Blues plans discourage opioids as primary pain treatment
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.