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July 4, 2018

Insurance firms continue to fail patients with chronic pain

A new study conducted by the John Hopkins University Bloomberg School of Public Health, titled Health insurance plans may be fuelling opioid epidemic: Study of coverage policies highlights inadequate effort to reduce opioid overuse, has concluded that public and private insurers contributed significantly to the seriousness of the opioid epidemic in the United States.

By GlobalData Healthcare

A new study conducted by the John Hopkins University Bloomberg School of Public Health, titled Health insurance plans may be fuelling opioid epidemic: Study of coverage policies highlights inadequate effort to reduce opioid overuse, has concluded that public and private insurers contributed significantly to the seriousness of the opioid epidemic in the United States. The researchers investigated the drug coverage policies of Medicare, Medicaid, and other major insurers, and how these institutions reimbursed treatment for chronic back pain. They found that insurance providers consistently steered patients away from safer and more effective treatments in favour of prescription pills.

The opioid epidemic remains a major threat to public health, with over 40,000 patients dying from opioid overdoses in 2016 alone, and an estimated 2.1 million Americans suffering from addiction. The opioid epidemic has had a massive impact on the economy, with economic costs estimated to be half a trillion dollars. The study analysed fifty coverage policies from different insurers, and 62 prescription drugs used to treat chronic back pain. Their analysis found that many insurers failed to enact evidence-based rules to discourage opioid overuse, and that even when used, utilisation rules were often incorrectly applied to non-opioids. The study highlighted a stark lack of direction and policy management within many healthcare insurance institutions. Even simple rules, like limiting pill supply, were often incorrectly enacted. For example, insurance companies considered a 30-day prescription a short supply, even though the CDC recommends even shorter prescriptions.

No doubt, the low price tag associated with opioid prescriptions has continued to guide the behaviour of insurance groups in the United States. Instead of developing new policies for helping patients manage pain without pills, insurers have focused on identifying high-volume prescribers and patients in order to do their part in stemming the epidemic.

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