The expert’s answers to these supplementary questions will be interesting to compare with the response from CLN readers, as in general the panelist’s do not describe as much change in their practice as had been anticipated in the face of recent financial and analytical developments. The debate about using initial immunoassay screening versus direct to mass spectrometry testing will certainly continue unless robust studies can show that one UDT approach versus another has a significant cost benefit ratio, i.e. better outcomes and lower costs for pain management patients.

Has your lab made any analytical or business changes to counter the 2016 adjustments for urine drug testing reimbursement? 

How will this impact your operation (such as work flow changes or moving from screen to confirming directly to definitive testing, for example)?

What advantages do you see, if any, to measuring urine drug metabolites in their native form (glucuronides) in addition to the parent drug? Or is it sufficient to simply hydrolyze all samples and measure parent drug levels?

Do you offer or plan to offer testing on alternative matrices like oral fluids? What are the advantages and disadvantages of oral fluid testing for your laboratory?