Blues plans dis­cour­age opi­oids as primary pain treat­ment

Modern Healthcare - - Late News - — Alex Kacik

The Blue Cross and Blue Shield As­so­ci­a­tion has adopted a new stan­dard that opi­oids should not be the first or sec­ond treat­ment op­tions to man­age pain, mir­ror­ing guide­lines set by the Cen­ters for Dis­ease Con­trol and Pre­ven­tion in an ef­fort to curb the opi­oid epi­demic.

In most cases, ibupro­fen and ac­etaminophen can treat pain more ef­fec­tively than opi­oids, said Dr. Trent Hay­wood, chief med­i­cal of­fi­cer for the Blues as­so­ci­a­tion, whose plans rep­re­sent about 106 mil­lion mem­bers.

The new stan­dard was part of a broader set of rec­om­men­da­tions for ed­u­cat­ing physi­cians about opi­oid use and ad­dic­tion treat­ment.

It’s not an ab­so­lute de­cree. In many cases, par­tic­u­larly in can­cer treat­ment or end-of-life care, opi­oids may be the best rem­edy, Hay­wood said.

In­sur­ers, phar­ma­cies, dis­trib­u­tors and providers have re­stricted the num­ber and size of opi­oid pre­scrip­tions they dole out. Blue Cross and Blue Shield of Michigan re­cently lim­ited opi­oid pre­scrip­tions to 30-day or five-day sup­plies.

Blue Cross and Blue Shield of Mas­sachusetts re­quires prior au­tho­riza­tion for opi­oid pre­scrip­tions for more than 30 days and asks doc­tors and pa­tients to co-sign an agree­ment. Prior to th­ese changes, many opi­oid pre­scrip­tions ex­ceeded max­i­mum dosage lev­els and rec­om­mended sup­ply, re­search shows.

Salt Lake City-based In­ter­moun­tain Health­care is look­ing to cut the num­ber of opi­oids pre­scribed for acute pain across its en­tire sys­tem by 40% by the end of this year.

But physi­cians worry that re­duc­ing the sup­ply could cut off ac­cess for pa­tients who need the po­tent drugs.

Also, in­sur­ers have been slow to cover opi­oid al­ter­na­tives.

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