Insurance companies are restricting access to more expensive pain medications that are safer, less-addictive alternatives to opioids, reported ProPublica and The New York Times.
The news organizations reviewed Medicare prescription drug plans for 35.7 million people and found only one-third of them have access to Butrans, which contains the less-risky opioid buprenorphine.
Medicare drug plans that cover lidocaine patches, also a safer alternative, require prior approval for the patches, but patients hardly every have to go through that hurdle to acquire common opioids, the reports found.
As the country is becoming more aware of opioid addiction and its severe consequences, policy makers are looking at several areas in the healthcare industry for solutions. Doctors who prescribe the drugs — and the drugmakers themselves — are being examined, but the latest reporting shows payers certainly have a role as well.
As many as 2 million Americans are currently addicted to or dependent on prescription opioids, and 91 Americans die from opioid overdoses daily, according to the Centers for Disease Control. More than half of those deaths involve prescription opioids. One method for reducing these numbers is to encourage safer pain treatments, including physical therapy and medications that are less dangerous.
Some payers and providers are using their resources to further examine the issue and attempt to reduce opioid use. Anthem said recently it had reached its goal of reducing filled opioid prescriptions by 30%. Earlier this year, Cigna said it achieved a 12% reduction in customer opioid use. Intermountain Health set a goal last month of reducing opioid prescriptions 40% by the end of next year. These individual efforts could serve as a blueprint for a broader plan across the industry.
In response to the ProPublica/New York Times report, the National Association of Attorneys General sent a letter to Marilyn Tavenner, president and CEO of America’s Health Insurance Plans (AHIP). They asked AHIP to encourage members to review the policies and revise them to prioritize non-opioid pain management when appropriate. Insurance companies are in a position help relieve the opioid crisis by incentivizing providers who "will often favor those treatment options that are most likely to be compensated," they said.
Public health officials have been speaking out about the opioid crisis for years, and experts have worried about how President Donald Trump is handling the situation. A Commission on Combating Drug Addiction and the Opioid Crisis report, released July 31, requested the president declare a national public health emergency regarding opioids. Last month, Trump said he would do so, but no further action has been taken.
Trump presented the crisis as a law enforcement issue rather than a public health one, furthering the worries of policy experts. Granting a national emergency on the opioid crisis would give more federal money to states and communities to fight opioid addiction.
On Monday, New Jersey Gov. Chris Christie, who chairs the Trump Administration's opioid committee, said 17 pharmaceutical companies have agreed to work with the National Institutes of Health to develop solutions to the epidemic, including increasing nonaddictive pain medications.