Insurance Companies Under Fire Over Opioid Crisis
It’s easy to point fingers at doctors and prescribers when it comes to America’s opioid crisis. But could there be other factors to blame? According to a new study shared on TheFix.com, insurance companies may also have played a hand in this deadly epidemic.
Now the research was quick to point out that many of these carriers could have contributed unwittingly, but it does appear as though damage was still done. Based on a 2017 analysis of 15 Medicaid plans, 14 Medicare plans and 20 private insurers, it was revealed that many companies are not applying evidence-based”utilization management” rules that could cut down on addictions. The data appeared to show that not enough limits were put on refills or initial prescriptions for these types of painkillers.
“Our findings suggest that both public and private insurers, at least unwittingly, have contributed importantly to the epidemic,” study author Dr. G. Caleb Alexander said on the site. “Opioids are just one tool in the pain management tool box, and unfortunately, many of the plans that we examined didn’t have well-developed policies in place to limit their overuse.”
Often times, insurers can put quantity limits on pharmaceutical products to ensure that patients don’t receive more than they need. Though, for the most part, this was enacted with opioid prescriptions, the study claims that the limits were simply too high. For painkillers like OxyContin, many companies capped scripts at a 30-day supply instead of the shorter limits recommended by the CDC.
There also could have been steps taken that require doctors to begin prescribing less addictive painkillers (such as NSAIDs) before moving on to opioids. Beyond that, authorization regulations could have been enacted too; which mandates that medical professionals call the insurance company for approval before writing any prescriptions. Even The New York Times touched on the story, providing data which showed that multiple large insurers limited access to less addictive (but more expensive) alternatives.
“Insurers can either be part of the problem, or part of the solution,” Dr. Alexander concluded. “The good news is that an increasing number of health plans are recognizing their contribution to the epidemic and developing new policies to address it. The bad news is that we have a very long way to go.”
So while we agree that insurance companies don’t deserve the brunt of the blame for this, they can certainly start changing policies today to help curb the crisis.