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PLANS FOR PREVENTION


Health plans besides Cigna recently have ad- dressed the opioid epidemic by, among other things, announcing the removal of preauthorization require- ments on treatments used to battle dependency. Some plans also have certain prior authorization re- quirements, invoking the Centers for Disease Control and Prevention (CDC) guidelines.


Aetna: In June, Aetna released a “comprehensive strategy” to “limit the use of opioids to only a short period,” and to set “limits for opioid prescriptions to stop patients from receiving large quantities,” Aetna’s chief medical oficer, Harold L. Paz, MD, said, The plan includes:


• Creation of a controlled substance use program to identify potential opioid-abusing patients, alert prescribers, and offer help through medica- tion-assisted treatment combined with behav- ioral therapy.


• Ending preauthorization requirements on all products of buprenorphine, a drug used to treat opioid addiction.


According to Aetna, Dr. Paz sent personal letters


in 2016 to “super-prescribers” of opioids, who Aetna says refilled prescriptions “at a considerably higher rate than their peers.”


Blue Cross and Blue Shield of Texas: In a state- ment, Blue Cross and Blue Shield said it uses “uti- lization management and drug utilization review activities.” Blue Cross also created the Controlled Substance Integration Action Committee, which intervenes in suspected abuse and misuse cases and provides care education to patients and practitioners.


Blue Cross also says it works with physicians who


prescribe opioids within the top 2 percent of their peers. “If the prescriptions are deemed excessive,” Blue Cross said, “we will work with the provider, giv- ing them a snapshot of their written prescriptions compared to what their peers are prescribing.”


UnitedHealthcare: In a white paper, United said OptumRx, a pharmacy care segment of United- Health Group, conducts, among other things, “a range of initiatives that ensure appropriate prescrib- ing,” including pharmacy and prescriber surveillance, dispensing limits and prior authorization, patient outreach, and case management. United also has ended preauthorization require-


ments for opioid-dependence treatments on its prescription drug lists.


PHOTO BY ISTOCK.COM/BACKYARD PRODUCTION


November 2017 TEXAS MEDICINE 43


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