Can a pharmacy drug benefits company play a role in beating the opioid crisis?

Zemanta prescription opioid drug benefits insurance

A major U.S. pharmacy benefit manager placed a limit on pain pills in the hopes of reducing the risk of their abuse.

Express Scripts, the largest pharmacy drug benefits manager in the United States, created a new program to limit prescriptions for new opioid patients. This program will launch across the entire country as of September 1, 2017.

The opioid drug limitations will target new patients and will not apply to cancer patients or those in hospice care.

According to Express Scripts, the time has come to take a bold stand against the opioid drug abuse crisis occurring across the country. They hope to make a difference by using drug benefits restrictions to stop opioid abuse before it starts. According to a statement from that pharmacy benefit manager, their goal is “to help people get the medicine they need, without getting more than they need.”

The company currently has 83 million members and will be changing the way first-time opioid patients – who are not cancer patients or in a hospice – can access their prescription drugs.

The drug benefits strategy is meant to curb a rapidly growing abuse crisis affecting the entire country.

Zemanta prescription opioid drug benefits insuranceDoctors have expressed concern over the changes, worried that patients will see limitations to the numbers and strengths of their prescription pain medications.

Express Scripts’ strategy is to limit first-time opioid patient prescriptions to 7-day supplies at a time and will restrict total daily doses. Beyond that, the company is advising doctors to begin prescribing short-acting drugs whenever possible and to avoid writing prescriptions for extended-release forms.

That said, the new opioid drug program is not without exceptions. It does allow doctors to obtain authorization to write prescriptions beyond the restricted amounts.

The new limitations are based on the results of an Express Scripts pilot study involving 100,000 members. According to the company, this new program decreased both emergency room visits and hospitalizations by 40 percent.

A statement from the American Medical Association about the new drug benefits limits stated that they were worried that “chronic pain-one-size fits all limits” could lead to “delays in care that could severely harm patients.” That said, they did add that if doctors feel opioid prescriptions are the best possible option for a patient, “we recommend that physicians prescribe the lowest effective dose for the shortest possible duration for pain severe enough to require opioids.”

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