AHCCCS committee declines to OK anti-opioid alternatives

Arizona’s largest public health-insurance program, Medicaid, pays for only one type of buprenorphine drug designed to wean people from opioid addiction.

Despite calls from doctors to authorize competing versions of the drug, a state Medicaid committee this week decided to stick with Suboxone as a preferred medication for opioid dependence.

The Arizona Health Care Cost Containment System’s pharmacy and therapeutics committee decided it was more cost-effective to maintain Suboxone as Medicaid’s preferred drug, which means doctors aren’t required to seek authorization before prescribing.

Doctors wanted the committee to approve two other versions of drug, called Zubsolv and Bunavail.

All three versions of the drug combine buprenorphine and naloxone and work by blocking opioids from attaching to brain receptors. The medications help reduce cravings and withdrawal for

individuals addicted to opioids such as OxyContin and heroin.

Doctors who wanted Arizona’s Medicaid program to allow the other versions of the drug said that it’s critical to give people as many options as possible to beat addiction. An average of more than two Arizonans died every day of an opioid overdose in 2016, and preliminary figures suggest the state’s overdose rate accelerated in 2017.

Federal, state and local governments have dedicated more funding to addiction treatment, including drugs such as Suboxone designed to wean people from opioid dependence. Gov. Doug Ducey’s opioid plan calls for funding $10 million in addiction treatment, but there have been no details on how that money will be spent.

Doctors who addressed the committee said they want more choices for their patients.

“I find it ironic that Arizona prides itself on libertarian tendencies,” said Zaheer Shah, an internal medicine doctor and attorney who asked for the committee to authorize more addiction-weaning drugs. “The government should not be in the business of choosing winners and losers in the marketplace.”

AHCCCS, Arizona’s Medicaid program, covers several types and classes of medication-assisted treatments for opioid-use disorder.

Along with Suboxone, AHCCCS covers drugs such as methadone and naltrexone, a non-opioid medication that can come in a pill or a shot. The state’s Medicaid program also pays for the overdose reversal drug naloxone.