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Health insurers 'unwittingly' played a role in opioid crisis, researchers say

In an analysis of Medicare, Medicaid and large private insurer policies on treatment for chronic back pain, researchers found a lack of methods for limiting the use of highly-addictive opioid-based painkillers.

By HealthDay News

FRIDAY, June 22, 2018 -- Health insurers may have helped fuel the U.S. opioid epidemic by not encouraging use of less addictive pain medications, a new study contends.

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In 2016, more than 2.1 million Americans had an opioid addiction. And more than 42,000 died from opioid overdoses, government data show.

"Our findings suggest that both public and private insurers, at least unwittingly, have contributed importantly to the epidemic," said study senior author Dr. G. Caleb Alexander, of Johns Hopkins Bloomberg School of Public Health in Baltimore.

Opioid-based painkillers like oxycodone (OxyContin) and hydrocodone (Vicodin) are just one tool in the pain management tool box, said Alexander, co-director of Hopkins' Center for Drug Safety and Effectiveness.

"Unfortunately, many of the plans that we examined didn't have well-developed policies in place to limit their overuse," he said in a university news release.

Alexander's team examined Medicare, Medicaid and large private insurers' 2017 coverage policies for drugs to treat chronic lower-back pain. Chronic back pain is frequently linked to overuse of prescription opioids.

The analysis included 30 prescription opioids and 32 non-opioid medications. Non-opioids included nonsteroidal anti-inflammatory drugs (NSAIDs), muscle relaxants and pain relievers applied to the skin.

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The researchers concluded that the insurers' drug coverage policies should have done more to get patients to use safer and more effective treatments than prescription opioids.

Insurers can more strictly limit painkiller quantities and require use of less risky drugs before proceeding to powerful narcotics, the researchers said. They can also require the prescriber to obtain authorization from the insurer before ordering opioids for non-cancer pain, the study authors added.

The study was published June 22 in the journal JAMA Network Open.

Efforts by HealthDay to get a comment from the trade association America's Health Insurance Plans were unsuccessful.

More information

The U.S. National Institute on Drug Abuse has more about prescription opioids.

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