Center would be to:

• Foster basic and clinical research on the biology of pain and the causes of and treatments for pain
• Establish a national agenda for supporting and conducting pain and palliative care research
• Identify, coordinate, and support research, research training, and related activities with respect to primary and secondary pain, including acute pain, cancer- and HIV-related pain, and back, headache, and other intractable pain
• Conduct and support pain and palliative care research, research training, and research on other painful conditions
• Coordinate all pain and palliative care research, research training, and related activities of the other national research institutes
• Ensure prompt and effective dissemination of current and future pain research results
• Initiate a comprehensive, collaborative interdisciplinary research program among schools, colleges, and universities

The Center would also be required to prepare an annual report on the state of public and private pain and palliative care research funding and its adequacy.

Provisions of H.R. 1863 would also require the establishment of not less than six regional pain research centers, which would operate as part of the Center and be competitively selected. Four of these centers would be required to have as their primary focus research on acute pain, cancer- and HIV-related pain, back and headache pain, and other chronic and intractable pain. One regional pain center would be required to be established in each of the following areas: the Northeast, Southeast, Midwest, Southwest, West (including Hawaii), and the Pacific Northwest (including Alaska). The Center would also be required to hold an annual consensus-development conference. The bill would authorize $40 million for each of fiscal years 2004 through 2006, and such sums as may be necessary in the years thereafter.

H.R. 2507/S. 1278—Conquering Pain Act of 2003

H.R. 2507 and S. 1278, companion bills, contain broad provisions related to the development of guidelines for the treatment of pain and Internet access to them by providers, quality improvement education projects, pain coverage quality evaluation and information, and family support networks in and insurance coverage of pain and symptom management. NIH-related provisions would require the Secretary of HHS, acting through the Director of NIH, to convene a national conference to discuss the translation of pain research results into health services delivery, including mental health services to people experiencing chronic pain and those needing end-of-life care. The Secretary would be required to use appropriated but unobligated Departmental funds for this conference.

Status and Outlook

H.R. 1863 was introduced by Representative Michael J. Rogers (R-MI) on April 29, 2003, and was referred to the House Committees on Energy and Commerce, on Ways and Means, on Armed Services, and on Veterans’ Affairs.

H.R. 2507, a companion measure to S. 1278, was introduced by Representative Darlene Hooley (D-OR) on June 18, 2003, and was referred to the House Committees on Energy and Commerce and on Ways and Means.

S. 1278, a companion measure to H.R. 2507, was introduced by Senator Ron Wyden (D-OR) on June 18, 2003, and was referred to the Senate Committee on Health, Education, Labor and Pensions.