AGs from 37 States Urge Insurers to Cover Non-Opioid Pain Management

AGs from 37 States Urge Insurers to Cover Non-Opioid Pain Management

Attorneys general from over three dozen states are urging health insurers to review their coverage policies for pain treatment to help reduce the role that prescription painkillers continue to play in the deadly opioid epidemic. More than 40 Americans die each day from overdoses involving prescription opioids, according to the CDC, and the costs in lives and health care are almost incalculable. AGs from 35 states, Puerto Rico and the District of Columbia have written a letter to America's Health Insurance Plans, the insurance industry's top trade group. They say that prioritizing insurance for alternatives to opioid painkillers, such as physical therapy, chiropractic, non-opioid analgesics and other means, will lead to reductions not just in overdose deaths but also in the rate of new addictions.

Take proactive steps

The AGs asks insurers "to take proactive steps to encourage your members to review their payment and coverage policies and revise them, as necessary and appropriate, to encourage healthcare providers to prioritize non-opioid pain management options over opioid prescriptions for the treatment of chronic, non-cancer pain." The AGs assert that the opioid epidemic "is the preeminent public health crisis of our time." Citing the devastating loss of lives and the costs to the healthcare system and the broader economy, the States' chief legal officers say, "we are committed to using all tools at our disposal to combat this epidemic and to protect patients suffering from chronic pain or addiction, who are among the most vulnerable consumers in our society." The AG letter points out that:
  • Statistics from the Surgeon General of the United States indicate that as many as 2 million Americans are currently addicted to or otherwise dependent upon prescription opioids.
  • Millions more are at risk of developing a dependency - in 2014 as many as 10 million people reported using opioids for non-medical reasons.
  • The economic toll of the epidemic is costing the U.S. economy an estimated $78.5 billion annually.
  • State and local governments alone spend nearly 8 billion dollars a year on criminal justice costs related to opioid abuse.
  • According to the CDC, opioid overdoses kill 91 Americans every single day, and more than half of those deaths involve prescription opioids.
The AGs emphasize how the "unnecessary over-prescription of opioid painkillers" significantly contributes to the problem:
  • Although the amount of pain reported by Americans has remained steady since 1999, prescriptions for opioid painkillers have nearly quadrupled over the same period.
  • The four-fold increase in prescriptions perfectly matches the four-fold increase in opioid overdose deaths during the same period.
  • A "dramatic increase in supply" has made it easy to obtain prescription opioids without having to resort to the black market.
  • Over 50 percent of people who misuse opioids report that they obtained them free from a friend or relative, while another 22 percent misused drugs that they obtained directly from a doctor.
Illegal opioids like heroin remain a serious problem that must be addressed, the AGs say, but the role played by prescription opioids cannot be ignored.

"Incentivizing" opioid alternatives

"All else being equal," the AG letter says, "providers will often favor those treatment options that are most likely to be compensated, either by the government, an insurance provider, or a patient paying out-of-pocket. Insurance companies thus are in a position to make a very positive impact in the way that providers treat patients with chronic pain. "When patients seek treatment for any of the myriad conditions that cause chronic pain, doctors should be encouraged to explore and prescribe effective non-opioid alternatives, ranging from non-opioid medications (such as NSAIDs) to physical therapy, acupuncture, massage, and chiropractic care. Insurance companies can play an important role in reducing opioid prescriptions and making it easier for patients to access other forms of pain management treatment.

Status quo unacceptable

"In the near future, working in conjunction with other institutional stakeholders (such as State Insurance Commissioners), we hope 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. We hope that this process will highlight problematic policies and spur increased use of non-opioid pain management techniques. The status quo, 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 so that you can play an important role in stopping further deaths," the AGs said.

Here at Novus, we are 100 percent behind any intelligent effort that can help reduce the proliferation of prescription opioids. Other, less risky treatment options do exist, and they should be encouraged.

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