(Bloomberg) — The Food and Drug Administration, aspart of a sweeping overhaul in how it regulates opioid painkillers, plans to look to someunusual allies to limit the flood of the addictivepills — health insurers and companies that manageprescription drug benefits.

Food and Drug Administration Commissioner Scott Gottlieb plansto meet in September with the benefit payers and insuranceadministrators, groups the FDA hasn’t typically worked with in itsrole as a drug regulator. The plan, Gottlieb said, is to stem thetide of addiction to the pills by limiting the number of peopleexposed to them in the first place.

“Most people who become addicted to opioids are medicallyaddicted,” Gottlieb said in a wide-ranging interview with Bloombergin New York. “The way to reduce the rate of new addiction is toreduce the rate of exposure, and the way to reduce the rate ofexposure is to make sure people are receiving prescriptions whenit’s only medically appropriate.”

Gottlieb, who was picked by President Donald Trump earlier thisyear to lead the agency, said he views it as part of his mandate totackle the opioid crisis, as well as other issues such as drugcosts. The sessions with insurers and pharmacy managers will be hisfirst official meetings with health-care companies, he said.The agency doesn’t have regulatory authority over insurancecompanies, which are largely overseen by state regulators or otherdepartments within the Health and Human Services Department.

Millions of pills

More than 240 million opioid prescriptions were dispensed in the U.S.in 2014, according to the Department of Health and Human Services.Deaths from opioid pain pill overdoses in 2015 totaled almost23,000 in the U.S., double the number a decade ago, according tothe National Institute on Drug Abuse.

Gottlieb said he wants to examine whether insurers and pharmacybenefit managers, or PBMs, can reduce the number of pillsdispensed. That could involve changing drug labels or requiringdoctor education for longer prescriptions.

“There shouldn’t be 30-day prescriptions for a tooth extraction,or 30-day prescriptions for a hernia repair,” Gottlieb said.

Gottlieb, 45, served in several senior positions at the FDAduring the George W. Bush administration. He’s also worked as anadviser to investment firms and as a fellow at theconservative-leaning American Enterprise Institute, a Washingtonthink tank.

“I’m looking at different models that could potentially be lessburdensome but be more effective at achieving the goal of makingsure that prescribing conforms more closely with clinicalguidelines,” Gottlieb said. “They’re not in there right now.There’s no information in the drug label about what the appropriatedispensing should be.”

Opioid mandate

Gottlieb said that he’s altered the FDA’s focus on certainissues since he was confirmed as commissioner in May, but theagency’s opioids policy has been the biggest change in focus.

“Coming out of the confirmation process, I had a mandate to tryto steer the agency in a little bit of a different philosophicaldirection,” he said. “I talked to 65 senators who all wanted to seethe agency act differently.”

In a first, the FDA in June asked Endo International Plc to pullits opioid Opana ER from the market. Endo has since agreed to stopsales of the painkiller that became a favorite of people abusingsuch drugs and led to a serious outbreak of HIV and hepatitis C linkedto shared needles used to inject crushed versions of the drug.

The move marked a shift in FDA policy to consider how opioidsare used not just by appropriate patients but also by peopleaddicted to the pills.

“We’re constantly looking retrospectively to what’s on themarket and making sure that it still makes sense relative totoday’s marketplace and what’s available,” he said.

Gottlieb said the agency will keep looking at how drugs that arealready on the market are used, in both medical settings and alsoillicit ones.

“It’s like I said on the drug pricing thing, there’s no silverbullet,” he said. “There’s not going to be one thing that we’regoing to do. We’re going to be doing a long list of things.”

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