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Independence Blue Cross to place additional restrictions on OxyContin® and Oxycodone ER to help reduce opioid use and abuse

Independence Blue Cross (Independence) announced that as part of its commitment to helping reduce opioid misuse and overprescribing, it is placing new restrictions on OxyContin® and Oxycodone ER. These products will be removed from some formularies and will require a new prior authorization on others, effective October 1.

In addition, Xtampza® XR, an extended-release abuse-deterrent form of oxycodone, will become a preferred brand drug, also effective on October 1. Xtampza® is designed to make crushing, grinding, cutting, chewing, and injecting the drug more difficult. All members on OxyContin and Oxycodone ER will require a trial of Xtampza ER. Those members who already have an authorization and are receiving OxyContin and Oxycodone ER will not require prior authorization to be switched to Xtampza.

“Combatting the opioid epidemic is a top priority at Independence Blue Cross,” said Dr. Richard Snyder, chief medical officer at Independence. “We want our members to have access to the most cost-effective pain medication, while at the same time helping to reduce the risk of these drugs being abused.”

Independence’s changes align with the most up-to-date prescription and formulary management policies regarding opioids from the Centers for Disease Control and Prevention (CDC) which include:

  • Opioids should not be considered a first-line option or routine therapy for chronic pain;
  • Opioid dosage should be limited to less than 90 morphine milligram equivalent (MME) per day when possible;
  • Opioid therapy should not be initiated with extended-release/long-acting opioids as they are associated with higher overdose risks.

Independence members will be able to purchase OxyContin and Oxycodone ER with a prior authorization from their doctor. However, as a non-preferred drug, these prescriptions will have higher cost shares.

Independence recently released results that highlight its success in reducing opioid use and prescriptions.
“Since 2014, our efforts to educate members and providers, and restrict avoidable use of opioids to situations that warrant, has resulted in a 45 percent reduction in opioid users (45,000 fewer members), a 35 percent reduction in opioid prescriptions (100,000 total), and an 18 percent reduction in the morphine equivalent dose,” said Eric Estes, senior director Pharmacy Services at Independence.

In addition, since limited first-time low-dose opioid prescriptions to a five-day supply, the number of members using opioids dropped 22 percent during the last six months of 2017 compared to the same time period in 2016.

Visit Independence our website for resources to help support individuals and families dealing with substance abuse and read what the Independence Blue Cross Foundation is doing to fight opioid abuse.

Visit Independence for resources to help support individuals dealing with substance abuse, and learn about what the Independence Blue Cross Foundation is doing to fight opioid abuse.

Media contact:
Ruth Stoolman
215-241-4807 (o)
215-667-9567 (c)