Highmark announces new prescription limitations in war against opioids - Sovereign Health Group
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02-19-18 Category: Addiction

Highmark announces new prescription limitations in war against opioids

In recent years, various entities that comprise the health care system in the United States have been taking initiatives to restrict prescriptions for opioid painkillers in their fight against the opioid epidemic. Contributing its bit in the war against opioids, Pittsburgh-based health insurer Highmark Inc. recently announced new prescription limitations and program expansions.

Starting early March 2018, Highmark will enforce new policies, for its commercial members who would be using opioid painkillers for the first time, limiting their prescriptions to seven days. In addition, members who have not been on opioids recently will require prior authorization for new prescriptions covering extended-release opioids. These new rules will be subjected to certain exceptions, including cases where opioids would be required for chronic pain management in individuals battling cancer or other malignancies.

With effect from February 2018, Highmark expanded its partnership with axialHealthcare, a company offering analytical tools for pain and opioid management. Highmark and axialHealthcare had previously implemented an opioid abuse monitoring program in West Virginia and achieved significantly positive results, especially a 28 percent reduction in “doctor-shopping” (patients getting opioids from multiple prescribers). Besides extending the coverage to Pennsylvania, the expansion would introduce new tools offering real-time, patient-specific opioid risk information to providers in both the states, enabling them to make better care decisions.

Emphasizing that it was “truly a crisis,” Highmark president Deborah L. Rice-Johnson said that the company was using all its resources to tackle the problem. She mentioned that since it was not possible for a company to fight the issue single-handedly, Highmark was partnering with external entities.

Reducing risk of dependence among first-time opioid users

Highmark’s policy changes are aimed at helping first-time opioid users to reduce their risk of opioid dependence. It also strengthened current policies which enforced safeguards like restrictions on prescribed amounts, prior authorizations and monitoring abuse among members already on long-term opioids. According to Sarah Marche, vice-president of pharmacy markets at Highmark, even low-dosage, long-term opioid use increased the risk of addiction. The initiatives sought to discourage inappropriate, long-term opioid usage right from inception, thereby ensuring the safety of Highmark’s members and the communities it served.

According to the Centers for Disease Control and Prevention (CDC) individuals given at least one day of prescription opioids have a 6 percent and 2.9 percent probability of continuing the usage after one year and three years, respectively. Individuals who start treatment with a long-acting opioid have the highest probabilities of continued opioid use at one year (27.3 percent) and three years (20.5 percent). Highmark’s new policies are along the lines of CDC’s “Guidelines for Prescribing Opioids for Chronic Pain.”

During a press conference telecast live on social media, Charles DeShazer, senior vice president and chief medical officer of Highmark, blamed large pharmaceutical companies for the opioid epidemic since they misrepresented the fact that opioids used for managing pain were not addictive. These companies prevailed upon medical associations to recommend opioid use. Along with the growing trend of seeing more patients within a given time frame, doctors gradually started prescribing opioids for pain instead of evaluating and recommending other possibilities for better pain management.

Dealing with prescription drug addiction

In 2012, health care providers wrote 259 million prescriptions for painkillers, equivalent to one bottle of pills for every American adult. It was estimated that 46 people died from prescription painkiller overdoses every day. Although there was a nearly four-time increase in sales of prescription opioids between 1999 and 2014, it was not accompanied by a corresponding overall change in the level of pain reported by individuals. However, there was a proportionate increase in prescription overdose deaths during the period.

Addiction to drugs and other substances can be treated by combining detox processes, behavioral therapies and medication. Medicines including buprenorphine, methadone and naltrexone are additionally used in the treatment of prescription opioid addiction. These medicines are administered in combination with counseling and behavioral therapies as part of medication-assisted treatment (MAT).

Sovereign Health of San Clemente, California offers customized prescription drug detox programs. Our licensed clinicians use evidence-based approaches to resolve each underlying problem. To know more about our prescription drug addiction rehab centers, call our 24/7 helpline or chat online with one of our representatives.

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