Georgia Attorney General Chris Carr on Monday joined three dozen other states’ attorneys general in firing a shot across the bow of insurance companies in regards to the opioid crisis. Opioid addiction among Americans is at epidemic proportions.
This weekend, ProPublica and The New York Times published an investigation into the role insurance companies have played in the opioid epidemic. It found patients who had tried to use pain medication for their conditions that was less addictive but who said they were were thwarted by their insurance companies, and they wound up using more addictive opioids instead.
The problem, according to the findings: Opioids are cheaper for the insurance companies.
Insurance companies replied that they are dedicated to reducing opioid misuse and funding drugs that have proved to help the patients.
The investigation detailed one Smyrna patient who had tweeted about her predicament. Her crippling abdominal pains had been soothed by the drug patch Butrans. But her insurance company suddenly stopped covering Butrans. Instead, the patient now is on long-acting morphine.
According to the report, morphine is more addictive and carries a higher risk of overdose.
But the Butrans, which contains a less risky opioid, cost the insurer $342 for a four-week supply. The morphine: $29.
Other roadblocks that customers encountered included denials they had to appeal — with no guarantee of success — to obtain the expensive but safer drugs, as well as requirements for pre-approval.
To get national data, the reporters analyzed Medicare prescription drug plans. Examples listed in the findings showed that only one-third of the people covered had any access to Butrans; and every drug plan that covered lidocaine patches, which are not addictive but cost more than other generic pain drugs, required that patients obtain prior approval for them.
The letter from the attorneys general did not mention the investigation published the day before. But the signers were following in the footsteps of their New York colleague, Eric Schneiderman, who received prominent mention in the investigation for his letter to three pharmacy benefit managers asking that they explain their role in the crisis.
In the letter the attorneys general sent, they told the insurance companies that they wished to reduce over prescription of opioids and promote reasonable pain management, and to “initiate a dialogue concerning your members’ incentive structures in an effort to identify those practices that are conducive to these efforts and those that are not.”
The officials continued that the current system, “in which there may be financial incentives to prescribe opioids for pain which they are ill-suited to treat, is unacceptable.”
“We ask that you quickly initiate additional efforts,” they wrote, “so that you can play an important role in stopping further deaths.”
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