Efforts include policy that recommends not prescribing opioids as first or second line of pain therapy, and limiting initial opioid scripts to five days
The Blue Cross Blue Shield Association (BCBSA) National Council of Physician and Pharmacist Executives announced today that it has adopted a professional standard that opioids should not be prescribed as first or second lines of pain therapy in most clinical situations. The recommendation aligns with recent CDC guidelines and is designed to limit unnecessary harm from opioid use to Blue Plan members. Independence has long supported this policy and promotes alternatives to opioids that include more optimal use of non-opioid prescription painkillers and existing over-the-counter pain medications.
In addition, Independence has taken an aggressive position on preventing substance abuse. In July 2017, Independence became one of the first insurers in the country to restrict most initial low-dose opioid prescriptions to no more than five days. As a result, during the last six months of 2017, the number of members using opioids dropped 14 percent and the number of prescriptions dropped 16 percent, compared with the prior six-month period.
“In many cases, addiction starts at home when patients receive prescriptions at high dosage or for too long a duration,” said Dr. Richard Snyder, chief medical officer at Independence Blue Cross and chair of the National Council of Physician and Pharmacist Executives. “Research shows that children and teens who first abuse prescription drugs often obtain them from the medicine cabinets of family or friends who did not properly dispose of unused or outdated medication.”
Independence has taken a number of other steps to help prevent and treat substance use disorder, including:
- Our members suffering with opioid abuse disorder must get the treatment they need, which is why there are no limits on visits to detox facilities, and access to full range of inpatient and outpatient treatment, including residential facilities.
- Because medication-assisted treatments (MATs) have proven to be effective, there are no prior authorizations for Vivitrol and Suboxone, two of the most common MATs. We also began covering methadone in August 2017.
- Independence is one of the first Blue plans in the country to remove member cost-sharing for injectable and nasal spray formulations of naloxone and Narcan (a brand of naloxone).