Health panel OKs opioid curb

Quantity restrictions affect public school, state employees

A state board on Tuesday approved limits on coverage for opioids for public school and state employees but delayed the effective date for the restrictions until Sept. 1.

The State and Public School Life and Health Insurance Board also voted to solicit comments on the restrictions from the Arkansas Medical Society, the Arkansas chapter of the American Academy of Pediatrics and the Arkansas Pharmacists Association.

“We may not agree with what they say, but they can’t say they didn’t know it was coming if we’ve got a formal response from them,” board member Joe Thompson, director of the Arkansas Center for Health Improvement, said.

The plans cover about 148,000 people, including 45,000 school employees and 26,000 state employees in addition to retirees and the spouses and dependents of employees and retirees.

Board member Shelby McCook said the delay will allow the health plans’ pharmacy consultant to develop plans for implementing the restrictions and report to the board, which may also consider other measures.

Recommended by the board’s Drug Utilization and Evaluation Committee, the restrictions are based on guidelines issued last year by the U. S. Centers for Disease Control and Prevention and are designed to curb drug dependence and abuse.

The restrictions call for the health plans to limit prescriptions for both acute and chronic pain to a maximum dose of 50 morphine milligram equivalents per day.

According to the CDC, that’s equal to about 10 5- milligram tablets of hydrocodone or two 15- milligram tablets of oxycodone a day.

For acute pain, such as following surgery, prescriptions would be limited to a sevenday supply.

Covering more than 30 days’ worth of such prescriptions for a patient would require the doctor to submit information about the patient to a pharmacy consultant, the Evidence- Based Prescription Drug Program at the University of Arkansas for Medical Sciences College of Pharmacy, for approval.

The restrictions would only apply to patients who aren’t already using opioids.

Members of the drug review committee have said they plan to make recommendations at a later date on curbing the dosages prescribed for some of those already taking opioids for chronic pain.

None of the restrictions would apply to patients who have cancer or who are receiving care for a terminal illness.