This state’s largest insurer just cut coverage to OxyContin

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In an effort to prevent opioid abuse, Blue Cross and Blue Shield of Alabama will no longer cover OxyContin.

The insurer announced Wednesday it will stop covering the medication on Jan. 1, in response to the hundreds of overdose deaths that occur yearly in the state. In 2016, 742 people died after overdosing on opioids in Alabama. BCBS will continue to cover certain types of oxycodone and alternatives, the insurer said. OxyContin is the brand name for oxycodone, an opioid medication that treats moderate to severe pain and is highly addictive.

Purdue Pharma, the manufacturer of OxyContin, said it no longer markets opioids to prescribing healthcare professionals through a sales team but remains committed to patients who need the medication. “The nation’s opioid crisis is a significant and urgent public health challenge, and Purdue Pharma is deeply concerned about the toll this crisis is having on communities,” the company said in a statement. The manufacturer reformulated OxyContin eight years ago to deter intranasal and intravenous abuse.

See: Opioids only partly explain America’s ‘deaths of despair’

Blue Cross and Blue Shield of Alabama isn’t the first insurer to react to opioid abuse. Blue Cross and Blue Shield of Tennessee also said it would drop OxyContin coverage next year, and Cigna stopped covering the drug in January 2018. “Our focus is on helping customers get the most value from their medications — this means obtaining effective pain relief while also guarding against opioid misuse,” Cigna said last year.

Florida’s largest insurer, Florida Blue,(a licensee of Blue Cross and Blue Shield of Florida) stopped covering OxyContin prescriptions there in January 2018. The insurer said there was a 68% reduction in utilization of OxyContin, and that it has seen a 75% increase in non-opioid prescriptions to its members across the state, including nonsteroidal anti-inflammatories (such as Motrin and Advil) and non-drug treatments (exercise, physical therapy and relaxation training).

Opioids are more likely to be prescribed in places with lower median household incomes and higher unemployment rates, and prescriptions for them are more prevalent among people who are 55 to 64 years old, according to a Centers for Disease Control and Prevention analysis of almost 3.5 million adults under 65 with disabilities and receiving Medicare Part D. The South, Southwest and Midwest are where opioid prescriptions were most common, the CDC found.

More than 115 people die after overdosing on opioids every day in the U.S., according to the National Institute on Drug Abuse. More than 72,000 Americans died from drug overdoses in 2017, including illicit drugs and prescription opioids (a two-fold increase in 10 years), according to preliminary CDC data. That’s compared to 41,000 Americans who died in car crashes last year.

Blue Cross and Blue Shield of Alabama said opioid prescriptions across the country, and specifically Alabama, have been declining since 2015, and over the last two years prescriptions for Blue Cross and Blue Shield of Alabama’s members have decreased 18%. Still, “while progress is being made, this issue calls for continued action by all parties,” Blue Cross and Blue Shield of Alabama said in a statement.

Also see: Jamie Lee Curtis: ‘I was ahead of the curve of the opiate epidemic’

But defeating opioid abuse and overdose deaths may be an uphill battle. Despite concerns from health advocates, the U.S. Food and Drug Administration approved a new opioid medication earlier this month that is at least 500 times stronger than morphine. AceIRx Pharmaceuticals, the manufacturer of this medication (called Dsuvia), said it was dose-adjusted to be no stronger than already available medications like it.

President Donald Trump declared opioid addiction a national health emergency in October 2017. The Senate passed bipartisan legislation in September 2018 to combat the opioid crisis. To become law, the bill would have to be reconciled with legislation the House of Representatives passed earlier in the year, though Senate members said they were optimistic that could happen by the end of the year.

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